title: Prediction of radiofrequency ablation lesion formation using a novel temperature sensing technology incorporated in a force sensing catheter.
abstract: Real-time radiofrequency (RF) ablation lesion assessment is a major unmet need in cardiac electrophysiology.
  
  
  
  The purpose of this study was to assess whether improved temperature measurement using a novel thermocoupling (TC) technology combined with information derived from impedance change, contact force (CF) sensing, and catheter orientation allows accurate real-time prediction of ablation lesion formation.
  
  
  
  RF ablation lesions were delivered in the ventricles of 15 swine using a novel externally irrigated-tip catheter containing 6 miniature TC sensors in addition to force sensing technology. Ablation duration, power, irrigation rate, impedance drop, CF, and temperature from each sensor were recorded. The catheter "orientation factor" was calculated using measurements from the different TC sensors. Information derived from all the sources was included in a mathematical model developed to predict lesion depth and validated against histologic measurements.
  
  
  
  A total of 143 ablation lesions were delivered to the left ventricle (n = 74) and right ventricle (n = 69). Mean CF applied during the ablations was 14.34 ± 3.55g, and mean impedance drop achieved during the ablations was 17.5 ± 6.41 Ω. Mean difference between predicted and measured ablation lesion depth was 0.72 ± 0.56 mm. In the majority of lesions (91.6%), the difference between estimated and measured depth was ≤1.5 mm.
  
  
  
  Accurate real-time prediction of RF lesion depth is feasible using a novel ablation catheter-based system in conjunction with a mathematical prediction model, combining elaborate temperature measurements with information derived from catheter orientation, CF sensing, impedance change, and additional ablation parameters.
authors.affiliation: Heart Center, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Guy
authors.initials: G
authors.lastname: Rozen
authors.affiliation: Heart Center, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Leon
authors.initials: L
authors.lastname: Ptaszek
authors.affiliation: Biosense Webster Inc, Diamond Bar, California.
authors.forename: Israel
authors.initials: I
authors.lastname: Zilberman
authors.affiliation: Heart Center, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Kevin
authors.initials: K
authors.lastname: Cordaro
authors.affiliation: Heart Center, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: E Kevin
authors.initials: EK
authors.lastname: Heist
authors.affiliation: Biosense Webster Inc, Diamond Bar, California.
authors.forename: Christopher
authors.initials: C
authors.lastname: Beeckler
authors.affiliation: Biosense Webster Inc, Diamond Bar, California.
authors.forename: Andres
authors.initials: A
authors.lastname: Altmann
authors.affiliation: Heart Center, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Ying
authors.affiliation: Heart Center, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Zhenjiang
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Heart Center, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Ruskin
authors.affiliation: Biosense Webster Inc, Diamond Bar, California.
authors.forename: Assaf
authors.initials: A
authors.lastname: Govari
authors.affiliation: Heart Center, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: mmansour@mgh.harvard.edu.
authors.forename: Moussa
authors.initials: M
authors.lastname: Mansour
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000209:etiology; D004867:Equipment Design; D006352:Heart Ventricles / Q000601:surgery*; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods; D008953:Models, Anatomic; D013552:Swine; D016896:Treatment Outcome
keywords: Catheter ablation; Contact force sensing, Catheter orientation; Lesion assessment; Radiofrequency; Thermocouple