Maximal Electrogram Attenuation Recorded from Mini Electrodes Embedded on 4.5‐mm Irrigated and 8‐mm Nonirrigated Catheters Signifies Lesion Maturation

Abstract

Titration of the RF application time to the maximal EGM attenuation based on the ME recordings represents atrial lesion maturation and deep ventricular lesions. Prolonging the RF application results in greater extracardiac injury and char formation without increasing lesion size.

Mini Electrodes on Ablation Catheters: Valuable Addition or Redundant Information?—Insights from a Computational Study

“…Simulated UEGMs-MEs were reduced by around 80% after the RFA procedure. The attenuation of these EGMs is in accordance with the studies from Avitall et al and Price et al [19, 37]. BEGM-ME1-ME2 was reduced by around 85% in O and nearly completely in parallel position.…”

“…Additionally, they confirmed lesion monitoring and improved diagnostic accuracy of these integrated MEs. However, further clinical studies are required to prove reproducibility of lesion assessment with this catheter [19]. …”

Observations on Attenuation of Local Electrogram Amplitude and Circuit Impedance During Atrial Radiofrequency Ablation: An In vivo Investigation Using a Novel Direct Endocardial Visualization Catheter

“…The local electrogram amplitude attenuation is widely used to guide ablation, with an 80% diminution of electrogram being considered evidence for adequate lesion size by several investigators . The relationship between lesion growth and electrogram diminution has not been studied in detail until the recent introduction of microelectrode (ME) embedded catheters . Impedance decrement during ablations is another metric used to guide ablation time, and has been studied extensively for its usefulness as a surrogate marker for effective lesion formation and also to predict complications; however, the association with lesion growth remains unclear …”

Cryotherapy of cardiac arrhythmia: From basic science to the bedside

“…Given the cost and complexity of placing multiple temperature and electrodes on the balloon, an alternative option, currently under investigation, is to place Z1 temperature and impedance sensors on the shaft distal to the anterior surface of the balloon, providing the rate and thickness of ice formation. 56 Uncited references 14; 15 Acknowledgments We thank the Engineering Department of the R&D section of Medtronic and Blake 770 771 772 773 774 775 776 777 778 779 780 781 782 783 784 785 786 787 788 789 790 791 792 793 794 795 796 797 798 799 800 801 802 803 804 805 806 807 808 809 810 811 812 813 814 815 816 817 818 819 820 821 822 823 824 825 826 827 828 829 830 831 832 833 834 835 836 837 838 839 840 841 842 843 844 845 846 847 848 849 850 851 852 853 854 855 856 857 858 859 860 861 862 863 864 865 866 867 868 869 870 871 872 873 874 875 876 877 878 879 880 881 882 883 Cardioplegia reduces myocardial temperature and perfusion. Improves lesion outcomes; however, the technique is impracti...…”

“…The current system provides temperature monitoring only in the balloon, which correlates poorly with the ice formation of the tissues. 56 Ideally, tissue temperature could be obtained by placing temperature sensors and recording electrodes on or close to the balloon surface, which should greatly improve the monitoring of tissue cooling rate and interface temperature. The recording electrodes would establish the postablation efficacy.…”