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The Effective Contact Force to Minimize Edema Relative to Chronic Lesion Formation During Radiofrequency Ablation in Ventricular Wall.
Int Heart J. 2019 Nov 30; 60(6):1407-1414.IH

Abstract

Radiofrequency (RF) ablation results in creation of acute edema which can lead to temporary disruption of electrical propagation.The goal of this study was to find the effective contact force (CF) to minimize edema formation in comparison to the lesion size.Ventricular RF lesions (n = 49) were created by a CF-sensing catheter in a canine model (n = 10) with varying force for 30 seconds. Animals underwent T2-weighted (T2w) and late gadolinium enhancement MRI (LGE-MRI) immediately after ablation and at 12 weeks. Acute LGE lesion volume, acute edema, and chronic LGE lesion volume were measured. Acute edema/acute LGE lesion volume ratio was used to divide the lesions into two groups.Mean edema/lesion volume ratio was 5.0 ± 2.8. The lesions were divided into greater edema group (n = 8) and smaller edema group (n = 41) based on a cutoff edema/lesion volume ratio. When comparing the two groups, the CF and force time integral (FTI) were significantly lower in the greater edema group. There was no difference in catheter power setting, tip temperature change, impedance drop, and bipolar electrogram voltage change. Acute LGE volume and chronic lesion depth were significantly smaller in the greater edema group. Moreover, receiver-operator characteristic curve for the smaller edema lesion group showed that the most discriminant cutoff values for CF and FTI were 12.4 g and 584 gs, respectively.To minimize edema size while still forming permanent lesions, ablation should be performed with FTI > 584 gs or CF > 12.4 g.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Yamashita K
Division of Cardiovascular Medicine, University of Utah. Nora Eccles Harrison CVRTI, University of Utah.
Ghafoori E
Nora Eccles Harrison CVRTI, University of Utah. Department of Bioengineering, University of Utah.
Silvernagel J
Nora Eccles Harrison CVRTI, University of Utah. Department of Bioengineering, University of Utah.
Ashton J
Biosense Webster.
J Dosdall D
Nora Eccles Harrison CVRTI, University of Utah. Department of Bioengineering, University of Utah. Division of Cardiothoracic Surgery, University of Utah.
MacLeod R
Nora Eccles Harrison CVRTI, University of Utah. Department of Bioengineering, University of Utah.
Ranjan R
Division of Cardiovascular Medicine, University of Utah. Nora Eccles Harrison CVRTI, University of Utah. Department of Bioengineering, University of Utah.

MeSH

AnimalsCatheter AblationDisease Models, AnimalDogsEdemaHeart VentriclesMagnetic Resonance ImagingPostoperative Complications

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31735778

Citation

Yamashita, Kennosuke, et al. "The Effective Contact Force to Minimize Edema Relative to Chronic Lesion Formation During Radiofrequency Ablation in Ventricular Wall." International Heart Journal, vol. 60, no. 6, 2019, pp. 1407-1414.
Yamashita K, Ghafoori E, Silvernagel J, et al. The Effective Contact Force to Minimize Edema Relative to Chronic Lesion Formation During Radiofrequency Ablation in Ventricular Wall. Int Heart J. 2019;60(6):1407-1414.
Yamashita, K., Ghafoori, E., Silvernagel, J., Ashton, J., J Dosdall, D., MacLeod, R., & Ranjan, R. (2019). The Effective Contact Force to Minimize Edema Relative to Chronic Lesion Formation During Radiofrequency Ablation in Ventricular Wall. International Heart Journal, 60(6), 1407-1414. https://doi.org/10.1536/ihj.19-128
Yamashita K, et al. The Effective Contact Force to Minimize Edema Relative to Chronic Lesion Formation During Radiofrequency Ablation in Ventricular Wall. Int Heart J. 2019 Nov 30;60(6):1407-1414. PubMed PMID: 31735778.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Effective Contact Force to Minimize Edema Relative to Chronic Lesion Formation During Radiofrequency Ablation in Ventricular Wall. AU - Yamashita,Kennosuke, AU - Ghafoori,Elyar, AU - Silvernagel,Josh, AU - Ashton,John, AU - J Dosdall,Derek, AU - MacLeod,Robert, AU - Ranjan,Ravi, Y1 - 2019/11/15/ PY - 2019/11/19/pubmed PY - 2019/12/18/medline PY - 2019/11/19/entrez KW - Acute edema KW - Magnetic resonance imaging SP - 1407 EP - 1414 JF - International heart journal JO - Int Heart J VL - 60 IS - 6 N2 - Radiofrequency (RF) ablation results in creation of acute edema which can lead to temporary disruption of electrical propagation.The goal of this study was to find the effective contact force (CF) to minimize edema formation in comparison to the lesion size.Ventricular RF lesions (n = 49) were created by a CF-sensing catheter in a canine model (n = 10) with varying force for 30 seconds. Animals underwent T2-weighted (T2w) and late gadolinium enhancement MRI (LGE-MRI) immediately after ablation and at 12 weeks. Acute LGE lesion volume, acute edema, and chronic LGE lesion volume were measured. Acute edema/acute LGE lesion volume ratio was used to divide the lesions into two groups.Mean edema/lesion volume ratio was 5.0 ± 2.8. The lesions were divided into greater edema group (n = 8) and smaller edema group (n = 41) based on a cutoff edema/lesion volume ratio. When comparing the two groups, the CF and force time integral (FTI) were significantly lower in the greater edema group. There was no difference in catheter power setting, tip temperature change, impedance drop, and bipolar electrogram voltage change. Acute LGE volume and chronic lesion depth were significantly smaller in the greater edema group. Moreover, receiver-operator characteristic curve for the smaller edema lesion group showed that the most discriminant cutoff values for CF and FTI were 12.4 g and 584 gs, respectively.To minimize edema size while still forming permanent lesions, ablation should be performed with FTI > 584 gs or CF > 12.4 g. SN - 1349-3299 UR - https://www.unboundmedicine.com/medline/citation/31735778/The_Effective_Contact_Force_to_Minimize_Edema_Relative_to_Chronic_Lesion_Formation_During_Radiofrequency_Ablation_in_Ventricular_Wall_ DB - PRIME DP - Unbound Medicine ER -
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