Document Detail


Optimal Contact Forces to Minimize Cardiac Perforations Before, During and/or Following Radiofrequency or Cryo- Ablations.
MedLine Citation:
PMID:  25461502     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Catheter perforations remain a major clinical concern during ablation procedures for treating atrial arrhythmias, and may lead to life-threatening cardiac tamponade. Radiofrequency (RF) ablation alters the biomechanical properties of cardiac tissue, ultimately allowing for perforation to occur more readily. Studies on the effects cryoablation has on perforation force, as well as defining the perforation force of human tissue are limited.
OBJECTIVE: Investigate the required force to elicit perforation of cardiac atrial tissue following or during ablation procedures.
METHODS: Effects of RF and cryo- ablation on catheter perforation forces for both swine (n=83 animals, 530 treatments) and human (n=8 specimens, 136 treatments) cardiac tissue were investigated.
RESULTS: Overall average forces resulting in perforation of healthy unablated tissue were 406±170g for swine and 591±240g for humans. Post-RF ablation applications considerably reduced these forces to 246±118g for swine and 362±185g for humans (p<0.001); treatments with cryoablation did not significantly alter forces required to induce perforations. Decreasing catheter sizes resulted in a reduction in forces required to perforate the atrial wall (p<0.001). Catheter perforations occurred over an array of contact forces with a minimum of 38g being observed.
CONCLUSION: We consider that the swine model likely underestimates the required perforation forces relative to those of human tissues. We provided novel insights related to the comparative effects of RF and cryo- ablations on the potential for inducing undesired punctures, with RF ablation reducing perforation force significantly. These data are insightful for physicians performing ablation procedures as well as medical device designers.
Authors:
Stephen G Quallich; Michael Van Heel; Paul A Iaizzo
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-24
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
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