Abstract 16827: Algorithmic Lesion Dimension Assessment: in vivo Assessment Using a Novel Irrigated-tip Catheter With Six Temperature Sensors
Introduction: A novel irrigated-tip, force-sensing radiofrequency ablation catheter with 6 microelectrodes with temperature (tip-tissue interface) sensors (Oracle, Biosense Webster, Inc) allows for algorithmic assessment of lesion dimensions based on estimated tissue temperature.
Objective: To compare the estimated lesion dimensions created in vivo to actual measurements of lesions on necropsy.
Methods: In 9 swine, 54 atrial and 61 ventricular lesions were applied. Discrete ablations were performed using a transfemoral venous approach with transseptal access for the left heart. The study catheter was positioned in all four chambers at locations using CARTO3 mapping and ICE guidance. Irrigated RF was delivered using 20-50W for durations that ranged from 15-90 seconds with contact force ranging from 5-45 gm to replicate a wide spectrum of clinical conditions. All swine were then humanely sacrificed, lesions identified and then photographed after TTC staining. Three independent observers made offline-measurements using custom software, which were then averaged to obtain lesion width and depth.
Results: Lesions were analyzed by chamber type. Table 1 describes the mean difference between measured and estimated lesion depth and width for atria and ventricles. For the ventricles, 80% of depth estimates were within 1.1mm of the actual depths. For the atria, 80% of width estimates were within 1.74mm of the actual widths.
Conclusions: Estimation of lesion dimensions can be achieved with clinically relevant accuracy using unique temperature signatures. The ability to do so in atrial tissues has never been attempted before. These data have important implications for assessing adequacy of lesion overlap and assessment of transmurality
Author Disclosures: J. Koruth: Research Grant; Modest; ACT, BIOSENSE WEBSTER, Vytronus. Consultant/Advisory Board; Modest; Biosense Webster, St Jude. Research Grant; Significant; MODEST, Significant, Significant. Consultant/Advisory Board; Significant; Significant, Signifcant. M. Bartal: Employment; Significant; BIOSENSE WEBSTER. U. Yigal: Employment; Significant; BIOSENSE WEBSTER. A. Sigal: Employment; Significant; BIOSENSE WEBSTER. M. Liron: Employment; Significant; BIOSENSE WEBSTER. J. Iwasawa: None. Y. Enomoto: None. D. Sharma: None. R. bhardwaj: None. S. Choudry: None. S. Dukkipati: Research Grant; Significant; biosense webster. V. Reddy: Research Grant; Modest; Biosense Webster. Ownership Interest; Modest; VytronUS ACT AcutusMedical Iowa Approach. Ownership Interest; Significant; Manual Surgical Sciences. Consultant/Advisory Board; Significant; VytronUS ACT AcutusMedical IowaApproach.
- © 2016 by American Heart Association, Inc.