What does this research mean for the field?

During temperature-controlled radiofrequency ablation, popping phenomena are significantly more likely to occur when the electrode and tissue surface are exposed to fluid flow and electrode-tissue contact is poor, which can cause tissue temperatures to exceed measured tip temperatures and reach 100 degrees C. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate how fluid cooling, electrode-tissue contact force, and tip temperature contribute to popping phenomena during temperature-controlled radiofrequency ablation.

February 1, 2000Pacing and Clinical Electrophysiology

Popping Phenomena in Temperature‐Controlled Radiofrequency Ablation: When and Why Do They Occur?

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Why the study?

Does fluid flow and electrode contact force influence the occurrence of popping phenomena during temperature-controlled radiofrequency ablation in an in vitro porcine ventricle model?

Population

In vitro model using pieces of porcine ventricle immersed in a bath of saline solution at 37 degrees C

Comparison

Temperature-controlled radiofrequency ablation… vs Temperature-controlled radiofrequency ablation…

Design

Preclinical

Authors

OEOLAF J. EICKBakken Museum BGBart GerritseElectrophysiology BSBurghard SchumacherWestpfalz Klinikum

Discussion

Member takes

Implication

Popping risk may rise with fluid flow and low contact force in vitro; leaves open clinical relevance for temperature-controlled RF ablation.

Key Points

To evaluate how fluid cooling, electrode-tissue contact force, and tip temperature contribute to popping phenomena during temperature-controlled radiofrequency ablation.
Conducted 42 temperature-controlled radiofrequency ablations (70 °C setpoint, 30 s, 50 W maximum power, 4-mm tip) on porcine ventricular myocardium immersed in 37 °C saline.
Evaluated electrode-tissue contact forces from 0.0 to 0.44 N across two equal groups: with fluid flow (0.1 m/s, Group I, n=21) and without fluid flow (Group II, n=21).
Group I exhibited significantly lower tip temperatures (55.6 ± 8.5 °C vs. 67.3 ± 1.5 °C), higher power delivery (36.2 ± 13.8 W vs. 9.9 ± 5.2 W), and larger lesion volumes (121 ± 57 mm³ vs. 42 ± 18 mm³) compared to Group II.
Ten popping phenomena occurred in Group I and none in Group II; pops clustered at contact forces < 0.1 N (8/10) and tip temperatures < 60 °C (8/10), resulting in two endocardial ruptures.

Structured PICO

Does fluid flow and electrode contact force influence the occurrence of popping phenomena during temperature-controlled radiofrequency ablation in an in vitro porcine ventricle model?

Population

In vitro model using pieces of porcine ventricle immersed in a bath of saline solution at 37 degrees C (n=42 RF ablations)

Intervention

Temperature-controlled radiofrequency ablation (70 degrees C setpoint, 30 s, 50 W maximum power output, 4-mm tip) with fluid flow (0.1 m/s)

Comparator

Temperature-controlled radiofrequency ablation without fluid flow

Outcome

Occurrence of popping phenomenasurrogate

During temperature-controlled RF ablation, the probability of popping phenomena is significantly higher when exposed to fluid flow and poor electrode-tissue contact, potentially leading to endocardial rupture.

Cite This Study

EICK et al. (2000) studied this question.

synapsesocial.com/papers/6a1d755873c56dd1bd2fb5aa https://doi.org/10.1111/j.1540-8159.2000.tb00807.x

Topics

AF ablation outcomes

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Implication

Popping risk may rise with fluid flow and low contact force in vitro; leaves open clinical relevance for temperature-controlled RF ablation.

Popping Phenomena in Temperature‐Controlled Radiofrequency Ablation: When and Why Do They Occur?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Popping Phenomena in Temperature‐Controlled Radiofrequency Ablation: When and Why Do They Occur?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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