Prediction of radiofrequency ablation lesion formation using a novel temperature sensing technology incorporated in a force sensing catheter

详细信息    查看全文

• 作者：Guy Rozen ; MD ; MHA^* ; Leon Ptaszek ; MD^* ; Israel Zilberman ; DVM^&dagger ; ; Kevin Cordaro ; BS^* ; E. Kevin Heist ; MD ; PhD ; FHRS^* ; Christopher Beeckler ; BS^&dagger ; ; Andres Altmann ; BSc^&dagger ; ; Zhang Ying ; MD^* ; Zhenjiang Liu ; MD^* ; Jeremy N. Ruskin ; MD ; FHRS^* ; Assaf Govari ; PhD^&dagger ; ; Moussa Mansour ; MD ; FHRS^* ; ^{mmansour@mgh.harvard.edu}
• 关键词：Radiofrequency ; Catheter ablation ; Lesion assessment ; Contact force sensing ; Catheter orientation ; Thermocouple
• 刊名：Heart Rhythm
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：14
• 期：2
• 页码：248-254
• 全文大小：907 K
• 卷排序：14

文摘

Real-time radiofrequency (RF) ablation lesion assessment is a major unmet need in cardiac electrophysiology.ObjectiveThe purpose of this study was to assess whether improved temperature measurement using a novel thermocoupling (TC) technology combined with information derived from impedance change, contact force (CF) sensing, and catheter orientation allows accurate real-time prediction of ablation lesion formation.MethodsRF ablation lesions were delivered in the ventricles of 15 swine using a novel externally irrigated-tip catheter containing 6 miniature TC sensors in addition to force sensing technology. Ablation duration, power, irrigation rate, impedance drop, CF, and temperature from each sensor were recorded. The catheter “orientation factor” was calculated using measurements from the different TC sensors. Information derived from all the sources was included in a mathematical model developed to predict lesion depth and validated against histologic measurements.ResultsA total of 143 ablation lesions were delivered to the left ventricle (n = 74) and right ventricle (n = 69). Mean CF applied during the ablations was 14.34 ± 3.55g, and mean impedance drop achieved during the ablations was 17.5 ± 6.41 Ω. Mean difference between predicted and measured ablation lesion depth was 0.72 ± 0.56 mm. In the majority of lesions (91.6%), the difference between estimated and measured depth was ≤1.5 mm.ConclusionAccurate real-time prediction of RF lesion depth is feasible using a novel ablation catheter-based system in conjunction with a mathematical prediction model, combining elaborate temperature measurements with information derived from catheter orientation, CF sensing, impedance change, and additional ablation parameters.