Local impedance‐guided radiofrequency ablation with standard and high power: Results of a preclinical investigation

Osei, Kofi; Sulkin, Matthew S.; Hamann, Jason J.; Hughes, Christopher C.W.; Shuros, Allan; Nagy, Tamás; Kapa, Suraj; Meyers, Jason D.

doi:10.1111/jce.15135

Cited by 6 publications

(4 citation statements)

References 33 publications

(71 reference statements)

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“…A recent animal study by Osei et al 52 demonstrated improved procedural and ablation times and increased ability to achieve target LI drops (15–40 Ω) with a higher power (50 W) shorter duration approach. A total of 50 W power delivery using CF‐LI catheter is supported by preliminary data from a human observational study of first‐time PVI with CF guidance, reporting an impressively short procedure duration of only 46.5 ± 10.4 min and RF delivery time of 13.5 ± 4.3 min 50 .…”

Section: Local Impedance—the New Kid On the Blockmentioning

confidence: 99%

Local impedance for the optimization of radiofrequency lesion delivery: A review of bench and clinical data

Chu

Calvert

Futyma

et al. 2021

Cardiovasc electrophysiol

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Introduction Radiofrequency catheter ablation is a cornerstone of treatment for many cardiac arrhythmias. Progression in three‐dimensional mapping and contact‐force sensing technologies have improved our capability to achieve success, but challenges still remain. Methods In this article, we discuss the importance of overall circuit impedance in radiofrequency lesion formation. This is followed by a review of the literature regarding recently developed “local impedance” technology and its current and future potential applications and limitations, in the context of established surrogate markers currently used to infer effective ablation. Results We discuss the role of local impedance in assessing myocardial substrate, as well as its role in clinical studies of ablation. We also discuss safety considerations, limitations and ongoing research. Conclusion Local impedance is a novel tool which has the potential to tailor ablation in a manner distinct from other established metrics.

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Section: Local Impedance—the New Kid On the Blockmentioning

confidence: 99%

Local impedance for the optimization of radiofrequency lesion delivery: A review of bench and clinical data

Chu

Calvert

Futyma

et al. 2021

Cardiovasc electrophysiol

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“…However, since a thermal feedback system can hardly be installed in the SE, the temperature in the RF-ablated esophagus was continuously recorded using a thermal camera instead. Moreover, as other studies have reported that the tissue temperature rises, ion mobility within the heated tissue increases, causing a higher current flow and a lower impedance, it could be a specific marker of local tissue heating at a given target site during the RF ablation procedure [26][27][28] . Therefore, it could be expected that a certain ablation region would be achieved despite the absence of a thermal feedback system, since the difference in impedance during the RF ablation time was not large as 10-30 Ω in our current study [29][30][31] .…”

Section: Discussionmentioning

confidence: 95%

Stent-based electrode for radiofrequency ablation in the rat esophagus: a preliminary study

Won

Park

et al. 2022

Sci Rep

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Endoluminal radiofrequency (RF) ablation has been widely used as a safe and effective treatment for Barrett’s esophagus. However, inadequate RF ablation may occur due to insufficient contact between the electrode and target tissues. Herein, a stent-based monopolar RF electrode (SE) was developed to evenly deliver RF energy to the inner wall of the rat esophagus. The optimal RF parameters were evaluated in the exposed rat esophagus. The temperature in the rat esophagus reached 70 ℃ in 89 s at 30 W, 59 s at 40 W, and 34 s at 50 W. The technical feasibility and efficacy of RF ablation using SE were evaluated based on changes in histological transformation and immunohistochemical parameters of tissues compared at immediately, 1 and 2 weeks after the procedure. The degrees of inflammatory cell infiltration, fibrotic changes, TUNEL, and HSP70 in the RF-ablated rat esophagus were significantly higher than compared with sham control (all p < 0.05). TUNEL-positive deposition gradually decreased, but HSP 70-positive deposition maintained a similar level for 2 weeks. The stent-based RF ablation was technically feasible and effective in evenly inducing thermal damages to the rat esophagus. The RF ablation system using the SE may represent a promising treatment for endoluminal malignancies.

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“…Previous studies have used pig models to test different innovative ablation technologies such as the laser-balloon, the low-intensity collimated ultrasound system, the diamond tip ablation catheter, impedance-guided ablations and the different pulsed field ablation catheter (9)(10)(11)(12)(13)(14)(15)(16). All of these studies investigated single ablation lesions without the specific goal of achieving complete pulmonary vein isolation.…”

Section: Discussionmentioning

confidence: 99%

3D-electroanatomical mapping of the left atrium and catheter-based pulmonary vein isolation in pigs: A practical guide

Hertel

Jerltorp²,

Hansen³

et al. 2023

Front. Cardiovasc. Med.

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AimTo propose a standardized workflow for 3D-electroanatomical mapping guided pulmonary vein isolation in pigs.Materials and methodsDanish female landrace pigs were anaesthetized. Ultrasound-guided puncture of both femoral veins was performed and arterial access for blood pressure measurement established. Fluoroscopy- and intracardiac ultrasound-guided passage of the patent foramen ovale or transseptal puncture was performed. Then, 3D-electroanatomical mapping of the left atrium was conducted using a high-density mapping catheter. After mapping all pulmonary veins, an irrigated radiofrequency ablation catheter was used to perform ostial ablation to achieve electrical pulmonary vein isolation. Entrance- and exit-block were confirmed and re-assessed after a 20-min waiting period. Lastly, animals were sacrificed to perform left atrial anatomical gross examination.ResultsWe present data from 11 consecutive pigs undergoing pulmonary vein isolation. Passage of the fossa ovalis or transseptal puncture was uneventful and successful in all animals. Within the inferior pulmonary trunk 2–4 individual veins as well as 1–2 additional left and right pulmonary veins could be cannulated. Electrical isolation by point-by-point ablation of all targeted veins was successful. However, pitfalls including phrenic nerve capture during ablation, ventricular arrhythmias during antral isolation close to the mitral valve annulus and difficulties in accessing right pulmonary veins were encountered.ConclusionFluoroscopy- and intracardiac ultrasound-guided transseptal puncture, high-density electroanatomical mapping of all pulmonary veins and complete electrical pulmonary vein isolation can be achieved reproducibly and safely in pigs when using current technologies and a step-by-step approach.

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Local impedance‐guided radiofrequency ablation with standard and high power: Results of a preclinical investigation

Abstract: are salaried employees of Boston Scientific.

Cited by 6 publications

References 33 publications

Local impedance for the optimization of radiofrequency lesion delivery: A review of bench and clinical data

Local impedance for the optimization of radiofrequency lesion delivery: A review of bench and clinical data

Stent-based electrode for radiofrequency ablation in the rat esophagus: a preliminary study

3D-electroanatomical mapping of the left atrium and catheter-based pulmonary vein isolation in pigs: A practical guide

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