Gastric slow-wave modulation via power-controlled, irrigated radio-frequency ablation.

IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY
Neurogastroenterology and Motility Pub Date : 2024-09-01 Epub Date: 2024-07-19 DOI:10.1111/nmo.14873
Ashton Matthee, Zahra Aghababaie, Linley A Nisbet, Sam Simmonds, Jarrah M Dowrick, Gregory B Sands, Timothy R Angeli-Gordon
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引用次数: 0

Abstract

Background: Recently, radio-frequency ablation has been used to modulate slow-wave activity in the porcine stomach. Gastric ablation is, however, still in its infancy compared to its history in the cardiac field, and electrophysiological studies have been restricted to temperature-controlled, non-irrigated ablation. Power-controlled, irrigated ablation may improve lesion formation at lower catheter-tip temperatures that produce the desired localized conduction block.

Methods and results: Power-controlled, irrigated radio-frequency ablation was performed on the gastric serosal surface of female weaner pigs (n = 5) in vivo. Three combinations of power (10-15 W) and irrigation settings (2-5 mL min-1) were investigated. A total of 12 linear lesions were created (n = 4 for each combination). Slow waves were recorded before and after ablation using high-resolution electrical mapping.

Key results: Irrigation maintained catheter-tip temperature below 50°C. Ablation induced a complete conduction block in 8/12 cases (4/4 for 10 W at 2 mL min-1, 1/4 for 10 W at 5 mL min-1, 3/4 for 15 W at 5 mL min-1). Blocks were characterized by a decrease in signal amplitude at the lesion site, along with changes in slow-wave propagation patterns, where slow waves terminated at and/or rotated around the edge of the lesion.

Conclusions and inferences: Power-controlled, irrigated ablation can successfully modulate gastric slow-wave activity at a reduced catheter-tip temperature compared to temperature-controlled, non-irrigated ablation. Reducing the irrigation rate is more effective than increasing power for blocking slow-wave activity. These benefits suggest that irrigated ablation is a suitable option for further translation into a clinical intervention for gastric electrophysiology disorders.

通过功率控制、灌注射频消融术调节胃慢波。
背景:最近,射频消融被用于调节猪胃的慢波活动。然而,与心脏领域的消融历史相比,胃部消融仍处于起步阶段,电生理研究仅限于温控、非灌注消融。功率控制、灌注消融可在较低的导管尖端温度下改善病灶形成,从而产生理想的局部传导阻滞:在活体雌性断奶猪(n = 5)的胃浆膜表面进行了功率控制、灌注射频消融。研究了三种功率组合(10-15 W)和灌注设置(2-5 mL min-1)。共创建了 12 个线性病灶(每个组合 4 个)。使用高分辨率电图记录消融前后的慢波:冲洗使导管尖端温度保持在 50°C 以下。消融在 8/12 个病例中诱发了完全传导阻滞(4/4 为 10 W,2 mL min-1;1/4 为 10 W,5 mL min-1;3/4 为 15 W,5 mL min-1)。阻滞的特点是病变部位信号振幅下降,慢波传播模式发生变化,慢波终止于病变边缘和/或围绕病变边缘旋转:与温控、非灌注消融相比,功率控制、灌注消融可在导管尖端温度降低的情况下成功调节胃慢波活动。在阻断慢波活动方面,降低灌注率比增加功率更有效。这些优点表明,灌注消融是一种合适的选择,可进一步转化为胃电生理紊乱的临床干预措施。
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来源期刊
Neurogastroenterology and Motility
Neurogastroenterology and Motility 医学-临床神经学
CiteScore
7.80
自引率
8.60%
发文量
178
审稿时长
3-6 weeks
期刊介绍: Neurogastroenterology & Motility (NMO) is the official Journal of the European Society of Neurogastroenterology & Motility (ESNM) and the American Neurogastroenterology and Motility Society (ANMS). It is edited by James Galligan, Albert Bredenoord, and Stephen Vanner. The editorial and peer review process is independent of the societies affiliated to the journal and publisher: Neither the ANMS, the ESNM or the Publisher have editorial decision-making power. Whenever these are relevant to the content being considered or published, the editors, journal management committee and editorial board declare their interests and affiliations.
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