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Soft thrombus formation in radiofrequency catheter ablation
Julie M Demolin1, Olaf J Eick, Kuno Münch
1Université de Technologie Compiègne, France.
Pacing and Clinical Electrophysiology : PACE
|October 3, 2002
Summary
Radiofrequency (RF) catheter ablation can cause heat-induced protein deposits, termed soft thrombus, on electrodes. This occurs independently of heparin and may impact ablation technology development.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Materials Science
Background:
- Radiofrequency (RF) catheter ablation can lead to coagulum formation on electrodes, causing impedance rise.
- A recent study identified a 'soft thrombus' during experimental ablations, which does not increase impedance.
- The mechanism and coagulation system involvement in soft thrombus formation remain unclear.
Purpose of the Study:
- To investigate the formation mechanism of soft thrombus during RF catheter ablation.
- To determine the role of the natural coagulation system in soft thrombus development.
- To analyze the composition and formation conditions of soft thrombus.
Main Methods:
- Temperature-controlled RF energy delivery to heparinized blood and serum.
- Varied heparin concentrations were tested in blood samples.
- Scanning electron microscopy (SEM) was used to analyze deposit composition.
Main Results:
- A semisolidified mass (soft thrombus) formed around the electrode in blood at 80°C, irrespective of heparin concentration.
- Similar, smaller deposits formed in serum under identical conditions.
- SEM analysis confirmed deposits consist of denatured and aggregated proteins, not classical thrombus.
Conclusions:
- Soft thrombus formation is a result of heat-induced protein denaturation and aggregation.
- Formation is independent of heparin concentration and occurs in serum.
- Soft thrombus can form at temperatures below 100°C, with implications for ablation technology.