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@article{1670341,
author = {Souček, Filip and Caluori, Guido and Lehar, František and Jež, Jiří and Pešl, Martin and Wolf, Jiří and Wojtaszczyk, Adam and Bělašková, Silvie and Stárek, Zdeněk},
article_location = {HOBOKEN},
article_number = {5},
doi = {http://dx.doi.org/10.1111/jce.14407},
keywords = {contact force bipolar ablation; radiofrequency catheter ablation; thermal lesion size; ventricular tachycardia},
language = {eng},
issn = {1045-3873},
journal = {JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY},
title = {Bipolar ablation with contact force-sensing of swine ventricles shows improved acute lesion features compared to sequential unipolar ablation},
url = {https://onlinelibrary.wiley.com/doi/full/10.1111/jce.14407},
volume = {31},
year = {2020}
}
TY - JOUR
ID - 1670341
AU - Souček, Filip - Caluori, Guido - Lehar, František - Jež, Jiří - Pešl, Martin - Wolf, Jiří - Wojtaszczyk, Adam - Bělašková, Silvie - Stárek, Zdeněk
PY - 2020
TI - Bipolar ablation with contact force-sensing of swine ventricles shows improved acute lesion features compared to sequential unipolar ablation
JF - JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
VL - 31
IS - 5
SP - 1128-1136
EP - 1128-1136
PB - WILEY
SN - 10453873
KW - contact force bipolar ablation
KW - radiofrequency catheter ablation
KW - thermal lesion size
KW - ventricular tachycardia
UR - https://onlinelibrary.wiley.com/doi/full/10.1111/jce.14407
L2 - https://onlinelibrary.wiley.com/doi/full/10.1111/jce.14407
N2 - 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.
ER -
SOUČEK, Filip, Guido CALUORI, František LEHAR, Jiří JEŽ, Martin PEŠL, Jiří WOLF, Adam WOJTASZCZYK, Silvie BĚLAŠKOVÁ and Zdeněk STÁREK. Bipolar ablation with contact force-sensing of swine ventricles shows improved acute lesion features compared to sequential unipolar ablation. \textit{JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY}. HOBOKEN: WILEY, 2020, vol.~31, No~5, p.~1128-1136. ISSN~1045-3873. Available from: https://dx.doi.org/10.1111/jce.14407.
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