Title:
|
Relation between denaturation time measured by optical coherence reflectometry and thermal lesion depth during radiofrequency cardiac ablation: feasibility numerical study
|
Author:
|
González-Suárez, Ana; Herranz, David; Berjano, Enrique J.; Rubio-Guivernau, Jose L.; Margallo-Balbás, Eduardo
|
Abstract:
|
Background/Objective: Radiofrequency (RF) catheter ablation is a minimally invasive medical procedure used to thermally destroy the focus of cardiac arrhythmias. Novel optical techniques are now being integrated into RF catheters in order to detect the changes in tissue properties. Loss of birefringence due to fiber denaturation at around 70ºC is related to changes in accumulated phase retardation and can be measured by polarization-sensitive optical coherence reflectometry (PS-OCR). Since irreversible thermal lesions are produced when the tissue reaches 50ºC, our goal was to seek the mathematical relationship between both isotherms.
Materials and Methods: A two-dimensional model based on a coupled electric-thermal problem was built and solved using the finite element method. The model consisted of cardiac tissue, blood and a non-irrigated electrode with a sensor embedded in its tip to maintain a specific target electrode temperature. Computer simulations were conducted by varying the tissue characteristics. Lesion depth was estimated by the 50ºC isotherm, while the denaturation time (TD) was taken as the time at which the 70ºC isotherm reached a depth of 0.75 mm (which corresponds to the optical depth reached by PS-OCR technology).
Results: A strong correlation (R2>0.83) was found between TD and lesion depth and an even stronger correlation (R2>0.96) was found between TD and the time required to achieve a specific lesion depth. For instance, the ablation time required to ensure a minimum lesion depth of 3 mm was 1.33 × TD + 3.93.
Conclusions: The computer results confirmed the strong relationship between denaturation time and lesion depth and suggest that measuring denaturation time by PS-OCR could
3
provide information on the ablation time required to reach a specific lesion depth. |
Abstract:
|
This work was partially supported by the Spanish Government under the “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-Suárez has a Postdoctoral Grant“Juan de la Cierva-formación” (FJCI-2015-27202) sup-ported by the Spanish Ministerio de Economía, Industria yCompetitividad. This study was partially presented at the 2017 Annual Meeting of the American Society for LaserMedicine and Surgery. A. González-Suárez received atravel grant from the United States Air Force Office of Scientific Research. |
Subject(s):
|
-Cardiac ablation -Computer model -Polarization-sensitive optical coherence reflectometry -Radiofrequency ablation |
Rights:
|
This is the peer reviewed version of the following article: González-Suárez A, Herranz D, Berjano E, Rubio-Guivernau JL, Margallo-Balbás E. Relation between denaturation time measured by optical coherence reflectometry and thermal lesion depth during radiofrequency cardiac ablation: feasibility numerical study. Lasers in surgery and medicine. 2017 Nov;0(0):1-28, which has been published in final form at http://dx.doi.org/10.1002/lsm.22771 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
Document type:
|
Article Article - Accepted version |
Published by:
|
Wiley
|
Share:
|
|