Department of Medicine, Section of Electrophysiology, Rush University Medical Center, 1717 W. Harrison St., Chicago, IL, 60612, USA.
Focused Therapeutics, 91 E Edgecombe, Dr. Salt Lake City, UT, 841034, USA.
J Interv Card Electrophysiol. 2023 Jan;66(1):125-131. doi: 10.1007/s10840-022-01276-z. Epub 2022 Jul 2.
Currently, RF ablation is limited in its ability to deliver deep lesions, as most of the energy delivered to the tissue is dissipated in the first few millimeters from the catheter tip. Focused electric field (FEF) is a novel technology with the potential to ablate deeper than currently available RF catheters. This work is the first proof of concept of FEF technology.
To introduce FEF technology and demonstrate its feasibility as an ablation tool.
We constructed a FEF catheter with a truncated dome-shaped tip, creating a toroidal ablating surface. We performed ablation ex vivo in porcine hearts and examined ablation characteristics using both tissue sectioning and real-time thermal imaging.
RF lesions were 9.1 ± 1.0 mm wide by 6.1 ± 1.1 mm deep with ablation using a conventional irrigated tip catheter (Thermocool SF). In contrast, lesions created using FEF ablation were 12.8 ± 1.6 mm wide and 14.0 ± 1.6 mm deep. Steam pops were less frequent in the FEF group. Thermal imaging demonstrated that in contrast to an irrigated tip RF catheter, the FEF catheter generated a uniform temperature profile down to a maximum depth exceeding 15 mm.
This study is the first proof of concept of FEF technology. Using a novel toroidal catheter tip design, the electric field remains confined to a narrow tissue region, thus avoiding the rapid fall off in energy delivery from the tissue surface inherent to current RF catheter designs. FEF ablation may allow delivery of deeper ablations lesions with potentially lower risk of tissue hyperthermia than conventional catheters. Future studies are needed.
目前，射频消融在递送深部病变方面能力有限，因为输送到组织的大部分能量都消散在距导管尖端几毫米的范围内。聚焦电场（FEF）是一种具有潜在能力的新技术，可以比目前可用的射频导管更深地消融。这项工作是 FEF 技术的第一个概念验证。
介绍 FEF 技术并证明其作为消融工具的可行性。
我们构建了一种具有截顶圆顶形尖端的 FEF 导管，形成了一个环形消融表面。我们在猪心脏中进行了离体消融，并使用组织切片和实时热成像检查了消融特性。
使用常规的灌流尖端导管（Thermocool SF）进行消融时，RF 损伤的宽度为 9.1 ± 1.0mm，深度为 6.1 ± 1.1mm。相比之下，使用 FEF 消融产生的损伤宽度为 12.8 ± 1.6mm，深度为 14.0 ± 1.6mm。FEF 组蒸汽弹的出现频率较低。热成像显示，与灌流尖端 RF 导管相比，FEF 导管生成的温度分布均匀，最大深度超过 15mm。
这项研究是 FEF 技术的第一个概念验证。使用新型的环形导管尖端设计，电场仍然局限于狭窄的组织区域，从而避免了当前 RF 导管设计中固有的从组织表面迅速下降的能量输送。FEF 消融可能允许输送更深的消融损伤，与传统导管相比，组织过热的风险可能更低。需要进一步研究。
