Superiority of the Combination of Input and Output Parameters to the Single Parameter for Lesion Size Estimation
Background: For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal.Methods and Results: Radiofrequency applications at a range of pow...
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| Published in: | Circulation Journal Vol. 87; no. 12; pp. 1757 - 1764 |
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24-11-2023
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| Abstract | Background: For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal.Methods and Results: Radiofrequency applications at a range of power (30–50 W), contact force (10 g and 20 g), duration (10–60 s), and catheter orientation with normal saline (NS)- or half-normal saline (HNS)-irrigation were performed in excised porcine hearts. The correlations, with lesion size of AE, absolute impedance drop (∆Imp-drop), relative impedance drop (%Imp-drop), and AE*%Imp-drop were examined. Lesion size was analyzed in 283 of 288 lesions (NS-irrigation, n=142; HNS-irrigation, n=141) without steam pops. AE*%Imp-drop consistently showed the strongest correlations with lesion maximum depth (NS-irrigation, ρ=0.91; HNS-irrigation, ρ=0.94), surface area (NS-irrigation, ρ=0.87; HNS-irrigation, ρ=0.86), and volume (NS-irrigation, ρ=0.94; HNS-irrigation, ρ=0.94) compared with the other parameters. Moreover, compared with AE alone, AE*%Imp-drop significantly improved the strength of correlation with lesion maximum depth (AE vs. AE*%Imp-drop, ρ=0.83 vs. 0.91, P<0.01), surface area (ρ=0.73 vs. 0.87, P<0.01), and volume (ρ=0.84 vs. 0.94, P<0.01) with NS-irrigation. This tendency was also observed with HNS-irrigation. Parallel catheter orientation showed a better correlation with lesion depth and volume using ∆Imp-drop, %Imp-drop, and AE*%Imp-drop than perpendicular orientation.Conclusions: The combination of input and output parameters is more optimal than each single parameter for lesion prediction. |
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| AbstractList | Background: For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal.Methods and Results: Radiofrequency applications at a range of power (30–50 W), contact force (10 g and 20 g), duration (10–60 s), and catheter orientation with normal saline (NS)- or half-normal saline (HNS)-irrigation were performed in excised porcine hearts. The correlations, with lesion size of AE, absolute impedance drop (∆Imp-drop), relative impedance drop (%Imp-drop), and AE*%Imp-drop were examined. Lesion size was analyzed in 283 of 288 lesions (NS-irrigation, n=142; HNS-irrigation, n=141) without steam pops. AE*%Imp-drop consistently showed the strongest correlations with lesion maximum depth (NS-irrigation, ρ=0.91; HNS-irrigation, ρ=0.94), surface area (NS-irrigation, ρ=0.87; HNS-irrigation, ρ=0.86), and volume (NS-irrigation, ρ=0.94; HNS-irrigation, ρ=0.94) compared with the other parameters. Moreover, compared with AE alone, AE*%Imp-drop significantly improved the strength of correlation with lesion maximum depth (AE vs. AE*%Imp-drop, ρ=0.83 vs. 0.91, P<0.01), surface area (ρ=0.73 vs. 0.87, P<0.01), and volume (ρ=0.84 vs. 0.94, P<0.01) with NS-irrigation. This tendency was also observed with HNS-irrigation. Parallel catheter orientation showed a better correlation with lesion depth and volume using ∆Imp-drop, %Imp-drop, and AE*%Imp-drop than perpendicular orientation.Conclusions: The combination of input and output parameters is more optimal than each single parameter for lesion prediction. For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal. Radiofrequency applications at a range of power (30-50 W), contact force (10 g and 20 g), duration (10-60 s), and catheter orientation with normal saline (NS)- or half-normal saline (HNS)-irrigation were performed in excised porcine hearts. The correlations, with lesion size of AE, absolute impedance drop (∆Imp-drop), relative impedance drop (%Imp-drop), and AE*%Imp-drop were examined. Lesion size was analyzed in 283 of 288 lesions (NS-irrigation, n=142; HNS-irrigation, n=141) without steam pops. AE*%Imp-drop consistently showed the strongest correlations with lesion maximum depth (NS-irrigation, ρ=0.91; HNS-irrigation, ρ=0.94), surface area (NS-irrigation, ρ=0.87; HNS-irrigation, ρ=0.86), and volume (NS-irrigation, ρ=0.94; HNS-irrigation, ρ=0.94) compared with the other parameters. Moreover, compared with AE alone, AE*%Imp-drop significantly improved the strength of correlation with lesion maximum depth (AE vs. AE*%Imp-drop, ρ=0.83 vs. 0.91, P<0.01), surface area (ρ=0.73 vs. 0.87, P<0.01), and volume (ρ=0.84 vs. 0.94, P<0.01) with NS-irrigation. This tendency was also observed with HNS-irrigation. Parallel catheter orientation showed a better correlation with lesion depth and volume using ∆Imp-drop, %Imp-drop, and AE*%Imp-drop than perpendicular orientation. The combination of input and output parameters is more optimal than each single parameter for lesion prediction. For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal.BACKGROUNDFor lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal.Radiofrequency applications at a range of power (30-50 W), contact force (10 g and 20 g), duration (10-60 s), and catheter orientation with normal saline (NS)- or half-normal saline (HNS)-irrigation were performed in excised porcine hearts. The correlations, with lesion size of AE, absolute impedance drop (∆Imp-drop), relative impedance drop (%Imp-drop), and AE*%Imp-drop were examined. Lesion size was analyzed in 283 of 288 lesions (NS-irrigation, n=142; HNS-irrigation, n=141) without steam pops. AE*%Imp-drop consistently showed the strongest correlations with lesion maximum depth (NS-irrigation, ρ=0.91; HNS-irrigation, ρ=0.94), surface area (NS-irrigation, ρ=0.87; HNS-irrigation, ρ=0.86), and volume (NS-irrigation, ρ=0.94; HNS-irrigation, ρ=0.94) compared with the other parameters. Moreover, compared with AE alone, AE*%Imp-drop significantly improved the strength of correlation with lesion maximum depth (AE vs. AE*%Imp-drop, ρ=0.83 vs. 0.91, P<0.01), surface area (ρ=0.73 vs. 0.87, P<0.01), and volume (ρ=0.84 vs. 0.94, P<0.01) with NS-irrigation. This tendency was also observed with HNS-irrigation. Parallel catheter orientation showed a better correlation with lesion depth and volume using ∆Imp-drop, %Imp-drop, and AE*%Imp-drop than perpendicular orientation.METHODS AND RESULTSRadiofrequency applications at a range of power (30-50 W), contact force (10 g and 20 g), duration (10-60 s), and catheter orientation with normal saline (NS)- or half-normal saline (HNS)-irrigation were performed in excised porcine hearts. The correlations, with lesion size of AE, absolute impedance drop (∆Imp-drop), relative impedance drop (%Imp-drop), and AE*%Imp-drop were examined. Lesion size was analyzed in 283 of 288 lesions (NS-irrigation, n=142; HNS-irrigation, n=141) without steam pops. AE*%Imp-drop consistently showed the strongest correlations with lesion maximum depth (NS-irrigation, ρ=0.91; HNS-irrigation, ρ=0.94), surface area (NS-irrigation, ρ=0.87; HNS-irrigation, ρ=0.86), and volume (NS-irrigation, ρ=0.94; HNS-irrigation, ρ=0.94) compared with the other parameters. Moreover, compared with AE alone, AE*%Imp-drop significantly improved the strength of correlation with lesion maximum depth (AE vs. AE*%Imp-drop, ρ=0.83 vs. 0.91, P<0.01), surface area (ρ=0.73 vs. 0.87, P<0.01), and volume (ρ=0.84 vs. 0.94, P<0.01) with NS-irrigation. This tendency was also observed with HNS-irrigation. Parallel catheter orientation showed a better correlation with lesion depth and volume using ∆Imp-drop, %Imp-drop, and AE*%Imp-drop than perpendicular orientation.The combination of input and output parameters is more optimal than each single parameter for lesion prediction.CONCLUSIONSThe combination of input and output parameters is more optimal than each single parameter for lesion prediction. |
| ArticleNumber | CJ-23-0574 |
| Author | Takigawa, Masateru Yamaguchi, Junji Ikenouchi, Takashi Yamamoto, Tasuku Amemiya, Miki Iwakawa, Hidehiro Tao, Susumu Takamiya, Tomomasa Sasano, Tetsuo Goya, Masahiko Watanabe, Hiroyuki Martin, Claire A Kawamura, Iwanari Goto, Kentaro Shigeta, Takatoshi Negishi, Miho Miyazaki, Shinsuke Nishimura, Takuro |
| Author_xml | – sequence: 1 fullname: Iwakawa, Hidehiro organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 2 fullname: Takigawa, Masateru organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 3 fullname: Yamaguchi, Junji organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 4 fullname: Martin, Claire A organization: Royal Papworth Hospital – sequence: 5 fullname: Goya, Masahiko organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 6 fullname: Yamamoto, Tasuku organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 7 fullname: Amemiya, Miki organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 8 fullname: Ikenouchi, Takashi organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 9 fullname: Negishi, Miho organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 10 fullname: Kawamura, Iwanari organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 11 fullname: Goto, Kentaro organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 12 fullname: Shigeta, Takatoshi organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 13 fullname: Nishimura, Takuro organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 14 fullname: Takamiya, Tomomasa organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 15 fullname: Tao, Susumu organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 16 fullname: Miyazaki, Shinsuke organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University – sequence: 17 fullname: Watanabe, Hiroyuki organization: Department of Cardiovascular Medicine, Akita University Graduate School of Medicine – sequence: 18 fullname: Sasano, Tetsuo organization: Department of Cardiovascular Medicine, Tokyo Medical and Dental University |
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| Snippet | Background: For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We... For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize... |
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| SubjectTerms | Animals Catheter ablation Catheter Ablation - methods Catheters Electric Impedance Energy Equipment Design Heart Heart Ventricles - pathology Impedance Lesion Radiofrequency Saline Solution Swine |
| Title | Superiority of the Combination of Input and Output Parameters to the Single Parameter for Lesion Size Estimation |
| URI | https://www.jstage.jst.go.jp/article/circj/87/12/87_CJ-23-0574/_article/-char/en https://www.ncbi.nlm.nih.gov/pubmed/37899173 https://www.proquest.com/docview/2884182016 |
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| ispartofPNX | Circulation Journal, 2023/11/24, Vol.87(12), pp.1757-1764 |
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