Abstract
Neither the actual in vivo tissue temperatures reached with a novel contact force sensing catheter with a mesh-shaped irrigation tip (TactiFlex SE, Abbott) nor the safety profile has been elucidated. In a porcine model (n=8), thermocouples were implanted epicardially in the superior vena cava, right pulmonary vein, and esophagus close to the inferior vena cava following a right thoracotomy. After chest closure, endocardial ablation was conducted near the thermocouples under fluoroscopic guidance. We compared tissue temperatures during 50W/13-s high-power short-duration (HPSD) and 30W/30-s standard ablation. No steam pops were observed in 34 HPSD and 35 standard ablation applications. Tmax (maximum tissue temperature when the thermocouple was located ≤5mm from the catheter tip) was modestly higher in HPSD compared to standard ablation (60.1°C±12.4°C vs. 57.8°C±12.9°C; p = 0.46). The peak tissue temperature correlated inversely with the catheter tip-to-thermocouple distance (HPSD: r = -0.40; standard: r = -0.57). Lethal temperatures (≥50°C) were reached faster with HPSD (6.5±3.2s vs. 10.3±8.6s; p=0.04) and the distance from the catheter tip achieving a lethal tissue temperature ≥50°C (indicative of the lesion depth) was slightly shallower with HPSD (4.2 and 4.8mm, respectively). The esophageal injury occurred superficially in both settings (0.98±0.22mm vs. 1.16±0.18mm; p=0.29). HPSD ablation produced a modestly higher and more rapid increase in the tissue temperature around the veno-atrial junction with a shorter catheter tip-to-thermocouple distance required to reach lethal temperatures. This data contributes to understanding effective lesion creation and collateral injury prevention with the TactiFlex catheter.
Published Version
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