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October 5, 2021Advances in Clinical and Experimental MedicineOpen Access

During all 25 RF applications ending in steam pops, an abrupt impedance increase (8.2 ±2.0 Ω, p < 0.001) was always observed after the steam pop occurrence (207.4 ±155.9 ms), indicating it cannot be used for prediction.

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Why the study?

The exact correlation between steam pop occurrence and the subsequent rise in impedance during radiofrequency ablation had not been experimentally described.

Does an abrupt impedance rise predict steam pop occurrence during radiofrequency ablation in an in vitro porcine heart model?

Population

Porcine heart tissue specimens across 25 experimental RF current deliveries

Comparison

RFA delivered at 35 W vs 30 W in standardized conditions

Design

Experimental in vitro study

Authors

RORafał OlszewskiPPPaweł PtaszyńskiMedical University of LodzICIwona CygankiewiczMemorial University of Newfoundland

Discussion

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Overview

Abrupt post-pop impedance rise precludes prediction in this model; challenges monitoring assumptions and leaves open safer real-time markers for clinical RF ablation.

Structured PICO

Does an abrupt impedance rise predict steam pop occurrence during radiofrequency ablation in an in vitro porcine heart model?

P
Population
Porcine heart tissue specimens (3 hearts from healthy pigs approx 6 months old) prepared into 3 cuboid samples.
I
Intervention
Radiofrequency ablation (RFA) using contact force measurement-enabled open irrigation ablation catheter (ThermoCool SmartTouch) in power-control mode at 35 W or 30 W, with contact force of 20 g or 30 g.
C
Comparator
Different power settings (30 W vs 35 W) and contact force settings (20 g vs 30 g).
O
Outcome
Time to steam pop occurrence and subsequent abrupt impedance rise.surrogate

An abrupt impedance rise occurs after, not before, a steam pop during radiofrequency ablation, meaning it cannot be used to predict this complication.

Limitations

  • Approximation of real-life intracardiac conditions as in vitro settings with the use of porcine cardiac tissue

Cite This Study

Olszewski et al. (2021) studied this question.

synapsesocial.com/papers/6a0ff560fb2817e31dfcd812https://doi.org/10.17219/acem/136845
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Also Consider

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

  1. 1Ablation characteristics associated with steam pops in ablation index-guided radiofrequency ablation of atrial fibrillation2025 · 4 citations
  2. 2Occurrence of Steam Pops During Irrigated RF Ablation: Novel Insights from Microwave Radiometry2013 · 27 citations
  3. 3Visualizing Intramyocardial Steam Formation with a Radiofrequency Ablation Catheter Incorporating Near‐Field Ultrasound2013 · 33 citations
  4. 4Effect of Baseline Impedance in Radiofrequency Delivery on Lesion Characteristics and the Relationship Between Impedance and Steam Pops2022 · 7 citations
  5. 5Establishing Safe Working Parameters for Radiofrequency Ablation In Vitro Using Acoustic Sensing, Probability Mapping, and Catheter Contact Angle2022