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Journal of Interventional Cardiac Electrophysiology
Published in: Journal of Interventional Cardiac Electrophysiology 2/2015

01-03-2015

Open-irrigated laser catheter ablation: influence of catheter–tissue contact force on lesion formation

Authors: Michaela Sagerer-Gerhardt, Helmut P. Weber

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 2/2015

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Abstract

Purpose

Catheter–tissue contact force (CF) is a major determinant for radiofrequency (RF) ablation lesion size and quality. We sought to test the influence of catheter CF on lesion formation by using an open-irrigated electrode-laser mapping and ablation (ELMA) catheter.

Methods

With the ELMA catheter in a stable vertical position, continuous wave 1064 nm laser impacts at 15 W (9.5 W/mm2), 30 s (285 J/mm2), irrigation flow 30 mL/min, were aimed at the endocardial surface of bovine myocardium in heparinized stagnant blood (ACT >350 s) at room temperature (18 °C). Lesions were produced with CFs of 100 g, 10 g, in contact but without pressure, with the catheter tip 2.0 mm, and 5.0 mm away (n = 10, each). Lesions were evaluated morphometrically and were compared by the unpaired t tests.

Results

There were no significant differences between volumes of lesions achieved with catheter–tissue CF of 100 g, 10 g, and in contact without pressure: 297 ± 56.0 vs. 300 ± 39 vs. 320 ± 24, respectively (p > 0.05). However, volumes of lesions produced at a distance of 2 mm (95 ± 14 mm3) were significantly smaller (p < 0.0001), whereas at a distance of 5.0 mm, no lesions were produced. No steam-pop with crater or thrombus formation occurred.

Conclusions

By using an open-irrigated ELMA catheter, catheter–tissue CF is not a determinant for laser ablation lesion size and quality. Maximum sizes of lesions can be achieved with the catheter in intimate endocardial contact without pressure. However, lesions can be produced also at a catheter–tissue distance of 2.0 mm. Noticeably, there is no thrombus formation during laser application with the free floating ELMA catheter in the stagnant blood.
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Metadata
Title
Open-irrigated laser catheter ablation: influence of catheter–tissue contact force on lesion formation
Authors
Michaela Sagerer-Gerhardt
Helmut P. Weber
Publication date
01-03-2015
Publisher
Springer US
Published in
Journal of Interventional Cardiac Electrophysiology / Issue 2/2015
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-015-9977-4

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