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An in vivo comparison of radiofrequency cardiac lesions formed by standard and magnetically steered 4 mm tip catheters

(2010) NETHERLANDS HEART JOURNAL. 18(2). p.66-71
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Organization
Abstract
Background. In vivo comparison of cardiac radiofrequency ablation lesions between standard and magnetically steered 4 turn tip catheters has never been reported. Methods. High and low right atrium (RA) free wall, isthmus, right ventricle (RV) free wall and outflow tract lesions were studied macroscopically and microscopically five days after lesion formation in seven pigs. Shape, size, thrombus formation, and ablation parameters were compared. The effect of minimal, medium and high wall contact was assessed by a contact measurement utility for magnetic catheters. Results. All 14 RA free wall lesions were transmural with a similar epicardial and endocardial surface area. In the RV, the epicardial area usually appeared to be smaller than the endocardial area with standard catheters. Isthmus lesions were difficult to assess transmurality. There was no difference in endocardial area: standard 39 mm(2) (range 16 to 82 mm(2)) vs. magnetic 36 mm(2) (range 23 to 111 mm(2)). If the catheter tip was perpendicular to the tissue, magnetic lesions were more often round or oval, while standard lesions were more often elongated (p<0.05). When the catheter tip was parallel to tissue, lesions always tended to be elongated. Microscopic characteristics were similar. The contact utility was not useful. Average impedance (p<0.0001) and energy delivered (p<0.05) were less with magnetic catheters. Conclusion. Lesions from magnetically steered catheters are transmural of similar size, but with less variability than standard catheter lesions when the tip is perpendicular to the tissue. Magnetic lesions are associated with lower impedance and energy delivery. This suggests a more stable tip-to-tissue contact.
Keywords
Magnetics, NODAL REENTRANT TACHYCARDIA, Myocardium/pathology, Equipment Design, Catheter Ablation/instrumentation, TISSUE TEMPERATURES, GUIDANCE-SYSTEM, ABLATION, NAVIGATION, VITRO, EXPERIENCE, ELECTRODE, SAFETY, SIZE

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Chicago
Thornton, AS, CAB De Castro, E van Deel, HMM van Beusekom, and Luc Jordaens. 2010. “An in Vivo Comparison of Radiofrequency Cardiac Lesions Formed by Standard and Magnetically Steered 4 Mm Tip Catheters.” Netherlands Heart Journal 18 (2): 66–71.
APA
Thornton, A., De Castro, C., van Deel, E., van Beusekom, H., & Jordaens, L. (2010). An in vivo comparison of radiofrequency cardiac lesions formed by standard and magnetically steered 4 mm tip catheters. NETHERLANDS HEART JOURNAL, 18(2), 66–71.
Vancouver
1.
Thornton A, De Castro C, van Deel E, van Beusekom H, Jordaens L. An in vivo comparison of radiofrequency cardiac lesions formed by standard and magnetically steered 4 mm tip catheters. NETHERLANDS HEART JOURNAL. 2010;18(2):66–71.
MLA
Thornton, AS et al. “An in Vivo Comparison of Radiofrequency Cardiac Lesions Formed by Standard and Magnetically Steered 4 Mm Tip Catheters.” NETHERLANDS HEART JOURNAL 18.2 (2010): 66–71. Print.
@article{8094252,
  abstract     = {Background. In vivo comparison of cardiac radiofrequency ablation lesions between standard and magnetically steered 4 turn tip catheters has never been reported. 
Methods. High and low right atrium (RA) free wall, isthmus, right ventricle (RV) free wall and outflow tract lesions were studied macroscopically and microscopically five days after lesion formation in seven pigs. Shape, size, thrombus formation, and ablation parameters were compared. The effect of minimal, medium and high wall contact was assessed by a contact measurement utility for magnetic catheters. 
Results. All 14 RA free wall lesions were transmural with a similar epicardial and endocardial surface area. In the RV, the epicardial area usually appeared to be smaller than the endocardial area with standard catheters. Isthmus lesions were difficult to assess transmurality. There was no difference in endocardial area: standard 39 mm(2) (range 16 to 82 mm(2)) vs. magnetic 36 mm(2) (range 23 to 111 mm(2)). If the catheter tip was perpendicular to the tissue, magnetic lesions were more often round or oval, while standard lesions were more often elongated (p<0.05). When the catheter tip was parallel to tissue, lesions always tended to be elongated. Microscopic characteristics were similar. The contact utility was not useful. Average impedance (p<0.0001) and energy delivered (p<0.05) were less with magnetic catheters. 
Conclusion. Lesions from magnetically steered catheters are transmural of similar size, but with less variability than standard catheter lesions when the tip is perpendicular to the tissue. Magnetic lesions are associated with lower impedance and energy delivery. This suggests a more stable tip-to-tissue contact.},
  author       = {Thornton, AS and De Castro, CAB and van Deel, E and van Beusekom, HMM and Jordaens, Luc},
  issn         = {0929-7456},
  journal      = {NETHERLANDS HEART JOURNAL},
  keywords     = {Magnetics,NODAL REENTRANT TACHYCARDIA,Myocardium/pathology,Equipment Design,Catheter Ablation/instrumentation,TISSUE TEMPERATURES,GUIDANCE-SYSTEM,ABLATION,NAVIGATION,VITRO,EXPERIENCE,ELECTRODE,SAFETY,SIZE},
  language     = {eng},
  number       = {2},
  pages        = {66--71},
  title        = {An in vivo comparison of radiofrequency cardiac lesions formed by standard and magnetically steered 4 mm tip catheters},
  url          = {http://dx.doi.org/10.1007/BF03091740},
  volume       = {18},
  year         = {2010},
}

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