Key result
Transcatheter microwave ablation creates significantly longer lesions than conventional RF ablation.
Why the study?
The determinants of lesion dimensions during transcatheter microwave ablation for cardiac arrhythmias were not well characterized.
Does transcatheter microwave ablation with varying parameters affect lesion dimensions compared to conventional radiofrequency ablation in a swine thigh muscle preparation?
Does transcatheter microwave ablation with varying parameters affect lesion dimensions compared to conventional radiofrequency ablation in a swine thigh muscle preparation?
Transcatheter microwave ablation lesion size can be effectively controlled by adjusting temperature, duration, and antenna length, with 80 degrees C for >150 seconds providing optimal dimensions and lower risk of surface desiccation.
Answers are grounded in this paper and cite their sources.
Microwave ablation lesion size is titratable in swine models; leaves open clinical translation for arrhythmia ablation.
BACKGROUND: Transcatheter microwave ablation is a novel technique for treating cardiac arrhythmias. METHODS: We investigated the effects of catheter temperature, application duration, and antenna length on lesion dimensions during catheter-based microwave ablation. In a swine thigh muscle preparation, microwave was delivered at targeted temperatures of 60 degrees C (n = 18), 70 degrees C (n = 27), 80 degrees C (n = 43), or 90 degrees C (n = 18) for 120 seconds with 10-mm antenna; and at targeted temperatures of 80 degrees C for 120 seconds (n = 22), 150 seconds (n = 18), 180 seconds (n = 18), 210 seconds (n = 18), and 240 seconds (n = 17) with 20-mm antenna using 10 F catheter (MedWaves, San Diego, CA, USA) during parallel orientation. Conventional radiofrequency ablation (RF) using a 4-mm tip electrode was performed as control. RESULTS: With 120-second energy applications, lesion length and depth were significantly larger with targeted temperatures of 80 degrees C and 90 degrees C than 60 degrees C (P< 0.05). Furthermore, lesion depth and width, but not length, were significantly increased by prolonging energy application duration from 120 to 240 seconds at targeted temperature of 80 degrees C (P< 0.05). Compared to RF, microwave lesions were significantly longer but had comparable depth and width. A 20-mm microwave antenna produced longer lesions than either a 10-mm antenna or RF ablation catheter. Multivariate analysis demonstrated that targeted temperature >or=80 degrees C, application duration >or=150 seconds, and use of 20-mm antenna were independent predictors for lesion depth and width (P< 0.05). Surface dessication was observed in 4/18 (22%) lesions at 90 degrees C, as compared with 1/136 (0.7%) at 80 degrees C targeted tip temperature (P < 0.05). CONCLUSIONS: This study demonstrated that lesions size with transcatheter microwave ablation can be controlled by adjusting targeted temperature, energy application duration, and antenna length. A targeted temperature of 80 degrees C for more than 150 seconds should provide optimal lesion dimensions and lower risk of surface dessication or charring.
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Tse et al. (2009) studied Cardiac arrhythmias (n=199). Transcatheter microwave ablation vs. Conventional radiofrequency ablation (RF) was evaluated on Lesion dimensions (length, depth, width) (p=<0.05). Transcatheter microwave ablation produced longer lesions than conventional radiofrequency ablation, with targeted temperature ≥80°C and duration ≥150 seconds predicting larger dimensions.
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