Fehmi Keçe

Chapter 4 112 4.4 Discussion/Conclusion In line with previous reports, the MES count was particularly high for the left superior PV, which may be due to a steep angle between the catheter and the vein resulting in poor contact. In ablations with high power and high total effective energy, the higher MES count may be explained by stronger tissue devolution. A low temperature after 2 seconds may also be related to poor catheter contact, increasing the MES count. Increased impedance may be due to denaturization of blood proteins (MES particles). A slower temperature rise requires higher power to achieve the target temperature, and hence is related to a higher MES count. Electrode proximity/interaction and temperature overshoot (responsible for high MES counts in the first-generation PVAC) occurred infrequently and could not explain MES occurrence. In conclusion, in PVAC-Gold ablation, catheter contact-related biophysical parameters are associated with the increased amount of MES. A re-design including monitoring and improving catheter contact is therefore desirable.