Feasibility of rapid linear-endocardial and epicardial ventricular ablation using an irrigated multipolar radiofrequency ablation catheter

Babak Nazer, Tomos E. Walters, Srikant Duggirala, Edward P. Gerstenfeld

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background - A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern. Methods and Results - We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3.5 cm with an irrigated radiofrequency catheter. The linear catheter contained 7 irrigated electrodes spaced over 3.5 cm and could deliver ≤25 W to each electrode. Linear ablation required significantly less radiofrequency time than focal ablation (56±11 versus 497±110 seconds; P<0.0001). At gross pathology, linear (n=18) epicardial lines were longer than focal (n=8) epicardial lines (3.3±0.7 versus 2.1±0.9 cm; P<0.0005), with greater volume (3.8±2.9 versus 1.5±1.6 cm3; P=0.002). There was no difference between linear (n=22) and focal (n=7) endocardial line length or volume. Gaps (length 2.8±0.9 mm) were present in 53% of focal lines and 0% of linear ablation lines. No perforations, steam pops, or thrombus were noted. Conclusions - Compared with sequential focal radiofrequency ablation in a linear pattern, an irrigated multipolar linear ablation catheter safely delivers contiguous endocardial or epicardial lesions without gaps in a single ablation. This catheter shows promise for decreasing ventricular tachycardia ablation procedure time and improving outcome.

Original languageEnglish (US)
Article numbere004760
JournalCirculation: Arrhythmia and Electrophysiology
Volume10
Issue number3
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

Fingerprint

Catheter Ablation
Catheters
Ventricular Tachycardia
Electrodes
Steam
Cicatrix
Thrombosis
Swine
Pathology

Keywords

  • catheter ablation
  • electrodes
  • endocardium
  • tachycardia
  • tachycardia
  • ventricular

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Feasibility of rapid linear-endocardial and epicardial ventricular ablation using an irrigated multipolar radiofrequency ablation catheter. / Nazer, Babak; Walters, Tomos E.; Duggirala, Srikant; Gerstenfeld, Edward P.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 10, No. 3, e004760, 01.03.2017.

Research output: Contribution to journalArticle

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abstract = "Background - A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern. Methods and Results - We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3.5 cm with an irrigated radiofrequency catheter. The linear catheter contained 7 irrigated electrodes spaced over 3.5 cm and could deliver ≤25 W to each electrode. Linear ablation required significantly less radiofrequency time than focal ablation (56±11 versus 497±110 seconds; P<0.0001). At gross pathology, linear (n=18) epicardial lines were longer than focal (n=8) epicardial lines (3.3±0.7 versus 2.1±0.9 cm; P<0.0005), with greater volume (3.8±2.9 versus 1.5±1.6 cm3; P=0.002). There was no difference between linear (n=22) and focal (n=7) endocardial line length or volume. Gaps (length 2.8±0.9 mm) were present in 53{\%} of focal lines and 0{\%} of linear ablation lines. No perforations, steam pops, or thrombus were noted. Conclusions - Compared with sequential focal radiofrequency ablation in a linear pattern, an irrigated multipolar linear ablation catheter safely delivers contiguous endocardial or epicardial lesions without gaps in a single ablation. This catheter shows promise for decreasing ventricular tachycardia ablation procedure time and improving outcome.",
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AU - Gerstenfeld, Edward P.

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N2 - Background - A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern. Methods and Results - We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3.5 cm with an irrigated radiofrequency catheter. The linear catheter contained 7 irrigated electrodes spaced over 3.5 cm and could deliver ≤25 W to each electrode. Linear ablation required significantly less radiofrequency time than focal ablation (56±11 versus 497±110 seconds; P<0.0001). At gross pathology, linear (n=18) epicardial lines were longer than focal (n=8) epicardial lines (3.3±0.7 versus 2.1±0.9 cm; P<0.0005), with greater volume (3.8±2.9 versus 1.5±1.6 cm3; P=0.002). There was no difference between linear (n=22) and focal (n=7) endocardial line length or volume. Gaps (length 2.8±0.9 mm) were present in 53% of focal lines and 0% of linear ablation lines. No perforations, steam pops, or thrombus were noted. Conclusions - Compared with sequential focal radiofrequency ablation in a linear pattern, an irrigated multipolar linear ablation catheter safely delivers contiguous endocardial or epicardial lesions without gaps in a single ablation. This catheter shows promise for decreasing ventricular tachycardia ablation procedure time and improving outcome.

AB - Background - A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern. Methods and Results - We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3.5 cm with an irrigated radiofrequency catheter. The linear catheter contained 7 irrigated electrodes spaced over 3.5 cm and could deliver ≤25 W to each electrode. Linear ablation required significantly less radiofrequency time than focal ablation (56±11 versus 497±110 seconds; P<0.0001). At gross pathology, linear (n=18) epicardial lines were longer than focal (n=8) epicardial lines (3.3±0.7 versus 2.1±0.9 cm; P<0.0005), with greater volume (3.8±2.9 versus 1.5±1.6 cm3; P=0.002). There was no difference between linear (n=22) and focal (n=7) endocardial line length or volume. Gaps (length 2.8±0.9 mm) were present in 53% of focal lines and 0% of linear ablation lines. No perforations, steam pops, or thrombus were noted. Conclusions - Compared with sequential focal radiofrequency ablation in a linear pattern, an irrigated multipolar linear ablation catheter safely delivers contiguous endocardial or epicardial lesions without gaps in a single ablation. This catheter shows promise for decreasing ventricular tachycardia ablation procedure time and improving outcome.

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