The effect of half-normal saline irrigation on lesion characteristics in temperature-flow-controlled ablation.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-09-01 Epub Date: 2023-11-09 DOI:10.1007/s10840-023-01678-7

Takashi Ikenouchi, Masateru Takigawa, Masahiko Goya, Junji Yamaguchi, Claire A Martin, Tasuku Yamamoto, Miho Negishi, Iwanari Kawamura, Kentaro Goto, Takatoshi Shigeta, Takuro Nishimura, Tomomasa Takamiya, Susumu Tao, Shinsuke Miyazaki, Tetsuo Sasano

{"title":"The effect of half-normal saline irrigation on lesion characteristics in temperature-flow-controlled ablation.","authors":"Takashi Ikenouchi, Masateru Takigawa, Masahiko Goya, Junji Yamaguchi, Claire A Martin, Tasuku Yamamoto, Miho Negishi, Iwanari Kawamura, Kentaro Goto, Takatoshi Shigeta, Takuro Nishimura, Tomomasa Takamiya, Susumu Tao, Shinsuke Miyazaki, Tetsuo Sasano","doi":"10.1007/s10840-023-01678-7","DOIUrl":null,"url":null,"abstract":"Purpose: Radiofrequency (RF) ablation with half-normal saline (HNS) irrigation is reported to potentially enlarge local lesion compared to normal saline (NS) in power-controlled ablation (PC-Abl). However, the effect of HNS-irrigation in temperature-flow-controlled ablation (TFC-Abl) on lesion characteristics is unknown. We compared this between TFC-Abl with QDOT-Micro™ catheter and PC-Abl with Thermocool SmartTouch SF™ catheter (STSF).Methods: RF-application with NS (n = 480) and HNS (n = 480) irrigation were performed on swine myocardium placed in a circulating saline bath. Lesion characteristics without steam-pops under various conditions (target AI, 400/550; ablation power, 30/50 W; contact force, 10/20/30 g; catheter orientation, perpendicular/parallel) were assessed and compared between two irrigants.Results: After matching, 343 lesions without steam-pops in each group were evaluated. In PC-Abl, lesion size did not differ between two groups (NS, 188 ± 97 vs. HNS, 200 ± 95 mm3, p = 0.28 in volume; 33.9 ± 7.3 vs. 34.8 ± 9.5 mm2, p = 0.34 in surface area; and 4.0 ± 1.0 vs. 4.0 ± 1.0 mm, p = 0.81 in depth), but steam-pops were more frequently observed with HNS-irrigation (23.8% vs. 37.9%, p = 0.001). Contrary, in TFC-Abl, HNS-irrigation produced significantly larger (214 ± 106 vs. 243 ± 128 mm3, p = 0.017) and deeper (4.0 ± 1.0 vs. 4.3 ± 1.1 mm, p = 0.002) lesions without increasing the risk of steam-pops (15.0% vs 15.0%, p = 0.99). Automatic temperature-guided titration was more frequently observed in HNS-irrigation (54.8% vs. 78.5%, p < 0.001).Conclusions: TFC-Abl with QDOT-Micro™ catheter utilizing HNS-irrigation might increase volume and depth of local lesion without increasing the risk of stem-pops compared to NS-irrigation.","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Interventional Cardiac Electrophysiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10840-023-01678-7","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/9 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Radiofrequency (RF) ablation with half-normal saline (HNS) irrigation is reported to potentially enlarge local lesion compared to normal saline (NS) in power-controlled ablation (PC-Abl). However, the effect of HNS-irrigation in temperature-flow-controlled ablation (TFC-Abl) on lesion characteristics is unknown. We compared this between TFC-Abl with QDOT-Micro™ catheter and PC-Abl with Thermocool SmartTouch SF™ catheter (STSF).

Methods: RF-application with NS (n = 480) and HNS (n = 480) irrigation were performed on swine myocardium placed in a circulating saline bath. Lesion characteristics without steam-pops under various conditions (target AI, 400/550; ablation power, 30/50 W; contact force, 10/20/30 g; catheter orientation, perpendicular/parallel) were assessed and compared between two irrigants.

Results: After matching, 343 lesions without steam-pops in each group were evaluated. In PC-Abl, lesion size did not differ between two groups (NS, 188 ± 97 vs. HNS, 200 ± 95 mm³, p = 0.28 in volume; 33.9 ± 7.3 vs. 34.8 ± 9.5 mm², p = 0.34 in surface area; and 4.0 ± 1.0 vs. 4.0 ± 1.0 mm, p = 0.81 in depth), but steam-pops were more frequently observed with HNS-irrigation (23.8% vs. 37.9%, p = 0.001). Contrary, in TFC-Abl, HNS-irrigation produced significantly larger (214 ± 106 vs. 243 ± 128 mm³, p = 0.017) and deeper (4.0 ± 1.0 vs. 4.3 ± 1.1 mm, p = 0.002) lesions without increasing the risk of steam-pops (15.0% vs 15.0%, p = 0.99). Automatic temperature-guided titration was more frequently observed in HNS-irrigation (54.8% vs. 78.5%, p < 0.001).

Conclusions: TFC-Abl with QDOT-Micro™ catheter utilizing HNS-irrigation might increase volume and depth of local lesion without increasing the risk of stem-pops compared to NS-irrigation.

Abstract Image

查看原文本刊更多论文

半生理盐水灌注对温流控制消融损伤特征的影响。

目的：据报道，与功率控制消融（PC Abl）中的生理盐水（NS）相比，射频（RF）消融加半生理盐水（HNS）灌注可能会扩大局部病变。然而，温流控制消融（TFC Abl）中HNS冲洗对病变特征的影响尚不清楚。我们比较了TFC Abl和QDOT Micro™ 带Thermocoll SmartTouch SF的导管和PC消融仪™ 方法：射频应用NS（n = 480）和HNS（n = 480）对置于循环盐水浴中的猪心肌进行冲洗。评估并比较两种冲洗剂在各种条件下（靶AI，400/550；消融功率，30/50 W；接触力，10/20/30 g；导管方向，垂直/平行）无蒸汽爆裂的损伤特征。结果：配对后，每组343个无蒸汽爆裂的病变进行了评估。在PC Abl中，两组之间的病变大小没有差异（NS，188 ± 97对HNS，200 ± 95 mm3，p = 体积0.28；33.9 ± 7.3对34.8 ± 9.5平方毫米，p = 表面积0.34；和4.0 ± 1.0与4.0 ± 1.0毫米，p = 深度0.81），但HNS灌溉更频繁地观察到蒸汽爆裂（23.8%对37.9%，p = 0.001）。相反，在TFC Abl中，HNS冲洗产生明显更大的（214 ± 106对243 ± 128 mm3，p = 0.017）及更深（4.0 ± 1.0与4.3 ± 1.1毫米，p = 0.002）病变而不增加蒸汽爆裂的风险（15.0%vs15.0%，p = 0.99）。在HNS灌溉中更频繁地观察到自动温度引导滴定（54.8%对78.5%，p 结论：采用QDOT-Micro的TFC-Abl™ 与NS冲洗相比，使用HNS冲洗的导管可能会增加局部病变的体积和深度，而不会增加阀杆爆裂的风险。与生理盐水（NS）冲洗相比，HNS冲洗的功率控制消融显示出类似的局灶性病变，蒸汽爆裂（SP）的发生率更高。相反，与SP发生率相似的NS冲洗相比，HNS冲洗的温流控制消融提供了更大、更深的病变。ns，p > 0.05；*，0.01

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.