In vitro characterization of radiofrequency ablation lesions in equine and swine myocardial tissue.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
02 Oct 2024
02 Oct 2024
Historique:
received:
02
02
2024
accepted:
26
09
2024
medline:
3
10
2024
pubmed:
3
10
2024
entrez:
2
10
2024
Statut:
epublish
Résumé
Radiofrequency ablation is a promising technique for arrhythmia treatment in horses. Due to the thicker myocardial wall and higher blood flow in horses, it is unknown if conventional radiofrequency settings used in human medicine can be extrapolated to horses. The study aim is to describe the effect of ablation settings on lesion dimensions in equine myocardium. To study species dependent effects, results were compared to swine myocardium. Right ventricular and right and left atrial equine myocardium and right ventricular swine myocardium were suspended in a bath with circulating isotonic saline at 37 °C. The ablation catheter delivered radiofrequency energy at different-power-duration combinations with a contact force of 20 g. Lesion depth and width were measured and lesion volume was calculated. Higher power or longer duration of radiofrequency energy delivery increased lesion size significantly in the equine atrial myocardium and in equine and swine ventricular myocardium (P < 0.001). Mean lesion depth in equine atrial myocardium ranged from 2.9 to 5.5 mm with a diameter ranging from 6.9 to 10.1 mm. Lesion diameter was significantly larger in equine tissue compared to swine tissue (P = 0.020). Obtained data in combination with estimated wall thickness can improve lesion transmurality which might reduce arrhythmia recurrence. Optimal ablation settings may differ between species.
Identifiants
pubmed: 39358479
doi: 10.1038/s41598-024-74486-2
pii: 10.1038/s41598-024-74486-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
22877Subventions
Organisme : Fonds Wetenschappelijk Onderzoek
ID : 1SE9122N
Informations de copyright
© 2024. The Author(s).
Références
Buschmann, E. et al. Three-dimensional electro-anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: a case report. J. Vet. Intern. Med.37, 728–734. https://doi.org/10.1111/jvim.16668 (2023).
doi: 10.1111/jvim.16668
Van Steenkiste, G. et al. Detection of the origin of atrial tachycardia by 3D electro-anatomical mapping and treatment by radiofrequency catheter ablation in horses. J. Vet. Intern. Med.36, 1481–1490. https://doi.org/10.1111/jvim.16473 (2022).
doi: 10.1111/jvim.16473
Issa, Z. M. & Zipes, J. M. DP. In Clinical Arrhythmology and Electrophysiology Ch. Ablation Energy Sources 206–237 (Elsevier, 2019).
Kowalski, M. et al. Histopathologic characterization of chronic Radiofrequency ablation lesions for pulmonary vein isolation. J. Am. Coll. Cardiol.59, 930–938. https://doi.org/10.1016/j.jacc.2011.09.076 (2012).
doi: 10.1016/j.jacc.2011.09.076
Hindricks, G. ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery. Eur Heart J42, https://doi.org/10.1093/eurheartj/ehaa798 (2021).
doi: 10.1093/eurheartj/ehaa798
Borne, R. T. et al. Longer Duration Versus increasing Power during Radiofrequency ablation yields different ablation lesion characteristics. JACC Clin. Electrophysiol.4, 902–908. https://doi.org/10.1016/j.jacep.2018.03.020 (2018).
doi: 10.1016/j.jacep.2018.03.020
Bhaskaran, A. et al. Circuit Impedance could be a crucial factor influencing Radiofrequency ablation efficacy and safety: a myocardial Phantom Study of the Problem and its correction. J. Cardiovasc. Electr.27, 351–357. https://doi.org/10.1111/jce.12893 (2016).
doi: 10.1111/jce.12893
Barkagan, M. et al. High-power and short-duration ablation for pulmonary vein isolation: safety, efficacy, and long-term durability. J. Cardiovasc. Electrophysiol.29, 1287–1296. https://doi.org/10.1111/jce.13651 (2018).
doi: 10.1111/jce.13651
Wittkampf, F. H., Hauer, R. N. & de Robles, E. O. Control of radiofrequency lesion size by power regulation. Circulation. 80, 962–968. https://doi.org/10.1161/01.cir.80.4.962 (1989).
doi: 10.1161/01.cir.80.4.962
Nath, S. & Haines, D. E. Biophysics and Pathology of Catheter Energy Delivery systems. Prog Cardiovasc. Dis.37, 185–204. https://doi.org/10.1016/S0033-0620(05)80006-4 (1995).
doi: 10.1016/S0033-0620(05)80006-4
Haines, D. E. Determinants of lesion size during radiofrequency catheter ablation: the role of electrode-tissue contact pressure and duration of energy delivery. J. Cardiovasc. Electrophysiol.2, 509–515 (1991).
doi: 10.1111/j.1540-8167.1991.tb01353.x
Neuzil, P. et al. Electrical reconnection after pulmonary vein isolation is contingent on Contact Force during initial treatment results from the EFFICAS I study. Circulation-Arrhythmia Electrophysiol.6, 327–333. https://doi.org/10.1161/Circep.113.000374 (2013).
doi: 10.1161/Circep.113.000374
Shah, D. C. et al. Area under the real-time contact force curve (force-Time integral) predicts Radiofrequency Lesion size in an in vitro contractile model. J. Cardiovasc. Electr.21, 1038–1043. https://doi.org/10.1111/j.1540-8167.2010.01750.x (2010).
doi: 10.1111/j.1540-8167.2010.01750.x
Mulder, M. J., Kemme, M. J. B. & Allaart, C. P. Radiofrequency ablation to achieve durable pulmonary vein isolation. Europace. 24, 874–886. https://doi.org/10.1093/europace/euab279 (2022).
doi: 10.1093/europace/euab279
Buschmann, E. et al. Successful caudal vena cava and pulmonary vein isolation in healthy horses using 3D electro-anatomical mapping and a contact force-guided ablation system. Equine Vet. J. https://doi.org/10.1111/evj.14037 (2023).
doi: 10.1111/evj.14037
Falasconi, G. et al. Personalized pulmonary vein antrum isolation guided by left atrial wall thickness for persistent atrial fibrillation. Europace https://doi.org/10.1093/europace/euad118 (2023).
doi: 10.1093/europace/euad118
Mulder, M. J. et al. Impact of local left atrial wall thickness on the incidence of acute pulmonary vein reconnection after Ablation Index-guided atrial fibrillation ablation. Ijc Heart Vasc29, https://doi.org/10.1016/j.ijcha.2020.100574 (2020).
Inoue, J., Skanes, A. C., Gula, L. J. & Drangova, M. Effect of Left Atrial Wall Thickness on Radiofrequency ablation success. J. Cardiovasc. Electr.27, 1298–1303. https://doi.org/10.1111/jce.13065 (2016).
doi: 10.1111/jce.13065
Teres, C. et al. Personalized paroxysmal atrial fibrillation ablation by tailoring ablation index to the left atrial wall thickness: the ‘Ablate by-LAW’ single-centre study-a pilot study. Europace. 24, 390–399. https://doi.org/10.1093/europace/euab216 (2022).
doi: 10.1093/europace/euab216
Ibrahim, L., Buschmann, E., van Loon, G. & Cornillie, P. Morphological evidence of a potential arrhythmogenic substrate in the caudal and cranial vena cava in horses. Equine Vet. J. https://doi.org/10.1111/evj.14075 (2024).
doi: 10.1111/evj.14075
Sapp, J. L. et al. Deep myocardial ablation lesions can be created with a retractable needle-tipped catheter. Pacing Clin. Electrophysiol.27, 594–599. https://doi.org/10.1111/j.1540-8159.2004.00492.x (2004).
doi: 10.1111/j.1540-8159.2004.00492.x
Berte, B. et al. Irrigated needle ablation creates larger and more transmural ventricular lesions compared with standard unipolar ablation in an ovine model. Circ. Arrhythm. Electrophysiol.8, 1498–1506. https://doi.org/10.1161/CIRCEP.115.002963 (2015).
doi: 10.1161/CIRCEP.115.002963
Futyma, P. et al. Bipolar ablation of refractory atrial and ventricular arrhythmias: importance of temperature values of intracardiac return electrodes. J. Cardiovasc. Electr.30, 1718–1726. https://doi.org/10.1111/jce.14025 (2019).
doi: 10.1111/jce.14025
Futyma, P., Głuszczyk, C. K., Sander, R., Futyma, J. & Kułakowski, M. Bipolar ablation of refractory atrial and ventricular arrhythmias: importance of temperature values of intracardiac return electrodes. J. Cardiovasc. Electrophysiol.30, 1717–1726 (2019).
doi: 10.1111/jce.14025
Sandhu, A. & Nguyen, D. T. Forging ahead: update on radiofrequency ablation technology and techniques. J. Cardiovasc. Electrophysiol.31, 360–369. https://doi.org/10.1111/jce.14317 (2020).
doi: 10.1111/jce.14317
Dukkipati, S. R. et al. Intramural Needle Ablation for refractory premature ventricular contractions. Circ. Arrhythm. Electrophysiol.15, e010020. https://doi.org/10.1161/CIRCEP.121.010020 (2022).
doi: 10.1161/CIRCEP.121.010020
Leshem, E. et al. High-power and short-duration ablation for pulmonary vein isolation: Biophysical characterization. JACC Clin. Electrophysiol.4, 467–479. https://doi.org/10.1016/j.jacep.2017.11.018 (2018).
doi: 10.1016/j.jacep.2017.11.018
Qiu, J., Wang, Y., Wang, D. W., Hu, M. & Chen, G. Update on high-power short-duration ablation for pulmonary vein isolation. J. Cardiovasc. Electrophysiol.31, 2499–2508. https://doi.org/10.1111/jce.14649 (2020).
doi: 10.1111/jce.14649
Lee, A. C. et al. A Randomized Trial of High vs Standard Power Radiofrequency Ablation for pulmonary vein isolation: SHORT-AF. JACC Clin. Electrophysiol.9, 1038–1047. https://doi.org/10.1016/j.jacep.2022.12.020 (2023).
doi: 10.1016/j.jacep.2022.12.020
Ravi, V. et al. High-power short duration vs. conventional radiofrequency ablation of atrial fibrillation: a systematic review and meta-analysis. Europace. 23, 710–721. https://doi.org/10.1093/europace/euaa327 (2021).
doi: 10.1093/europace/euaa327
Bhaskaran, A. et al. Five seconds of 50–60 W radio frequency atrial ablations were transmural and safe: an in vitro mechanistic assessment and force-controlled in vivo validation. Europace. 19, 874–880. https://doi.org/10.1093/europace/euw077 (2017).
doi: 10.1093/europace/euw077
Bourier, F. et al. High-power short-duration versus standard radiofrequency ablation: insights on lesion metrics. J. Cardiovasc. Electrophysiol.29, 1570–1575. https://doi.org/10.1111/jce.13724 (2018).
doi: 10.1111/jce.13724
Di Biase, L., Diaz, J. C., Zhang, X. D. & Romero, J. Pulsed field catheter ablation in atrial fibrillation. Trends Cardiovasc. Med.32, 378–387. https://doi.org/10.1016/j.tcm.2021.07.006 (2022).
doi: 10.1016/j.tcm.2021.07.006
Shtembari, J. et al. Efficacy and Safety of Pulsed Field Ablation in Atrial Fibrillation: A Systematic Review. J. Clin. Med.12, https://doi.org/10.3390/jcm12020719 (2023).
De Asmundis, C. & Chierchia, G. B. Pulsed field ablation: have we finally found the holy grail?. Europace23, 1691–1692. https://doi.org/10.1093/europace/euab169 (2021).
doi: 10.1093/europace/euab169
Chinitz, J. S., Michaud, G. F. & Stephenson, K. Impedance-guided Radiofrequency ablation: using impedance to improve ablation outcomes. J. Innov. Card Rhythm Manag. 8, 2868–2873. https://doi.org/10.19102/icrm.2017.081003 (2017).
doi: 10.19102/icrm.2017.081003
Avitall, B., Mughal, K., Hare, J., Helms, R. & Krum, D. The effects of electrode-tissue contact on radiofrequency lesion generation. Pace. 20, 2899–2910. https://doi.org/10.1111/j.1540-8159.1997.tb05458.x (1997).
doi: 10.1111/j.1540-8159.1997.tb05458.x
Ikeda, A. et al. Relationship between Catheter Contact Force and Radiofrequency Lesion size and incidence of Steam Pop in the beating Canine Heart Electrogram Amplitude, Impedance, and Electrode Temperature are poor predictors of Electrode-Tissue Contact Force and lesion size. Circulation-Arrhythmia Electrophysiol.7, 1174–1180. https://doi.org/10.1161/Circep.113.001094 (2014).
doi: 10.1161/Circep.113.001094
Chinitz, J. S. et al. Sites with small impedance decrease during catheter ablation for Atrial Fibrillation are Associated with Recovery of Pulmonary Vein Conduction. J. Cardiovasc. Electrophysiol.27, 1390–1398. https://doi.org/10.1111/jce.13095 (2016).
doi: 10.1111/jce.13095
Tungjitkusolmun, S. et al. Guidelines for predicting lesion size at common endocardial locations during radio-frequency ablation. Ieee T Bio-Med Eng.48, 194–201. https://doi.org/10.1109/10.909640 (2001).
doi: 10.1109/10.909640
Petersen, H. H., Chen, X., Pietersen, A., Svendsen, J. H. & Haunso, S. Lesion dimensions during temperature-controlled radiofrequency catheter ablation of left ventricular porcine myocardium - impact of ablation site, electrode size, and convective cooling. Circulation. 99, 319–325. https://doi.org/10.1161/01.Cir.99.2.319 (1999).
doi: 10.1161/01.Cir.99.2.319
Petersen, H. H., Chen, X., Pietersen, A., Svendsen, J. H. & Haunso, S. Lesion size in relation to ablation site during radiofrequency ablation. Pace. 21, 322–326. https://doi.org/10.1111/j.1540-8159.1998.tb01114.x (1998).
doi: 10.1111/j.1540-8159.1998.tb01114.x
Lacko, C. S. et al. Development of a clinically relevant ex vivo model of cardiac ablation for testing of ablation catheters. J. Cardiovasc. Electr.34, 682–692. https://doi.org/10.1111/jce.15768 (2023).
doi: 10.1111/jce.15768
Münkler, P. et al. Local impedance guides catheter ablation in patients with ventricular tachycardia. J. Cardiovasc. Electr.31, 61–69. https://doi.org/10.1111/jce.14269 (2020).
doi: 10.1111/jce.14269
Jacobson, J. T. et al. Tissue-specific variability in human epicardial impedance. J. Cardiovasc. Electrophysiol.22, 436–439. https://doi.org/10.1111/j.1540-8167.2010.01929.x (2011).
doi: 10.1111/j.1540-8167.2010.01929.x
Lu, L. et al. Cardiac fibrosis in the ageing heart: contributors and mechanisms. Clin. Exp. Pharmacol. Physiol.44, 55–63. https://doi.org/10.1111/1440-1681.12753 (2017).
doi: 10.1111/1440-1681.12753
Nath, L. C. et al. Histological evaluation of cardiac remodelling in equine athletes. Sci. Rep.14, 16709. https://doi.org/10.1038/s41598-024-67621-6 (2024).
doi: 10.1038/s41598-024-67621-6
Qu, L. J. et al. Effect of Baseline Impedance in Radiofrequency Delivery on Lesion Characteristics and the Relationship Between Impedance and Steam Pops. Front. Cardiovasc. Med. https://doi.org/10.3389/fcvm.2022.872961 (2022).
doi: 10.3389/fcvm.2022.872961
Bourier, F. et al. RF electrode-tissue coverage significantly influences steam pop incidence and lesion size. J. Cardiovasc. Electrophysiol.32, 1594–1599. https://doi.org/10.1111/jce.15063 (2021).
doi: 10.1111/jce.15063
Olson, M. D. et al. Effect of catheter movement and contact during application of radiofrequency energy on ablation lesion characteristics. J. Interv Card Electr.38, 123–129. https://doi.org/10.1007/s10840-013-9824-4 (2013).
doi: 10.1007/s10840-013-9824-4