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Epicardial ablation with irrigated electrodes: – effect of bipolar vs. unipolar ablation on lesion formation –.
Circ J. 2012; 76(2):322-7.CJ

Abstract

BACKGROUND

Ablation of ventricular tachycardia originating from the left ventricular (LV) epicardium is often limited by the radiofrequency power delivery. We compared the effect of bipolar vs. unipolar epicardial ablation on lesion size.

METHODS AND RESULTS

Eleven excised pig hearts were superfused with saline (2 L/min). Unipolar ablation (25 or 30 W for 120 s) was performed between the LV epicardial saline-irrigated electrode and an indifferent electrode (n = 33 lesions). Bipolar ablation (25 or 30 W for 120 s) was performed between a 4-mm saline-irrigated-tip (20 ml/min) electrode on the LV epicardium and an opposing 10-mm non-irrigated-tip electrode on the LV endocardium (n = 38 lesions). Wall thickness did not differ between experiments (15.4 ± 2.4 vs. 15.3 ± 2.1 mm). Impedance was lower at the beginning and end of unipolar ablation than at the beginning and end of bipolar ablation (163.2 ± 20.3Ω and 109.9 ± 16.0Ω vs. 194.6 ± 23.3Ω and 127.1 ± 16.4Ω, respectively) (P<0.001). Epicardial lesion width did not differ between unipolar and bipolar ablation (10.1 ± 2.7 vs. 10.2 ± 2.4 mm), but lesion depth was greater with bipolar ablation (10.6 ± 2.7 vs. 7.5 ± 1.0 mm) (P<0.001). Unipolar ablation produced no transmural lesion, but bipolar ablation produced 15 (46%) (P<0.001). Steam pop occurred in 11 (29%) and 3 (9%) cases, respectively (P = 0.036).

CONCLUSIONS

Bipolar ablation of the LV free wall is highly effective at creating an appropriately deep epicardial lesion.

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Authors+Show Affiliations

Nagashima K
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Watanabe I
No affiliation info available
Okumura Y
No affiliation info available
Sonoda K
No affiliation info available
Kofune M
No affiliation info available
Mano H
No affiliation info available
Ohkubo K
No affiliation info available
Nakai T
No affiliation info available
Kunimoto S
No affiliation info available
Kasamaki Y
No affiliation info available
Hirayama A
No affiliation info available

MeSH

AnimalsCatheter AblationElectric ImpedanceElectrodesEndocardiumHeart VentriclesPericardiumSodium ChlorideSteamSwineTachycardia, VentricularTherapeutic Irrigation

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22166835

Citation

Nagashima, Koichi, et al. "Epicardial Ablation With Irrigated Electrodes: – Effect of Bipolar Vs. Unipolar Ablation On Lesion Formation –." Circulation Journal : Official Journal of the Japanese Circulation Society, vol. 76, no. 2, 2012, pp. 322-7.
Nagashima K, Watanabe I, Okumura Y, et al. Epicardial ablation with irrigated electrodes: – effect of bipolar vs. unipolar ablation on lesion formation –. Circ J. 2012;76(2):322-7.
Nagashima, K., Watanabe, I., Okumura, Y., Sonoda, K., Kofune, M., Mano, H., Ohkubo, K., Nakai, T., Kunimoto, S., Kasamaki, Y., & Hirayama, A. (2012). Epicardial ablation with irrigated electrodes: – effect of bipolar vs. unipolar ablation on lesion formation –. Circulation Journal : Official Journal of the Japanese Circulation Society, 76(2), 322-7.
Nagashima K, et al. Epicardial Ablation With Irrigated Electrodes: – Effect of Bipolar Vs. Unipolar Ablation On Lesion Formation –. Circ J. 2012;76(2):322-7. PubMed PMID: 22166835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epicardial ablation with irrigated electrodes: – effect of bipolar vs. unipolar ablation on lesion formation –. AU - Nagashima,Koichi, AU - Watanabe,Ichiro, AU - Okumura,Yasuo, AU - Sonoda,Kazumasa, AU - Kofune,Masayoshi, AU - Mano,Hiroaki, AU - Ohkubo,Kimie, AU - Nakai,Toshiko, AU - Kunimoto,Satoshi, AU - Kasamaki,Yuji, AU - Hirayama,Atsushi, Y1 - 2011/12/14/ PY - 2011/12/15/entrez PY - 2011/12/15/pubmed PY - 2012/5/30/medline SP - 322 EP - 7 JF - Circulation journal : official journal of the Japanese Circulation Society JO - Circ J VL - 76 IS - 2 N2 - BACKGROUND: Ablation of ventricular tachycardia originating from the left ventricular (LV) epicardium is often limited by the radiofrequency power delivery. We compared the effect of bipolar vs. unipolar epicardial ablation on lesion size. METHODS AND RESULTS: Eleven excised pig hearts were superfused with saline (2 L/min). Unipolar ablation (25 or 30 W for 120 s) was performed between the LV epicardial saline-irrigated electrode and an indifferent electrode (n = 33 lesions). Bipolar ablation (25 or 30 W for 120 s) was performed between a 4-mm saline-irrigated-tip (20 ml/min) electrode on the LV epicardium and an opposing 10-mm non-irrigated-tip electrode on the LV endocardium (n = 38 lesions). Wall thickness did not differ between experiments (15.4 ± 2.4 vs. 15.3 ± 2.1 mm). Impedance was lower at the beginning and end of unipolar ablation than at the beginning and end of bipolar ablation (163.2 ± 20.3Ω and 109.9 ± 16.0Ω vs. 194.6 ± 23.3Ω and 127.1 ± 16.4Ω, respectively) (P<0.001). Epicardial lesion width did not differ between unipolar and bipolar ablation (10.1 ± 2.7 vs. 10.2 ± 2.4 mm), but lesion depth was greater with bipolar ablation (10.6 ± 2.7 vs. 7.5 ± 1.0 mm) (P<0.001). Unipolar ablation produced no transmural lesion, but bipolar ablation produced 15 (46%) (P<0.001). Steam pop occurred in 11 (29%) and 3 (9%) cases, respectively (P = 0.036). CONCLUSIONS: Bipolar ablation of the LV free wall is highly effective at creating an appropriately deep epicardial lesion. SN - 1347-4820 UR - https://www.unboundmedicine.com/medline/citation/22166835/Epicardial_ablation_with_irrigated_electrodes:_–_effect_of_bipolar_vs__unipolar_ablation_on_lesion_formation_–_ L2 - https://joi.jlc.jst.go.jp/JST.JSTAGE/circj/CJ-11-0984?from=PubMed DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓6]

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