Author + information
- Received February 7, 2018
- Revision received March 12, 2018
- Accepted March 26, 2018
- Published online July 16, 2018.
- Ryan T. Borne, MD,
- William H. Sauer, MD,
- Matthew M. Zipse, MD,
- Lijun Zheng, MS,
- Wendy Tzou, MD and
- Duy T. Nguyen, MD∗ ()
- Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado
- ↵∗Address for correspondence:
Dr. Duy T. Nguyen, Section of Cardiac Electrophysiology, University of Colorado, B-132, Leprino Building, 12401 East 17th Avenue, Aurora, Colorado 80045.
Objectives The goal of this study was to characterize differences in ablation lesions with varying radiofrequency ablation (RFA) power and time.
Background Increasing power delivery or prolonging duration can improve the efficacy of RFA. However, the extent to which ablation lesion characteristics change, based on varying degrees of power and duration, is unknown.
Methods An ex vivo model consisting of viable bovine myocardium in a circulating warmed saline bath was used. An open irrigated RFA catheter was positioned with 10 g of force in the perpendicular position, and RFA was delivered at powers of 20, 30, 40, and 50 W and for various time intervals, up to a total of 90 s, at each power. An in vivo porcine thigh preparation model was used to perform RFA at 50 W for 5 s and 20 W for 30 s. Lesion volumes were analyzed.
Results Greater power delivery and longer radiofrequency time increased ablation lesion size. However, compared with a proportional change in radiofrequency duration, the same proportional increase in power produced a significantly larger lesion volume (p < 0.01). For in vivo models, 50 W/5 s ablation lesions yielded similar volumes but significantly less depth than 20 W/30 s ablation lesions. Peak temperatures were not significantly different at 2 and 4 mm with 50 W/5 s versus 20 W/30 s.
Conclusions Varying power and duration will confer different ablation lesion characteristics that can be tailored according to the substrate/anatomy that is being ablated. This phenomenon has important implications during catheter ablation.
This research was partly funded by a grant from Biosense Webster, Inc. Drs. Sauer and Nguyen receive significant research grants from Biosense Webster and CardioNXT and educational grants from Biosense Webster, Boston Scientific, and Medtronic. Drs. Sauer and Nguyen have a provisional patent on partially insulated focused catheter ablation. Drs. Nguyen and Sauer have nonpublic equity interests/stock options in CardioNXT. Dr. Tzou is a consultant to Biosense Webster, and Abbott; and has received speaker honoraria from Biosense Webster, Boston Scientific, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest that 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 February 7, 2018.
- Revision received March 12, 2018.
- Accepted March 26, 2018.
- 2018 American College of Cardiology Foundation