Abstract
Purpose To assess the effect of intracardiac blood flow pulsatility on tissue and blood distributions during radiofrequency (RF) cardiac ablation (RFCA). Methods A three-dimensional computer model was used to simulate constant power ablations with an irrigated-tip electrode and three possible catheter orientations (perpendicular, parallel and 45°). Continuous flow and three different pulsatile flow profiles were considered, with four average blood velocity values: 3, 5.5, 8.5 and 24.4 cm/s. The 50 °C contour was used to assess thermal lesion size. Results The differences in lesion size between continuous flow and the different pulsatile flow profiles were always less than 1 mm. As regards maximum tissue temperature, the differences between continuous and pulsatile flow were always less than 1 °C, with slightly higher differences in maximum blood temperature, but never over 6 °C. While the progress of maximum tissue temperature was identical for continuous and pulsatile flow, maximum blood temperature with the pulsatile profile showed small amplitude oscillations associated with blood flow pulsatility. Conclusions The findings show that intracardiac blood pulsatility has a negligible effect on lesion size and a very limited impact on maximum tissue and blood temperatures, which suggests that future experimental studies based on ex vivo or in silico models can ignore pulsatility in intracardiac blood flow.
Highlights
Ex vivo [1,2] and computer [3,4,5,6,7] models are broadly employed to study different technical issues involved in radiofrequency (RF) cardiac ablation (RFCA)
We found that the maximum tissue temperature evolved to a more or less stationary state with hardly any fluctuations and behaved in all the blood flow profiles
Our aim was to study by means of computer modeling the effect of intracardiac blood flow pulsatility on the thermal lesion created during RFCA
Summary
Ex vivo [1,2] and computer [3,4,5,6,7] models are broadly employed to study different technical issues involved in radiofrequency (RF) cardiac ablation (RFCA). Clinical studies and those based on in vivo models did take pulsatility into account, as it is inherent to the heartbeat. Since this type of study does not make it possible to keep all the process variables under control (unlike ex vivo and computer studies), the relationship between flow pulsatility and tissue temperature distribution cannot be established. Our objective was to use a computer model to assess the effect of considering different blood flow pulsatile profiles (equivalent to those physiological profiles) on temperature distributions and the thermal lesions created in the cardiac tissue by comparing them with the continuous blood flow case. The results of this study are expected to contribute to the information available on the thermal effect of intracardiac blood flow pulsatilty on the thermal lesion created during RFCA, and perhaps on future ex vivo or computational studies in which blood flow has a relevant thermal impact
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
