Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: High-power short-duration (HPSD) radiofrequency ablation (RFA) for atrial fibrillation (AF) treatment carries the risk of steam pops (SPs) due to rapid tissue heating. However, methods to predict impending SP during HPSD-RFA remain undefined.
Objective: This study aims to establish a quantitative criterion for predicting SPs during HPSD-RFA.
Methods: Retrospective analysis was performed on 489 patients undergoing HPSD-RFA for AF, focusing on corresponding RFA parameters in those who experienced SPs.
Results: Among 1943 ablation lesions (ALs) delivered in 18 patients with SPs, 24 ALs had SP occurrence. Tip temperature, RFA duration, and ablation index were not significantly different between SP ALs and non-SP ALs. The mean contact force was significantly higher in SP ALs (12 g vs. 9, p < 0.001). All SPs adhered to the following criteria: impedance drop ≥8Ω during the first 4 s of RFA, impedance variability <5Ω within the first 4 s of RFA (24/24 vs. 79/247, p < 0.001), no events in the posterior wall of the left atrium, impedance drop ≥12Ω within 4-12 s. By halting delivery of RFA early with this finding in approximately five ALs per patient, the risk of SP complications could be significantly mitigated.
Conclusion: Monitoring impedance trends in the initial 4 s of HPSD-RFA can effectively predict impending SP occurrences. Automated algorithms should be developed to halt RFA delivery in this setting.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/pace.70003 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Bipolar radiofrequency ablation for refractory scar-related interatrial septal tachycardias: a multicenter study.
J Interv Card Electrophysiol
September 2025
Electrophysiology Section, Cardiovascular Division, Cleveland Clinic, Cleveland, OH, USA.
Background: Catheter ablation of scar-related interatrial septal atrial tachycardias (IAS-ATs) is challenging and can be refractory to conventional unipolar radiofrequency catheter ablation (RFCA).
Aim: This multicenter study investigated the safety and efficacy of bipolar radiofrequency catheter ablation (Bi-RFCA) in patients with IAS-AT refractory to conventional unipolar RFCA.
Methods: Consecutive patients with scar-related IAS-AT refractory to conventional unipolar RFA across three electrophysiological centers were included in the study.
High-Power Short-Duration Ablation Versus Conventional Power Ablation in Pulmonary Vein Isolation in Patients With Atrial Fibrillation: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.
J Cardiovasc Electrophysiol
August 2025
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Background: High-power short-duration (HPSD) ablation has emerged as a promising alternative to conventional power delivery (CPD) for pulmonary vein isolation (PVI) among patients with atrial fibrillation (AF), though its efficacy, procedural efficiency, and safety profile remain uncertain.
Aims: To evaluate and compare the efficacy, procedural efficiency, and safety of HPSD versus CPD ablation strategies for PVI in patients with AF through a systematic review and meta-analysis of randomized controlled trials (RCTs).
Materials And Methods: PubMed, Embase, Cochrane Library, and ClinicalTrials.
Incidence and Influencing Factors for Steam Pops in Cardiac Ablations: A Systematic Review.
Pacing Clin Electrophysiol
July 2025
Department of Cardiology, Dr. Sulaiman Al-Habib Hospital, Riyadh, Saudi Arabia.
Background: Steam pops (SPs) during cardiac ablations have emerged as a notable phenomenon with potential implications for procedural safety and efficacy. This is the first review of SPs, which aims to explore the current understanding of SPs. The review investigates their incidence, associations, predictors, clinical significance, and management strategies.
View Article and Find Full Text PDFPredictive Parameters for Impending Steam Pops During High-Power Short-Duration Ablation for Atrial Fibrillation.
Pacing Clin Electrophysiol
August 2025
Smidt Heart institute, Cedars Sinai Medical Center, Los Angeles, California, USA.
Background: High-power short-duration (HPSD) radiofrequency ablation (RFA) for atrial fibrillation (AF) treatment carries the risk of steam pops (SPs) due to rapid tissue heating. However, methods to predict impending SP during HPSD-RFA remain undefined.
Objective: This study aims to establish a quantitative criterion for predicting SPs during HPSD-RFA.
Endoepicardial transmural lesion formation utilizing multipolar radiofrequency ablation.
Heart Rhythm
May 2025
Division of Electrophysiology, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Canada. Electronic address:
Background: Conventional unipolar radiofrequency (RF) catheter ablation is limited by maximal lesion depths that fail to eliminate ventricular tachycardias with deep midmyocardial critical components. The use of multipolar mapping catheters as an active part of the ablation circuit may provide a solution to these limitations.
Objective: This study aimed to evaluate a novel endoepicardial multipolar RF catheter ablation technique for creating transmural lesions in an in vivo porcine model.