4.5 Article

Radiofrequency induced lesion characteristics according to force-time integral in experimental model

Journal

MEDICINE
Volume 100, Issue 10, Pages -

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000025126

Keywords

cardiac electrophysiology; catheter ablation; radiofrequency ablation

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Investigators found that in radiofrequency ablation lesion formation, the time factor is more important than the force factor, and the force-power-time index (FPTI) is a better predictor for lesion size than the force-time integral (FTI). Under the same FTI condition, the time factor has a greater impact on lesion formation.
Contact force (CF)-sensing technology has enabled accurate real-time CF measurement in tissue. Average CF, which is quantified by the force-time integral (FTI), correlates with lesion volume. Little is known about which of the time and force factors that compose FTI plays a more important role and which is a better index for predicting lesion size, FTI, or force-power-time index (FPTI). Investigators sought to identify a better index for predicting radiofrequency ablation lesion formation with experimental model. Radiofrequency current was delivered to the swine skeletal muscle at radiofrequency energy current was delivered at 4 fixed power settings (15, 25, 30, and 40 W) for 6 variable time durations (5, 10, 20, 30, 40, and 50 s) with 6 variable CF settings (5, 10, 20, 30, 40, and 50 g). At each setting, the following parameters were evaluated: (1) transmural lesion depth, (2) lesion width, and (3) lesion volume. Between FTI factors, the time factor was more important than the force factor for lesion formation. The area under the curve was greater for FPTI (0.943) than for FTI (0.870). On univariate linear regression analysis, the explanatory power of the linear regression model was better explained by FPTI (56.4%) than FTI (32.1%). Under the same FTI condition, the time factor had a greater effect on lesion formation. When power was included, the power factor had a greater effect on lesion formation and steam pop.

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