Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter
Background: High-power, short-duration (HPSD) radiofrequency ablation (RFA) may reduce ablation time. Concerns that catheter-mounted thermocouples (TCs) can underestimate tissue temperature, resulting in elevated risk of steam pop formation, potentially limit widespread adoption of HPSD ablation. Ob...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Heart Rhythm O2 |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501822002811 |
| _version_ | 1797946175891963904 |
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| author | Leon M. Ptaszek, MD, PhD, FHRS Jacob Koruth, MD Pasquale Santangeli, MD Jonathan P. Piccini, MD, MHS, FHRS Ravi Ranjan, MD, PhD, FHRS Srijoy Mahapatra, MD, FHRS Catherine Pipenhagen, BS Jeffrey M. Fish, DVM L. Boyce Moon, BS Nicholas M. Ambrosius, BS Hana Boudlali, MS James A. Jensen, PhD |
| author_facet | Leon M. Ptaszek, MD, PhD, FHRS Jacob Koruth, MD Pasquale Santangeli, MD Jonathan P. Piccini, MD, MHS, FHRS Ravi Ranjan, MD, PhD, FHRS Srijoy Mahapatra, MD, FHRS Catherine Pipenhagen, BS Jeffrey M. Fish, DVM L. Boyce Moon, BS Nicholas M. Ambrosius, BS Hana Boudlali, MS James A. Jensen, PhD |
| author_sort | Leon M. Ptaszek, MD, PhD, FHRS |
| collection | DOAJ |
| description | Background: High-power, short-duration (HPSD) radiofrequency ablation (RFA) may reduce ablation time. Concerns that catheter-mounted thermocouples (TCs) can underestimate tissue temperature, resulting in elevated risk of steam pop formation, potentially limit widespread adoption of HPSD ablation. Objective: The purpose of this study was to compare the safety and efficacy of HPSD and low-power, long-duration (LPLD) RFA in the context of pulmonary vein isolation (PVI). Methods: An open-irrigated ablation catheter with a contact force sensor and a flexible-tip electrode containing a TC at its distal end (TactiFlexTM Ablation Catheter, Sensor EnabledTM, Abbott) was used to isolate the left pulmonary veins (PVs) in 12 canines with HPSD RFA (50 W for 10 seconds) and LPLD RFA (30 W for a maximum of 60 seconds). PVI was assessed at 30 minutes and 28 ± 3 days postablation. Computed tomographic scans were performed to assess PV stenosis after RFA. Lesions were evaluated with histopathology. Results: A total of 545 ablations were delivered: 252 with LPLD (0 steam pops) and 293 with HPSD RFA (2 steam pops) (P = .501). Ablation time required to achieve PVI was >3-fold shorter for HPSD than for LPLD RFA (P = .001). All 24 PVs were isolated 30 minutes after ablation, with 12/12 LPLD-ablated and 11/12 HPSD-ablated PVs still isolated at follow-up. Histopathology revealed transmural ablations for HPSD and LPLD RFA. No major adverse events occurred. Conclusion: An investigational ablation catheter effectively delivered RFA lesions. Ablation time required to achieve PVI with HPSD with this catheter was >3-fold shorter than with LPLD RFA. |
| first_indexed | 2024-04-10T21:06:44Z |
| format | Article |
| id | doaj.art-9ce80865fb514d1ead158fe8fc40ab44 |
| institution | Directory Open Access Journal |
| issn | 2666-5018 |
| language | English |
| last_indexed | 2024-04-10T21:06:44Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heart Rhythm O2 |
| spelling | doaj.art-9ce80865fb514d1ead158fe8fc40ab442023-01-22T04:42:10ZengElsevierHeart Rhythm O22666-50182023-01-01414250Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheterLeon M. Ptaszek, MD, PhD, FHRS0Jacob Koruth, MD1Pasquale Santangeli, MD2Jonathan P. Piccini, MD, MHS, FHRS3Ravi Ranjan, MD, PhD, FHRS4Srijoy Mahapatra, MD, FHRS5Catherine Pipenhagen, BS6Jeffrey M. Fish, DVM7L. Boyce Moon, BS8Nicholas M. Ambrosius, BS9Hana Boudlali, MS10James A. Jensen, PhD11Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Address reprint requests and correspondence: Dr Leon M. Ptaszek, Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, 55 Fruit Str, GRB 825, Boston MA 02114.Helmsley Electrophysiology Center, Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New YorkCardiac Electrophysiology Section, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PennsylvaniaElectrophysiology Section, Duke University Hospital and Duke Clinical Research Institute, Durham, North CarolinaDivision of Cardiovascular Medicine, University of Utah, Salt Lake City, UtahM Health Fairview University of Minnesota, Minneapolis, MinnesotaAbbott, Plymouth, MinnesotaAbbott, Plymouth, MinnesotaAbbott, Plymouth, MinnesotaAbbott, Plymouth, MinnesotaAbbott, Plymouth, MinnesotaAbbott, Plymouth, MinnesotaBackground: High-power, short-duration (HPSD) radiofrequency ablation (RFA) may reduce ablation time. Concerns that catheter-mounted thermocouples (TCs) can underestimate tissue temperature, resulting in elevated risk of steam pop formation, potentially limit widespread adoption of HPSD ablation. Objective: The purpose of this study was to compare the safety and efficacy of HPSD and low-power, long-duration (LPLD) RFA in the context of pulmonary vein isolation (PVI). Methods: An open-irrigated ablation catheter with a contact force sensor and a flexible-tip electrode containing a TC at its distal end (TactiFlexTM Ablation Catheter, Sensor EnabledTM, Abbott) was used to isolate the left pulmonary veins (PVs) in 12 canines with HPSD RFA (50 W for 10 seconds) and LPLD RFA (30 W for a maximum of 60 seconds). PVI was assessed at 30 minutes and 28 ± 3 days postablation. Computed tomographic scans were performed to assess PV stenosis after RFA. Lesions were evaluated with histopathology. Results: A total of 545 ablations were delivered: 252 with LPLD (0 steam pops) and 293 with HPSD RFA (2 steam pops) (P = .501). Ablation time required to achieve PVI was >3-fold shorter for HPSD than for LPLD RFA (P = .001). All 24 PVs were isolated 30 minutes after ablation, with 12/12 LPLD-ablated and 11/12 HPSD-ablated PVs still isolated at follow-up. Histopathology revealed transmural ablations for HPSD and LPLD RFA. No major adverse events occurred. Conclusion: An investigational ablation catheter effectively delivered RFA lesions. Ablation time required to achieve PVI with HPSD with this catheter was >3-fold shorter than with LPLD RFA.http://www.sciencedirect.com/science/article/pii/S2666501822002811Atrial fibrillationHigh-powershort-duration ablationPulmonary vein isolationPulmonary vein stenosisRadiofrequency ablation |
| spellingShingle | Leon M. Ptaszek, MD, PhD, FHRS Jacob Koruth, MD Pasquale Santangeli, MD Jonathan P. Piccini, MD, MHS, FHRS Ravi Ranjan, MD, PhD, FHRS Srijoy Mahapatra, MD, FHRS Catherine Pipenhagen, BS Jeffrey M. Fish, DVM L. Boyce Moon, BS Nicholas M. Ambrosius, BS Hana Boudlali, MS James A. Jensen, PhD Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter Heart Rhythm O2 Atrial fibrillation High-power short-duration ablation Pulmonary vein isolation Pulmonary vein stenosis Radiofrequency ablation |
| title | Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter |
| title_full | Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter |
| title_fullStr | Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter |
| title_full_unstemmed | Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter |
| title_short | Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter |
| title_sort | safe and effective delivery of high power short duration radiofrequency ablation lesions with a flexible tip ablation catheter |
| topic | Atrial fibrillation High-power short-duration ablation Pulmonary vein isolation Pulmonary vein stenosis Radiofrequency ablation |
| url | http://www.sciencedirect.com/science/article/pii/S2666501822002811 |
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