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

[EN] Purpose: 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 the...

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Bibliographic Details
Authors: Pérez, Juan J|||0000-0001-8486-8699, González-Suárez, Ana|||0000-0002-1813-4176, Berjano, Enrique|||0000-0002-3247-2665
Format: article
Publication Date:2018
Country:España
Institution:Universitat Politècnica de València (UPV)
Repository:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
Language:English
OAI Identifier:oai:riunet.upv.es:10251/104554
Online Access:https://riunet.upv.es/handle/10251/104554
Access Level:Open access
Keyword:Blood perfusion
Cardiac ablation
Computer model
Intramyocardial blood flow
Radiofrequency ablation
TECNOLOGIA ELECTRONICA
Description
Summary:[EN] Purpose: 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.Methods: 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 1719ml/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.Results: 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 60s RFCA they were 0.45 and 1mm 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.Conclusions: The findings suggest that the heat-sink effect of blood perfusion should be taken into account in the case of ablations (>1minute) such as those conducted in RFCA of the ventricular wall.