Bipolar endo-epicardial RF ablation: Animal feasibility study
Paweł Derejko1, Izabela Janus2, Piotr Kułakowski3
1Department of Cardiology, Medicover Hospital, Warsaw, Poland; Department of Cardiac Arrhythmias, National Institute of Cardiology, Warsaw, Poland.
Heart Rhythm
|February 9, 2024
Summary
Bipolar radiofrequency ablation (B-RFA) creates smaller chronic lesions than acute ones. High steam pop incidence during endo-epicardial B-RFA requires careful power management.
Area of Science:
- Cardiovascular Ablation Technologies
- Cardiac Electrophysiology Research
- Animal Models in Medical Research
Background:
- Bipolar radiofrequency ablation (B-RFA) treats arrhythmias resistant to unipolar ablation.
- Limited research exists on endo-epicardial B-RFA applications.
Purpose of the Study:
- Evaluate chronic lesions from endo-epicardial B-RFA.
- Determine optimal settings for endo-epicardial B-RFA in an animal model.
Main Methods:
- Performed endo-epicardial B-RFA in 7 pigs using 2 electrodes on the left ventricular free wall.
- Delivered radiofrequency current at 25, 30, 35, 40, and 50 W for 60 seconds.
- Assessed 31 lesions at 12 weeks post-ablation.
Main Results:
- Lesion size (7.2–68 mm²) correlated with power, endocardial temperature, and epicardial temperature.
- Lesion depth (1.9–11 mm) correlated with impedance decrement; 8 lesions were transmural.
- Steam pops occurred in 20% of applications (30–50 W), with one fatal tamponade at 40 W.
Conclusions:
- Chronic endo-epicardial B-RFA lesions are smaller and less transmural than acute lesions.
- High incidence of steam pops observed, even at lower power settings.
