Numerical analysis of thermal impact of intramyocardial capillary blood flow during radiofrequency cardiac ablation. 2018

Juan J Pérez, and Ana González-Suárez, and Enrique Berjano
a BioMIT-Department of Electronic Engineering , Universitat Politècnica de València , Valencia , Spain.

The thermal effect of the intramyocardial blood perfusion on the size of lesions created by radiofrequency cardiac ablation (RFCA) has not been adequately studied to date. Our objective was to assess the impact of including this phenomenon in RFCA computer modelling in terms of the thermal lesion depth created. A computer model was built and computer simulations were conducted to assess the effect of including the blood perfusion term in the bioheat equation. This term mimics the intramyocardial blood flow (i.e., blood perfusion) in the cardiac wall at the site at which the RFCA is being conducted and hence represents a heat removing mechanism. When considered, blood perfusion rates ranged from 609 to 1719 ml/min/kg. Two electrode design and modes were considered: a non-irrigated electrode with constant temperature mode and an irrigated electrode with constant power mode. All the depths computed without including the blood perfusion term were larger than those that did include it, regardless of perfusion rate. The differences in lesion depth between ignoring and including blood perfusion increased over time; for a 60 s RFCA they were 0.45 and 1 mm for minimum and maximum perfusion rate, respectively. The differences were more or less independent of blood flow in the cardiac chamber, electrode type and ablation mode. The findings suggest that the heat-sink effect of blood perfusion should be taken into account in the case of ablations (>1 minute) such as those conducted in RFCA of the ventricular wall.

UI MeSH Term Description Entries
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D002196 Capillaries The minute vessels that connect arterioles and venules. Capillary Beds,Sinusoidal Beds,Sinusoids,Bed, Sinusoidal,Beds, Sinusoidal,Capillary,Capillary Bed,Sinusoid,Sinusoidal Bed
D006321 Heart The hollow, muscular organ that maintains the circulation of the blood. Hearts
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017097 Electric Impedance The resistance to the flow of either alternating or direct electrical current. Bioelectrical Impedance,Electric Resistance,Impedance,Ohmic Resistance,Biolectric Impedance,Electrical Impedance,Electrical Resistance,Impedance, Bioelectrical,Impedance, Biolectric,Impedance, Electric,Impedance, Electrical,Ohmic Resistances,Resistance, Electric,Resistance, Electrical,Resistance, Ohmic,Resistances, Ohmic
D017115 Catheter Ablation Removal of tissue with electrical current delivered via electrodes positioned at the distal end of a catheter. Energy sources are commonly direct current (DC-shock) or alternating current at radiofrequencies (usually 750 kHz). The technique is used most often to ablate the AV junction and/or accessory pathways in order to interrupt AV conduction and produce AV block in the treatment of various tachyarrhythmias. Ablation, Transvenous Electric,Catheter Ablation, Electric,Catheter Ablation, Percutaneous,Catheter Ablation, Radiofrequency,Catheter Ablation, Transvenous,Ablation, Catheter,Ablation, Transvenous Electrical,Catheter Ablation, Electrical,Electric Catheter Ablation,Electrical Catheter Ablation,Percutaneous Catheter Ablation,Radiofrequency Catheter Ablation,Transvenous Catheter Ablation,Ablation, Electric Catheter,Ablation, Electrical Catheter,Ablation, Percutaneous Catheter,Ablation, Radiofrequency Catheter,Ablation, Transvenous Catheter,Electric Ablation, Transvenous,Electrical Ablation, Transvenous,Transvenous Electric Ablation,Transvenous Electrical Ablation

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