One-Stage Versus Sequential Hybrid Radiofrequency Ablation: An In Vitro Evaluation

Area of Science:

• Cardiac electrophysiology
• Minimally invasive cardiac surgery

Background:

• Radio-frequency ablation is a key technique in treating cardiac arrhythmias.
• Optimizing ablation strategies, including timing and approach, is crucial for procedural efficacy.

Purpose of the Study:

• To compare lesion size and depth using a 1-step, sequential, and delayed radio-frequency ablation in a hybrid setup.
• To evaluate the impact of ablation timing on lesion characteristics.

Main Methods:

• Porcine heart left atrium tissues were used in an ABLABOX simulator.
• Three groups were compared: 0-minute delay (SEQ-0), 60-minute delay (SEQ 1), and 240-minute delay (SEQ 2) between epicardial and endocardial ablation.
• Lesion size and depth were quantified via morphometric evaluation.

Main Results:

• No transmural lesions were achieved in any group.
• Simultaneous ablation (SEQ 0) resulted in significantly larger lesion diameters, area, and volume compared to delayed groups (SEQ 1 and SEQ 2).
• No significant differences in lesion morphometrics were observed between the delayed ablation groups (SEQ 1 and SEQ 2).

Conclusions:

• In this in vitro model, simultaneous epicardial-endocardial radio-frequency ablation yielded broader and deeper lesions than delayed approaches.
• The timing sequence of combined ablation did not produce transmural lesions.
• Further investigation is required to validate these findings.