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<p>High-power, short-duration (HP-SD) ablation is a well-established radiofrequency (RF) ablation protocol in cardiac electrophysiology. Recently, very high-power, short-duration (vHP-SD) ablation has emerged as an alternative. This study compares lesion metrics between vHP-SD and HP-SD ablation protocols using the latest irrigated RF catheter with temperature-based power regulation, considering the impact of contact force (CF). RF ablations were performed in a porcine ex vivo model using myocardial preparations in a circulating saline bath. Three protocols were applied: vHP-SD (90&#xa0;W for 4s), HP-SD-4 (50&#xa0;W for 4s) and HP-SD-15 (50&#xa0;W for 15s). A total of 360 lesions in 12 hearts were analyzed (vHP-SD: 120; HP-SD-4: 120, HP-SD-15: 120). The HP-SD-4 protocol produced the lowest mean lesion depth (2.42 ± 0.61&#xa0;mm vs. 3.16 ± 0.41&#xa0;mm vs. 4.49 ± 0.66&#xa0;mm, <i>p</i> &lt; 0.001), mean maximum lesion diameter (6.02 ± 1.00&#xa0;mm vs. 7.34 ± 0.92&#xa0;mm vs. 9.13 ± 1.59&#xa0;mm), and mean lesion volume (52.0 ± 22.5&#xa0;mm³ vs. 96.4 ± 28.8&#xa0;mm³ vs. 211.4 ± 95.3&#xa0;mm³, <i>p</i> &lt; 0.001), followed by the vHP-SD protocol. In contrast, the HP-SD-15 protocol resulted in the highest values across all three parameters. Lesion depth, maximum lesion diameter, and lesion volume increased significantly with higher contact force (<i>p</i> &lt; 0.001, <i>p</i> = 0.002, and <i>p</i> = 0.003, respectively). However, the absolute changes in these lesion dimensions were relatively small compared to those observed with power-controlled RF catheters, likely due to the effect of temperature-based power regulation.</p>

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Comparative lesion metrics analysis of very high power and high power short duration radiofrequency ablation in a Porcine ex vivo model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月20日

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  • Yannick Teumer,
  • Henrik Ziemssen,
  • Lyuboslav Katov,
  • Carlo Bothner,
  • Benjamin Mayer,
  • Wolfgang Rottbauer,
  • Karolina Weinmann-Emhardt

摘要

High-power, short-duration (HP-SD) ablation is a well-established radiofrequency (RF) ablation protocol in cardiac electrophysiology. Recently, very high-power, short-duration (vHP-SD) ablation has emerged as an alternative. This study compares lesion metrics between vHP-SD and HP-SD ablation protocols using the latest irrigated RF catheter with temperature-based power regulation, considering the impact of contact force (CF). RF ablations were performed in a porcine ex vivo model using myocardial preparations in a circulating saline bath. Three protocols were applied: vHP-SD (90 W for 4s), HP-SD-4 (50 W for 4s) and HP-SD-15 (50 W for 15s). A total of 360 lesions in 12 hearts were analyzed (vHP-SD: 120; HP-SD-4: 120, HP-SD-15: 120). The HP-SD-4 protocol produced the lowest mean lesion depth (2.42 ± 0.61 mm vs. 3.16 ± 0.41 mm vs. 4.49 ± 0.66 mm, p < 0.001), mean maximum lesion diameter (6.02 ± 1.00 mm vs. 7.34 ± 0.92 mm vs. 9.13 ± 1.59 mm), and mean lesion volume (52.0 ± 22.5 mm³ vs. 96.4 ± 28.8 mm³ vs. 211.4 ± 95.3 mm³, p < 0.001), followed by the vHP-SD protocol. In contrast, the HP-SD-15 protocol resulted in the highest values across all three parameters. Lesion depth, maximum lesion diameter, and lesion volume increased significantly with higher contact force (p < 0.001, p = 0.002, and p = 0.003, respectively). However, the absolute changes in these lesion dimensions were relatively small compared to those observed with power-controlled RF catheters, likely due to the effect of temperature-based power regulation.