Radiofrequency ablation using a 2-mm irrigated tip electrode produced deeper lesions (8.0 vs 5.4 mm) and higher tissue temperatures than a 5-mm electrode in perpendicular orientation.
Does a 2-mm irrigated tip electrode increase lesion size and tissue temperature compared to a 5-mm electrode during radiofrequency ablation?
During radiofrequency ablation with active cooling, a smaller 2-mm electrode creates larger, deeper lesions with less dependence on orientation compared to a 5-mm electrode.
Absolute Event Rate: 8% vs 5.4%
BACKGROUND: Clinical efficacy has driven the use of larger electrodes (7F, length > or =4 mm) for radiofrequency ablation, which reduces electrogram resolution and causes variability in tissue contact depending on electrode orientation. With active cooling, ablation electrode size may be reduced. The purpose of this study was to examine the effect of electrode length on tissue temperature and lesion size with saline irrigation used for active cooling. METHODS AND RESULTS: In 11 anesthetized dogs, the thigh muscle was exposed and bathed with heparinized canine blood. A 7F ablation catheter with a 2- or 5-mm irrigated tip electrode was positioned perpendicular or parallel to the thigh muscle. Radiofrequency current was delivered at constant voltage (50 V) for 30 seconds during saline irrigation (20 mL/min) to 148 sites. Tissue temperature at depths of 3.5 and 7 mm and lesion size were measured. In the perpendicular electrode-tissue orientation, radiofrequency applications at 50 V with the 2-mm electrode compared with the 5-mm electrode resulted in lower power at 50 V (26 versus 36 W) but higher tissue temperatures, larger lesion depth (8.0 versus 5.4 mm), and greater diameter (12.4 mm versus 8.4 mm). Also, in the parallel orientation, overall power was lower with the 2-mm electrode (25 versus 33 W), but tissue temperatures were higher and lesions were deeper (7.3 versus 6.9 mm). Lesion diameter was similar (11.1 versus 11.3 mm) for both electrodes. CONCLUSIONS: The smaller electrode resulted in transmission of a greater fraction of the radiofrequency power to the tissue and resulted in higher tissue temperature, larger lesions, and lower dependency of lesion size on the electrode orientation.
Nakagawa et al. (1998) studied Radiofrequency ablation (n=11). 2-mm irrigated tip electrode vs. 5-mm irrigated tip electrode was evaluated on Lesion depth in perpendicular orientation (mm). Radiofrequency ablation using a 2-mm irrigated tip electrode produced deeper lesions (8.0 vs 5.4 mm) and higher tissue temperatures than a 5-mm electrode in perpendicular orientation.