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Contact Geometry Affects Lesion Formation in Radio-Frequency Cardiac Catheter Ablation

机译:接触几何影响射频导管消融术中病变的形成

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摘要

One factor which may be important for determining proper lesion creation during atrial ablation is catheter-endocardial contact. Little information is available that relates geometric contact, depth and angle, to ablation lesion formation. We present an electrothermal computer model of ablation that calculated lesion volume and temperature development over time. The Pennes bioheat equation was coupled to a quasistatic electrical problem to investigate the effect of catheter penetration depth, as well as incident catheter angle as may occur in practice. Biological experiments were performed to verify the modelling of electrical phenomena. Results show that for deeply penetrating tips, acute catheter angles reduced the rate of temperature buildup, allowing larger lesions to form before temperatures elevated excessively. It was also found that greater penetration did not lead to greater transmurality of lesions. We conclude that catheter contact angle plays a significant role in lesion formation, and the time course must be considered. This is clinically relevant because proper identification and prediction of geometric contact variables could improve ablation efficacy.
机译:对于确定房消融过程中适当的病变形成可能很重要的一个因素是导管与心内膜的接触。关于几何接触,深度和角度与消融病变的形成有关的信息很少。我们提出了一种消融的电热计算机模型,该模型可计算出随着时间推移的病变体积和温度变化。将Pennes生物热方程式与准静态电问题耦合,以研究导管穿透深度的影响以及在实践中可能发生的入射导管角度。进行了生物实验以验证电现象的建模。结果表明,对于深部穿透的尖端,锐角的导管会降低温度积累的速率,从而可以在温度过度升高之前形成较大的病变。还发现更大的穿透率不会导致更大的透壁性。我们得出的结论是,导管接触角在病变形成中起着重要作用,因此必须考虑时间进程。这在临床上是有意义的,因为正确识别和预测几何接触变量可以提高消融效果。

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