TY - JOUR
T1 - Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter
AU - Ptaszek, Leon M.
AU - Koruth, Jacob
AU - Santangeli, Pasquale
AU - Piccini, Jonathan P.
AU - Ranjan, Ravi
AU - Mahapatra, Srijoy
AU - Pipenhagen, Catherine
AU - Fish, Jeffrey M.
AU - Moon, L. Boyce
AU - Ambrosius, Nicholas M.
AU - Boudlali, Hana
AU - Jensen, James A.
N1 - Funding Information:
This work was conducted with support from Harvard Catalyst|The Harvard Clinical and Translational Science Center ( National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR002541) and financial contributions from Harvard University and its affiliated academic healthcare centers.
Funding Information:
This study was funded by Abbott Medical, Inc. The sponsor determined neither the study protocol nor the content of the manuscript.
Publisher Copyright:
© 2022 Heart Rhythm Society
PY - 2023/1
Y1 - 2023/1
N2 - Background: High-power, short-duration (HPSD) radiofrequency ablation (RFA) may reduce ablation time. Concerns that catheter-mounted thermocouples (TCs) can underestimate tissue temperature, resulting in elevated risk of steam pop formation, potentially limit widespread adoption of HPSD ablation. Objective: The purpose of this study was to compare the safety and efficacy of HPSD and low-power, long-duration (LPLD) RFA in the context of pulmonary vein isolation (PVI). Methods: An open-irrigated ablation catheter with a contact force sensor and a flexible-tip electrode containing a TC at its distal end (TactiFlexTM Ablation Catheter, Sensor EnabledTM, Abbott) was used to isolate the left pulmonary veins (PVs) in 12 canines with HPSD RFA (50 W for 10 seconds) and LPLD RFA (30 W for a maximum of 60 seconds). PVI was assessed at 30 minutes and 28 ± 3 days postablation. Computed tomographic scans were performed to assess PV stenosis after RFA. Lesions were evaluated with histopathology. Results: A total of 545 ablations were delivered: 252 with LPLD (0 steam pops) and 293 with HPSD RFA (2 steam pops) (P = .501). Ablation time required to achieve PVI was >3-fold shorter for HPSD than for LPLD RFA (P = .001). All 24 PVs were isolated 30 minutes after ablation, with 12/12 LPLD-ablated and 11/12 HPSD-ablated PVs still isolated at follow-up. Histopathology revealed transmural ablations for HPSD and LPLD RFA. No major adverse events occurred. Conclusion: An investigational ablation catheter effectively delivered RFA lesions. Ablation time required to achieve PVI with HPSD with this catheter was >3-fold shorter than with LPLD RFA.
AB - Background: High-power, short-duration (HPSD) radiofrequency ablation (RFA) may reduce ablation time. Concerns that catheter-mounted thermocouples (TCs) can underestimate tissue temperature, resulting in elevated risk of steam pop formation, potentially limit widespread adoption of HPSD ablation. Objective: The purpose of this study was to compare the safety and efficacy of HPSD and low-power, long-duration (LPLD) RFA in the context of pulmonary vein isolation (PVI). Methods: An open-irrigated ablation catheter with a contact force sensor and a flexible-tip electrode containing a TC at its distal end (TactiFlexTM Ablation Catheter, Sensor EnabledTM, Abbott) was used to isolate the left pulmonary veins (PVs) in 12 canines with HPSD RFA (50 W for 10 seconds) and LPLD RFA (30 W for a maximum of 60 seconds). PVI was assessed at 30 minutes and 28 ± 3 days postablation. Computed tomographic scans were performed to assess PV stenosis after RFA. Lesions were evaluated with histopathology. Results: A total of 545 ablations were delivered: 252 with LPLD (0 steam pops) and 293 with HPSD RFA (2 steam pops) (P = .501). Ablation time required to achieve PVI was >3-fold shorter for HPSD than for LPLD RFA (P = .001). All 24 PVs were isolated 30 minutes after ablation, with 12/12 LPLD-ablated and 11/12 HPSD-ablated PVs still isolated at follow-up. Histopathology revealed transmural ablations for HPSD and LPLD RFA. No major adverse events occurred. Conclusion: An investigational ablation catheter effectively delivered RFA lesions. Ablation time required to achieve PVI with HPSD with this catheter was >3-fold shorter than with LPLD RFA.
KW - Atrial fibrillation
KW - High-power
KW - Pulmonary vein isolation
KW - Pulmonary vein stenosis
KW - Radiofrequency ablation
KW - Steam pop
KW - short-duration ablation
UR - http://www.scopus.com/inward/record.url?scp=85144416880&partnerID=8YFLogxK
U2 - 10.1016/j.hroo.2022.10.009
DO - 10.1016/j.hroo.2022.10.009
M3 - Article
AN - SCOPUS:85144416880
SN - 2666-5018
VL - 4
SP - 42
EP - 50
JO - Heart Rhythm O2
JF - Heart Rhythm O2
IS - 1
ER -