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Real-time intracardiac echocardiography validation of saline-enhanced radiofrequency needle-tip ablation: lesion characteristics and gross pathology correlation

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Real-time intracardiac echocardiography validation of saline-enhanced radiofrequency needle-tip ablation: lesion characteristics and gross pathology correlation. / Dickow, Jannis; Wang, Songyun; Suzuki, Atsushi ; Imamura, Kimitake ; Lehmann, H Immo ; Parker, Kay D ; Newman, Laura K ; Monahan, Kristi H ; Rettmann, Maryam E ; Curley, Michael G; Packer, Douglas L .

In: EUROPACE, Vol. 23, No. 11, 11.2021, p. 1826–1836.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Dickow, J, Wang, S, Suzuki, A, Imamura, K, Lehmann, HI, Parker, KD, Newman, LK, Monahan, KH, Rettmann, ME, Curley, MG & Packer, DL 2021, 'Real-time intracardiac echocardiography validation of saline-enhanced radiofrequency needle-tip ablation: lesion characteristics and gross pathology correlation', EUROPACE, vol. 23, no. 11, pp. 1826–1836. https://doi.org/10.1093/europace/euab121

APA

Dickow, J., Wang, S., Suzuki, A., Imamura, K., Lehmann, H. I., Parker, K. D., Newman, L. K., Monahan, K. H., Rettmann, M. E., Curley, M. G., & Packer, D. L. (2021). Real-time intracardiac echocardiography validation of saline-enhanced radiofrequency needle-tip ablation: lesion characteristics and gross pathology correlation. EUROPACE, 23(11), 1826–1836. https://doi.org/10.1093/europace/euab121

Vancouver

Dickow J, Wang S, Suzuki A, Imamura K, Lehmann HI, Parker KD et al. Real-time intracardiac echocardiography validation of saline-enhanced radiofrequency needle-tip ablation: lesion characteristics and gross pathology correlation. EUROPACE. 2021 Nov;23(11):1826–1836. https://doi.org/10.1093/europace/euab121

Bibtex

@article{aaea60f293794e4b81ee7c6a793271c1,
title = "Real-time intracardiac echocardiography validation of saline-enhanced radiofrequency needle-tip ablation: lesion characteristics and gross pathology correlation",
abstract = "AimsWith the implementation of saline-enhanced radiofrequency (SERF) needle-tip ablation, real-time validation of lesion formation is needed for the controllable creation of transmural lesions. The aim of the study was to analyse the ability of two-dimensional intracardiac echocardiography (2D-ICE) to guide and validate SERF ablation in real-time.Methods and resultsFifty-six SERF energy deliveries at left ventricular sites of 11 dogs guided by 2D-ICE were analysed (power: 15–50 W; time: 25–120 s; irrigation saline: 60°C with 10 mL/min flow rate). Catheter tip/tissue orientation and lesion formation could be well detected by 2D-ICE in 49 (87.5%) energy deliveries. Gross pathology analysis confirmed excellent 2D-ICE lesion localization, the ability to detect transmural lesions (70% sensitivity, 47% specificity) and positive correlation between 2D-ICE and the corresponding gross pathology measurements of {\textquoteleft}maximal lesion depth{\textquoteright}; (repeated measures correlation: rrm = 0.43, P = 0.012) and {\textquoteleft}depth at maximal lesion width{\textquoteright} (D@MW; rrm = 0.51, P = 0.003). The median angle between SERF catheter tip and endocardium was 76° [interquartile range (IQR) 58–83°]. The more perpendicular the catheter tip/tissue orientation was the deeper D@MW (rrm = 0.32, P = 0.045). Grade 3 microbubbles on 2D-ICE during ablation, indicating inadequate catheter tip/tissue contact, was associated with smaller lesion volumes than with Grade 1 microbubbles (284.8 mm3 [IQR 151.3–343.1] vs. 2114.1 mm3 [IQR 1437.0–3026.3], P < 0.001).ConclusionWith excellent lesion localization and a 70% detection rate of transmural lesions, 2D-ICE is well suited to validate SERF ablation lesion formation in real-time. The catheter tip/tissue angle impacts the lesion formation and through perpendicular catheter positioning, deeper intramural areas of the myocardium can be reached.",
author = "Jannis Dickow and Songyun Wang and Atsushi Suzuki and Kimitake Imamura and Lehmann, {H Immo} and Parker, {Kay D} and Newman, {Laura K} and Monahan, {Kristi H} and Rettmann, {Maryam E} and Curley, {Michael G} and Packer, {Douglas L}",
year = "2021",
month = nov,
doi = "10.1093/europace/euab121",
language = "English",
volume = "23",
pages = "1826–1836",
journal = "EUROPACE",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "11",

}

RIS

TY - JOUR

T1 - Real-time intracardiac echocardiography validation of saline-enhanced radiofrequency needle-tip ablation: lesion characteristics and gross pathology correlation

AU - Dickow, Jannis

AU - Wang, Songyun

AU - Suzuki, Atsushi

AU - Imamura, Kimitake

AU - Lehmann, H Immo

AU - Parker, Kay D

AU - Newman, Laura K

AU - Monahan, Kristi H

AU - Rettmann, Maryam E

AU - Curley, Michael G

AU - Packer, Douglas L

PY - 2021/11

Y1 - 2021/11

N2 - AimsWith the implementation of saline-enhanced radiofrequency (SERF) needle-tip ablation, real-time validation of lesion formation is needed for the controllable creation of transmural lesions. The aim of the study was to analyse the ability of two-dimensional intracardiac echocardiography (2D-ICE) to guide and validate SERF ablation in real-time.Methods and resultsFifty-six SERF energy deliveries at left ventricular sites of 11 dogs guided by 2D-ICE were analysed (power: 15–50 W; time: 25–120 s; irrigation saline: 60°C with 10 mL/min flow rate). Catheter tip/tissue orientation and lesion formation could be well detected by 2D-ICE in 49 (87.5%) energy deliveries. Gross pathology analysis confirmed excellent 2D-ICE lesion localization, the ability to detect transmural lesions (70% sensitivity, 47% specificity) and positive correlation between 2D-ICE and the corresponding gross pathology measurements of ‘maximal lesion depth’; (repeated measures correlation: rrm = 0.43, P = 0.012) and ‘depth at maximal lesion width’ (D@MW; rrm = 0.51, P = 0.003). The median angle between SERF catheter tip and endocardium was 76° [interquartile range (IQR) 58–83°]. The more perpendicular the catheter tip/tissue orientation was the deeper D@MW (rrm = 0.32, P = 0.045). Grade 3 microbubbles on 2D-ICE during ablation, indicating inadequate catheter tip/tissue contact, was associated with smaller lesion volumes than with Grade 1 microbubbles (284.8 mm3 [IQR 151.3–343.1] vs. 2114.1 mm3 [IQR 1437.0–3026.3], P < 0.001).ConclusionWith excellent lesion localization and a 70% detection rate of transmural lesions, 2D-ICE is well suited to validate SERF ablation lesion formation in real-time. The catheter tip/tissue angle impacts the lesion formation and through perpendicular catheter positioning, deeper intramural areas of the myocardium can be reached.

AB - AimsWith the implementation of saline-enhanced radiofrequency (SERF) needle-tip ablation, real-time validation of lesion formation is needed for the controllable creation of transmural lesions. The aim of the study was to analyse the ability of two-dimensional intracardiac echocardiography (2D-ICE) to guide and validate SERF ablation in real-time.Methods and resultsFifty-six SERF energy deliveries at left ventricular sites of 11 dogs guided by 2D-ICE were analysed (power: 15–50 W; time: 25–120 s; irrigation saline: 60°C with 10 mL/min flow rate). Catheter tip/tissue orientation and lesion formation could be well detected by 2D-ICE in 49 (87.5%) energy deliveries. Gross pathology analysis confirmed excellent 2D-ICE lesion localization, the ability to detect transmural lesions (70% sensitivity, 47% specificity) and positive correlation between 2D-ICE and the corresponding gross pathology measurements of ‘maximal lesion depth’; (repeated measures correlation: rrm = 0.43, P = 0.012) and ‘depth at maximal lesion width’ (D@MW; rrm = 0.51, P = 0.003). The median angle between SERF catheter tip and endocardium was 76° [interquartile range (IQR) 58–83°]. The more perpendicular the catheter tip/tissue orientation was the deeper D@MW (rrm = 0.32, P = 0.045). Grade 3 microbubbles on 2D-ICE during ablation, indicating inadequate catheter tip/tissue contact, was associated with smaller lesion volumes than with Grade 1 microbubbles (284.8 mm3 [IQR 151.3–343.1] vs. 2114.1 mm3 [IQR 1437.0–3026.3], P < 0.001).ConclusionWith excellent lesion localization and a 70% detection rate of transmural lesions, 2D-ICE is well suited to validate SERF ablation lesion formation in real-time. The catheter tip/tissue angle impacts the lesion formation and through perpendicular catheter positioning, deeper intramural areas of the myocardium can be reached.

U2 - 10.1093/europace/euab121

DO - 10.1093/europace/euab121

M3 - SCORING: Journal article

VL - 23

SP - 1826

EP - 1836

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 11

ER -