J 2020

Bipolar ablation with contact force-sensing of swine ventricles shows improved acute lesion features compared to sequential unipolar ablation

SOUČEK, Filip, Guido CALUORI, František LEHAR, Jiří JEŽ, Martin PEŠL et. al.

Základní údaje

Originální název

Bipolar ablation with contact force-sensing of swine ventricles shows improved acute lesion features compared to sequential unipolar ablation

Autoři

SOUČEK, Filip (203 Česká republika, domácí), Guido CALUORI (380 Itálie, domácí), František LEHAR (203 Česká republika, domácí), Jiří JEŽ (203 Česká republika, domácí), Martin PEŠL (203 Česká republika, domácí), Jiří WOLF (203 Česká republika), Adam WOJTASZCZYK (616 Polsko), Silvie BĚLAŠKOVÁ (203 Česká republika) a Zdeněk STÁREK (203 Česká republika, garant, domácí)

Vydání

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, HOBOKEN, WILEY, 2020, 1045-3873

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 2.424 v roce 2019

Kód RIV

RIV/00216224:14110/20:00115977

Organizační jednotka

Lékařská fakulta

UT WoS

000517338700001

Klíčová slova anglicky

contact force bipolar ablation; radiofrequency catheter ablation; thermal lesion size; ventricular tachycardia

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 16. 9. 2020 10:36, Mgr. Tereza Miškechová

Anotace

V originále

Introduction Despite technical progress, ventricular tachycardia (VT) recurrence after unipolar ablation remains relatively high (12%-47%). Bipolar ablation has been proposed as an appealing solution that may overcome limitations associated with unipolar ablation settings. We designed an animal study to compare bipolar (BPA) vs sequential unipolar ablation (UPA) using contact force-sensing technology on both ablation catheters. Methods Twenty large white female pigs (6-months-old, 50-60 kg) underwent multiple RF ablations (30 W, 60 seconds, 30 mL/min irrigation) on the ventricular myocardium from the epicardial and endocardial sides. The hearts were fixed and scanned with high-resolution cardiac magnetic resonance imaging. Thermal lesions were located and characterized in volume, depth, width, and transmurality. Results Lesion volume was calculated as the sum of epicardial or endocardial conjoined/isolated lesions at one location. Linear dimensions (width and depth) were measured twice for each location, on the endocardial and epicardial side. We evaluated 35 lesions across the intraventricular septum (UPA, N = 17 vs BPA, N = 18). No difference in volume, linear dimensions or impedance drop was observed in this area between UPA and BPA. However, BPA required half RF time and showed an increased transmurality trend. We then analyzed 73 lesions from the endocardial side (UPA, N = 35 vs BPA, N = 38) and 50 from the epicardial side (UPA, N = 11 vs BPA N = 39) of the ventricular free walls. Lesion transmurality was markedly improved by BPA (P = .030, odds ratio, 23.73 [4.71,31.96]). Ventricular BPA lesions were significantly deeper on the epicardial side (P < .0001) and endocardial side (P = .015). Conclusion Bipolar ablation is more likely to create transmural and epicardial lesions in the ventricle wall. Half the time is needed for the creation of comparably deep and large lesions.

Návaznosti

LM2015062, projekt VaV
Název: Národní infrastruktura pro biologické a medicínské zobrazování
Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, National research infrastructure for biological and medical imaging