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Bio-battery signal predicts myocardial lesion formation and depth in vitro
Aims:
The aim of this study was to determine if the bio-battery signal can predict myocardial lesion formation and depth.
Methods:
Fresh bovine ventricular myocardium was immersed in a temperature-controlled bath of circulating blood. RF energy was delivered with a custom generator to a catheter electrode. RF energy, electrode temperature, bio-battery signal and tissue impedance were displayed and recorded. A copper return plate was placed in the bath.
Results:
When 50 volts of constant RF energy was terminated at a 20, 40, or 60% decline from the maximum bio-battery signal, the lesion depth was 4 +/- 0.4 mm. When RF energy application was terminated later, at a point characterized by a brief change of slope of the bio-battery signal, the lesions measured 7.8 +/- 1.4 mm in depth. This "bump" occurred before a rapid impedance rise.
Conclusion:
The depth of lesions created at the "bump" point was almost two-fold deeper than those at the termination points of 20, 40 and 60% bio-battery decrease (p = 0.0001). When RF energy was terminated at the rapid impedance rise the lesions were similar in depth, 8.2 +/- 0.9 mm, to those obtained when RF energy was stopped at the "bump" (p = 0.28). The bio-battery signal provides a unique marker that might be useful to obtain maximum lesion depth while avoiding rapid impedance rise.