Radiofrequency ablation significantly reduced the average contact force required to cause atrial perforation in a swine model from 197 g to 151.8 g (P=0.00005).
Does radiofrequency ablation reduce the contact force required to cause atrial perforation in a swine model?
In a swine model, atrial perforation can occur with contact forces as low as 77 g, and concurrent radiofrequency ablation significantly reduces the force required to cause perforation.
Absolute Event Rate: 151.8% vs 197%
p-value: p=0.00005
BACKGROUND: Force sensing is a recently developed technology that allows the determination of the contact force (CF) at the tip of the catheter during electrophysiology procedures. Previous studies suggested that the optimal CF for adequate catheter contact ranges between 10 and 40 g. The aim of this study was to determine the CF needed to cause perforation in the swine atria. METHODS AND RESULTS: Pericardial access was obtained at the beginning of the study in a swine model to drain pericardial effusions. Electroanatomic maps of the right atrium (RA) and left atrium (LA) were constructed. Ablation was performed using an irrigated-tip radiofrequency catheter equipped with force-sensing technology (30 W, 30 mL/min, for 30 seconds). Perforations of the LA and RA wall were intentionally performed in different locations with and without radiofrequency ablation. CF values preceding each perforation were recorded. A total of 111 cardiac perforations were achieved in 7 pigs. The overall average CF resulting in perforation was 175.8±60.4 g (range, 77 to 376 g). This was significantly lower after 30 seconds of radiofrequency delivery: 151.8±49.9 g versus 197±61.3 g (P=0.00005). The average value of CF resulting in perforation was not statistically different between the RA and the LA (169.6±61.6 g versus 181.7±59.3 g) (P=0.29). CONCLUSIONS: Perforation of the atrial wall in a swine model can occur over a wide range of CF values. Perforation can occur with a CF as low as 77 g. Ablation reduces the perforating force by 23%.
Perna et al. (Thu,) conducted a other in Cardiac perforation (n=7). Radiofrequency ablation vs. No radiofrequency ablation was evaluated on Contact force resulting in cardiac perforation (p=0.00005). Radiofrequency ablation significantly reduced the average contact force required to cause atrial perforation in a swine model from 197 g to 151.8 g (P=0.00005).