© 2001 by European Society of Cardiology
Electrochemical potentials during radiofrequency energy delivery: a new method to control catheter ablation of arrhythmias
Kerckhoff-Heart Center, Department of Cardiology ; *Max-Planck-Institute for Experimental Cardiology Benekestr. 2–8, D-61231, Bad Nauheim, Germany
AIMS: Thermal injury of subendocardial tissue leads to a release of electrolytes and free radicals from the intracellular site creating a change in electrochemical potential (eP) between the distal and the proximal catheter tip electrodes. The aim of the study was to verify the detection of ablation-induced release of electrolytes and free radicals and to assess the suitability of control-line energy delivery at ablation by measuringeP .
METHODS AND RESULTS: In vitro tests under constant flow conditions were performed in a 10 l bath of physiological saline solution or bovine blood. Endomyocardial preparations of fresh bovine hearts were used. Closed-loop temperature-controlled, irrigated and closed-loop eP -controlled ablations were performed.In vivo animal investigations were performed in six anaesthetized and ventilated pigs. The existence of the eP was established in the tank model and was confirmed in animal investigations. High correlations were found between eP and catheter tip temperature (r=0·87) and between maximum eP and induced lesion size (r=0·85). Also a high correlation (r=0·85, P< 0·001) was found between eP and lesion volume.
CONCLUSIONS: Control of energy delivery during RF ablation by the measurement ofeP is feasible. In comparison with temperature controlled RF ablation, ablation guided by eP -measurement revealed a superior correlation with induced lesion size. Especially during cooled radiofrequency catheter ablation eP is the only parameter for control of energy delivery.
Key Words: Radiofrequency catheter ablation, potential measurement, energy control
Correspondence: A. Erdogan, MD, Justus-Liebig-Universitaet Giessen, Internal Medicine, Dept. of Cardiology, Klinikstr. 36, D-35392 Giessen, Germany.
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