Circulation, Vol 80, 962-968, Copyright © 1989 by American Heart Association
FH Wittkampf, RN Hauer and EO Robles de Medina
The influence of power and exposure duration on lesion size in
radiofrequency catheter ablation was investigated in 15 closed-chest dogs.
Radiofrequency energy was delivered to the right ventricular endocardium
between the tip of a standard 6F electrode catheter and a large W and
durations of 5, 10, 20, 30, and 60 seconds. At necropsy 1 week later,
well-demarcated homogeneous lesions were found when power had exceeded a
threshold level that decreased from 1.8 W at 5 seconds to 0.7 W at 60
seconds. Lesion size ranged from 0 to 7.5 mm in depth and 0 to 9 mm in
diameter. For the 5, 10, and 20 second ablations, lesion size was
determined by exposure duration and power level. However, after a 20 second
exposure, lesion size had reached maturity and was related to delivered
power only. Therefore, a gradual, controlled growth of the lesion can be
obtained by a stepwise increase of the radiofrequency power level with
ample exposure duration at each level to allow for stabilization. At levels
exceeding 7 W, the formation of a thin insulating layer of blood coagulum
on the electrode surface caused an abrupt increase of impedance within
approximately 30 seconds. Therefore, lesion size is limited to 8.5 mm in
radiofrequency ablation with a standard 6F endocardial electrode catheter.
ARTICLES
Control of radiofrequency lesion size by power regulation
Department of Cardiology, University Hospital, Utrecht, The Netherlands.
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