Leshem Eran, Tschabrunn Cory M, Contreras-Valdes Fernando M, Zilberman Israel, Anter Elad
Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Biosense Webster, Research and Development, Haifa, Israel.
Heart Rhythm. 2017 Aug;14(8):1234-1240. doi: 10.1016/j.hrthm.2017.04.035. Epub 2017 Apr 26.
An in vivo animal thigh model is the standard technique for evaluation of ablation catheter technologies, including efficacy and safety of ablation. However, the biophysics of ablation in a thigh model may not be similar to a beating heart.
The purpose of this study was to compare efficacy and safety of ablation between a thigh preparation model and a beating heart.
In 7 swine, radiofrequency ablation using a 3.5-mm open irrigated catheter (ThermoCool Smart Touch) was performed sequentially in a thigh muscle and in vivo beating ventricles. Ablation was performed at low (30 W for 40 s) and high (40 W for 60 s) energy settings and at similar contact force. Ablation lesions were scanned in high resolution and measured using electronic calipers.
A total of 152 radiofrequency ablation lesions were measured (86 thigh and 66 heart). At low energy, lesion width was greater in the thigh model (12.19 ± 1.8 mm vs 8.99 ± 2.1 mm; P <.001), whereas lesion depth was similar between the thigh and heart (5.71 ± 0.8 mm vs 5.95 ± 1.3 mm, respectively; P = .18). The planar cross-sectional lesion area was greater in the thigh model (thigh 54.8 ± 10.8 mm vs heart 43.1 ± 16.1 mm; P <.001). At the high-energy setting, lesion depth, width, and area were all greater in the thigh model (thigh 91.5 ± 16.8 mm vs heart 56.0 ± 15.5 mm; P <.001). The incidence of steam pop and char formation was similar between the models.
The thigh preparation model is a reasonable technique for evaluation of ablation catheter technology; however it often results in overestimation of lesion size, especially at higher energy settings.
体内动物大腿模型是评估消融导管技术（包括消融的有效性和安全性）的标准技术。然而，大腿模型中的消融生物物理学可能与跳动的心脏不同。
本研究的目的是比较大腿制备模型和跳动心脏之间消融的有效性和安全性。
在7头猪中，使用3.5毫米开放式灌注导管（ThermoCool Smart Touch）依次在大腿肌肉和体内跳动的心室中进行射频消融。在低能量（30瓦，持续40秒）和高能量（40瓦，持续60秒）设置下以及相似的接触力下进行消融。以高分辨率扫描消融灶并使用电子卡尺测量。
共测量了152个射频消融灶（86个大腿灶和66个心脏灶）。在低能量时，大腿模型中的病灶宽度更大（12.19±1.8毫米对8.99±2.1毫米；P<.001），而大腿和心脏之间的病灶深度相似（分别为5.71±0.8毫米对5.95±1.3毫米；P=.18）。大腿模型中的平面横截面病灶面积更大（大腿54.8±10.8毫米对心脏43.1±16.1毫米；P<.001）。在高能量设置下，大腿模型中的病灶深度、宽度和面积均更大（大腿91.5±16.8毫米对心脏56.0±15.5毫米；P<.001）。模型之间蒸汽泡和焦痂形成的发生率相似。
大腿制备模型是评估消融导管技术的一种合理技术；然而，它常常导致对病灶大小的高估，尤其是在较高能量设置下。
