PO-03-068 CATHETER STABILITY AND LESION CHARACTERISTICS IN APNEA-ONLY RADIOFREQUENCY ABLATION LESIONS VS HIGH FREQUENCY, LOW TIDAL VOLUME - A SINGLE-CENTER ANALYSIS WITH CARTONET

Abstract

Catheter stability plays a vital role in ensuring durable ablation lesions. The high frequency low tidal volume (HRV) has demonstrated improved catheter stability. Eliminating respiratory motion altogether could allow for further improvement in catheter stability. We compared catheter stability and lesion characteristics during intermittent apnea-only lesion protocol (IAP) vs. HRV A retrospective, single-center analysis of patients who underwent AF ablation utilizing Smart touch ST SF catheter under IAP and HRV respiratory protocols. All patients received ablations in both respiratory protocols. IAP was utilized for every ablation site. The repeat lesions using HRV protocol were performed at the left superior pulmonary vein (LSPV), left the roof, and septum. The ablation lesion data were collected from the Cartonet. The outcomes in two respiratory protocols – stability, surpoint value, impedance drop, and average contact force – were compared using a two-sided t-test. Of 21 patients with a mean age of 72.5 (SD ± 10.1), 38.1% were female, 14.3% had diabetes, 86% had hyperlipidemia, 81% had hypertension, and 52.4% had a smoking history. IAP demonstrated a trend towards improved catheter stability at the LSPV (0.87 vs. 0.91; p=0.28) and left roof (0.95 vs. 1.1; p=0.21). Surpoint values were higher with IAP at the LSPV (437.3 vs. 421.8; p= 0.006) and trended higher in the left roof (422.99 vs. 398.88; p=0.139), and septum (456.77 vs. 431.74; p=0.22). Average contact force trended lower with IAP at the LSPV (10.95 vs. 11.85; p=0.91), left roof (12.64 vs. 14.45; p=0.22), septum (12.37 vs. 13.48; p=0.12). The impedance drop was higher with IAP at the left roof (7.93 vs. 5.67; p=0.026) and trended lower with IAP at LSPV (6.48 vs. 7.4; p=0.28). Apnea-only ablation lesions demonstrated a trend towards improved catheter stability at LSPV and left roof. In addition, impedance drop during apnea-only lesions was higher in the left atrial roof. Larger multicenter studies are needed to validate our hypothesis. The Cartonet software is a beneficial tool for analyzing ablation lesion characteristics.