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Beating-heart epicardial radiofrequency ablation: optimal temperature setting
Yoshito Inoue1, Issei Kiso, Ryuichi Takahashi
1Department of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan. yosito_inoue@saimiya.com
The Annals of Thoracic Surgery
|June 30, 2004
Summary
Epicardial radiofrequency ablation at 70 degrees C effectively isolates pulmonary veins for atrial fibrillation treatment. Temperatures above 70 degrees C risk heat injury to surrounding tissues.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Pulmonary vein isolation (PVI) is a key treatment for atrial fibrillation.
- Epicardial ablation is a minimally invasive approach for PVI.
- Optimal temperature for epicardial ablation requires investigation.
Purpose of the Study:
- To determine the effective temperature for creating conduction block lesions during epicardial PVI.
- To evaluate the safety and efficacy of different ablation temperatures.
Main Methods:
- Swine model used for epicardial ablation around the pulmonary vein-left atrial junction.
- A seven-electrode catheter delivered ablation at 60°C, 70°C, 80°C, and 90°C for 120 seconds.
- Conduction block assessed via pacing post-ablation.
Main Results:
- Complete conduction block achieved in groups treated at 70°C, 80°C, and 90°C.
- No conduction block observed in the 60°C group.
- Adjacent tissue injury and coronary artery discoloration noted at higher temperatures (80°C and 90°C).
Conclusions:
- Effective temperature for epicardial radiofrequency PVI is 70°C and above.
- 70°C provides a balance between efficacy and safety, minimizing collateral damage.