Contact Forces Required to Record Monophasic Action Potentials: A Complement to Catheter Contact Force Measurement

Megan M. Schmidt, Mark A. Benscoter, Paul A. Iaizzo

Research output: Contribution to journalArticlepeer-review

Abstract

The ability to monitor catheter contact force (CF) plays a major role in assessing radiofrequency ablation, impacting lesion size and arrhythmia recurrence, and dictating ablation duration and/or overall patient safety. Our study sought to determine the relative CFs required to elicit reproducible monophasic action potential (MAP) recordings. Methods: The study utilized four swine in which: first, median sternotomies were performed and MAPs were collected from seven ventricular locations on the epicardial surface of each heart; and second, a subset of endocardial signals was recorded from a reanimated heart. In these studies, the initial elicitation and then loss of stable MAP waveforms were recorded, as were their associated catheter CFs (n = 371). Results: Mean CF at the onset of stable MAP recordings was 14.2 ± 2.9 g for epicardial and 16.6 ± 2.5 g for endocardial locations. Across epicardial locations, no significant differences in CF were required to elicit MAPs. Additionally, endocardial and epicardial CFs for MAPs did not significantly differ for respective locations, i.e., right ventricular septum endocardial versus epicardial. In our study, the catheter CFs required to elicit MAPs were within optimal ranges previously reported for eliciting clinically viable radiofrequency ablations. Conclusion: We believe that MAP recordings could complement CF measurements with electrical data, providing additional clinical feedback for physicians performing cardiac ablation. Significance: If applied clinically, MAP recordings could potentially improve ablation outcomes in patients with cardiac arrhythmias.

Original languageEnglish (US)
Article number8642340
Pages (from-to)2974-2978
Number of pages5
JournalIEEE Transactions on Biomedical Engineering
Volume66
Issue number10
DOIs
StatePublished - Oct 2019

Bibliographical note

Funding Information:
This work was supported by the University of Minnesota's Institute for Engineering in Medicine and a Medtronic research contract.

Funding Information:
Manuscript received September 17, 2018; revised January 2, 2019; accepted February 7, 2019. Date of publication February 14, 2019; date of current version September 18, 2019. This work was supported by the University of Minnesota’s Institute for Engineering in Medicine and a Medtronic research contract. (Corresponding author: Paul A. Iaizzo.) M. M. Schmidt was with the University of Minnesota. She is now with Medtronic. M. A. Benscoter was with the University of Minnesota. He is now with the Mayo Clinic. P. A. Iaizzo is with the University of Minnesota, Minneapolis, MN 55455 USA (e-mail:,[email protected]). Digital Object Identifier 10.1109/TBME.2019.2899554

Publisher Copyright:
© 1964-2012 IEEE.

Keywords

  • Catheter ablation
  • MAP
  • radiofrequency ablation

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