P5700Comparison of efficacy and safety of ventricular lesions formation by unipolar and bipolar radiofrequency ablation on an animal model

P5700Comparison of efficacy and safety of ventricular lesions formation by unipolar and bipolar radiofrequency ablation on an animal model

Abstract Aims Despite all this technical progress, VT recurrence after unipolar ablation remains relatively high (12–47%). Bipolar ablation has been proposed as an appealing solution, which may overcome boundaries associated with unipolar ablation settings. Therefore, we have proposed an animal stud...

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Veröffentlicht in:European heart journal 2019-10, Vol.40 (Supplement_1)
Hauptverfasser: Soucek, F, Caluori, C, Lehar, F, Jez, J, Pesl, M, Wolf, J, Wojtaszczyk, A, Belaskova, S, Starek, Z
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container_end_page
container_issue Supplement_1
container_start_page
container_title European heart journal
container_volume 40
creator Soucek, F
Caluori, C
Lehar, F
Jez, J
Pesl, M
Wolf, J
Wojtaszczyk, A
Belaskova, S
Starek, Z
description Abstract Aims Despite all this technical progress, VT recurrence after unipolar ablation remains relatively high (12–47%). Bipolar ablation has been proposed as an appealing solution, which may overcome boundaries associated with unipolar ablation settings. Therefore, we have proposed an animal study to compare bipolar (BPA) vs sequential unipolar ablation (UPA) using a contact-force sensing technology on both catheters. Methods 20 large white female pigs (6 months-old, 60–70kg) underwent multiple RF ablations (30W, 60s, 30ml/min irrigation) on ventricular myocardium, from epicardial and endocardial sides. After the procedure, the animal underwent euthanasia, cardioplegia and organ excision. The hearts were fixed and underwent high-resolution cardiac MRI. Each lesion was characterized primarily in terms of volume, depth, width and transmurality. Results We evaluated 35 lesions across the intraventricular septum. No difference in volume, linear dimensions and impedance drop was observed in this area, between the two ablation settings. However, for the generation of unipolar lesions, twice the ablation time was needed. Transmurality of the lesions shows a trend in favor of BPA. We then analyzed 73 lesions from the endocardial side and 34 from the epicardial one of the ventricular free walls. Lesion transmurality was found remarkably improved in BPA (p=0.030, OR 23.73 [4.71,11.96]). Ventricular BPA lesions were significantly deeper on the epicardial side (p
doi_str_mv 10.1093/eurheartj/ehz746.0642
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Bipolar ablation has been proposed as an appealing solution, which may overcome boundaries associated with unipolar ablation settings. Therefore, we have proposed an animal study to compare bipolar (BPA) vs sequential unipolar ablation (UPA) using a contact-force sensing technology on both catheters. Methods 20 large white female pigs (6 months-old, 60–70kg) underwent multiple RF ablations (30W, 60s, 30ml/min irrigation) on ventricular myocardium, from epicardial and endocardial sides. After the procedure, the animal underwent euthanasia, cardioplegia and organ excision. The hearts were fixed and underwent high-resolution cardiac MRI. Each lesion was characterized primarily in terms of volume, depth, width and transmurality. Results We evaluated 35 lesions across the intraventricular septum. No difference in volume, linear dimensions and impedance drop was observed in this area, between the two ablation settings. However, for the generation of unipolar lesions, twice the ablation time was needed. Transmurality of the lesions shows a trend in favor of BPA. We then analyzed 73 lesions from the endocardial side and 34 from the epicardial one of the ventricular free walls. Lesion transmurality was found remarkably improved in BPA (p=0.030, OR 23.73 [4.71,11.96]). Ventricular BPA lesions were significantly deeper on the epicardial side (p&lt;0.0001) Conclusion BPA is more likely to create transmural lesions in the ventricle, when compared to UPA. Half the time is needed for the creation of comparably deep and large lesions. BPA is specifically more effective in creating epicardial lesions.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz746.0642</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids></links><search><creatorcontrib>Soucek, F</creatorcontrib><creatorcontrib>Caluori, C</creatorcontrib><creatorcontrib>Lehar, F</creatorcontrib><creatorcontrib>Jez, J</creatorcontrib><creatorcontrib>Pesl, M</creatorcontrib><creatorcontrib>Wolf, J</creatorcontrib><creatorcontrib>Wojtaszczyk, A</creatorcontrib><creatorcontrib>Belaskova, S</creatorcontrib><creatorcontrib>Starek, Z</creatorcontrib><title>P5700Comparison of efficacy and safety of ventricular lesions formation by unipolar and bipolar radiofrequency ablation on an animal model</title><title>European heart journal</title><description>Abstract Aims Despite all this technical progress, VT recurrence after unipolar ablation remains relatively high (12–47%). Bipolar ablation has been proposed as an appealing solution, which may overcome boundaries associated with unipolar ablation settings. Therefore, we have proposed an animal study to compare bipolar (BPA) vs sequential unipolar ablation (UPA) using a contact-force sensing technology on both catheters. Methods 20 large white female pigs (6 months-old, 60–70kg) underwent multiple RF ablations (30W, 60s, 30ml/min irrigation) on ventricular myocardium, from epicardial and endocardial sides. After the procedure, the animal underwent euthanasia, cardioplegia and organ excision. The hearts were fixed and underwent high-resolution cardiac MRI. Each lesion was characterized primarily in terms of volume, depth, width and transmurality. Results We evaluated 35 lesions across the intraventricular septum. No difference in volume, linear dimensions and impedance drop was observed in this area, between the two ablation settings. However, for the generation of unipolar lesions, twice the ablation time was needed. Transmurality of the lesions shows a trend in favor of BPA. We then analyzed 73 lesions from the endocardial side and 34 from the epicardial one of the ventricular free walls. Lesion transmurality was found remarkably improved in BPA (p=0.030, OR 23.73 [4.71,11.96]). Ventricular BPA lesions were significantly deeper on the epicardial side (p&lt;0.0001) Conclusion BPA is more likely to create transmural lesions in the ventricle, when compared to UPA. Half the time is needed for the creation of comparably deep and large lesions. 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Bipolar ablation has been proposed as an appealing solution, which may overcome boundaries associated with unipolar ablation settings. Therefore, we have proposed an animal study to compare bipolar (BPA) vs sequential unipolar ablation (UPA) using a contact-force sensing technology on both catheters. Methods 20 large white female pigs (6 months-old, 60–70kg) underwent multiple RF ablations (30W, 60s, 30ml/min irrigation) on ventricular myocardium, from epicardial and endocardial sides. After the procedure, the animal underwent euthanasia, cardioplegia and organ excision. The hearts were fixed and underwent high-resolution cardiac MRI. Each lesion was characterized primarily in terms of volume, depth, width and transmurality. Results We evaluated 35 lesions across the intraventricular septum. No difference in volume, linear dimensions and impedance drop was observed in this area, between the two ablation settings. However, for the generation of unipolar lesions, twice the ablation time was needed. Transmurality of the lesions shows a trend in favor of BPA. We then analyzed 73 lesions from the endocardial side and 34 from the epicardial one of the ventricular free walls. Lesion transmurality was found remarkably improved in BPA (p=0.030, OR 23.73 [4.71,11.96]). Ventricular BPA lesions were significantly deeper on the epicardial side (p&lt;0.0001) Conclusion BPA is more likely to create transmural lesions in the ventricle, when compared to UPA. Half the time is needed for the creation of comparably deep and large lesions. BPA is specifically more effective in creating epicardial lesions.</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz746.0642</doi></addata></record>
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title P5700Comparison of efficacy and safety of ventricular lesions formation by unipolar and bipolar radiofrequency ablation on an animal model
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