B-AB12-04 OPTIMAL LESION SIZE INDEX TO MAKE CHRONIC TRANSMURAL CONTINUOUS LESION USING RECOVERY PIG MODEL

Abstract

Contact force sensing technology dramatically improved to treat atrial arrhythmia but the effective catheter setting still remains unclear to achieve durable atrial lesion. The goal of this study was to find the optimal lesion size index (LSI) to create durable transmural ablation lesion in atrium using survival pig model. Atrial ablation lesions (n=157) were created by using a contact force-sensing irrigated catheter in a pig model (n=8) using 3D mapping system. Lesions were made based on varying lesion size index with several inter-lesion distance. After 8 weeks, all lesions were assessed by electrical physiological study and excised hearts underwent pathological evaluation. Lesion length was significantly larger according to LSI value (Panel A). Two lesions were excluded in this study because of pop phenomenon. All lesions were divided into durable (DL group, n=137) and non-durable lesions (NL group, n=16) based on whether the lesions were transmural. Panel B shows that the total energy, duration, and average contact force were significantly larger in DL group. Panel C represents the contact force parameters for DL and NL group at 30-, 40-, and 50W power, respectively. No significant difference was seen in contact force, impedance change, and tip temperature. The longer ablation time and higher force time integral and LSI were significant differences between 2 groups. Minimum ablation time and LSI values are critical parameters that determine durable atrial scar creation and their minimum values vary with the ablation power setting.