Mehdirad A, Gaiser J, Baker P, West S, Lehmkuhl L, Yong P, Meimer J, Nelson S
Division of Cardiology, OSU Medical Center, Ohio State University School of Medicine, Columbus 43210, USA.
Pacing Clin Electrophysiol. 1998 Jan;21(1 Pt 2):316-21. doi: 10.1111/j.1540-8159.1998.tb01113.x.
The safety and lesion volume of temperature controlled radiofrequency ablation (TCRFA) in the right ventricle (RV), left ventricle (LV), and coronary sinus (CS) comparing long 5 Fr to standard tip electrodes have not been previously reported. In 10 canines, TCRFA was delivered at a 70 degrees C set point for 30 seconds. Lateral and septal RV lesions were made with either a 5 Fr/5 mm or 7 Fr/4 mm tip. Lateral and septal LV lesions were made with either a 5 Fr/7 mm or 7 Fr/4 mm tip. Proximal and distal CS lesions were made with either a 7 Fr/4 mm, 5 Fr/5 mm or 5 Fr/7 mm tip. Gross and histologic examination of the lesions was completed. Lesion size, tip temperature and power required are related to electrode surface area (SA) when ablating in the RV, LV or CS. 5 Fr/7 mm tips (SA = 36 mm2) tended to create larger lesions than 7 Fr/4 mm tips (SA = 29 mm2) in the LV. 7 Fr4 mm tips tended to create larger lesions than 5 Fr/5 mm tips (SA = 26 mm2) in the RV. 7 Fr/4 LV lesions exceeded 7 Fr/4 mm RV lesions due to thicker LV walls. In the CS, 5 Fr/7 mm tips tended to create the largest lesions. In the RV, LV and CS, tips with larger SA tended to have lower temperatures and require higher power. No high temperature or high impedance shut-downs were observed. In conclusion, varying 5 Fr tip length can safely produce larger or smaller lesions compared to those created with 7 Fr/4 mm tips.
此前尚未有关于使用长5 Fr电极与标准尖端电极对比进行右心室（RV）、左心室（LV）和冠状窦（CS）温控射频消融（TCRFA）的安全性及损伤体积的报道。在10只犬中，以70摄氏度的设定点进行30秒的TCRFA。使用5 Fr/5 mm或7 Fr/4 mm尖端电极制作RV的侧壁和间隔损伤。使用5 Fr/7 mm或7 Fr/4 mm尖端电极制作LV的侧壁和间隔损伤。使用7 Fr/4 mm、5 Fr/5 mm或5 Fr/7 mm尖端电极制作CS的近端和远端损伤。完成了对损伤的大体和组织学检查。在RV、LV或CS中进行消融时，损伤大小、尖端温度和所需功率与电极表面积（SA）相关。在LV中，5 Fr/7 mm尖端（SA = 36 mm²）形成的损伤往往比7 Fr/4 mm尖端（SA = 29 mm²）更大。在RV中，7 Fr/4 mm尖端形成的损伤往往比5 Fr/5 mm尖端（SA = 26 mm²）更大。由于LV壁较厚，7 Fr/4 mm的LV损伤超过了7 Fr/4 mm的RV损伤。在CS中，5 Fr/7 mm尖端往往形成最大的损伤。在RV、LV和CS中，SA较大的尖端往往温度较低且需要更高的功率。未观察到高温或高阻抗停机情况。总之，与7 Fr/4 mm尖端相比，不同长度的5 Fr尖端可安全地产生更大或更小的损伤。
