Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature rise
Introduction: During radiofrequency (RF) ablation, impedance monitoring has been used to avoid steam-pop caused by excessive intramyocardial temperature (IMT) rise. However, it is uncertain why the impedance decline is related to steam-pop and whether the impedance decline is correlated to IMT. Meth...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Indian Pacing and Electrophysiology Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629223001274 |
| _version_ | 1797226720101662720 |
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| author | Takumi Kasai Osamu Saitoh Kyogo Fuse Ayaka Oikawa Hiroshi Furushima Masaomi Chinushi |
| author_facet | Takumi Kasai Osamu Saitoh Kyogo Fuse Ayaka Oikawa Hiroshi Furushima Masaomi Chinushi |
| author_sort | Takumi Kasai |
| collection | DOAJ |
| description | Introduction: During radiofrequency (RF) ablation, impedance monitoring has been used to avoid steam-pop caused by excessive intramyocardial temperature (IMT) rise. However, it is uncertain why the impedance decline is related to steam-pop and whether the impedance decline is correlated to IMT. Methods: Twenty-one bipolar ablations (40 W, 30-g contact, 120 s) were attempted for seven perfused porcine myocardium. Immediately after ablation, a temperature electrode was inserted into the mid-myocardial portion, and the recovery process of impedance and its correlation to IMT were assessed. Results: Transmural lesion was created in all 21 applications but steam-pop occurred in 5/21 applications with large impedance decline. In the 16 applications without steam-pop, impedance and IMT soon after ablation were 97.2 ± 4.0 Ω and 66.1 ± 4.8 °C, respectively. Reasonably high linear correlation was demonstrated between the maximum IMT after ablation and impedance differences before and after ablation. Recovery processes of the decreased impedance and the elevated IMT fit well to each equation of the single exponential decay function and showed symmetric shapes with no statistical difference of time constant (100.1 ± 34.5 s in impedance vs. 108.7 ± 27.3 s in IMT) and half-time of recovery (144.5 ± 49.8 s in impedance vs. 156.9 ± 39.4 s in IMT). Recovered impedance after ablation (104.8 ± 3.9 Ω) was 5.1 ± 2.0 Ω smaller than that before ablation (109.9 ± 2.7 Ω), suggesting several factors other than IMT rise participate in impedance decline in RF ablation. Conclusions: Recovery of impedance and IMT after ablation well correlated, which supports the usefulness of impedance monitoring for safe RF ablation. |
| first_indexed | 2024-04-24T14:29:23Z |
| format | Article |
| id | doaj.art-d1dc5b0aca644ec2ac3dd56cadd8b313 |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-04-24T14:29:23Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-d1dc5b0aca644ec2ac3dd56cadd8b3132024-04-03T04:26:06ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922024-03-012426874Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature riseTakumi Kasai0Osamu Saitoh1Kyogo Fuse2Ayaka Oikawa3Hiroshi Furushima4Masaomi Chinushi5Cardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanCardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanCardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanCardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanCardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanCorresponding author. Graduate School of Health Science, Niigata University School of Medicine, 2-746 Asahimachi, Niigata, 951-8518, Japan.; Cardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanIntroduction: During radiofrequency (RF) ablation, impedance monitoring has been used to avoid steam-pop caused by excessive intramyocardial temperature (IMT) rise. However, it is uncertain why the impedance decline is related to steam-pop and whether the impedance decline is correlated to IMT. Methods: Twenty-one bipolar ablations (40 W, 30-g contact, 120 s) were attempted for seven perfused porcine myocardium. Immediately after ablation, a temperature electrode was inserted into the mid-myocardial portion, and the recovery process of impedance and its correlation to IMT were assessed. Results: Transmural lesion was created in all 21 applications but steam-pop occurred in 5/21 applications with large impedance decline. In the 16 applications without steam-pop, impedance and IMT soon after ablation were 97.2 ± 4.0 Ω and 66.1 ± 4.8 °C, respectively. Reasonably high linear correlation was demonstrated between the maximum IMT after ablation and impedance differences before and after ablation. Recovery processes of the decreased impedance and the elevated IMT fit well to each equation of the single exponential decay function and showed symmetric shapes with no statistical difference of time constant (100.1 ± 34.5 s in impedance vs. 108.7 ± 27.3 s in IMT) and half-time of recovery (144.5 ± 49.8 s in impedance vs. 156.9 ± 39.4 s in IMT). Recovered impedance after ablation (104.8 ± 3.9 Ω) was 5.1 ± 2.0 Ω smaller than that before ablation (109.9 ± 2.7 Ω), suggesting several factors other than IMT rise participate in impedance decline in RF ablation. Conclusions: Recovery of impedance and IMT after ablation well correlated, which supports the usefulness of impedance monitoring for safe RF ablation.http://www.sciencedirect.com/science/article/pii/S0972629223001274RF ablationImpedance monitoringIntramyocardial temperature |
| spellingShingle | Takumi Kasai Osamu Saitoh Kyogo Fuse Ayaka Oikawa Hiroshi Furushima Masaomi Chinushi Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature rise Indian Pacing and Electrophysiology Journal RF ablation Impedance monitoring Intramyocardial temperature |
| title | Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature rise |
| title_full | Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature rise |
| title_fullStr | Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature rise |
| title_full_unstemmed | Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature rise |
| title_short | Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature rise |
| title_sort | symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation role of impedance monitoring to estimate temperature rise |
| topic | RF ablation Impedance monitoring Intramyocardial temperature |
| url | http://www.sciencedirect.com/science/article/pii/S0972629223001274 |
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