ArticleIndian pacing and electrophysiology journal
Lesion characteristics created by bipolar radiofrequency ablation; right vs left side of septum and epicardium vs endocardium in the free wall.
Article in Indian pacing and electrophysiology journal. 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
backgroundCircumstances around ablation catheters placed in the ventricular cavity and pericardial space are not identical, and therefore bipolar (BIP) ablation targeting the interventricular septum (IVS) or left ventricular free wall (LVFW) may induce lesions with different characteristics on either side of the wall.
methodsPorcine hearts prepared for IVS or LVFW were placed between two inner containers which were set in an outer experimental container. For IVS ablation, each inner container was filled with Tyrode's solution circulated by a pump to mimic the right- and left-ventricular cavities. For LVFW ablation, a plastic board was inserted into one of the inner containers to mimic the pericardial space, thereby minimizing the circulating solution. Thereafter, BIP ablation (30W, 120-s) was attempted 30 applications each in IVS and LVFW.
resultsAll 60 applications were successfully accomplished without steam-pop. Total impedance decline (TID) and %-TID were larger in LVFW than IVS ablation (-19.4 ± 5.3 vs. -15.8 ± 4.6 Ω, and -16.2 ± 4.0 vs. -13.2 ± 3.6%), and total lesion depth was deeper in LVFW than in IVS (14.4 ± 2.6 vs. 12.7 ± 3.3 mm) due to deeper lesions in the epicardial wall. Surface lesions were also larger in epicardial than in endocardial wall in LVFW ablation, whereas there were no differences between right- and left-side septal wall. Transmural lesion was created in 13/30 in LVFW and 9/30 in IVS ablation.
conclusionsAs compared to IVS, BIP ablation targeting LVFW demonstrated larger TID and induced deeper lesions in the epicardial wall in this study, probably due to less current leakage into the small space.
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