Introduction: Open irrigated radiofrequency (RF) ablation catheters with a porous tip (56 holes, TC-SF) permit delivering RF energy in a temperature-controlled mode without temperature rise. This prospective observational study investigated the association of different catheter parameters on the occurrence of audible steam pops during left atrial (LA) ablation.
Methods And Results: A total of 226 patients underwent TC-SF catheter ablation for atrial fibrillation. RF power delivery, impedance and catheter tip temperature were continually recorded throughout the ablation. Pulmonary vein isolation was performed with a maximum of 27 W and LA electrogram-guided or linear ablation with a maximum of 30 W. A total of 59 audible steam pops occurred, 2 of them resulting in pericardial tamponade. In the initial 89 patients, with an irrigation flow rate of 10 mL/min, 18 steam pops with one tamponade occurred in 12 (14%) patients. Subsequently, the irrigation flow rate was increased to 20 mL/min in the following 137 patients, resulting in the occurrence of 41 steam pops including one case of tamponade in a total of 30 (22%) patients. The maximal power was significantly higher in RF applications associated with a pop than those that did not. In only 12 (20%) steam pops, a significant impedance change occurred immediately before pop occurrence (4 [7%] impedance rise >10 ohm, 8 [13%] impedance drop >15 ohm).
Conclusions: The TC-SF catheter does not provide sufficient feedback from the ablated tissue to prevent steam popping.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/jce.12721 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Very high-power short-duration radiofrequency ablation in patients with typical atrial flutter: rationale and design of the FASD-HP randomized trial.
J Interv Card Electrophysiol
December 2024
Arrhythmia Unit, Cardiology Department,, Hospital Universitario Doctor Balmis, Alicante, Spain.
Background: The aim of cavotricuspid isthmus (CTI)-dependent flutter ablation is the bidirectional conduction block of the CTI. Very-high-power short-duration (vHPSD) radiofrequency ablation aims to minimize conductive heating and increase resistive heating to create shallower but wider lesions in a very short time, while reducing the risk of collateral tissue damage. Experimental studies have shown that it produces effective transmural lesions with an equal or better safety profile compared to conventional parameters.
View Article and Find Full Text PDFImpact of dispersive patch electrode positioning on safety and efficacy of radiofrequency catheter ablation.
Europace
November 2024
Cardiac Arrhythmia Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Safe and efficient radiofrequency catheter ablation depends significantly on the proper placement of dispersive patch electrodes (DPEs), on the skin. This viewpoint describes the role of DPE positioning in optimizing lesion creation and reducing the risk of complications. Incorrect DPE placement can lead to suboptimal energy delivery, prolonging the procedure and/or increasing the risk of adverse events, such as steam pops and potentially fatal atrio-oesophageal fistula.
View Article and Find Full Text PDFImpact of irrigation flow rates on lesion size and safety of ablation catheters: an ex vivo porcine heart study.
Heart Vessels
October 2024
Division of Cardiology, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Radiofrequency (RF) catheter ablation is a well-established therapeutic approach for treating arrhythmias, where lesion size and safety are critical for efficacy. This study explored the impact of varying irrigation flow rates on lesion characteristics using the TactiFlex™ SE Ablation Catheter (TF) in an ex vivo porcine heart model, focusing on the size and safety outcomes associated with low versus standard flow rates. Myocardial slabs from porcine hearts were subjected to ablation using two types of irrigated catheters.
View Article and Find Full Text PDFFeasibility and safety assessment of RF double applications in very high power and short duration ablation.
Heart Rhythm
October 2024
Department of Cardiovascular Medicine, Tokyo Medical and Dental University Hospital, Tokyo, Japan.
Background: Very high power and short duration (vHPSD) ablation is recently used for pulmonary vein isolation. However, low first-pass isolation rates have been reported, possibly because of shallow lesion formation, necessitating deeper lesions to improve treatment outcomes.
Objective: This study aimed to confirm the safety and efficacy of double radiofrequency applications of vHPSD ablation in an in vivo beating swine heart model.
Volumetric lesion analysis and validation of various bipolar configurations in radiofrequency ablation of ventricular myocardium in a bovine model.
J Interv Card Electrophysiol
October 2024
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, India.
Article Synopsis
- The study investigates the effectiveness of bipolar radiofrequency ablation (B-RFA) compared to conventional methods, focusing on how different configurations and settings impact lesion formation and minimize complications like steam pops.
- A custom ex-vivo model tested lesion outcomes under various power levels and catheter orientations, showing that lesions created with a true parallel configuration had significantly fewer steam pops and better tissue penetration (transmurality).
- Findings suggest that using a 30 W to 40 W power setting and maintaining at least 15 mm distance between electrodes enhances safety and effectiveness in B-RFA procedures.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!