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在体外模型中使用TactiFlex与TactiCath进行消融的益处:一项面对面实验比较研究。

The benefits of ablation using TactiFlex compared with TactiCath in an ex vivo model: a face-to-face experimental comparison study.

作者信息

Odake Yodo, Tokuyama Takehito, Aonuma Kazutaka, Kuroki Kenji, Inden Yasuya, Furutani Motoki, Okubo Yousaku, Okamura Sho, Miyauchi Shunsuke, Miyamoto Shogo, Oguri Naoto, Uotani Yukimi, Sakai Takumi, Nakano Yukiko

机构信息

Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.

Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

出版信息

J Interv Card Electrophysiol. 2024 Aug 20. doi: 10.1007/s10840-024-01897-6.

Abstract

BACKGROUND

TactiFlex is a next-generation catheter that is being used increasingly in ablation-treatment strategies. The purpose of this study was to investigate the differences in ablation lesions when the ablation power, time, and perfusion flow are varied with TactiFlex and TactiCath catheters.

METHODS

The TactiFlex and TactiCath catheters were contacted perpendicularly/obliquely/parallel to the swine myocardium at varying powers (30, 40, and 50 W), time points (10, 15, 20, 25, 30, and 40 s), and forces (5, 10, 15, 20, and 30 g); the depth, width, and area of each lesion were measured, and the number of steam pops that occurred was counted.

RESULTS

A total of 672 (336 lesions for each catheter) radiofrequency (RF) energy applications were delivered and 648 lesions were analyzed, excluding steam pops. The surface area and volume increased significantly with an increasing contact force for the TactiCath. The TactiCath lesions were significantly deeper than those for TactiFlex in most groups with the same power and seconds. The surface area was significantly larger when the catheters were contacted obliquely/parallel to the myocardium than perpendicularly using TactiCath, whereas the difference was less significant in the case of TactiFlex. In a 10-g contact force ablation experiment, TactiFlex did not cause pops, but TactiCath caused pops in 9.8% of cases.

CONCLUSION

The TactiFlex lesions were shallower than those of TactiCath. However, TactiFlex catheters reduced the steam pops during RF applications. Those data should help clinicians understand the characteristics of the catheters and develop adequate strategies.

摘要

背景

TactiFlex是一种新一代导管,在消融治疗策略中的应用日益广泛。本研究旨在探讨使用TactiFlex和TactiCath导管时,消融功率、时间和灌注流量变化时消融灶的差异。

方法

将TactiFlex和TactiCath导管以不同功率(30、40和50瓦)、时间点(10、15、20、25、30和40秒)和压力(5、10、15、20和30克)垂直/倾斜/平行接触猪心肌;测量每个病灶的深度、宽度和面积,并统计产生的蒸汽泡数量。

结果

共进行了672次(每种导管336个病灶)射频(RF)能量施加,并分析了648个病灶,不包括蒸汽泡。TactiCath导管的表面积和体积随着接触压力的增加而显著增加。在大多数相同功率和时间的组中,TactiCath导管造成的病灶比TactiFlex导管造成的病灶显著更深。使用TactiCath导管时,与心肌倾斜/平行接触时的表面积显著大于垂直接触时,而使用TactiFlex导管时这种差异较小。在10克接触压力消融实验中,TactiFlex导管未产生气泡,但TactiCath导管在9.8%的情况下产生了气泡。

结论

TactiFlex导管造成的病灶比TactiCath导管造成的病灶浅。然而,TactiFlex导管减少了射频应用过程中的蒸汽泡。这些数据应有助于临床医生了解导管的特性并制定适当的策略。

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