Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation
Introduction: Unipolar radiofrequency (RF) ablation using half-normal saline irrigation (UNIP-HNS) and bipolar RF ablation using normal saline irrigation (BIP-NS) are effective to treat arrhythmias from inside thick myocardium. However, differences between these two ablations when using a long appli...
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Elsevier
2025-01-01
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| Series: | Indian Pacing and Electrophysiology Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629224001554 |
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| author | Takumi Kasai Osamu Saitoh Ayaka Oikawa Naomasa Suzuki Yasuhiro Ikami Yuki Hasegawa Sou Otsuki Takayuki Inomata Hiroshi Furushima Masaomi Chinushi |
| author_facet | Takumi Kasai Osamu Saitoh Ayaka Oikawa Naomasa Suzuki Yasuhiro Ikami Yuki Hasegawa Sou Otsuki Takayuki Inomata Hiroshi Furushima Masaomi Chinushi |
| author_sort | Takumi Kasai |
| collection | DOAJ |
| description | Introduction: Unipolar radiofrequency (RF) ablation using half-normal saline irrigation (UNIP-HNS) and bipolar RF ablation using normal saline irrigation (BIP-NS) are effective to treat arrhythmias from inside thick myocardium. However, differences between these two ablations when using a long application time had not fully been studied. Methods: UNIP-HNS, BIP-NS and unipolar RF ablation using normal saline irrigation (UNIP-NS) were applied for 120 s (30 W and 20-g contact) to porcine endocardial wall (≧15.0 mm thickness). Results: All ablations (30 applications each in UNIP-HNS and BIP-NS, and 20 applications in UNIP-NS) were successfully accomplished without steam-pop. Total impedance decline was largest in BIP-NS followed by UNIP-HNS and UNIP-NS. UNIP-HNS created larger surface lesions and greater maximum lesion width under the surface than those by UNIP-NS and BIP-NS. Endocardial lesion depth in UNIP-HNS and BIP-NS were deeper than that in UNIP-NS, but with no difference between UNIP-HNS and BIP-NS, when selecting non-transmural lesions. Similar results were obtained when all lesions (non-transmural and transmural) were included and endocardial lesion depth of the transmural lesions (13/30 applications of BIP-NS) was estimated as 50 % of the myocardial thickness. Lesion length in the transverse myocardial wall (endocardial plus epicardial lesions) was greatest in BIP-NS. Conclusions: Longer application time ablation (30 W) targeting the thick myocardium was performable in UNIP-HNS and BIP-NS. Since a transmural lesion and/or a deeper lesion into the myocardial wall are created, BIP-NS is preferable if two ablation catheters can be positioned on either side of the target. |
| format | Article |
| id | doaj-art-140beb26275c4314997ae4d49f092099 |
| institution | DOAJ |
| issn | 0972-6292 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj-art-140beb26275c4314997ae4d49f0920992025-08-20T02:56:55ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922025-01-0125121110.1016/j.ipej.2024.11.003Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigationTakumi Kasai0Osamu Saitoh1Ayaka Oikawa2Naomasa Suzuki3Yasuhiro Ikami4Yuki Hasegawa5Sou Otsuki6Takayuki Inomata7Hiroshi Furushima8Masaomi Chinushi9Cardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanCardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanCardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanDepartment of Cardiovascular Biology and Medicine, Niigata University School of Medicine, Niigata, JapanDepartment of Cardiovascular Biology and Medicine, Niigata University School of Medicine, Niigata, JapanDepartment of Cardiovascular Biology and Medicine, Niigata University School of Medicine, Niigata, JapanDepartment of Cardiovascular Biology and Medicine, Niigata University School of Medicine, Niigata, JapanDepartment of Cardiovascular Biology and Medicine, Niigata University School of Medicine, Niigata, JapanCardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, JapanCardiovascular Research of Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, Japan; Corresponding author. Graduate School of Health Sciences, Niigata University School of Medicine, 2-746 Asahimachi, Niigata 951-8518, Japan.Introduction: Unipolar radiofrequency (RF) ablation using half-normal saline irrigation (UNIP-HNS) and bipolar RF ablation using normal saline irrigation (BIP-NS) are effective to treat arrhythmias from inside thick myocardium. However, differences between these two ablations when using a long application time had not fully been studied. Methods: UNIP-HNS, BIP-NS and unipolar RF ablation using normal saline irrigation (UNIP-NS) were applied for 120 s (30 W and 20-g contact) to porcine endocardial wall (≧15.0 mm thickness). Results: All ablations (30 applications each in UNIP-HNS and BIP-NS, and 20 applications in UNIP-NS) were successfully accomplished without steam-pop. Total impedance decline was largest in BIP-NS followed by UNIP-HNS and UNIP-NS. UNIP-HNS created larger surface lesions and greater maximum lesion width under the surface than those by UNIP-NS and BIP-NS. Endocardial lesion depth in UNIP-HNS and BIP-NS were deeper than that in UNIP-NS, but with no difference between UNIP-HNS and BIP-NS, when selecting non-transmural lesions. Similar results were obtained when all lesions (non-transmural and transmural) were included and endocardial lesion depth of the transmural lesions (13/30 applications of BIP-NS) was estimated as 50 % of the myocardial thickness. Lesion length in the transverse myocardial wall (endocardial plus epicardial lesions) was greatest in BIP-NS. Conclusions: Longer application time ablation (30 W) targeting the thick myocardium was performable in UNIP-HNS and BIP-NS. Since a transmural lesion and/or a deeper lesion into the myocardial wall are created, BIP-NS is preferable if two ablation catheters can be positioned on either side of the target.http://www.sciencedirect.com/science/article/pii/S0972629224001554Radiofrequency ablationBipolar ablationHalf-normal saline irrigation |
| spellingShingle | Takumi Kasai Osamu Saitoh Ayaka Oikawa Naomasa Suzuki Yasuhiro Ikami Yuki Hasegawa Sou Otsuki Takayuki Inomata Hiroshi Furushima Masaomi Chinushi Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation Indian Pacing and Electrophysiology Journal Radiofrequency ablation Bipolar ablation Half-normal saline irrigation |
| title | Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation |
| title_full | Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation |
| title_fullStr | Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation |
| title_full_unstemmed | Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation |
| title_short | Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation |
| title_sort | lesion characteristics of long application time ablation using unipolar half normal saline irrigation and bipolar normal saline irrigation |
| topic | Radiofrequency ablation Bipolar ablation Half-normal saline irrigation |
| url | http://www.sciencedirect.com/science/article/pii/S0972629224001554 |
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