"Effects of different ablation settings on lesion dimensions in an ex vivo swine heart model: Baseline impedance, irrigant, and electrode configuration"

作者全名："Jiang, Xi; Li, Sijie; Xiong, Qingsong; Zhang, Changzhi; Peng, Lijuan; Chen, Weijie; Cai, Yangwei; Yin, Yuehui; Chen, Shaojie; Ling, Zhiyu"

作者地址："[Jiang, Xi; Li, Sijie; Xiong, Qingsong; Zhang, Changzhi; Peng, Lijuan; Chen, Weijie; Cai, Yangwei; Yin, Yuehui; Chen, Shaojie; Ling, Zhiyu] Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, Chongqing, Peoples R China; [Chen, Shaojie] Cardioangiol Ctr Bethanien CCB, Frankfurt, Germany; [Ling, Zhiyu] Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, 74 Linjiang Rd, Chongqing 400010, Peoples R China"

通信作者："Ling, ZY (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, 74 Linjiang Rd, Chongqing 400010, Peoples R China."

来源：JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000892053200001

JCR分区：Q2

影响因子：2.3

年份：2023

卷号：34

期号：1

开始页：117

结束页：125

文献类型：Article

关键词：baseline impedance; bipolar ablation; HNS; lesion dimensions; radiofrequency catheter ablation; sequential unipolar ablation

摘要："IntroductionIntramural or epicardial locations of the arrhythmogenic substrate are regarded as one of the main reasons for radiofrequency (RF) catheter ablation failure. This study aims to conduct a comprehensive analysis of various factors including baseline impedance, irrigant and electrode configuration at similar ablation index (AI) value. MethodsIn 12 ex vivo swine hearts, RF ablation was performed at a target AI value of 500 and a multistep impedance load (100-180 omega) in 4 settings: (1) conventional unipolar configuration with an irrigant of normal saline (NS); (2) conventional unipolar configuration with an irrigant of half normal saline (HNS); (3) bipolar configuration with an irrigant of NS; (4) sequential unipolar configuration with an irrigant of NS. The relationships between lesion dimensions and above factors were examined. ResultsBaseline impedance had a strong negative linear correlation with lesion dimensions at a certain AI. The correlation coefficient between baseline impedance and depth, width, and volume were R = -0.890, R = -0.755 and R = -0.813, respectively (p < .01). There were 10 (total: 10/100, 10%; bipolar: 10/25, 40%) transmural lesions during the whole procedure. Bipolar ablation resulted in significantly deeper lesion than other electrode configurations. Other comparisons in our experiment did not achieve statistical significance. ConclusionThere is a strong negative linear correlation between baseline impedance and lesion dimensions at a certain AI value. Baseline impedance has an influence on the overall lesion dimensions among irrigated fluid and ablation configurations. Over a threshold impedance of 150 omega, the predictive accuracy of AI can be compromised."

基金机构："Joint Medical Research Project of Chongqing Municipal Health Commission and Chongqing Science and Technology Bureau [2018ZDXM015]; Chongqing Science and Technology Bureau""; Future Young Medical Innovation Team of Chongqing Medical University [W0078]; Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China [(2020)7]"

基金资助正文："The study was partly supported by ""Joint Medical Research Project of Chongqing Municipal Health Commission and Chongqing Science and Technology Bureau"" (Grant No. 2018ZDXM015) (ZL) ,""Future Young Medical Innovation Team of Chongqing Medical University"" (Grant No. W0078) (ZL) and ""Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"" (Grant No. (2020)7) (ZL)."