Relationship between luminal esophageal temperature and volume of esophageal injury during RF ablation: In silico study comparing low power‐moderate duration vs. high power‐short duration
Autor: | Enrique Berjano, Andre d'Avila, Hiroshi Nakagawa, Juan J. Pérez, Ana González-Suárez, Timothy Richard Maher |
---|---|
Rok vydání: | 2021 |
Předmět: |
Esophageal temperature
medicine.medical_treatment High power-short duration RF ablation Esophageal injury Body Temperature TECNOLOGIA ELECTRONICA Left atrial wall Physiology (medical) Atrial Fibrillation Humans Medicine Esophagus Short duration In silico study Radiofrequency Ablation business.industry Temperature Luminal esophageal temperature Ablation medicine.anatomical_structure Volume (thermodynamics) Pulmonary Veins Catheter Ablation Cardiology and Cardiovascular Medicine business Nuclear medicine Rf ablation |
Zdroj: | RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia instname |
ISSN: | 1540-8167 1045-3873 |
Popis: | [EN] Objective To model the evolution of peak temperature and volume of damaged esophagus during and after radiofrequency (RF) ablation using low power-moderate duration (LPMD) versus high power-short duration (HPSD) or very high power-very short duration (VHPVSD) settings. Methods An in silico simulation model of RF ablation accounting for left atrial wall thickness, nearby organs and tissues, as well as catheter contact force. The model used the Arrhenius equation to derive a thermal damage model and estimate the volume of esophageal damage over time during and after RF application under conditions of LPMD (30 W, 20 s), HPSD (50 W, 6 s), and VHPVSD (90 W, 4 s). Results There was a close correlation between maximum peak temperature after RF application and volume of esophageal damage, with highest correlation (R-2 = 0.97) and highest volume of esophageal injury in the LPMD group. A greater increase in peak temperature and greater relative increase in esophageal injury volume in the HPSD (240%) and VHPSD (270%) simulations occurred after RF termination. Increased endocardial to esophageal thickness was associated with a longer time to maximum peak temperature (R-2 > 0.92), especially in the HPSD/VHPVSD simulations, and no esophageal injury was seen when the distances were >4.5 mm for LPMD or >3.5 mm for HPSD. Conclusion LPMD is associated with a larger total volume of esophageal damage due to the greater total RF energy delivery. HPSD and VHPVSD shows significant thermal latency (resulting from conductive tissue heating after RF termination), suggesting a requirement for fewer esophageal temperature cutoffs during ablation. Ministerio de Ciencia, Innovación y Universidades, Grant/Award Number: RTI2018-094357-B-C21 |
Databáze: | OpenAIRE |
Externí odkaz: |