Gradual Temperature Rise in Radiofrequency Ablation: Enhancing Lesion Quality and Safety in Porcine Myocardial Tissue

Area of Science:

• Medical Devices
• Biomedical Engineering
• Cardiovascular Interventions

Background:

• Radiofrequency ablation (RFA) is crucial for treating cardiovascular and oncological conditions.
• Temperature-controlled RFA offers improved safety over energy-controlled modes.
• Optimizing temperature-controlled RFA protocols is essential for safe and effective energy delivery.

Purpose of the Study:

• To compare lesion formation between gradual-temperature-rise and fixed-temperature modes in RFA.
• To evaluate lesion size, energy delivery, time efficiency, and safety of different RFA modes.
• To determine the optimal temperature turn-up time for efficient lesion formation in cardiac ablation.

Main Methods:

• In vitro and in vivo experiments using porcine myocardial tissue.
• Comparison of gradual-temperature-rise mode against fixed-temperature (75 °C and 85 °C) RFA modes.
• Assessment of lesion dimensions, energy consumption, procedural duration, and safety parameters.

Main Results:

• The gradual-temperature-rise mode produced significantly larger lesions (10.48 ± 0.56 mm) than fixed-temperature modes (7.67 ± 0.37 mm at 75 °C, 8.05 ± 0.36 mm at 85 °C; p = 0.002).
• An optimal temperature turn-up time between 120 and 180 seconds was identified for efficient lesion formation.
• In vivo studies confirmed the safety and efficacy of the optimized gradual-temperature-rise mode.

Conclusions:

• The gradual-temperature-rise mode enhances lesion formation and energy transfer in temperature-controlled RFA.
• This mode improves procedural safety compared to fixed-temperature RFA.
• Optimized gradual-temperature-rise RFA is a promising approach for clinical cardiac ablation.