Radiofrequency catheter ablation of supraventricular arrhythmias

• Published in: Heart (British Cardiac Society) Vol. 85; no. 5; pp. 594 - 600
• Main Author: Calkins, Hugh
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01-05-2001; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Ablation (Surgery); Biological and medical sciences; Cardiac arrhythmia; Care and treatment; Catheter Ablation - economics; Catheter Ablation - methods; Catheters; Diseases of the cardiovascular system; Education in Heart; Electrodes; Health aspects; Health Care Costs; Heat; Humans; Laboratories; Medical sciences; Methods; Patients; Radio waves; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Surgery; Tachycardia, Atrioventricular Nodal Reentry - surgery; Tachycardia, Supraventricular - surgery; Temperature; Ultrasonic imaging; Ventricular fibrillation; Wolff-Parkinson-White Syndrome - surgery; United Kingdom; Human; Treatment; Arrhythmia; Indication; Heart disease; Treatment efficiency; Radiofrequency irradiation; Instrumentation therapy; Cardiovascular disease; Review; Paroxysmal supraventricular tachycardia; Technique
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/heart.85.5.594

The heating of tissue during radiofrequency catheter ablation may be thought of as a two step process; resistive heating followed by conductive heat transfer from the area of resistive heating to surrounding tissue. Because direct resistive heating falls precipitously with increasing distance from the ablation electrode, resistive heating is responsible for heating only a very narrow rim of tissue extending approximately 1 mm beyond the ablation electrode. 1 The majority of lesion volume is determined by the relative contributions of conductive heat exchange into surrounding tissue and convective heat loss towards the relatively cooler moving blood. [...]of the need to achieve a tissue temperature of 50°C for irreversible tissue injury, the 100°C temperature ceiling for tissue heating, and the rapid decrease in tissue temperature with increasing distance from the ablation electrode, the lesions created during radiofrequency catheter ablation procedures are small ( 5 mm) and have well demarcated borders (fig 1 ).