ArticleFrontiers in cardiovascular medicine2025
A novel enhanced stability detection algorithm for ablation catheters: purpose and application in high-power short-duration ablation.
Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Assessing catheter stability during ablation procedures is crucial. The current stability algorithm relies on end-expiration reference frame (Gated), requiring a full respiratory cycle before lesion tagging. This poses challenges with high-power, short-duration (HPSD) radiofrequency ablation workflows. To overcome these limitations, a novel algorithm, called Stability+, has been developed. It provides real-time tracking and analysis of catheter motion throughout the entire respiratory cycle. Objective: The aim of our study was to assess the performance of the new Stability + algorithm in HPSD ablations and to compare it with the current algorithm. Methods: Data from a series of consecutive left atrial ablations employing the new Stability + algorithm were prospectively collected. A retrospective analysis was conducted to compare the two algorithms. Results: A total of 1,056 applications were delivered, 123 (11.6%) using QMODE + (90 W, 3-4 s), and 933 (88.4%) using QMODE (50 W, ablation index guided 350/500). The number of unstable applications, outside the end-expiration phase, was detected with the Stability + for 9 positions (7.3%) using the QMODE+. Average time-to-tag appearance was 2.5 ± 1 s with the Stability + vs. 9 ± 1.1 s with the Gated algorithm. During QMODE ablation sessions, the Stability + algorithm prevented overshooting in 84% of the ablation positions. No steam pop or perforation occurred. Conclusion: The novel Stability + algorithm enhances lesion tracking for HPSD workflows like QMODE+/QMODE and holds the potential to improve stability detection across all radiofrequency ablation modes, marking a significant advancement in the field.
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