Effective ablation settings that predict chronic scar after atrial ablation with HELIOSTAR™ multi-electrode radiofrequency balloon catheter.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-11-27 DOI:10.1007/s10840-024-01948-y
Yuki Ishidoya, Eugene Kwan, Bram Hunt, Matthias Lange, Tushar Sharma, Derek J Dosdall, Rob S Macleod, Eugene G Kholmovski, T Jared Bunch, Ravi Ranjan
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引用次数: 0

Abstract

Background: Radiofrequency balloon (RFB) ablation (HELIOSTAR™, Biosense Webster) has been developed to improve pulmonary vein ablation efficiency over traditional point-by-point RF ablation approaches. We aimed to find effective parameters for RFB ablation that result in chronic scar verified by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR).

Methods: A chronic canine model (n = 8) was used to ablate in the superior vena cava (SVC), the right superior and the left inferior pulmonary vein (RSPV and LIPV), and the left atrial appendage (LAA) with a circumferential ablation approach (RF energy was delivered to all electrodes simultaneously) for 20 s or 60 s. The electroanatomical map with the ablation tags was projected onto the 3-month post-ablation LGE-CMR. Tags were divided into two groups depending on whether they correlated with CMR-based scar (ScarTags) or non-scar tissue (Non-ScarTags). The effective parameters for scar formation were estimated by multivariate logistic regression.

Results: This study assessed 80 lesions in the SVC, 80 lesions in the RSPV, 20 lesions in the LIPV, and 30 lesions in the LAA (168 ScarTags and 42 Non-ScarTags). In the multivariate analysis, two variables were associated with chronic scar formation: temperature of electrode before energy application (odds ratio (OR) 0.805, p = 0.0075) and long RF duration (OR 2.360, p = 0.0218), whereas impedance drop was not associated (OR 0.986, p = 0.373).

Conclusion: Lower temperature of the electrode before ablation and long ablation duration are critical parameters for durable atrial scar formation with RFB ablation.

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预测使用 HELIOSTAR™ 多电极射频球囊导管进行心房消融术后慢性瘢痕的有效消融设置。
背景:射频球囊(RFB)消融术(HELIOSTAR™,Biosense Webster)的开发旨在提高肺静脉消融效率,而非传统的逐点射频消融术。我们的目标是找到射频消融的有效参数,通过后期钆增强心脏磁共振(LGE-CMR)验证,这些参数可导致慢性瘢痕:采用慢性犬模型(n = 8),在上腔静脉(SVC)、右上肺静脉和左下肺静脉(RSPV 和 LIPV)以及左心房附壁(LAA)进行消融,消融时间为 20 秒或 60 秒(射频能量同时输送到所有电极)。根据标记是否与基于 CMR 的瘢痕(ScarTags)或非瘢痕组织(Non-ScarTags)相关,标记被分为两组。通过多变量逻辑回归估算了瘢痕形成的有效参数:本研究评估了 SVC 的 80 个病灶、RSPV 的 80 个病灶、LIPV 的 20 个病灶和 LAA 的 30 个病灶(168 个 ScarTags 和 42 个 Non-ScarTags)。在多变量分析中,有两个变量与慢性瘢痕形成相关:能量应用前的电极温度(几率比(OR)0.805,P = 0.0075)和射频持续时间长(OR 2.360,P = 0.0218),而阻抗下降与慢性瘢痕形成无关(OR 0.986,P = 0.373):结论:消融前电极温度较低和消融持续时间较长是 RFB 消融术持久形成心房瘢痕的关键参数。
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来源期刊
CiteScore
4.30
自引率
11.10%
发文量
320
审稿时长
4-8 weeks
期刊介绍: The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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