Identification of Radiofrequency Ablation Catheter Parameters That May Induce Intracardiac Steam Pops: Direct Visualization of Elicitation in Reanimated Swine Hearts

Tinen L. Iles, Stephen G. Quallich, Paul A. Iaizzo

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Radiofrequency, a common ablation modality, is used clinically to terminate cardiac arrhythmias. With excessive heating, complications sometimes occur when the applied energy generates steam pops, which cause release of energy in the form of tissue and/or air emboli. In this study, we investigated numerous parameters potentially associated with intracardiac steam pops including (1) wattage, (2) catheter tip temperature, (3) catheter irrigation, (4) anatomic site, and (5) repeat ablations at a given site. Using unique Visible Heart® methodologies in reanimated swine hearts, we visualized 539 ablations; steam pops developed in 140 of these ablations. The incidence of steam pops significantly increased for both nonirrigated and irrigated ablations at 40 W (p < 0.005), and for nonirrigated ablations with catheter contact angles perpendicular to the tissue or that encompassed larger surface areas (p < 0.05). To minimize the incidence of steam pops, clinicians performing radiofrequency ablations must consider catheter parameters.

Original languageEnglish (US)
Pages (from-to)250-256
Number of pages7
JournalJournal of cardiovascular translational research
Volume12
Issue number3
DOIs
StatePublished - Jun 15 2019

Bibliographical note

Funding Information:
This research was funded by the Institute for Engineering in Medicine at the University of Minnesota and by a research contract from Medtronic (Minneapolis, MN, USA).

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Atrial fibrillation
  • Cardiac arrhythmia
  • Radiofrequency ablation
  • Reanimated swine heart
  • Steam pops
  • Visualization

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