Radiofrequency catheter ablation with the split-tip electrode in the temperature-controlled mode

Area of Science:

• Electrophysiology
• Medical Device Technology
• Surgical Innovation

Background:

• Conventional catheter electrodes pose risks during radiofrequency (RF) ablation, including steam pops.
• Improved electrode design is crucial for enhancing both diagnostic resolution and therapeutic safety in electrophysiology.

Purpose of the Study:

• To evaluate the temperature-controlled ablation characteristics of a novel 7 Fr "split-tip electrode".
• To compare the ablation properties of the split-tip electrode with a conventional 4-mm catheter electrode.

Main Methods:

• In vivo study using anesthetized dogs with exposed thigh muscles superfused with blood.
• Positioning of split-tip and conventional electrodes perpendicular or parallel to the muscle surface.
• Radiofrequency (RF) lesions created in temperature-controlled mode, measuring impedance, lesion depth, power delivery, and occurrence of steam pops.

Main Results:

• The split-tip electrode demonstrated impedance variations correlating with tissue contact, aiding in contact assessment.
• Lesion depth was comparable between electrodes in parallel orientation but significantly deeper with the conventional electrode in perpendicular orientation.
• The split-tip electrode never produced steam pops, even at a higher target temperature (70°C vs. 60°C), unlike the conventional electrode (36% incidence).

Conclusions:

• The split-tip electrode's impedance measurements allow for effective determination of electrode-tissue contact.
• Temperature-controlled RF ablation with the split-tip electrode produces lesions of adequate size without the risk of steam pops.
• This novel electrode design enhances safety during RF ablation procedures.