Department of Surgery and the Institute for Engineering in Medicine, University of Minnesota, 420 Delaware St. SE, B172 Mayo, MMC 195, Minneapolis, MN, 55455, USA.
Department of Biomedical Engineering and Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
J Cardiovasc Transl Res. 2019 Jun;12(3):250-256. doi: 10.1007/s12265-018-9844-7. Epub 2018 Nov 14.
Radiofrequency, a common ablation modality, is used clinically to terminate cardiac arrhythmias. With excessive heating, complications sometimes occur when the applied energy generates steam pops, which cause release of energy in the form of tissue and/or air emboli. In this study, we investigated numerous parameters potentially associated with intracardiac steam pops including (1) wattage, (2) catheter tip temperature, (3) catheter irrigation, (4) anatomic site, and (5) repeat ablations at a given site. Using unique Visible Heart® methodologies in reanimated swine hearts, we visualized 539 ablations; steam pops developed in 140 of these ablations. The incidence of steam pops significantly increased for both nonirrigated and irrigated ablations at 40 W (p < 0.005), and for nonirrigated ablations with catheter contact angles perpendicular to the tissue or that encompassed larger surface areas (p < 0.05). To minimize the incidence of steam pops, clinicians performing radiofrequency ablations must consider catheter parameters.
射频，一种常见的消融方式，临床上用于终止心律失常。当应用的能量产生蒸汽爆裂时，过度加热会导致并发症，这些蒸汽爆裂会以组织和/或空气栓塞的形式释放能量。在这项研究中，我们研究了许多可能与心内蒸汽爆裂相关的参数，包括（1）瓦数，（2）导管尖端温度，（3）导管冲洗，（4）解剖部位，以及（5）在特定部位的重复消融。使用在复活猪心脏中独特的可视心脏®方法，我们可视化了 539 次消融；在这些消融中，140 次出现了蒸汽爆裂。非灌洗和灌洗消融在 40 瓦时蒸汽爆裂的发生率显著增加（p<0.005），并且对于与组织垂直的导管接触角或包含更大表面积的非灌洗消融也是如此（p<0.05）。为了最大限度地减少蒸汽爆裂的发生率，进行射频消融的临床医生必须考虑导管参数。
