Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-153 - Ablation Catheter-Tissue Interface Temperature Can Differentiate A Sliding Catheter Interface From A Moving Fixed Catheter-Tissue Interface (ID 229)

  S.J. Pollak: Honoraria/Speaking/Consulting Fee - Biosense Webster, Inc..


Background: Ablation catheter stability has been shown to help with pulmonary vein isolation and long term efficacy. Current stability parameters from conventional 3D electroanatomic mapping systems can be misleading. It is difficult to differentiate a sliding catheter-tissue interface from a stable catheter interface which is moving with the tissue due to respiratory and cardiac motion.
Objective: Investigate whether new technology of a temperature sensing ablation catheter can enhance detection of catheter-tissue interface stability.
Methods: Motion scenarios were investigated using the QDOT MICRO™ and CARTO-3®. A catheter and tissue movement simulator were utilized having the capability to move the catheter, tissue or both, back and forth between two fixed points over 7mm every 5 seconds. Two scenarios were investigated to simulate the dilemma of whether catheter movement is due to sliding over the tissue versus movement along with the tissue. (Scenario 1) Catheter is fixed in the tissue and both catheter and tissue bed oscillate linearly at a constant speed and frequency.(Scenario 2) Ablation catheter oscillates linearly at a constant speed and frequency while the tissue bed remains fixed. Thirty ablations were performed with 25W and 35W for each scenario with a contact force of 10 to 14g.
Results: Temperature curves for the two scenarios were compared by assessing the percentage of the ablation duration from 5 to 30 seconds within the target range. The target range was established using the upper bound of the maximum temperature recorded between 5 and 30 seconds and the lower bound was 90% of the maximum temperature from 5 to 30 seconds. The stable catheter-tissue interfaces, (Scenario 1) were in the target range for both 25W and 35W a significantly greater percentage of the ablation duration (p≤.01) compared to the movement scenario 2. The mean percentage that the catheter-tissue interface was in the target range for the two scenarios was: (Scenario 1) 89.9% ± 7.9@25W, 92.5% ± 6.6@35W vs (Scenario 2) 55.4% ± 20.7@25W. 53.6% ±18@35W.
Conclusion: Duration of catheter-tissue interface in the target range helped to monitor catheter -tissue interface stability.