Ablation Time is More Important than Contact Force for lesion Formation during Radiofrequency Catheter Ablation in Vitro Model using Force Sensing technology

Yoo Ri Kim1, Dasom Jang3, Segyeong Joo3, Woo-Seok Lee4, Gi-Byoung Nam2, Kee-Joon Choi2, You-Ho Kim2
1 Division of Cardiology, The Catholic University of Incheon St. Mary's Hospital, South Korea
2 Division of Cardiology, Asan Medical Center, South Korea
3 Deparment of biomedical engineering, Asan Medical Center, South Korea
4 Division of Cardiology, VHS hospital, South Korea

Background: Contact-force (CF) sensing technology allows real time CF measurement during catheter albation. Lesion size correlates linearly with contact force-time integral(FTI). This study aimed to investigate which factor is more critical for adequate lesion formation among time and CF

Methods: An open-tip irrigated CF sensing catheter was mounted perpendicularly over swine skeletal muscles and swine left ventricular endocardium. RF energy (30W, 17mL/min irrigation) was delivered during constant contact at 5g, 10g, 20g, 30g, 40g and 50g for 5 seconds(s), 10s, 20s, 30s, 40s, and 50s. We analyzed data from 108 consecutive ablation lesions by FTI.

Results:The ablation lesion depth, width, volume under the CF curve was calculated as the FTI. Lesion volume was classified into 2 groups according to the ablation time and CF. In same FTI, longer ablation time made deeper lesion depth and larger lesion volume than higher contact force. (256 mm3 vs. 68.37mm3, p<0.001). lesion volume over 100mm3 was created by at least 20 second-ablation time with variable contact forces.

Conclusion: Time was more important issue than contac force in same force-time integral to make adequate ablation lesion formation.

Figure 1. Ablation lesion formation according to time and force