Key result
Full electrode-tissue coverage produces wider, deeper RF lesions vs minor coverage, while local impedance tracks depth.
Why the study?
Data on the influence of local impedance and electrode-tissue-coverage on radiofrequency lesion formation are scarce.
Does electrode-tissue-coverage affect radiofrequency lesion formation and local impedance in an ex vivo porcine heart model?
Does electrode-tissue-coverage affect radiofrequency lesion formation and local impedance in an ex vivo porcine heart model?
p-value: p=<0.001
Electrode-tissue-coverage is a major determinant of radiofrequency lesion size and steam pop occurrence, with local impedance serving as a useful surrogate for real-time assessment.
May guide contact optimization in ablation; leaves open clinical translation from ex vivo models.
BACKGROUND: The influence of power, duration and contact force (CF) on radiofrequency (RF) lesion formation is well known, whereas data on local impedance (LI) and electrode-tissue-coverage (ETC) is scarce. The objective was to investigate their effect on lesion formation in an ex vivo model. METHODS AND RESULTS: An ex vivo model was developed utilizing cross-sections of porcine heart preparations and a force-sensing, LI-measuring catheter. N = 72 lesion were created systematically varying ETC (minor/full), CF (1-5 g, 10-15 g, 20-25 g) and power (20 W, 30 W, 40 W, 50 W). In minor ETC, the distal tip of the catheter was in electric contact with the tissue, in full ETC the whole catheter tip was embedded within the tissue. Lesion size and all parameters were measured once per second (n = 3320). LI correlated strongly with lesion depth (r = -0.742 for ΔLI; r = 0.781 for %LI-drop). Lesions in full ETC were significantly wider and deeper compared to minor ETC (p < .001) and steam pops were more likely. Baseline LI, ΔLI, and %LI-drop were significantly higher in full ETC (p < .001). In lesions resulting in steam pops, baseline LI, and ΔLI were significantly higher. The influence of CF on lesion size was higher in minor ETC than in full ETC. CONCLUSIONS: ETC is a main determinant of lesion size and occurrence of steam pops. Baseline LI and LI-drop are useful surrogate parameters for real-time assessment of ETC and ΔLI correlates strongly with lesion size.
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Bahlke et al. (2023) studied Radiofrequency ablation (ex vivo porcine model) (n=72). Full electrode-tissue-coverage (ETC) vs. Minor ETC was evaluated on Lesion width and depth (p=<0.001). Full electrode-tissue-coverage produced significantly wider and deeper radiofrequency lesions compared to minor coverage (p < 0.001), and local impedance correlated strongly with lesion depth.
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