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High‐Volume Lesions Using a New Second‐Generation Open Irrigation Radiofrequency Catheter Are Associated with the Development of Inhomogeneous Lesions
Author(s) -
AKCA FERDI,
HUBAY MARTHA,
ZIMA ENDRE,
SZÉPLAKI GÁBOR,
VÉGH ESZTER M.,
SKOPÁL JUDIT,
LENDVAI ZSUZSANNA,
THEUNS DOMINIC,
MERKELY BELA,
SZILITOROK TAMAS
Publication year - 2014
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12359
Subject(s) - medicine , lesion , catheter , homogeneous , confidence interval , nuclear medicine , odds ratio , radiology , surgery , pathology , physics , thermodynamics
Background After catheter ablation there is often a discrepancy between acute and chronic success rates. We aimed to evaluate major determinants for lesion quality and understand different manifestations of lesion structures. Methods In a canine thigh muscle model radiofrequency (RF) current was delivered for 60 seconds at 30 W (n = 39) or 50 W (n = 18) with 15‐g contact force. A second‐generation 12‐hole gold open irrigation catheter (SGIT) and a first‐generation six‐hole platinum‐iridium catheter (FGIT; Biotronik, Berlin, Germany) were used. Electrode and tissue temperatures (at the surface and 3.5‐mm and 7‐mm depth) were recorded and lesion dimensions were measured. Lesions with steam pops were excluded. Histological examination was performed to evaluate homogeneity of the lesions. Inhomogeneity was defined as a visual multiband lesion pattern indicating different histological characteristics. Results In total 57 lesions were created. Seventeen lesions were excluded (steam pops) and 40 lesions were analyzed. A total number of 11 homogeneous and 29 inhomogeneous lesions were identified. Using the SGIT catheter 16.7% of the lesions was homogeneous and 83.3% inhomogeneous; for FGIT it was 43.8% and 56.2% (P = 0.065), respectively. Homogeneous lesions had lower volumes as compared to inhomogeneous lesions (514.0 ± 198.8 vs 914.8 ± 399.1 mm, P = 0.003). Multiple logistic regression analysis indicated that the SGIT catheter is a significant predictor for inhomogeneous lesions (odds ratio 6.5, 95% confidence interval 1.1–38.8; P = 0.040) independent from power setting and flow rate. Conclusions The development of inhomogeneous lesions after acute RF ablation is associated with higher lesion volumes and the use of the second‐generation irrigation gold‐tip catheter.