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Radiofrequency ablation lesions in low-, intermediate-, and normal-voltage myocardium: an in vivo study in a porcine heart model.
Europace. 2019 12 01; 21(12):1919-1927.E

Abstract

AIMS

Contact force (CF) between radiofrequency (RF) ablation catheter and myocardium and ablation index (AI) correlates with RF lesion depth and width in normal-voltage (>1.5 mV) myocardium (NVM). We investigate the impact of CF on RF lesion depth and width in low (<0.5 mV) (LVM) and intermediate-voltage (0.5-1.5 mV) myocardium (IVM) following myocardial infarction. Correlation between RF lesion depth and width evaluated by native contrast magnetic resonance imaging (ncMRI) and gross anatomical evaluation was investigated.

METHODS AND RESULTS

Twelve weeks after myocardial infarction, 10 pigs underwent electroanatomical mapping and endocardial RF ablations were deployed in NVM, IVM, and LVM myocardium. In vivo ncMRI was performed before the heart was excised and subjected to gross anatomical evaluation. Ninety (82%) RF lesions were evaluated. Radiofrequency lesion depth and width were smaller in IVM and LVM compared with NVM (P < 0.001). Radiofrequency lesion depth and width correlated with CF, AI, and impedance drop in NVM (CF and AI P < 0.001) and IVM (CF and AI depths P < 0.001; CF and AI widths P < 0.05). Native contrast magnetic resonance imaging evaluated RF lesion depth and width correlated with gross anatomical depth and width (NVM and IVM P < 0.001; LVM P < 0.05).

CONCLUSIONS

Radiofrequency lesions deployed by similar duration, power and CF are smaller in IVM and LVM than in NVM. Radiofrequency lesion depth and width correlated with CF, AI, and impedance drop in NVM and IVM but not in LVM. Native contrast magnetic resonance imaging may be useful to assess RF lesion depth and width in NVM, IVM, and LVM.

Authors+Show Affiliations

Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark.Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31545375

Citation

Tofig, Bawer J., et al. "Radiofrequency Ablation Lesions in Low-, Intermediate-, and Normal-voltage Myocardium: an in Vivo Study in a Porcine Heart Model." Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 21, no. 12, 2019, pp. 1919-1927.
Tofig BJ, Lukac P, Nielsen JM, et al. Radiofrequency ablation lesions in low-, intermediate-, and normal-voltage myocardium: an in vivo study in a porcine heart model. Europace. 2019;21(12):1919-1927.
Tofig, B. J., Lukac, P., Nielsen, J. M., Hansen, E. S. S., Tougaard, R. S., Jensen, H. K., Nielsen, J. C., & Kristiansen, S. B. (2019). Radiofrequency ablation lesions in low-, intermediate-, and normal-voltage myocardium: an in vivo study in a porcine heart model. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 21(12), 1919-1927. https://doi.org/10.1093/europace/euz247
Tofig BJ, et al. Radiofrequency Ablation Lesions in Low-, Intermediate-, and Normal-voltage Myocardium: an in Vivo Study in a Porcine Heart Model. Europace. 2019 12 1;21(12):1919-1927. PubMed PMID: 31545375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiofrequency ablation lesions in low-, intermediate-, and normal-voltage myocardium: an in vivo study in a porcine heart model. AU - Tofig,Bawer J, AU - Lukac,Peter, AU - Nielsen,Jan M, AU - Hansen,Esben S S, AU - Tougaard,Rasmus S, AU - Jensen,Henrik K, AU - Nielsen,Jens C, AU - Kristiansen,Steen B, PY - 2019/03/06/received PY - 2019/08/21/accepted PY - 2019/9/24/pubmed PY - 2020/12/15/medline PY - 2019/9/24/entrez KW - Ablation index KW - Contact force KW - Lesion size KW - Low-voltage myocardium KW - Magnetic resonance imaging KW - RF lesion depth and width KW - Scar KW - Ventricular tachycardia SP - 1919 EP - 1927 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 21 IS - 12 N2 - AIMS: Contact force (CF) between radiofrequency (RF) ablation catheter and myocardium and ablation index (AI) correlates with RF lesion depth and width in normal-voltage (>1.5 mV) myocardium (NVM). We investigate the impact of CF on RF lesion depth and width in low (<0.5 mV) (LVM) and intermediate-voltage (0.5-1.5 mV) myocardium (IVM) following myocardial infarction. Correlation between RF lesion depth and width evaluated by native contrast magnetic resonance imaging (ncMRI) and gross anatomical evaluation was investigated. METHODS AND RESULTS: Twelve weeks after myocardial infarction, 10 pigs underwent electroanatomical mapping and endocardial RF ablations were deployed in NVM, IVM, and LVM myocardium. In vivo ncMRI was performed before the heart was excised and subjected to gross anatomical evaluation. Ninety (82%) RF lesions were evaluated. Radiofrequency lesion depth and width were smaller in IVM and LVM compared with NVM (P < 0.001). Radiofrequency lesion depth and width correlated with CF, AI, and impedance drop in NVM (CF and AI P < 0.001) and IVM (CF and AI depths P < 0.001; CF and AI widths P < 0.05). Native contrast magnetic resonance imaging evaluated RF lesion depth and width correlated with gross anatomical depth and width (NVM and IVM P < 0.001; LVM P < 0.05). CONCLUSIONS: Radiofrequency lesions deployed by similar duration, power and CF are smaller in IVM and LVM than in NVM. Radiofrequency lesion depth and width correlated with CF, AI, and impedance drop in NVM and IVM but not in LVM. Native contrast magnetic resonance imaging may be useful to assess RF lesion depth and width in NVM, IVM, and LVM. SN - 1532-2092 UR - https://www.unboundmedicine.com/medline/citation/31545375/Radiofrequency_ablation_lesions_in_low__intermediate__and_normal_voltage_myocardium:_an_in_vivo_study_in_a_porcine_heart_model_ DB - PRIME DP - Unbound Medicine ER -