Key result
Simultaneous biparietal bipolar radio frequency ablation achieved a higher rate of transmural lesions compared to simultaneous uniparietal bipolar ablation in an in vitro porcine model.
Why the study?
The study was designed to evaluate lesion size and depth produced by two different radiofrequency energy bipolar delivery modes: simultaneous biparietal bipolar versus simultaneous uniparietal bipolar.
Does simultaneous biparietal bipolar radio frequency ablation improve transmurality compared to uniparietal bipolar ablation in an in vitro pig left atrium model?
Does simultaneous biparietal bipolar radio frequency ablation improve transmurality compared to uniparietal bipolar ablation in an in vitro pig left atrium model?
In an in vitro model, simultaneous biparietal bipolar radiofrequency ablation achieved a higher rate of transmural lesions compared to uniparietal bipolar ablation, suggesting better energy penetration.
Answers are grounded in this paper and cite their sources.
Does not support clinical adoption; leaves open translation of biparietal bipolar ablation to human AF procedures.
Purpose To make an in vitro evaluation of the lesion size and depth produced in two different sets of radio frequency energy bipolar delivery: simultaneous biparietal bipolar (SBB) and simultaneous uniparietal bipolar (SUB). Methods Two separate prototypes have been built for our purpose: one to be used in SBB mode and the other to be used SUB mode. Forty left atrium samples were taken from the hearts of freshly slaughtered pigs. They were ablated into a simulator ABLABOX, where blood flow, temperature, and contact force were controlled. After being sliced into a cryotome, the samples were digitalized by a flatbed scanner, and the images were analyzed by a computer morphometric software. Results Transmural lesions were achieved in 18/20 samples (90%) in SBB, while SUB showed transmurality in 9/20 samples (45%). Overall maximum diameter ( D MAX ) resulted larger in SUB than in SBB (2.43 ± 0.30 mm, 1.62 ± 0.14 mm, respectively; p < 0.05): Moreover, maximum epicardial and endocardial diameters ( D EPI and D ENDO , respectively) were wider in SUB group than SBB group (2.28 ± 0.30 mm, 2.26 ± 0.40 and 1.60 ± 0.14 mm, 1.59 ± 0.15 mm, respectively; p < 0.05). We observed the same tendency in lesion depth: The total area and volume ( A TOT and V TOT ) were broader in SUB group than in SBB one (581.01 ± 65.38 mm/mm 2 , 58.10 ± 6.53 mm/mm 3 and 521.97 ± 73.05 mm/mm 2 , 52.19 ± 7.30 mm/mm 3 . respectively; p < 0.05). Conclusions In contrast with the smaller lesion sizes, the biparietal bipolar group showed a higher transmurality rate. These findings may suggest a better drive of the energy flow when compared with SUB lesions.
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Matteucci et al. (2020) studied Atrial Fibrillation (in vitro model) (n=40). Simultaneous biparietal bipolar (SBB) radio frequency ablation vs. Simultaneous uniparietal bipolar (SUB) radio frequency ablation was evaluated on Transmural lesions. Simultaneous biparietal bipolar radio frequency ablation achieved a higher rate of transmural lesions compared to simultaneous uniparietal bipolar ablation in an in vitro porcine model.
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