Safety and lesion characteristics of temperature-flow control vs power control modes in radiofrequency ablation: An in vivo study in swine

Background Steam pop is a major safety concern in radiofrequency (RF) ablation. The temperature-flow control (TFC) mode may mitigate this risk by precisely monitoring tissue temperature. Objective This study compared the safety and efficacy of TFC versus power control (PC) under ablation index (AI) guidance, focusing on steam pop incidence and lesion characteristics. Method In vivo experiments were conducted in 9 swine, with atrial ablations performed under AI control at 500–600 and ventricular ablations at 550–650. Procedural parameters were recorded, and lesion characteristics and steam pops were assessed pathologically. Result A total of 258 atrial and 117 ventricular ablations were performed in nine pigs, of which 227 atrial and 102 ventricular ablations met inclusion criteria. In both chambers, contact force was comparable between TFC and PC groups, but ablation time was significantly longer with TFC (P