Key result
Bipolar ablation improves transmural heating vs unipolar but is more sensitive to myocardial fat and impedance.
Why the study?
Variations in myocardial fat thickness and myocardial impedance may significantly influence the performance of bipolar radiofrequency catheter ablation.
Does bipolar radiofrequency catheter ablation improve heating effect compared to unipolar ablation under varying myocardial fat thickness and impedance?
Does bipolar radiofrequency catheter ablation improve heating effect compared to unipolar ablation under varying myocardial fat thickness and impedance?
Bipolar ablation provides superior heating effects compared to unipolar ablation, but its efficacy is more sensitive to myocardial fat thickness and impedance.
Hypothesis-generating in animal models; clinical trials needed before considering bipolar ablation in humans.
Radiofrequency catheter ablation is routinely used for the therapy of cardiac arrhythmias. Compared with the traditional unipolar ablation, bipolar ablation may improve the controllability of treatment, and prevent side effects and complications caused by catheter ablation. In addition, the variations of myocardial fat's thickness and myocardial impedance may have significant influence on the performance of bipolar ablation. In this study, computer simulation was performed to study the effects of myocardium fat's thickness and myocardial impedance on unipolar and bipolar ablation. The simulation demonstrates similar results with experimental ones using a swine heart. We observed that when the myocardial fat's thickness increases, bipolar ablation's heating effect and controllability may decrease. However, the final heating effect of bipolar ablation is invariably better than that of unipolar ablation. The ablation effects of unipolar and bipolar ablation are both reduced when myocardial impedance increases, while the heating effects of bipolar ablation are more sensitive to the variation of myocardial impedance and fat layers' thickness compared with unipolar ablation. The unipolar ablation is more stable in terms of fat, impedance and ablation time.
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Sun et al. (2021) studied Cardiac arrhythmias (Ventricular tachycardia). Bipolar radiofrequency catheter ablation vs. Unipolar radiofrequency catheter ablation was evaluated on Transmural lesion ratio and lesion depth. Bipolar ablation achieved better transmural heating effects than unipolar ablation, though its efficacy was more sensitive to increases in myocardial fat thickness and tissue impedance.
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