Accuracy of Voltage Signal Measurement During Radiofrequency Delivery Through the SMARTTOUCH Catheter

• Published in: Journal of cardiovascular electrophysiology 2017-01, Vol.28 (1), p.51-55
• Main Authors: SAFAVI‐NAEINI, PAYAM, ZAFAR‐AWAN, DREEMA, ZHU, HONGJIAN, ZABLAH, GERARDO, GANAPATHY, ANAND V., RASEKH, ABDI, SAEED, MOHAMMAD, RAZAVI, JOANNA ESTHER MOLINA, RAZAVI, MEHDI
• Format: Article
• Language: English
• Subjects: Ablation; Accuracy; Action Potentials; Aged; Aged, 80 and over; Algorithms; atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - physiopathology; Atrial Fibrillation - surgery; Cardiac Catheters; Catheter Ablation - adverse effects; Catheter Ablation - instrumentation; Catheters; Correlation coefficient; Correlation coefficients; Dimensional measurement; Dimensional measurements; Electric Impedance; Electrical measurement; Electrophysiologic Techniques, Cardiac - instrumentation; Equipment Design; Female; Fibrillation; Heart Rate; Humans; Male; Mapping; Measurement methods; Medical instruments; Medical personnel; Middle Aged; myocardial voltage; Predictive Value of Tests; Radio frequency; Radiofrequency; radiofrequency catheter ablation; radiofrequency energy noise; Reproducibility of Results; Signal measurement; Signal Processing, Computer-Assisted; SMARTTOUCH catheter; Voltage; voltage measurement
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.13113

Voltage Measurement During Radiofrequency Delivery Introduction Current methods for measuring voltage during radiofrequency (RF) ablation (RFA) necessitate turning off the ablation catheter. If voltage could be accurately read without signal attenuation during RFA, turning off the catheter would be unnecessary, allowing continuous ablation. We evaluated the accuracy of the Thermocool SMARTTOUCH catheter for measuring voltage while RF traverses the catheter. Methods and Results We studied 26 patients undergoing RFA for arrhythmias. A 7.5F SMARTTOUCH catheter was used for sensing voltage and performing RFA. Data were collected from the Carto‐3 3‐dimensional mapping system. Voltages were measured during ablation (RF‐ON) and immediately before or after ablation (RF‐OFF). In evaluating the accuracy of RF‐ON measurements, we utilized the RF‐OFF measure as the gold standard. We measured 465 voltage signals. The median values were 0.2900 and 0.3100 for RF‐ON and RF‐OFF, respectively. Wilcoxon signed rank testing showed no significant difference in these values (P = 0.608). The intraclass correlation coefficient (ICC) was 0.96, indicating that voltage measurements were similarly accurate during RF‐OFF versus RF‐ON. Five patients had baseline atrial fibrillation (AF), for whom 82 ablation points were measured; 383 additional ablation points were measured for the remaining patients. The voltages measured during RF‐ON versus RF‐OFF were similar in the presence of AF (P = 0.800) versus non‐AF rhythm (P = 0.456) (ICC, 0.96 for both). Conclusion Voltage signal measurement was similarly accurate during RF‐ON versus RF‐OFF independent of baseline rhythm. Physicians should consider not turning off the SMARTTOUCH ablation catheter when measuring voltage during RFA.