title: Saline-irrigated radiofrequency ablation electrode with external cooling.
abstract: BACKGROUND
  Open flush, irrigated ablation electrodes may improve the safety of radiofrequency catheter ablation by preventing protein aggregation and coagulum formation. This is particularly important in left-sided procedures like catheter ablation of atrial fibrillation. Electrode cooling and the inherent loss of temperature feedback, however, grossly reduce the ability to monitor tissue heating. Intimate contact may not be recognized and the delivery of nominal RF power levels may then lead to excessive tissue heating, steam explosions, and even tamponade.
  
  
  RESULTS
  Standard, open flush, irrigated catheters (Sprinklr, Medtronic Inc, Minneapolis, MN) were modified by thermally insulating the irrigation channels inside the ablation electrode. Using the thigh muscle preparation, multiple lesions were created with standard and modified catheters using 60 s, 20-50 Watt applications and a constant saline flush rate of 20 cc/min. A total of 57 lesions were created on five thigh muscles of three dogs. Lesion dimensions were not significantly different between both types of catheter, but the maximum electrode temperature rise during ablation was significantly higher with the modified catheter. Insulation of the irrigation channels improved the correlation coefficient between maximum electrode temperature rise and lesion volume from 0.38 (ns) to 0.62 (P < 0.001).
  
  
  CONCLUSIONS
  Thermal insulation of the irrigation channels facilitates temperature feedback during radiofrequency ablation and controllability of lesion formation.
authors.affiliation: Department of Cardiology, Heart Lung Center Utrecht, The Netherlands. fredwittkampf@mac.com
authors.forename: Fred H M
authors.initials: FH
authors.lastname: Wittkampf
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Sarah
authors.initials: S
authors.lastname: Foresti
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aoyama
authors.forename: Warren M
authors.initials: WM
authors.lastname: Jackman
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000601:surgery; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D003080:Cold Temperature; D004285:Dogs; D004566:Electrodes; D022062:Electrophysiologic Techniques, Cardiac / Q000295:instrumentation*; D004867:Equipment Design; D023421:Models, Animal; D012965:Sodium Chloride; D007507:Therapeutic Irrigation
chemical_list: D012965:Sodium Chloride