Efficiency and safety of high‐power ablation guided by Lesion size index: An ex vivo porcine heart study

Abstract

Background Although Lesion size index (LSI) has been reported to highly predict radiofrequency lesion size in vitro, its accuracy in lesion size and steam pop estimation has not been well investigated for every possible scenario. Methods Initially, radiofrequency ablations were performed on porcine myocardial slabs at various power, CF, and time settings with blinded LSI. Subsequently, radiofrequency power at 20, 30, 40, 50, and 60 W was applied at CF values of 5, 10, 20, and 30 g to reach target LSIs of 4, 5, 6, and 7. Lesion size and steam pops were recorded for each ablation. Results Lesion size was positively correlated with LSI regardless of power settings (p < 0.001). The linear correlation coefficients of lesion size and LSI decreased at higher power settings. At high power combined with high CF settings (50 W/20 g), lesion depth and LSI showed an irrelevant correlation (p = 0.7855). High‐power ablation shortened ablation time and increased the effect of resistive heating. LSI could predict the risk of steam pops at high‐power settings with the optimal threshold of 5.65 (sensitivity, 94.1%; specificity, 46.1%). The ablation depth of the heavy heart was shallower than that of the light heart under similar ablation settings. Conclusions LSI could predict radiofrequency lesion size and steam pops at high power settings in vitro, while synchronous high power and high CF should be avoided. Lighter hearts require relatively lower ablation settings to create appropriate ablation depth.

Integrated bioinformatics and experiment revealed that cuproptosis is the potential common pathogenesis of three kinds of primary cardiomyopathy

“…Recently, researchers have noticed the role of SLC31A1 in cardiomyopathy. One study reported that SLC31A1-related signaling pathways may be involved in the pathogenesis of diabetic cardiomyopathy [39]. MAP2K1 is a member of the dual specificity protein kinase family and is an important part of the intracellular and extracellular MAP kinase signaling pathway, which is involved in many biological processes such as cell proliferation and differentiation [40].…”