Automatic termination of radiofrequency energy upon catheter dislocation

Since 1987 radiofrequency (RF) catheter ablation has proven to be an effective treatment for many cardiac arrhythmias. However, catheter dislocation during RF delivery may result in an unintentional heating of healthy non-arrhythmogenic tissue. Therefore, a device was developed (15 cm x 9 cm x 3 cm) consisting of a microprocessor, powered by a 9 V battery and to be connected between the indifferent cable of the RF generator and the patient's back electrode that continuously reads the electrode position information using a 3 dimensional electrode visualization system (LocaLisa). A red light indicates a sudden change in electrode position and an electronic switch is activated by the software to interrupt the connection between the indifferent electrode and the RF generator resulting in a high impedance shutdown and termination of RF energy delivery. Four different sensitivity settings (10 is most and 100 is least sensitive) can be selected and were tested in an in vitro tank setup during electrode dragging speeds of 0.5 to 20 cm/sec. For the sensitivity levels 10, 20, 50 and 100, an immediate termination of RF (Atakr II, Medtronic, 25 W) was demonstrated for an electrode dragging speed of greater or equal than 1, 2, 5 and 10 cm/sec, respectively. We conclude that the developed device may improve safety during ablation procedures of cardiac arrhythmias.