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April 1, 1995Journal of Cardiovascular Electrophysiology

Temperature Measurement as a determinant of Tissue Heating During Radiofrequency Catheter ablation: An Examination of Electrode Thermistor Positioning for Measurement Accuracy

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Key result

A single flush-mounted tip thermistor adequately indicated peak electrode-tissue interface temperature during in vivo radiofrequency ablation, underestimating temperature in only 2 of 51 lesions.

Why the study?

Does a single tip thermistor accurately measure peak electrode-tissue interface temperature during radiofrequency catheter ablation in animal models?

Population

In vitro model using 3 porcine right ventricles and in vivo model using 7 mongrel dogs

Comparison

Radiofrequency energy delivery using a standard… vs Different catheter orientations in vitro…

Design

Preclinical

Authors

IMIan D. McRuryUniversity of Virginia Health SystemJWJ.G. WhayneMyocardial Solutions (United States)DHDavid E. HainesElectrophysiology

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Implication

Supports single-thermistor monitoring in animal RF ablation; leaves open human validation before practice change.

Key Points

  • This study aims to evaluate the accuracy of a tip thermistor for measuring temperature at the electrode-tissue interface during radiofrequency catheter ablation.
  • Used an 8-French, 4-mm electrode catheter with 5 thermistors on 3 porcine ventricles and 7 mongrel dogs.
  • Varied catheter orientation and power levels to assess temperature measurement in vitro and in vivo.
  • Pathologically examined created lesions and compared temperatures from tip and radial thermistors.
  • Tip thermistor underestimated peak electrode-tissue interface temperature by a median of 0.5°C to 5°C depending on orientation in vitro.
  • In vivo trials showed underestimation of 1.2°C and 7.6°C in 2 of 51 lesions.
  • One case of peak temperature below 95°C was observed, with a sudden rise in electrical impedance in 17 of 51 energy deliveries.

Structured PICO

Does a single tip thermistor accurately measure peak electrode-tissue interface temperature during radiofrequency catheter ablation in animal models?

P
Population
In vitro model using 3 porcine right ventricles and in vivo model using 7 mongrel dogs
I
Intervention
Radiofrequency energy delivery using a standard 8-French, 4-mm electrode catheter with 5 thermistors (1 tip, 4 radial) or a catheter with a thermistor extending 1 mm from the tip
C
Comparator
Different catheter orientations (perpendicular, 45 degrees, parallel) in vitro; standard single thermistor tipped electrode vs extended tip thermistor in vivo
O
Outcome
Accuracy of tip thermistor compared to radial thermistors for measuring peak electrode-tissue interface temperaturesurrogate

A single flush-mounted tip thermistor is adequate for temperature monitoring during radiofrequency ablation to avoid impedance rises when power is regulated to keep temperatures below 90°C.

Cite This Study

McRury et al. (1995) studied Radiofrequency Catheter Ablation (n=10). Radiofrequency catheter ablation with multi-thermistor catheter vs. Standard single thermistor tipped electrode was evaluated on Peak electrode-tissue interface temperature accuracy. A single flush-mounted tip thermistor adequately indicated peak electrode-tissue interface temperature during in vivo radiofrequency ablation, underestimating temperature in only 2 of 51 lesions.

synapsesocial.com/papers/6a0f2100a7a2fed64abdbc94https://doi.org/10.1111/j.1540-8167.1995.tb00399.x

Topics

AF ablation outcomes
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Tissue Heating During Radiofrequency Catheter Ablation: A Thermodynamic Model and Observations in Isolated Perfused and Superfused Canine Right Ventricular Free Wall1989 · 438 citations
  2. 2Observations on electrode-tissue interface temperature and effect on electrical impedance during radiofrequency ablation of ventricular myocardium.1990 · 319 citations
  3. 3Temperature monitoring during radiofrequency catheter ablation of accessory pathways.1992 · 180 citations
  4. 4The effect of temperature-guided radiofrequency ablation of ventricular myocardium1993 · 11 citations
  5. 5Temperature-controlled radiofrequency catheter ablation of AV conduction: first clinical experience1993 · 84 citations