Title:
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Numerical analysis of thermal impact of intramyocardial capillary blood flow during radiofrequency cardiac ablation
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Author:
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Pérez, Juan J.; González-Suárez, Ana; Berjano, Enrique J.
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Abstract:
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Purpose:
The thermal effect of the intramyocardial blood perfusion on the size of lesions created by
radiofrequency cardiac ablation (RFCA) has not been adequately studied to date. Our objective was to
assess the impact of including this phenomenon in RFCA computer modelling in terms of the thermal
lesion depth created.
Methods:
A computer model was built and computer simulations were conducted to assess the effect
of including the blood perfusion term in the bioheat equation. This term mimics the intramyocardial
blood flow (i.e., blood perfusion) in the cardiac wall at the site at which the RFCA is being conducted
and hence represents a heat removing mechanism. When considered, blood perfusion rates ranged
from 609 to 1719 ml/min/kg. Two electrode design and modes were considered: a non-irrigated elec-
trode with constant temperature mode and an irrigated electrode with constant power mode.
Results:
All the depths computed without including the blood perfusion term were larger than those
that did include it, regardless of perfusion rate. The differences in lesion depth between ignoring and
including blood perfusion increased over time; for a 60 s RFCA they were 0.45 and 1 mm for minimum
and maximum perfusion rate, respectively. The differences were more or less independent of blood
flow in the cardiac chamber, electrode type and ablation mode.
Conclusions:
The findings suggest that the heat-sink effect of blood perfusion should be taken into
account in the case of ablations (
>
1 minute) such as those conducted in RFCA of the ventricular wall. |
Abstract:
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This work was supported by the Ministerio de Economía y Competitividad under “Plan Estatal de Investigación, Desarrollo e Innovación Orientada a los Retos de la Sociedad” Grant “TEC2014-52383-C3 [TEC2014-52383-C3-1-R]”. A. González-Suáarez had a Postdoctoral Grant [APOSTD/2016/045] from the Generalitat Valenciana (Spain) and currently has a Postdoctoral Grant “Juan de la Cierva-formación” [FJCI-2015-27202] supported by the Spanish Ministerio de Economía, Industria y Competitividad. |
Subject(s):
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-Blood perfusion -Cardiac ablation -Computer model -Intramyocardial blood flow -Radiofrequency ablation |
Rights:
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© Taylor & Francis. This is an electronic version of an article published in Pérez JJ, González-Suárez A, Berjano E. Numerical analysis of thermal impact of intramyocardial capillary blood flow during radiofrequency cardiac ablation. Int J Hyperthermia. 2018;34(3):243-9. International Journal of Hyperthermia is available online at: www.tandfonline.com [with the open URL of your article].
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Document type:
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Article Article - Accepted version |
Published by:
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Taylor & Francis (Routledge)
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