Why a large tip electrode makes a deeper radiofrequency lesion: Effects of increase in electrode cooling and electrode-tissue interface area

Kenichiro Otomo, William S. Yamanashi, Claudio Tondo, Matthias Antz, Jonathan Bussey, Jan V. Pitha, Mauricio Arruda, Hiroshi Nakagawa, Fred H M Wittkampf, Ralph Lazzara, Warren M. Jackman

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Increasing electrode size allows an increase in radiofrequency lesion depth. The purpose of this study was to examine the roles of added electrode cooling and electrode-tissue interface area in producing deeper lesions. Methods and Results: In 10 dogs, the thigh muscle was exposed and superfused with heparinized blood. An 8-French catheter with 4- or 8-mm tip electrode was positioned against the muscle with a blood flow of 350 mL/min directed around the electrode. Radiofrequency current was delivered using four methods: (1) electrode perpendicular to the muscle, using variable voltage to maintain the electrode-tissue interface temperature at 60°C; (2) same except the surrounding blood was stationary; (3) perpendicular electrode position, maintaining tissue temperature (3.5-mm depth) at 90°C; and (4) electrode parallel to the muscle, maintaining tissue temperature at 90°C. Electrode-tissue interface temperature, tissue temperature (3.5- and 7.0-mm depths), and lesion size were compared between the 4- and 8-mm electrodes in each method. In Methods 1 and 2, the tissue temperatures and lesion depth were greater with the 8-mm electrode. These differences were smaller without blood flow, suggesting the improved convective cooling of the larger electrode resulted in greater power delivered to the tissue at the same electrode-tissue interface temperature. In Method 3 (same tissue current density), the electrode-tissue interface temperature was significantly lower with the 8-mm electrode. With parallel orientation and same tissue temperature at 3.5-mm depth (Method 4), the tissue temperature at 7.0-mm depth and lesion depth were greater with the 8- mm electrode, suggesting increased conductive heating due to larger volume of resistive heating because of the larger electrode-tissue interface area. Conclusion: With a larger electrode, both increased cooling and increased electrode-tissue interface area increase volume of resistive heating and lesion depth.

Original languageEnglish
Pages (from-to)47-54
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume9
Issue number1
Publication statusPublished - 1998

Keywords

  • Catheter ablation
  • Electrode cooling
  • Electrode size
  • Electrode-tissue interface area
  • Lesion size
  • Radiofrequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

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