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

D-PO02-200 - High Power Short Duration Radiofrequency Ablation Results In Less Esophageal Heating (ID 252)

Abstract

Background: High Power Short Duration (HPSD) radiofrequency ablation has been advocated for improving lesion durability. Esophageal heating using this technique has not been well studied.
Objective: To assess esophageal heating utilizing HPSD radiofrequency ablation compared to Low Power Long Duration (LPLD) radiofrequency ablation.
Methods: We assembled an ex vivo model for esophageal heating consisting of porcine esophageal tissue inclusive of an overlying fascial layer submerged in a heated saline bath titrated to a measured impedance of 130 ohms. Using a TactiCath (Abbott) force sensing catheter, we performed a series of radiofrequency ablation lesions at variable powers and duration at 10 g. Peak temperatures and time to rise 1°C above baseline temperature were recorded and compared. Temperatures were measured with insulated thermocouple wires placed directly below the radiofrequency ablation electrode and logged every second.
Results: Compared to LPLD (20W for 20s) ablation, HPSD (40W for 10 seconds) ablation resulted in significantly lower mean esophageal temperature rise (8.01 +/- 3.1 °C vs. 11.11 +/- 3.08 °C; P<0.001) despite equivalent total energy delivery (400 Joules). Further, in the time to reach a 1°C temperature rise in the esophagus, significantly more radiofrequency energy was delivered in the HPSD group compared to the LPLD group (128 J vs. 74 J; P<0.001).
Conclusion: In our experimental model, the use of HPSD radiofrequency ablation resulted in significantly more energy delivery to tissue overlying the esophagus with reduced intraluminal esophageal temperatures compared to LPLD delivery.

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