loading page

AMEN and ALARA – Remembering the dangers of the (new) technology of lesion formation
  • Mark Alexander,
  • Edward O'Leary
Mark Alexander
Boston Children's Hospital

Corresponding Author:mark.alexander@cardio.chboston.org

Author Profile
Edward O'Leary
Boston Children's Hospital
Author Profile


Catheter ablation in children has evolved to become a highly effective and safe therapy. Each iterative improvement in ablation technology provides another opportunity to investigate how much incremental benefit can be made without sacrificing safety. Contact force sensing catheters represent an example of such technology that has become commonplace in adult ablation. Its capability in predicting lesion size and collateral damage to critical structures has not been meticulously explored. Backhoff and colleagues describe an animal ablation model where they quantitate lesion characteristics at the atrium, atrioventricular groove, and ventricle using low and high contact force targets, with a specific focus on assessing for coronary arterial injury. In this controlled experiment, chronic lesion characteristics were widely variable (~0-8 mm diameter) yet there was a statistically significant (albeit small) increase in lesion diameter for high (vs low) contact force lesions delivered to the atrioventricular groove. The risk of chronic sub-clinical coronary artery injury was 1-2%.
21 Apr 2022Submitted to Journal of Cardiovascular Electrophysiology
28 Apr 2022Assigned to Editor
28 Apr 2022Submission Checks Completed
01 May 2022Editorial Decision: Revise Minor
01 May 20221st Revision Received
04 May 2022Submission Checks Completed
04 May 2022Assigned to Editor
04 May 2022Editorial Decision: Accept
28 May 2022Published in Journal of Cardiovascular Electrophysiology. 10.1111/jce.15546