Larger and deeper ventricular lesions using a novel expandable spherical monopolar irrigated radiofrequency ablation catheter.


Journal

Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756

Informations de publication

Date de publication:
09 2019
Historique:
received: 13 05 2019
revised: 06 07 2019
accepted: 17 07 2019
pubmed: 28 7 2019
medline: 6 10 2020
entrez: 27 7 2019
Statut: ppublish

Résumé

Radiofrequency (RF) ablation is an established treatment for ventricular tachycardia (VT). However, the inability of current RF catheters to address deep or large substrate may explain most of the clinical failures. The aim of this study is to assess the efficacy and safety of ablation in the left ventricle (LV) in sheep using a novel 8-Fr deflectable ablation catheter (Sphere-9; Affera, Inc) with a 9-mm expandable spherical monopolar irrigated RF tip vs a standard RF irrigated catheter (Biosense Webster, Diamond Bar, CA). The impact on tissue was assessed on local bipolar electrograms (from nine uniformly distributed mini surface electrodes and an internal central reference electrode), as well as on direct lesion measurement post mortem. Eleven sheep underwent LV endocardial ablation in healthy tissue using the Sphere-9 catheter (n = 6), or a conventional irrigated RF catheter (n = 5). Twenty lesions were created with the Sphere-9 (current limit: 2.7 A; temp. limit: 60°C; irrigation: 30 mL/min; and duration: 60-120 seconds). Local bipolar electrograms at the surface of the catheter disappeared during RF delivery in 17 of 20 (85%) lesions. The mean lesion volume was 1707 ± 771 mm This novel spherical monopolar irrigated RF catheter creates lesions that are twice as large and deep as a standard irrigated RF catheter.

Sections du résumé

BACKGROUND
Radiofrequency (RF) ablation is an established treatment for ventricular tachycardia (VT). However, the inability of current RF catheters to address deep or large substrate may explain most of the clinical failures.
OBJECTIVES
The aim of this study is to assess the efficacy and safety of ablation in the left ventricle (LV) in sheep using a novel 8-Fr deflectable ablation catheter (Sphere-9; Affera, Inc) with a 9-mm expandable spherical monopolar irrigated RF tip vs a standard RF irrigated catheter (Biosense Webster, Diamond Bar, CA). The impact on tissue was assessed on local bipolar electrograms (from nine uniformly distributed mini surface electrodes and an internal central reference electrode), as well as on direct lesion measurement post mortem.
METHODS AND RESULTS
Eleven sheep underwent LV endocardial ablation in healthy tissue using the Sphere-9 catheter (n = 6), or a conventional irrigated RF catheter (n = 5). Twenty lesions were created with the Sphere-9 (current limit: 2.7 A; temp. limit: 60°C; irrigation: 30 mL/min; and duration: 60-120 seconds). Local bipolar electrograms at the surface of the catheter disappeared during RF delivery in 17 of 20 (85%) lesions. The mean lesion volume was 1707 ± 771 mm
CONCLUSIONS
This novel spherical monopolar irrigated RF catheter creates lesions that are twice as large and deep as a standard irrigated RF catheter.

Identifiants

pubmed: 31347223
doi: 10.1111/jce.14089
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1644-1651

Subventions

Organisme : National Research Agency(ANR)
ID : ANR-11-EQPX-0030, ANR-10-IAHU-04
Pays : International

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Takeshi Kitamura (T)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Mélèze Hocini (M)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Felix Bourier (F)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Ruairidh Martin (R)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Masateru Takigawa (M)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Antonio Frontera (A)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Nathaniel Thompson (N)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Ghassen Cheniti (G)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Konstantinos Vlachos (K)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Claire A Martin (CA)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Anna Lam (A)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Josselin Duchateau (J)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Thomas Pambrun (T)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Arnaud Denis (A)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Frédéric Sacher (F)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Nicolas Derval (N)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Hubert Cochet (H)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Michel Haïssaguerre (M)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Pierre Jaïs (P)

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

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