Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Experimental methods D-PO01-NC - Non-CME Poster Session (ID 14) Poster

D-PO01-NC-18 - Modeling Adverse Event Risk In A Perfused Porcine Thigh Radiofrequency Ablation Model (ID 1484)

Disclosure
  J. Overmann: Salary from Employment (Commercial Interest) - Abbott.

Abstract

Background: Increasingly, RF ablations are performed at higher powers and shorter durations. Of concern, however, is the potential increased risk of complications with these higher power ablations.
Objective: To model adverse event risk with RF duration beyond 10s when ablating at 50W with an open-irrigated, kerfed, contact force-sensing, flexible-tip catheter.
Methods: RF ablations (N=162) were performed in nine thighs from five swine using power control mode (50W, contact force 20g, 13 ml/min irrigation rate). Ablations were balanced between parallel and perpendicular tip orientations and over durations of 6s to 24s (at 2s increments). Coagulum formation, char, steam pops and lesion depth were documented. Results were used to construct models to illustrate the risk of coagulum and char (binary logistic regression) and the increase in lesion depth (linear regression) when ablating beyond 10s at 50W. The maximum effect of RF duration was targeted when constructing models from regression results to approximate a worst-case scenario.
Results: Out of 162 ablations, coagulum occurred in 60 (in this hypercoagulable system) while char occurred in four. Only one steam pop occurred (24s ablation) precluding model construction for this adverse event. Models show the risk of coagulum increasing faster than that of char as duration increases. The model for increase in lesion depth shows that as RF ablation continues beyond 10s, depth increases by 0.18mm per second.
Conclusion: Binary logistic and linear regression models were useful in characterizing relative risk of adverse events when ablating at 50W with a novel flexible-tip, contact force sensing catheter.
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