Ablation Parameters Research Articles

Design of Multiobjective Optimal Laser Ablation Parameters of Hole Opening in Package-on-package Process

Design of Multiobjective Optimal Laser Ablation Parameters of Hole Opening in Package-on-package Process

Factors associated with the efficacy of atrial fibrillation radiofrequency catheter ablation: opinion of the specialists who use the “ablation index” module

This document provides an overview of current problems and trends in the catheter ablation of atrial fibrillation, summarizes the opinions of specialists, obtained during a web-based electronic survey, on aspects and parameters of radiofrequency ablation. The approaches on improving the efficacy and safety of radiofrequency catheter ablation of atrial fibrillation are provided.

Biological Dose Prediction Model with Deep Neural Networks on Bulky Thoracic Cancer Patients of Partial Stereotactic Ablation Radiotherapy: For Better Therapeutic Evaluation and Risk Assessment

Partial stereotactic ablation radiotherapy(P-SABR) could achieve encouraging local control rates for intractable bulky thoracic cancer. However, the range of ablation may increase the radiation risk of normal tissues surrounded. The purpose of this work was to develop a biological dose prediction model that considers tissue bioreaction in addition to patient anatomy to achieve more comprehensive evaluation for bulky thoracic tumor control and tissue toxicity. A newly developed deep learning architecture, Nestnet, was trained to establish the biological dose prediction model (D-B Nestnet). A database containing images and P-SABR plans of 94 bulky thoracic cancer patients was studied (74 patients for training/validation and 20 patients for testing). Patient-specific parameters of gross tumor ablation boost (GTVb) and other anatomical information, PTV and organs at risk (OAR), were extracted from the structure set. The linear quadratic (LQ)model applied to stereotactic radiotherapy and cell sensitivity for thoracic tissues in hyperfractionation radiotherapy were programmed to transfer the physical dose extracted from plans into biologically effective dose (BED). the training process was completed automatically after the validation loss continued for 100 epochs without fluctuation. We evaluated the model’s accuracy by comparing the minimum BED of GTVb and PTV, the maximum BED and the mean BED of all targets, BED-volume metrics for the predicted biological dose distribution against those of clinical delivered. We also trained a model based on the standard U-net architecture (D-B Unet) and compared the accuracy with the proposed model we mentioned before. The results demonstrate that the B-Nestnet model can predict clinically acceptable biological dose distributions. the average absolute biases of [max, mean] BED for GTVb, PTV are [2.1%, 3.3%] and [2.1%, 4.72%], respectively. Averaging across most of OARs, our proposed model is capable of predicting the errors of the max and mean BED within 6.3% and 6.1%, respectively. The standard D-B Unet performed worse, having averaged max and mean BED prediction errors within 9.9% and 9.7%, respectively. The new developed model, which predicts the biological dose instead of the physical dose, can still predict the distribution with reasonable accuracy. Using this model could provide a more intuitive prediction of tumor ablation and OARs risk. According to the prediction outcomes, clinicalists could modify the range of ablation for enhancing the BED of tumor or decreasing the risk of OARs toxicity. This novel D-B Nestnet model represents a major step forward towards P-SABR planning on bulky thoracic cancer in the real clinical practice.

Modeling esophageal protection from radiofrequency ablation via a cooling device: an analysis of the effects of ablation power and heart wall dimensions

BackgroundEsophageal thermal injury can occur after radiofrequency (RF) ablation in the left atrium to treat atrial fibrillation. Existing methods to prevent esophageal injury have various limitations in deployment and uncertainty in efficacy. A new esophageal heat transfer device currently available for whole-body cooling or warming may offer an additional option to prevent esophageal injury. We sought to develop a mathematical model of this process to guide further studies and clinical investigations and compare results to real-world clinical data.ResultsThe model predicts that the esophageal cooling device, even with body-temperature water flow (37 °C) provides a reduction in esophageal thermal injury compared to the case of the non-protected esophagus, with a non-linear direct relationship between lesion depth and the cooling water temperature. Ablation power and cooling water temperature have a significant influence on the peak temperature and the esophageal lesion depth, but even at high RF power up to 50 W, over durations up to 20 s, the cooling device can reduce thermal impact on the esophagus. The model concurs with recent clinical data showing an 83% reduction in transmural thermal injury when using typical operating parameters.ConclusionsAn esophageal cooling device appears effective for esophageal protection during atrial fibrillation, with model output supporting clinical data. Analysis of the impact of ablation power and heart wall dimensions suggests that cooling water temperature can be adjusted for specific ablation parameters to assure the desired myocardial tissue ablation while keeping the esophagus protected.

Fabrication of micro-reentrant structures by liquid/gas interface shape-regulated electrochemical deposition

Micro-reentrant structures that are wide at the top and narrow at the bottom have important application values. However, the lack of an effective and universal method for fabricating micro-reentrant structures on various metallic materials is a bottleneck that restricts their development and application. In this work, the micro re-entrant structures were proposed to be divided into two parts, viz., the upper roof structures and lower pillar structures. First, superhydrophobic micropillar arrays were fabricated by nanosecond laser ablation followed by a treatment for surface energy reduction. As the electrolyte droplet stands on the top of the micropillars, because of their superhydrophobicity, and the shape of the liquid/gas interface could be regulated, the microroof array could be fabricated on the top of the pillar array by electrochemical deposition, resulting in micro-reentrant structures. The influences of the processing parameters of the laser ablation and electrochemical deposition on the features of the micro-reentrant structures were studied comprehensively. Upon a further reduction in the surface energy with the use of fluoroalkylsilane, superamphiphobicity was achieved with a contact angle larger than 150° for both water and peanut oil. The results of this study enrich the theory and technology of micromachining and promote the practical applications of micro-reentrant structures.

Thermal Load During Corneal Excimer Laser Ablation: Impact of Different Ablation Parameters.

To characterize the impact of different ablation parameters on the change in peak corneal temperature during corneal excimer laser ablation. Forty-two ablations were performed (21 on polymethylmethacrylate [PMMA] and 21 on porcine eyes) simulating photorefractive keratectomy (PRK), transepithelial PRK, and laser in situ keratomileusis (LASIK) treatments. Each ablation was recorded using infrared thermography. The change in peak corneal temperature was analyzed with respect to varying ablation parameters. Excellent correlation between the temperature rise in PMMA and porcine eyes was found. The change in peak corneal temperature was significantly higher in myopic than in hyperopic corrections, ranging from 6 °C for hyperopic corrections to 16 °C for a -18.00 diopters (D) correction. The change decreased with larger optical zones. Of all analyzed metrics, the refractive correction together with the maximum slope of the treatment showed the best coefficient of determination. Transepithelial ablations led to a higher change in peak corneal temperature than pure stromal ablations. Isothermal lines as a function of the refractive correction and optical zone diameter were calculated with a hypersurface model. If keeping the change in peak corneal temperature below 8 °C is the limit, only 3.00 to 4.00 D can be treated (6.5 mm or larger optical zone); for 10 °C, a maximum of 7.00 D (7 mm or larger optical zone) can be treated and for 12 °C, 10.00 D can be treated (6 mm or larger optical zone). The effect of different parameters on change in peak corneal temperature during corneal laser ablation could be quantitatively evaluated. Cooling the cornea may aid in avoiding thermal denaturation. This is particularly important for transepithelial ablations, which further increase the thermal load due to the extra ablation of the epithelium. [J Refract Surg. 2020;36(10):667-676.].

Posterior Wall Isolation for Atrial Fibrillation: Effects on Echocardiographic Parameters of cardiac function.

Posterior wall isolation (PWI) in addition to circumferential pulmonary vein isolation (CPVA) requires more ablation of left atrial tissue. We compared the effect of PWI versus non-PWI methods (CPVA + linear lesions) on echocardiographic parameters of left atrial and left ventricular function. We selected patients who had pre and post ablation echocardiogram at our institution. Parameters assessed were: Left ventricular outflow tract velocity time integral (VTI), left ventricular ejection fraction (LVEF), atrial Doppler velocity across mitral valve (A), E/E', and deceleration time. Of the 72 patients studied, 32.5% had PWA in addition to CPVA. The mean duration between echocardiograms was 650 + 542 days. PWA group had an average postoperative VTI 0.21 + 0.05 vs 0.21 + 0.05 in the non-PWA (p=0.61) group. Average improvement compared to pre ablation parameters: VTI was 0.03 + 0.06 vs 0.008 + 0.05 (p=0.17), postoperative A was 0.49 + 0.19 vs 0.57 + 0.19 (p=0.16), postoperative LVEF was 57.5 + 9.9% vs 57.8 + 10.8 % (p=0.89), with average change in LVEF 1.5 ± 7.8 vs 0.86 ± 9.7 (p=0.78) in PWA and non-PWA groups respectively. There was no significant difference in change in deceleration time or E/E' when comparing the two groups. PWA did not adversely affect echocardiographic parameters of left atrial function or left ventricular systolic or diastolic function when compared to other types of ablation.

Risk Factors of Ureteral Stenosis After Percutaneous Microwave Ablation of Renal Tumor, a Single-Center Experience.

BackgroundUreteral stenosis after percutaneous microwave ablation (MWA) of renal tumor is a rare but severe complication, and its risk factors are not apparent.PurposeThis study aimed to investigate the risk factors for stenosis of ureter after MWA treatment of the renal tumor that is a rare complication.Materials and MethodsData of 211 patients who underwent MWA for the treatment of renal tumor were retrospectively analyzed from September 2006 to August 2019. Demographic characteristics, clinical features, ablation parameters, and outcomes were analyzed to find out the potential risk factors of this complication. P < 0.05 is considered significant.ResultsSix of 211 patients developed ureter stenosis, and the rate of this complication is 2.84%. The median time of emergence of hydronephrosis was 226 (range, 3–390) days. Univariate analysis shows the distance between ureter and tumor (P = 0.225) or ablation zone (P = 0.089) is not related to this complication. Postoperative urine routine (red blood cell, P = 0.001; white blood cell, P = 0.035) and R.E.N.A.L. score (P < 0.001) is related to this complication. But after multivariate logistic analysis, only R.E.N.A.L. score (P = 0.004) is associated with this complication. The location and growth pattern of tumor and the energy of ablation were not related to this complication independently.ConclusionThe stenosis of the ureter after MWA of renal tumor is not associated with the tumor size, location, or the distance between the ureter and tumor and ablation site independently. But R.E.N.A.L. score is associated with ureter stenosis after MWA for the treatment of renal tumor, which combines the information of location, depth, and size of tumor. Preoperative evaluation of the tumor is necessary for avoiding ureter stenosis. Further studies should focus on these risk factors of this complication.

Effects of different ablation points of renal denervation on the efficacy of resistant hypertension.

ObjectiveTo explore the blood pressure response to different ablation points of renal denervation (RDN) in patients with resistant hypertensionMethodsA total of 42 cases with resistant hypertension treated by RDN in our center from 2013 to 2015 were retrospectively analyzed. The patients were divided into two groups according to the different ablation points of RDN: the standard treatment group (spiral ablation from near to proximal, with less than 8 points per artery) and the intensive treatment group (from near to far by spiral ablation, with at least 8 points per artery), with 21 patients in each group. The ablation parameters, including points, impedance, actual wattage, and actual temperature, were recorded intraoperatively. Renal angiography was performed again after RDN. Ambulatory blood pressure (ABP) images were taken for all patients at the baseline and 6 months after operation.ResultsThe mean 24-h blood pressure of the standard treatment group was lower than that of the baseline (24-h systolic blood pressure decreased by 7.4 ± 10.6 mmHg and 24-h diastolic blood pressure decreased by 4.6 ± 6.1 mmHg), and the mean 24-h blood pressure decreased significantly from baseline to 6 months in the intensive treatment group (24–h systolic blood pressure decreased by 27.4 ± 11.4 mmHg, P < 0.0001; 24–h diastolic blood pressure decreased by 10.9 ± 9.6 mmHg, P = 0.005). There was a positive correlation between the decrease of systolic/diastolic 24-hour mean and the number of ablation points used in the procedure. The mean value of systolic and diastolic blood pressure was positively correlated with ablation points at 24-hour (R2 = 0.777 and 0.633 respectively, P < 0.01). There were no adverse events in either group after the operation and during the follow-up.ConclusionsRDN could significantly reduce BP in patients with resistant hypertension. Our study showed that the antihypertensive effect appeared to be positively correlated with the number of ablation points.

Techniques to Avoid Complications of Atrial Fibrillation Ablation

Atrial fibrillation ablation is an increasingly common procedure adapted by electrophysiologists across the world. Any procedure naturally comes with inherent risks of complications. The goal of this review is to elaborate latest techniques and strategies to avoid complications of ablation. There is increased focus on new tools for avoiding esophageal injury as well as minimizing phrenic nerve injury in addition to utilization of newer ablation technologies to address safer and effective ablation. A combination of improved patient selection and better treatment protocols combined with methods for early detection of complications will significantly reduce the incidence of complications. Newer innovative technologies like esophageal temperature monitoring, mechanical deviation, and integration of ablation parameters are helping to avoid or minimize collateral damage.

Physiochemical characteristics: A robust tool to overcome teeth heterogeneity on predicting laser ablation profile.

To avoid excessive tissue removal and collateral damage, the high-power density laser is apt for dental surgery also need to have high precision. For high-precision dental surgery with minimal tissue damage, the present work frames a method to predict laser ablation profile based on surface morphology and chemical composition of dentin. The surface morphology and chemical composition were studied on different dentin samples using scanning electron microscope (SEM) and Energy Dispersive X-ray Analysis (EDAX), respectively. The key laser ablation parameters (ω0 , Deff , and Fth ) were determined by laser irradiation study using 800 nm, Ti:Sapphire femtosecond laser at processing condition of 100 fs, 10 kHz and 10 mm/s. The dentin samples show a strong linear correlation between physiochemical characteristics and laser ablation parameters. The surface morphology exhibits a negative linear correlation with threshold fluence, whereas the converse is true for chemical composition. The laser ablation parameters of a random dentin sample are derived from the knowledge of linearity data. From the obtained laser ablation parameters, the complete theoretical ablation profile is constructed and validated with experimental ablation profile. Even though the surface morphology of dentin shows high linearity, the concentration of Ca and P can be used as the most feasible probe in clinical settings. Furthermore, the laser ablation rate and ablation efficiency are predicted by the method to optimize the laser processing condition for any specific teeth. The versatility of the method overcomes the problem of heterogeneity on various teeth and simplifies the method of finding optimal laser processing condition for immaculate laser surgery.

Impedance, power, and current in radiofrequency ablation: Insights from technical, ex vivo, and clinical studies.

Radiofrequency (RF) power is routinely considered during RF application. In contrast, impedance has been relatively poorly studied, despite also influencing RF lesion creation. The aim of this study was to examine the influence of electric impedance on RF lesion characteristics and on clinical RF ablation parameters. In the first part of the study, power and impedance were systematically varied and the resulting current was calculated using custom-made software. In the second part of the study, ablation lesions (n = 40) were analyzed in a porcine ex vivo model. RF applications were delivered in cardiac muscle preparations with systematically varied values of electric impedance using a contact force ablation catheter. In the third part of the study, n = 3378 clinical RF applications were analyzed, power, impedance, and current data were exported and correlated with clinical patient data. 20 ± 3 W/80 Ω, 30 ± 3 W/120 Ω, 40 ± 3 W/160 Ω, and 50 ± 3 W/200 Ω RF applications resulted in 498 ± 40, 499 ± 26, 500 ± 20, and 500 ± 16 mA RF current, which were not significantly different (p = .32). Ablation lesions were significantly different in depth and diameter when applied with the same power but different impedances (p < .01); lesion sizes decreased when increasing impedance. In clinical data, a large range of delivered current (e.g., 39-40 W: 530-754 mA) was measured, due to variations in impedance. RF lesion creation is determined by current rather than by power. During clinical RF ablation procedures, impedance significantly influences current delivery and varies considerably between patients. Impedance and current are clinically relevant parameters that should be considered during RF ablation.

MR-Guided High-Power Microwave Ablation in Hepatic Malignancies: Initial Results in Clinical Routine

PurposeEvaluation of technique effectiveness, patient safety and ablation parameters of MR-guided microwave ablation in hepatic malignancies using an MR-conditional high-power microwave ablation system.Materials and MethodsInstitutional review board approval and informed patient consent were obtained. Patients who underwent MR-guided microwave ablation of hepatic malignancies in a 1.5T wide-bore scanner using a perfusion-cooled high-power microwave ablation system with a maximum generator power of 150 W were included. Ablation parameters comprising procedure durations, net ablation duration, applicator positions and ablation zone dimensions were recorded. Adverse events were classified according to the CIRSE classification system. Technique effectiveness was assessed after 1 month. Follow-up was conducted with contrast-enhanced MRI and ranged from 1 to 20 months (mean: 6.1 ± 5.4 months).ResultsTwenty-one consecutive patients (age: 63.4 ± 10.5 years; 5 female) underwent 22 procedures for 28 tumours (9 hepatocellular carcinomas, 19 metastases) with a mean tumour diameter of 14.6 ± 5.4 mm (range: 6–24 mm). Technique effectiveness was achieved in all lesions. Tumours were treated using 1.7 ± 0.7 applicator positions (range: 1–3). Mean energy and ablation duration per tumour were 75.3 ± 35.4 kJ and 13.3 ± 6.2 min, respectively. Coagulation zone short- and long-axis diameters were 29.1 ± 6.4 mm and 39.9 ± 7.4 mm, respectively. Average procedure duration was 146.4 ± 26.2 min (range: 98–187 min). One minor complication was reported. Five patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed during initial follow-up.ConclusionMR-guided high-power microwave ablation provides safe and effective treatment of hepatic malignancies with short ablation times and within acceptable procedure durations.

Update on high-power short-duration ablation for pulmonary vein isolation.

Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. However, this procedure remains complex and time-consuming, and the recurrence of AF after PVI is still unsatisfactory. Current technologies have improved our knowledge of the association between radiofrequency lesion creation and ablation parameters (power and duration), which triggered the development of high-power short-duration (HPSD). During the past decade, several preclinical and clinical studies have been conducted to confirm the feasibility, safety, and outcome of PVI ablation with HPSD or very high-power short-duration (vHPSD) settings, which increased electrophysiologists' interests in the utility of HPSD strategies. This paper describes the theoretical basis and recent research findings of HPSD or vHPSD ablation and summarizes the state-of-the-art evidence behind the role of this strategy in PVI.

Transmural Temperature Monitoring to Quantify Thermal Conduction And Lesion Formation During Gastric Ablation, an Emerging Therapy for Gastric Dysrhythmias.

Gastric ablation is emerging as a potential therapy for electrical dysrhythmias associated with gastric disorders. Thermal conduction properties of gastric tissue during ablation have not yet been defined, but are necessary for optimizing the technique and translating ablation to clinical therapy. We developed custom needle-based transmural temperature probes to quantify the temperature of gastric tissue during ablation. These probes were applied in vivo in pigs (n=5), during gastric ablation (70 °C, 10 s duration), at distances of 2.5 - 20 mm from the ablation catheter tip. Thermal response of the tissue was non-linear; the maximum temperature increase from baseline (33.3 ± 1.0 °C) was observed at the closest temperature probe to the catheter tip (2.5 mm, 14.9 °C), and temperature change decreased with distance from the catheter tip. Probes positioned between 5 -20 mm from the catheter tip recorded temperature increases of less than 5.6 °C. This study provides methods for monitoring temperature during in vivo ablation, and demonstrates that functional temperature increases from ablation were restricted to within approximately 5 mm of the catheter. These methods can now be applied to optimize effective ablation parameters, and to inform models of gastric ablation.

A comparative clinical and histopathological pilot study of different fractional CO2 laser parameters in treatment of atrophic linear scars.

Atrophic scars cause significant patient morbidity. Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different etiologies. To assess the efficacy and safety of different fractional ablative CO2 laser parameters in treatment of linear atrophic depressed post-traumatic facial scars in adult male patients. A prospective pilot study of 20 adult male patients (skin types Π- Ⅳ, aged 18-45) with post-traumatic atrophic linear scars were divided into 2 groups each comprising 10 patients receiving different fractional CO2 laser parameters. Both groups received 3 laser sessions, one month apart, and were followed for 2months after the last treatment session. Clinical and histological assessments were done to all patients before treatment and 2months after the last treatment session. Also, patient satisfaction and side effects were recorded. The study showed statistically significant reduction in average scar volume in both groups (P<.01), with reduction in depth more obvious than reduction in width or length in both groups. There was a highly significant difference in overall scar improvement represented by scar volume between both groups (P<.01) with an average reduction in scar volume of 42.85% in group (a) compared with 35.29% in group (b). Also, there was a highly statistically significant increase in both epidermal and papillary and reticular dermis thickness in both groups after treatment. However, the difference between both groups was nonsignificant. Side effects were mild, well tolerated, and transient. Fractional CO2 laser can be utilized as a safe and effective modality in treatment of post-traumatic linear atrophic scars of the face. Adjusting parameters toward increasing depth of penetration and decreasing thermal coagulative effect gives better results.

Esophageal injury associated with catheter ablation for atrial fibrillation: Determinants of risk and protective strategies.

Catheter ablation has become an important element in the management of atrial fibrillation. Several technical advances allowed for better safety profiles and lower recurrence rates, leadingto an increasing number of ablations worldwide. Despite that, major complications are still reported, and esophageal thermal injury remains a significant concern as atrioesophageal fistula (AEF) is often fatal. Recognition of the mechanisms involved in the process of esophageal lesion formation and the identification of the main determinants of risk have set the grounds for the development and improvement of different esophageal protective strategies. More sensitive esophageal temperature monitoring, safer ablation parameters and catheters, and different energy sources appear to collectively reduce the risk of esophageal thermal injury. Adjunctive measures such as the prophylactic use of proton-pump inhibitors, as well as esophageal cooling or deviation devices, have emerged as complementary methods with variable but promising results. Nevertheless, as a multifactorial problem, no single esophageal protective measure has proven to be sufficiently effective to eliminate the risk, and further investigation is still warranted. Early screening in the patients at risk and prompt intervention in the cases of AEF are important risk modifiers and yield better outcomes.

Method for Accurately Preparing Cavities on Cortical Bones Using Picosecond Laser.

Objective: This study was conducted to (1) evaluate a new method for accurately and automatically preparing dental implant cavities; (2) investigate the quantitative relationships between the number of focal-plane additive pulse layers (n) in two-dimensional ablation, the Z-axis feed rate, and the ablation depth (d) during cortical-bone ablation using a numerically controlled three-axis picosecond laser; and (3) establish appropriate methods for precise ablation control. Materials and methods: Two-dimensional ablation was performed on swine-rib blocks in the focal plane on a preset circular path using a picosecond laser device and an in-house-developed three-axis numerically controlled micro-laser galvanometer scanner. The maximum two-dimensional d and the quantitative relationship between n and d within the maximum d were consequently obtained. The measured and theoretical values of the ablated cavities were then compared to obtain n and d values corresponding to the minimum difference, and to evaluate the error in d, resulting in a higher-accuracy d value (i.e., single-step ablation depth) being obtained. Results: The diameter and deep errors between the measured and design data for 24 cavities were 2.76 ± 1.51 and 10.23 ± 4.82 μm, respectively. Thus, high-quality cortical-bone cavities preparation was achieved using a picosecond laser with the parameters employed in this study. Conclusions: Precise control of cortical-bone ablation using a picosecond laser can be attained by optimizing the single-step ablation parameters.

Picosecond laser surface modification of aluminum oxide with fish-scale structures for cell culture

The surface modification of a layer substrate has received attention for many biomedical applications (e.g., tissue engineering and biosensing). Under an in situ control, we proposed a strategy for surface modification of hard and brittle ceramics with ultrafast laser pulses for cell culture. A type of ultrafast laser based on the picosecond pulse technique was employed to ablate the surface of a pristine aluminum oxide (Al2O3) substrate. The surface of the formed reproducible micro-nanostructures indicated the fish-scale structures, which was analyzed under different laser ablation conditions. Subsequently, the SV40 T-antigen human embryonic kidney 293 (HEK293T) cells were cultured on the laser-ablated Al2O3 substrates. These microstructures and nanostructures can enhance cell proliferation response. The surface effect played a crucial role, by which the surface roughness (Ra) and contact angle (CA) of water droplets on the ablated Al2O3 substrate increased with the increasing laser fluence. The formed fish-scale structures were formed by the parameters of laser ablation where the structural characteristics of the Al2O3 substrate can be remained in the ultrafast laser process. The presented process provides a simple support for developing ablated structures on the Al2O3 substrate for cell culture.

Using a nanosecond laser to pattern copper nanowire-based flexible electrodes: From simulation to practical application

Copper nanowire (Cu NW) electrodes have shown promise for use in next-generation transparent conducting films due to their high electrical conductivity, low-cost solution-based synthesis processes, and high transmittance properties. Recently, the use of lasers for the modification of nanostructures has received considerable attention. Despite the advantages of laser machining such as producing any shape in an accurate, time-saving, non-contact process, the laser patterning of Cu NW electrodes has not been extensively studied, particularly the heat effect of the laser irradiation process on the flexible substrate. In this report, we present experimental and computational results of a selective and direct patterning process by using nanosecond pulsed laser irradiation. The experimental and simulation results were used to optimize the laser ablation parameters for the patterning process of the ultra-long Cu NW transparent electrodes so as to not damage the flexible substrates. Finally, a bifunctional flexible smart-window was fabricated to demonstrate a practical application of the laser-patterned Cu NW electrodes.