Cardiothoracic Department, Maastricht University Hospital, Maastricht, The Netherlands.
Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands.
J Interv Card Electrophysiol. 2021 Sep;61(3):567-575. doi: 10.1007/s10840-020-00852-5. Epub 2020 Aug 24.
To make an in vitro evaluation of the lesion size and depth produced in two different sets of radio frequency energy bipolar delivery: simultaneous biparietal bipolar (SBB) and simultaneous uniparietal bipolar (SUB).
Two separate prototypes have been built for our purpose: one to be used in SBB mode and the other to be used SUB mode. Forty left atrium samples were taken from the hearts of freshly slaughtered pigs. They were ablated into a simulator ABLABOX, where blood flow, temperature, and contact force were controlled. After being sliced into a cryotome, the samples were digitalized by a flatbed scanner, and the images were analyzed by a computer morphometric software.
Transmural lesions were achieved in 18/20 samples (90%) in SBB, while SUB showed transmurality in 9/20 samples (45%). Overall maximum diameter (D) resulted larger in SUB than in SBB (2.43 ± 0.30 mm, 1.62 ± 0.14 mm, respectively; p < 0.05): Moreover, maximum epicardial and endocardial diameters (D and D, respectively) were wider in SUB group than SBB group (2.28 ± 0.30 mm, 2.26 ± 0.40 and 1.60 ± 0.14 mm, 1.59 ± 0.15 mm, respectively; p < 0.05). We observed the same tendency in lesion depth: The total area and volume (A and V) were broader in SUB group than in SBB one (581.01 ± 65.38 mm/mm, 58.10 ± 6.53 mm/mm and 521.97 ± 73.05 mm/mm, 52.19 ± 7.30 mm/mm. respectively; p < 0.05).
In contrast with the smaller lesion sizes, the biparietal bipolar group showed a higher transmurality rate. These findings may suggest a better drive of the energy flow when compared with SUB lesions.
对两种不同射频能量双极传递系统产生的病变大小和深度进行体外评估：同时双侧壁（SBB）和同时单侧双极（SUB）。
我们为此目的分别构建了两个原型：一个用于 SBB 模式，另一个用于 SUB 模式。从刚宰杀的猪的心脏中取出 40 个左心房样本。将它们在模拟器 ABLABOX 中消融，在那里控制血流、温度和接触力。样本被切成冷冻切片后，由平板扫描仪数字化，并由计算机形态计量软件进行分析。
在 SBB 中，18/20 个样本（90%）实现了透壁性病变，而 SUB 则在 9/20 个样本中显示了透壁性（45%）。总体最大直径（D）在 SUB 中大于 SBB（2.43±0.30 mm，1.62±0.14 mm，分别；p<0.05）：此外，SUB 组的最大心外膜和心内膜直径（D 和 D，分别）大于 SBB 组（2.28±0.30 mm，2.26±0.40 和 1.60±0.14 mm，1.59±0.15 mm，分别；p<0.05）。我们在病变深度上也观察到了同样的趋势：SUB 组的总面积和体积（A 和 V）大于 SBB 组（581.01±65.38 mm/mm，58.10±6.53 mm/mm 和 521.97±73.05 mm/mm，52.19±7.30 mm/mm，分别；p<0.05）。
与较小的病变大小相比，双侧壁双极组显示出更高的透壁率。这些发现可能表明与 SUB 病变相比，能量流的驱动更好。
