The Effect of Power-Control and Irrigation Settings on Lesion Size during Radio-Frequency Ablation of Gastric Tissue

Gastric ablation has recently emerged as a promising potential therapy for correcting bioelectrical dysrhythmias that underpin many gastrointestinal motility disorders. Despite similarities to well-developed cardiac radiofrequency (RF) ablation, gastric RF ablation is in its infancy and has thus far been limited to temperature-controlled, non-irrigated settings. The potential benefits of power-controlled and irrigated RF ablation have not been investigated in gastric tissue. In this study, RF ablation was performed in vivo in pigs ( n=5) using a range of power-control (10-30 W, 10s per point) and irrigation (2-5 ml/min) settings and compared to known temperature-controlled (65°C), non-irrigated settings. Excised tissue was stained with H&E. Lesion surface area was calculated and tissue damage was quantitatively ranked by visual assessment. The results demonstrated that irrigation allowed greater energy delivery to tissue with reduced interface temperatures compared to non-irrigated settings. Power settings above 10 W created lesions that extended through the full-thickness of the muscle layer, which suggests the parameter range that can now be used to correct gastric dysrhythmias. Clinical Relevance- This work presents the results of power-controlled, irrigated RF ablation settings applied to the in vivo porcine stomach. The relationships of both lesion area and depth to ablation dose provides an improved insight into which energy doses could provide a safe and effective therapeutic response.