Abstract
Cardiac radiofrequency ablation (RFA) has received substantial attention for the treatment of multiple arrhythmias. In this scenario, there is an ever-growing demand for monitoring the temperature trend inside the tissue as it may allow an accurate control of the treatment effects, with a consequent improvement of the clinical outcomes. There are many methods for monitoring temperature in tissues undergoing RFA, which can be divided into invasive and non-invasive. This paper aims to provide an overview of the currently available techniques for temperature detection in this clinical scenario. Firstly, we describe the heat generation during RFA, then we report the principle of work of the most popular thermometric techniques and their features. Finally, we introduce their main applications in the field of cardiac RFA to explore the applicability in clinical settings of each method.
Highlights
Catheter-mediated radiofrequency ablation (RFA) is the most widely used procedure in the field of cardiac electrophysiology
1987 [1,2,3], RFA has emerged as the key procedure for the treatment of multiple arrhythmias, due to the low mortality and morbidity associated with this practice, together with its high success rate [4]
In 2017 Halbfass et al [109] explored the incidence of the esophageal injuries occurrence after myocardial RFA performed with and without esophageal thermal probes devoted to local temperature control. 80 patients were subjected to left atrial RFA performed with the following setting: 35 W of maximum power delivery, target temperature at the electrode tip of 43 ◦ C, at least 20 s of treatment time and contact force ranging from 10 gf to 35 gf
Summary
Catheter-mediated radiofrequency ablation (RFA) is the most widely used procedure in the field of cardiac electrophysiology. High-intensity focused ultrasound (HIFU)), may be of fundamental importance, to ensure the success and the safety of the procedures, and to adjust the progress of the parameters set (e.g., power delivery and treatment time) Given this need, in the last few decades the effort made by researchers to develop methods for temperature monitoring during ablation procedures with better performance has led to the achievement of several solutions exploiting various technologies. Some attempts have been made through the use of ultrasound-based thermometry [68,69,70] and invasive methods, such as thermocouples [71,72] thermistors [57,73,74,75], and fiber optics [76,77,78,79], but limited to laboratory settings. An evaluation on the performances and a comparison between benefits and drawbacks brought by each methodology is reported
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