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导管接触角影响射频导管消融期间的局部阻抗下降:来自一项使用两种不同LI感应导管的猪实验研究的见解。

Catheter contact angle influences local impedance drop during radiofrequency catheter ablation: Insight from a porcine experimental study with 2 different LI-sensing catheters.

作者信息

Matsuura Gen, Fukaya Hidehira, Ogawa Emiyu, Kawakami Sota, Mori Hitoshi, Saito Daiki, Sato Tetsuro, Nakamura Hironori, Ishizue Naruya, Oikawa Jun, Kishihara Jun, Niwano Shinichi, Ako Junya

机构信息

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

Department of Medical Engineering and Technology, Kitasato University School of Allied Health Sciences, Sagamihara, Kanagawa, Japan.

出版信息

J Cardiovasc Electrophysiol. 2022 Mar;33(3):380-388. doi: 10.1111/jce.15356. Epub 2022 Jan 22.

Abstract

BACKGROUND

Local impedance (LI) can indirectly measure catheter contact and tissue temperature during radiofrequency catheter ablation (RFCA). However, data on the effects of catheter contact angle on LI parameters are scarce. This study aimed to evaluate the influence of catheter contact angle on LI changes and lesion size with two different LI-sensing catheters in a porcine experimental study.

METHODS

Lesions were created by the INTELLANAV MiFi™ OI (MiFi) and the INTELLANAV STABLEPOINT™ (STABLEPOINT). RFCA was performed with 30 W and a duration of 30 s. The contact force (CF) (0, 5, 10, 20, and 30 g) and catheter contact angle (30°, 45°, and 90°) were changed in each set (n = 8 each). The LI rise, LI drop, and lesion size were evaluated.

RESULTS

The LI rise increased as CF increased. There was no angular dependence with the LI rise under all CFs in the MiFi. On the other hand, the LI rise at 90° was lower than at 30° under 5 and 10 g of CF in STABLEPOINT. The LI drop increased as CF increased. Regarding the difference in catheter contact angles, the LI drop at 90° was lower than that at 30° for both catheters. The maximum lesion widths and surface widths were smaller at 90° than at 30°, whereas there were no differences in lesion depths.

CONCLUSION

The LI drop and lesion widths at 90° were significantly smaller than those at 30°, although the lesion depths were not different among the 3 angles for the MiFi and STABLEPOINT.

摘要

背景

局部阻抗(LI)可在射频导管消融(RFCA)期间间接测量导管接触情况和组织温度。然而,关于导管接触角度对LI参数影响的数据却很少。本研究旨在通过一项猪实验研究,评估两种不同的LI传感导管的导管接触角度对LI变化和病变大小的影响。

方法

使用INTELLANAV MiFi™ OI(MiFi)和INTELLANAV STABLEPOINT™(STABLEPOINT)创建病变。以30W功率和30秒持续时间进行RFCA。每组中改变接触力(CF)(0、5、10、20和30g)和导管接触角度(30°、45°和90°)(每组n = 8)。评估LI上升、LI下降和病变大小。

结果

LI上升随CF增加而增加。在MiFi中,所有CF下LI上升均无角度依赖性。另一方面,在STABLEPOINT中,5g和10g CF时,90°的LI上升低于30°时的LI上升。LI下降随CF增加而增加。关于导管接触角度的差异,两种导管90°时的LI下降均低于30°时的LI下降。90°时的最大病变宽度和表面宽度小于30°时的,而病变深度无差异。

结论

尽管MiFi和STABLEPOINT的3个角度之间病变深度无差异,但90°时的LI下降和病变宽度明显小于30°时的。

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