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
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 |
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