In:
Journal of Cardiovascular Electrophysiology, Wiley, Vol. 34, No. 8 ( 2023-08), p. 1671-1680
Kurzfassung:
Little is known about the impact of blood‐pool local impedance (LI) on lesion characteristics and the incidence of steam pops. Methods Radiofrequency applications at a range of powers (30, 40, and 50 W), contact forces (CF) (5, 15, and 25 g), and durations (15, 30, 45, and 120 s) using perpendicular/parallel catheter orientation were performed in 40 excised porcine preparations, using a catheter capable of monitoring LI (StablePoint©, Boston Scientific). To simulate the variability in blood‐pool impedance, the saline‐pool LI was modulated by calibrating saline concentrations. Lesion characteristics were compared under three values of saline‐pool LI: 120, 160, and 200 Ω. Results Of 648 lesions created, steam pops occurred in 175 (27.0%). When power, CF, time, and catheter orientation were adjusted, ablation at a saline‐pool impedance of 160 or 200 Ω more than doubled the risk of steam pops compared with a saline‐pool impedance of 120 Ω (Odds ratio = 2.31; p = .0002). Lesions in a saline‐pool impedance of 120 Ω were significantly larger in surface area (50 [38–62], 45 [34–56] , and 41 [34–60] mm 2 for 120, 160, and 200 Ω, p 〈 .05), but shallower in depth (4.0 [3–5], 4.4 [3.2–5.3] , and 4.5 [3.8–5.5] mmfor 120, 160, and 200 Ω, respectively, p 〈 .05) compared with the other two settings. The correlation between the absolute LI‐drop and lesion size weakened as the saline‐pool LI became higher (e.g., 120 Ω group ( r 2 = .30, r 2 = .18, and r 2 = .16, respectively for 120, 160, and 200 Ω), but the usage of %LI‐drop (= absolute LI‐drop/initial LI) instead of absolute LI‐drop may minimize this effect. Conclusions In an experimental model, baseline saline‐pool impedance significantly affects the lesion metrics and the risk of steam pops.
Materialart:
Online-Ressource
ISSN:
1045-3873
,
1540-8167
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2023
ZDB Id:
2037519-0
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