Continuous ablation improves lesion maturation compared with intermittent ablation strategies.

Area of Science:

• Cardiovascular Interventions
• Medical Device Technology

Background:

• Interrupted radiofrequency ablation (RFA) is being explored for high-power short-duration strategies.
• Ablation interruption can occur due to respiratory or cardiac motion.
• The impact of interrupted ablation on lesion characteristics requires investigation.

Purpose of the Study:

• To compare lesion characteristics between continuous and interrupted radiofrequency ablation (RFA).
• To evaluate the effect of ablation duration on lesion formation.
• To inform the optimization of RFA strategies.

Main Methods:

• Ex vivo and in vivo experiments were conducted.
• Lesion characteristics and tissue temperatures were compared between continuous and interrupted RFA groups with equal total ablation duration and contact force.
• Ablation durations ranged from 1 to 5 minutes.

Main Results:

• Continuous RFA produced significantly larger lesion volumes and greater depths compared to interrupted RFA in ex vivo studies.
• In vivo, continuous ablation resulted in larger lesions, greater depths, and higher tissue temperatures.
• While longer ablation durations increased lesion size, the rate of lesion formation decreased after 3 minutes.

Conclusions:

• Continuous RFA delivery yields larger, deeper lesions with higher tissue temperatures than interrupted ablation.
• Findings support strategies to minimize variations in ablation delivery.
• Results suggest an optimal ablation duration beyond which power delivery yields diminishing returns.