ArticleJournal of cardiovascular electrophysiology2025
Lesion Depth Optimization in High-Power Radiofrequency Ablation: Evaluating Single High-Power and Combined Very High-Power Applications.
Article in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Lesion Depth Optimization in High-Power Radiofrequency Ablation: Evaluating Single High-Power and Combined Very High-Power Applications.Journal of cardiovascular electrophysiology · 2025Article
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Authors and funding
17 authors.
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Abstract
backgroundA very high-power short-duration (vHPSD) radiofrequency (RF) ablation creates shallower lesions, which may be insufficient in thick myocardial regions.
aimsTo clarify an effective ablation strategy following the initial vHPSD application and determine the best approach to create sufficient lesion depth in thick myocardial regions using ex vivo and in vivo models.
methodsLesion metrics were compared under various settings: 35 W versus 50 W with the same target ablation index (AI) (Step 1); double vHPSD ablations versus vHPSD followed by AI-guided ablation (Step 2); double applications (DA) with vHPSD followed by AI-guided ablation with a target AI of 450 versus single application (SA) with a target AI of 550 at 50 W (Step 3).
resultsLesion depth was comparable between groups with the same AI but different RF powers. Lesions were significantly deeper in the vHPSD ablation followed by a target AI of 450 compared to double vHPSD ablations (vHPSD + vHPSD, 3.4 [3.1-3.6] mm; vHPSD + AI 450 at 35 W, 4.4 [4.1-4.9] mm; vHPSD + AI 450 at 50 W, 4.5 [4.1-4.9] mm, p < 0.001). High-power SA with a target AI of 550 created significantly deeper lesions than vHPSD + AI 450 (DA vs. SA, 4.5 [3.5-5.3] mm vs. 5.0 [4.1-5.9] mm, p = 0.01).
conclusionsAI-guided RF applications following vHPSD effectively increased lesion depth more than repeated vHPSD. However, a single high-power application targeting a higher AI resulted in the deepest lesions. This strategy may be particularly beneficial in thick atrial myocardial regions to enhance lesion durability and improve procedural outcomes.
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