Key result
Longer inter-lesion intervals during 90W ultra-high-power short-duration ablation yield lower peak tissue temperatures.
Why the study?
Discontinuous ablation may prevent excessive esophageal temperature rise during AF ablation, but the temperature characteristics of this strategy during ultra-high-power short-duration ablation remain unexplored.
Does the inter-lesion time interval affect tissue temperature rise during ultra-high-power short-duration ablation in an ex vivo porcine model?
Does the inter-lesion time interval affect tissue temperature rise during ultra-high-power short-duration ablation in an ex vivo porcine model?
p-value: p=< 0.0001
Longer inter-lesion intervals (≥40 seconds) during ultra-high-power short-duration ablation prevent excessive tissue temperature rise in an ex vivo model.
Ex vivo temperature data warrant prospective human trials; do not yet alter AF ablation techniques.
Background Esophageal injury following radiofrequency ablation for atrial fibrillation is closely associated with esophageal temperature. Studies suggest that discontinuous ablation may prevent excessive esophageal temperature rise; however, the temperature characteristics of discontinuous ablation strategy during ultra-high-power short-duration ablation remain unexplored. Methods Fresh porcine cardiac tissue was used. A 15-mm deep vertical hole was drilled from the endocardial surface, and a temperature probe was inserted. The QDOT catheter (Biosense Webster) was positioned at the endocardial site of probe insertion, and the lesion was created using a 90 W, 4-s ablation strategy. After a predefined interval, a second lesion was created.Based on the inter-lesion time interval, samples were divided into four groups: 10 s (group 1), 20 s (group 2), 40 s (group 3), and 60 s (group 4). Temperature was recorded every 10 s. Results Temperature curves in groups 1 and 2 exhibited a unimodal pattern, whereas groups 3 and 4 showed a bimodal pattern. Mean peak temperatures differed among groups: group 1, 39.1 °C (38.6–39.5 °C); group 2, 38.4 °C (38.0–38.7 °C); group 3, peak 38.0 °C (37.5–38.2 °C) with a sub-peak of 37.3 °C (37.1–37.5 °C); group 4, peak 37.8 °C (37.5–38.0 °C) with a sub-peak of 37.3 °C (36.9–37.6 °C). Peak temperatures differed significantly among groups (P < 0.0001). Analysis of repeated temperature measurements revealed a statistically significant between-groups effect (F = 7.2, P < 0.002). Using < 38.5 °C as a safety threshold for peak temperature, 8 cases (73.3%) in group 1 exceeded the threshold, 4 cases (27%) in group 2 reached the threshold, whereas neither group 3 nor group 4 exceeded it. Conclusion Tissue temperature demonstrates significant delayed and cumulative effects during ultra-high-power short-duration ablation. In our ex vivo model, longer inter-lesion intervals were associated with a more gradual temperature rise.
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LIU et al. (2026) studied Atrial fibrillation (ex vivo model). Inter-lesion time intervals (10 s, 20 s, 40 s, and 60 s) during ultra-high-power short-duration ablation vs. Different time intervals was evaluated on Peak tissue temperature (p=< 0.0001). Longer inter-lesion intervals during 90 W, 4-s ultra-high-power short-duration ablation were associated with a more gradual temperature rise and significantly lower peak temperatures (P<0.0001).
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