Author + information
- Received March 13, 2017
- Revision received August 14, 2017
- Accepted August 17, 2017
- Published online October 16, 2017.
- Jacob S. Koruth, MDa,∗ (, )
- Jin Iwasawa, MDa,
- Yoshinari Enomoto, MDa,
- Meir Bar-Tal, MScb,
- Yigal Ultchin, PhDb,
- Alona Sigal, BScb,
- Liron Mizrahi, MScb,
- Abraham Berger, MScc,
- Ori Hazan, MScc,
- Srinivas R. Dukkipati, MDa and
- Vivek Y. Reddy, MDa
- aHelmsley Electrophysiology Center, Mount Sinai Medical Center, New York, New York
- bBiosense Webster, Inc., Tirat-Hacarmel, Israel
- cBerger Thermal Research, Tel Aviv, Israel
- ↵∗Address for correspondence:
Dr. Jacob S. Koruth, Helmsley Electrophysiology Center, Mount Sinai Hospital and School of Medicine, One Gustave L. Levy Place, P.O. Box 1030, New York, New York 10029.
Objectives This study sought to compare a novel lesion dimension estimation approach to actual measurements of lesion dimensions on necropsy in porcine atria and ventricles.
Background An irrigated-tip, force-sensing radiofrequency catheter with 6 temperature (tip-tissue interface) sensors allows for assessment of lesion dimensions based on estimated tissue temperature. Lesion dimension assessment has not been attempted previously in atrial tissue.
Methods Ablations were performed using this catheter in all chambers. Irrigated radiofrequency was delivered using 20 to 50 W for durations that ranged from 15 to 90 s with contact force ranging from 5 to 45 g to replicate a wide spectrum of clinical conditions. All swine were then sacrificed and lesions were identified and photographed. Three independent observers made offline measurements, which were then averaged to obtain lesion width and depth for comparison with estimated dimensions based on interface tissue temperature.
Results In 9 swine, 54 atrial and 61 ventricular lesions were assessed. In the atria, the mean difference between the measured and estimated depth and width was 0.9 ± 0.74 mm and 1.2 ± 0.9 mm, respectively. Eighty percent of all lesions had a difference of ≤1.7 mm for depth and ≤1.74 mm for width. In the ventricle, the mean difference between the measured and estimated depth and width was 0.75 ± 0.6 mm and 1.66 ± 1.1 mm, respectively. Eighty percent of all lesions had a difference of ≤1.1 mm ventricular depth and ≤2.6 mm for width.
Conclusions Estimation of lesion dimensions can be achieved with clinically relevant accuracy using unique temperature signatures. These data have important implications for understanding the adequacy of lesion overlap and assessment of transmurality.
This study was funded by Biosense Webster, Inc. Drs. Koruth and Reddy have served as consultants to and received grant support from Biosense-Webster Inc. Meir Bar-Tal, Dr. Ultchin, Alona Sigal, and Liron Mizrachi are employees of Biosense-Webster. Abraham Berger and Ori Hazan are employees of Berger Thermal Research; and have served as consultants to Biosense Webster. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received March 13, 2017.
- Revision received August 14, 2017.
- Accepted August 17, 2017.