High frequency metrology for intracardiac ablation: in-vivo results

Cardiac Radiofrequency (RF) ablation is a commonly used clinical procedure for treating many cardiac arrhythmias. However, the efficacy of RF ablation may be limited by two factors: small ventricular lesions and impedance rise, leading to coagulum formation and desiccation of tissue. In this paper, a high frequency (HF) energy ablation system operating at 27.12 MHz based on an automated load matching system was developed. A HF energy matched probe associated to the automated impedance matching device ensures optimal transfer of the energy to the load. The aim of this study was to evaluate this energy for catheter ablation of the atrioventricular junction. In vivo studies were performed using 10 sheep to characterize the lesions created with the impedance matching system. No cardiac perforation was noted. No thrombus was observed at the catheter tip. Acute lesions ranged from 3 to 45 mm in diameter (mean ±SD = 10.3±10) and from 1 to 15 mm in depth (6.7±3.9), exhibiting a close relationship between HF delivered power level and lesion size. Catheter ablation using HF current is feasible and appears effective in producing a stable AV block when applied at the AV junction and large myocardial lesions at ventricular sites.