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High‐power short‐duration versus standard radiofrequency ablation: Insights on lesion metrics
Author(s) -
Bourier Felix,
Duchateau Josselin,
Vlachos Konstantinos,
Lam Anna,
Martin Claire A.,
Takigawa Masateru,
Kitamura Takeshi,
Frontera Antonio,
Cheniti Ghassen,
Pambrun Thomas,
Klotz Nicolas,
Denis Arnaud,
Derval Nicolas,
Cochet Hubert,
Sacher Frédéric,
Hocini Mélèze,
Haïssaguerre Michel,
Jais Pierre
Publication year - 2018
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13724
Subject(s) - lesion , medicine , ablation , radiofrequency ablation , nuclear medicine , rf ablation , biomedical engineering , ex vivo , in vivo , cardiology , surgery , microbiology and biotechnology , biology
Radiofrequency (RF) lesion metrics are influenced by underlying parameters like RF power, duration, and contact force (CF), and utilization of lesion metric indices (ablation index [AI]) is a proposed strategy to predict lesion quality. The aim of this study was to analyze the influence of underlying parameters on lesion metrics of high‐power short‐duration (HPSD) and standard RF applications using an in silico and ex vivo model. Methods and Results An in silico simulation study was designed to simulate HPSD and standard ablations, in which ablation parameters could systematically be varied. For each simulated ablation process ( n = 5732), the corresponding AI value was calculated. HPSD and standard RF settings were then applied in a porcine ex vivo model ( n = 120 lesions). The resulting lesion metrics were compared and analyzed regarding underlying parameters. RF applications of 50 W/13 seconds, 60 W/10 seconds, 70 W/7 seconds, and 80 W/6 seconds resulted in lesion volumes not significantly different from standard RF applications (30 W/30 seconds, P > 0.05). HPSD lesion diameters were significantly larger and lesion depths were significantly smaller ( P < 0.01) when compared with standard settings. Prolonging RF duration from 5 to 10 seconds resulted in a +27.5% increase, whereas a prolongation of RF duration from 35 to 40 seconds resulted in a +4.8% increase of AI value only. An increase of CF from 1 to 10 g resulted in a +73.0%, an increase of CF from 20 to 30 g resulted in a +10.1% increase of AI value. Conclusion HPSD RF applications resulted in similar lesion volumes but significantly different lesion geometries when compared with standard setting RF applications.