Chamber-Specific Radiofrequency Lesion Dimension Estimation Using Novel Catheter-Based Tissue Interface Temperature Sensing: A Preclinical Assessment

Abstract

Objectives This study sought to compare a novel lesion dimension estimation approach to actual measurements of lesion dimensions on necropsy in porcine atria and ventricles. Background An irrigated-tip, force-sensing radiofrequency catheter with 6 temperature (tip-tissue interface) sensors allows for assessment of lesion dimensions based on estimated tissue temperature. Lesion dimension assessment has not been attempted previously in atrial tissue. Methods Ablations were performed using this catheter in all chambers. Irrigated radiofrequency was delivered using 20 to 50 W for durations that ranged from 15 to 90 s with contact force ranging from 5 to 45 g to replicate a wide spectrum of clinical conditions. All swine were then sacrificed and lesions were identified and photographed. Three independent observers made offline measurements, which were then averaged to obtain lesion width and depth for comparison with estimated dimensions based on interface tissue temperature. Results In 9 swine, 54 atrial and 61 ventricular lesions were assessed. In the atria, the mean difference between the measured and estimated depth and width was 0.9 ± 0.74 mm and 1.2 ± 0.9 mm, respectively. Eighty percent of all lesions had a difference of ≤1.7 mm for depth and ≤1.74 mm for width. In the ventricle, the mean difference between the measured and estimated depth and width was 0.75 ± 0.6 mm and 1.66 ± 1.1 mm, respectively. Eighty percent of all lesions had a difference of ≤1.1 mm ventricular depth and ≤2.6 mm for width. Conclusions Estimation of lesion dimensions can be achieved with clinically relevant accuracy using unique temperature signatures. These data have important implications for understanding the adequacy of lesion overlap and assessment of transmurality.