Incidence and Influencing Factors for Steam Pops in Cardiac Ablations: A Systematic Review.

IF 1.3
Pacing and clinical electrophysiology : PACE Pub Date : 2025-09-01 Epub Date: 2025-07-31 DOI:10.1111/pace.70022
Khaled Elenizi, Rasha Alharthi
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引用次数: 0

Abstract

Background: Steam pops (SPs) during cardiac ablations have emerged as a notable phenomenon with potential implications for procedural safety and efficacy. This is the first review of SPs, which aims to explore the current understanding of SPs. The review investigates their incidence, associations, predictors, clinical significance, and management strategies. Presently, the factors that give rise to SPs have not been completely understood, and the root cause of SPs remains elusive. To achieve this goal, the study conducted a comprehensive review of existing research on SPs in cardiac ablation procedures to ascertain the prevalence and predictors of SPs.

Methods: The research involved an extensive search of databases from their inception until April 2024 to investigate the prevalence of SPs during cardiac ablation procedures in humans. The primary objective of this study was to gather patient demographics, incidence rates, and potential risk factors and predictors that could contribute to the occurrence of SPs and determine any significant correlations between them. The data collected were thoroughly reviewed to identify any significant associations between the various risk factors, predictors, and the incidence of SPs.

Results: A comprehensive review of literature sourced from EMBASE and PubMed identified 25 relevant studies focused on the incidence and clinical significance of steam pops (SPs) during catheter ablation procedures. The studies reported varying rates of SPs, ranging from 0% to 26%, with the highest incidence observed in atrial fibrillation (AFib) and ventricular ablation cases. The association between SPs and factors such as catheter type, irrigation methods, and monitoring parameters was assessed. Notably, advanced catheter technologies, such as the QDOT MICRO and THERMOCOOL SMARTTOUCH, demonstrated a significant reduction in SP occurrences. Additionally, the analysis highlighted the role of temperature control and contact force in minimizing the risk of SPs, with temperature-controlled ablation (TCA) generally leading to fewer SPs compared to power-controlled ablation (PCA). Despite the low incidence of severe complications, the review underscores the importance of careful monitoring of impedance and real-time feedback during ablation to ensure patient safety.

Conclusion: SPs are not uncommon during ablation procedures with irrigated catheters. Caution is required to avoid temperature feedback issues. Advanced catheters are associated with a reduced incidence of steam pops. The risks can be minimized by decreasing energy settings and monitoring impedance changes.

心脏消融术中蒸汽爆裂的发生率及影响因素:系统综述。
背景:心脏消融过程中的蒸汽爆裂(SPs)已成为一种值得注意的现象,对手术安全性和有效性具有潜在影响。这是对SPs的第一次回顾,旨在探讨目前对SPs的理解。本综述调查了其发病率、相关性、预测因素、临床意义和管理策略。目前,SPs产生的因素尚未完全了解,SPs的根本原因仍然难以捉摸。为了实现这一目标,本研究对心脏消融过程中SPs的现有研究进行了全面回顾,以确定SPs的患病率和预测因素。方法:该研究包括从数据库建立到2024年4月的广泛搜索,以调查人类心脏消融过程中SPs的患病率。本研究的主要目的是收集可能导致SPs发生的患者人口统计学、发病率、潜在危险因素和预测因素,并确定它们之间是否存在显著相关性。收集的数据进行了彻底的审查,以确定各种危险因素、预测因素和SPs发病率之间的任何重要关联。结果:对EMBASE和PubMed的文献进行了全面回顾,确定了25项相关研究,重点关注导管消融过程中蒸汽爆裂(SPs)的发生率和临床意义。这些研究报告了不同的SPs发生率,从0%到26%不等,其中在房颤(AFib)和心室消融病例中发病率最高。评估了SPs与导管类型、冲洗方法和监测参数等因素之间的关系。值得注意的是,先进的导管技术,如QDOT MICRO和THERMOCOOL SMARTTOUCH,可以显著减少SP的发生。此外,该分析强调了温度控制和接触力在最小化SPs风险方面的作用,与功率控制消融(PCA)相比,温度控制消融(TCA)通常导致更少的SPs。尽管严重并发症的发生率较低,但该综述强调了在消融过程中仔细监测阻抗和实时反馈以确保患者安全的重要性。结论:SPs在导管冲洗消融过程中并不罕见。注意避免温度反馈问题。先进的导管与减少蒸汽爆裂的发生率有关。通过降低能量设置和监测阻抗变化,可以将风险降至最低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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