February 1, 2010Journal of Cardiovascular Electrophysiology
Importance of Catheter Contact Force During Irrigated Radiofrequency Ablation: Evaluation in a Porcine Ex Vivo Model Using a Force‐Sensing Catheter
Why the study?
Does catheter contact force affect lesion size and the incidence of pops during irrigated radiofrequency ablation?
Population
Freshly excised hearts from 11 male pigs in an ex vivo model perfused and superfused using fresh…
Comparison
One-minute irrigated radiofrequency ablations… vs Comparison across different contact forces and…
Design
Preclinical
Authors
Discussion
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Implication
Higher contact force may raise steam pop risk in irrigated RF ablation; leaves open optimal force targets for clinical use.
Key Points
- To determine the role of catheter contact force in the effectiveness and safety of irrigated tip radiofrequency ablation.
- Utilized freshly excised hearts from 11 male pigs in an ex vivo setup.
- Conducted 101 ablations using 3 power control strategies and 3 contact force levels, creating 9 ablation groups.
- Monitored lesion depth and incidence of popping during ablation procedures.
- Lesion depths were significantly greater for higher contact forces, with values of 5.0 mm to 6.7 mm across different power settings (P < 0.01).
- Incidence of popping increased from 0% to 45% correlating with higher contact forces (P < 0.01).
- Impedance drop in initial seconds was positively correlated with catheter contact force (r = 0.65, P < 0.01).
Structured PICO
Does catheter contact force affect lesion size and the incidence of pops during irrigated radiofrequency ablation?
P
Population
Freshly excised hearts from 11 male pigs in an ex vivo model perfused and superfused using fresh, heparinized, oxygenated swine blood
I
Intervention
One-minute irrigated radiofrequency ablations using a force-sensing catheter (Tacticath) at varying contact forces (2 g, 20 g, 60 g) and power strategies (15 Omega target impedance drop, 20 W fixed, 30 W fixed)
C
Comparator
Comparison across different contact forces and power settings
O
Outcome
Lesion depth and incidence of popssurrogate
In an ex vivo porcine model, higher catheter contact force during irrigated radiofrequency ablation significantly increases both lesion depth and the risk of steam pops.
Cite This Study
Thiagalingam et al. (2010) studied this question.