Ablation Energy Sources

Issa, Ziad F.; Miller, John M.; Zipes, Douglas P.

doi:10.1016/b978-0-323-52356-1.00007-4

Cited by 10 publications

(15 citation statements)

References 93 publications

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“…In particular, a power above 30 W and lasting more than 60 seconds are likely to provoke steam pops. Moreover, the perpendicular orientation of the electrodes also are likely to cause steam pops and perforations 20 . We hypothesized that the very significant absence of steam pops during our experiments may be related to two different characteristics.…”

Section: Discussionmentioning

confidence: 93%

“…Moreover, the perpendicular orientation of the electrodes also are likely to cause steam pops and perforations. 20 We hypothesized that the very significant absence of steam pops during our experiments may be related to two different characteristics. First, the linear shape of the electrodes, rather than a more sharpened one, might spread the energy over a broader surface, resulting in a decreased impedance of the system and, consequently, producing less overheating effects on the myocardium.…”

Section: Discussionmentioning

confidence: 97%

“…We hypothesized that the very significant absence of steam pops during our experiments may be related to two different characteristics. First, the linear shape of the electrodes, rather than a more sharpened one, might spread the energy over a broader surface, resulting in a decreased impedance of the system and, consequently, producing less overheating effects on the myocardium 20 . The second hypothesis is that the synergy of magnetic coupling and the biparietal configuration might have caused the RF spread to drive in a very focused way within the tissue.…”

Section: Discussionmentioning

confidence: 99%

“…The second hypothesis is that the synergy of magnetic coupling and the biparietal configuration might have caused the RF spread to drive in a very focused way within the tissue. Indeed, the amount of contact force and transmurality of the lesions in cardiac ablation is still debated, but it is well known that by increasing the contact force the lesions become deeper and broader 20 …”

Section: Discussionmentioning

confidence: 99%

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In vivo preliminary test of a new biparietal bidirectional bipolar radiofrequency magnetic coupling system

Matteucci

Meir

Maesen

et al. 2021

Pacing Clinical Electrophis

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Background To test in vivo a new design prototype for radio frequency (RF) ablation. Methods A prototype based on a concept of endo‐epicardial biparietal bipolar RF ablation with the atrial tissue interposed and consisting of two specular endocardial‐epicardial catheters was tested in four pigs (80±5 kg). The endocardial catheter was introduced into the left atrium through the left atrial appendage on the beating heart. The epicardial counterpart was placed manually on the atrial epicardial surface. The coupling of the two catheters was achieved using a neodymium magnet around the gold plate electrode, and RF was applied to the interposed tissue. The hearts were excised, and the lesions were examined using morphometric evaluation. Results The RF application resulted in transmural lesions in all of the four animals tested. In these animals the maximum endocardial width (Wendo) was 6.34 ± 0.25, 6.54 ± 0.33, 6.36 ± 0.57, and 6.49 ± 0.96 mm. The pericardial width (Wepi) was similar: 6.37 ± 0.47, 6.58 ± 0.32, 6.35 ± 0.56 and 6.53 ± 0.94 mm. The lesion area was 924.78, 949.25, 944.25, and 926.05 mm2, and the lesion volume was 92.47, 94.92, 94.42, and 92.60 mm3, respectively. Conclusions The idea of an endocardial‐epicardial bidirectional biparietal bipolar radiofrequency tool such that the atrial tissue is fully interposed between the two RF poles might be promising for future clinical applications. Further research is warranted.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

In vivo preliminary test of a new biparietal bidirectional bipolar radiofrequency magnetic coupling system

Matteucci

Meir

Maesen

et al. 2021

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…Nonetheless, bipolar tools used in the hybrid ablation setting may not exploit the entire potential of this new technique, and often, the tissue penetration is limited only to a thin shallow rim [ 6 ]. We hypothesize that the settlement of the tissue interposed between the ablating poles (biparietal configuration) may result in a higher rate of transmural lesions.…”

Section: Introductionmentioning

confidence: 99%

Comparison between biparietal bipolar and uniparietal bipolar radio frequency ablation techniques in a simultaneous procedural setting

Matteucci

Maesen

Asmundis³

et al. 2020

J Interv Card Electrophysiol

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Purpose To make an in vitro evaluation of the lesion size and depth produced in two different sets of radio frequency energy bipolar delivery: simultaneous biparietal bipolar (SBB) and simultaneous uniparietal bipolar (SUB). Methods Two separate prototypes have been built for our purpose: one to be used in SBB mode and the other to be used SUB mode. Forty left atrium samples were taken from the hearts of freshly slaughtered pigs. They were ablated into a simulator ABLABOX, where blood flow, temperature, and contact force were controlled. After being sliced into a cryotome, the samples were digitalized by a flatbed scanner, and the images were analyzed by a computer morphometric software. Results Transmural lesions were achieved in 18/20 samples (90%) in SBB, while SUB showed transmurality in 9/20 samples (45%). Overall maximum diameter (DMAX) resulted larger in SUB than in SBB (2.43 ± 0.30 mm, 1.62 ± 0.14 mm, respectively; p < 0.05): Moreover, maximum epicardial and endocardial diameters (DEPI and DENDO, respectively) were wider in SUB group than SBB group (2.28 ± 0.30 mm, 2.26 ± 0.40 and 1.60 ± 0.14 mm, 1.59 ± 0.15 mm, respectively; p < 0.05). We observed the same tendency in lesion depth: The total area and volume (ATOT and VTOT) were broader in SUB group than in SBB one (581.01 ± 65.38 mm/mm2, 58.10 ± 6.53 mm/mm3 and 521.97 ± 73.05 mm/mm2, 52.19 ± 7.30 mm/mm3. respectively; p < 0.05). Conclusions In contrast with the smaller lesion sizes, the biparietal bipolar group showed a higher transmurality rate. These findings may suggest a better drive of the energy flow when compared with SUB lesions.

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In vitro characterization of radiofrequency ablation lesions in equine and swine myocardial tissue

Buschmann,

Van Steenkiste,

Duytschaever

et al. 2024

Sci Rep

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Radiofrequency ablation is a promising technique for arrhythmia treatment in horses. Due to the thicker myocardial wall and higher blood flow in horses, it is unknown if conventional radiofrequency settings used in human medicine can be extrapolated to horses. The study aim is to describe the effect of ablation settings on lesion dimensions in equine myocardium. To study species dependent effects, results were compared to swine myocardium. Right ventricular and right and left atrial equine myocardium and right ventricular swine myocardium were suspended in a bath with circulating isotonic saline at 37 °C. The ablation catheter delivered radiofrequency energy at different-power-duration combinations with a contact force of 20 g. Lesion depth and width were measured and lesion volume was calculated. Higher power or longer duration of radiofrequency energy delivery increased lesion size significantly in the equine atrial myocardium and in equine and swine ventricular myocardium ( P < 0.001). Mean lesion depth in equine atrial myocardium ranged from 2.9 to 5.5 mm with a diameter ranging from 6.9 to 10.1 mm. Lesion diameter was significantly larger in equine tissue compared to swine tissue ( P = 0.020). Obtained data in combination with estimated wall thickness can improve lesion transmurality which might reduce arrhythmia recurrence. Optimal ablation settings may differ between species. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-74486-2.

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Ablation Energy Sources

Cited by 10 publications

References 93 publications

In vivo preliminary test of a new biparietal bidirectional bipolar radiofrequency magnetic coupling system

In vivo preliminary test of a new biparietal bidirectional bipolar radiofrequency magnetic coupling system

Comparison between biparietal bipolar and uniparietal bipolar radio frequency ablation techniques in a simultaneous procedural setting

In vitro characterization of radiofrequency ablation lesions in equine and swine myocardial tissue

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