Radiofrequency ablation is an interventional technique that in recent years has come to be employed in very different medical fields, such as the elimination of cardiac arrhythmias or the destruction of tumors in different locations. In order to investigate and develop new techniques, and also to improve those currently employed, theoretical models and computer simulations are a powerful tool since they provide vital information on the electrical and thermal behavior of ablation rapidly and at low cost. In the future they could even help to plan individual treatment for each patient. This review analyzes the state-of-the-art in theoretical modeling as applied to the study of radiofrequency ablation techniques. Firstly, it describes the most important issues involved in this methodology, including the experimental validation. Secondly, it points out the present limitations, especially those related to the lack of an accurate characterization of the biological tissues. After analyzing the current and future benefits of this technique it finally suggests future lines and trends in the research of this area.
Abstract-Goal: Our aim was to compare the different methods of modeling the effect of circulating blood flow on the thermal lesion dimensions created by radiofrequency cardiac ablation and on the maximum blood temperature. Methods: Computational models were built to study the temperature distributions and lesion dimensions created by a non-irrigated electrode by two radiofrequency energy delivery protocols (constant voltage and constant temperature) under high and low blood flow conditions. Four methods of modeling the effect of circulating blood flow on lesion dimensions and temperature distribution were compared. Three of them considered convective coefficients at the electrode-blood and tissue-blood interfaces to model blood flow: 1) without including blood as a part of the domain; 2) constant electrical conductivity of blood; and 3) temperature-dependent electrical conductivity of blood (+2%/ºC). Method 4) included blood motion and was considered to be a reference method for comparison purposes. Results: Only Method 4 provided a realistic blood temperature distribution. The other three methods predicted lesion depth values similar to those of the reference method (differences smaller than 1 mm), regardless of ablation mode and blood flow conditions. Conclusion: Considering the aspects of lesion size and maximum temperature reached in blood and tissue, Method 2 seems to be the most suitable alternative to Method 4 in order to reduce the computational complexity. Significance: Our findings could have an important implication in future studies of RF cardiac ablation, in particular, in choosing the most suitable method to model the thermal effect of circulating blood.
Radiofrequency catheter ablation (RFCA) is a routine treatment for cardiac arrhythmias. During RFCA, the electrode-tissue interface temperature should be kept below 80°C to avoid thrombus formation. Open-irrigated electrodes facilitate power delivery while keeping low temperatures around the catheter. No computational model of an open-irrigated electrode in endocardial RFCA accounting for both the saline irrigation flow and the blood motion in the cardiac chamber has been proposed yet. We present the first computational model including both effects at once. The model has been validated against existing experimental results. Computational results showed that the surface lesion width and blood temperature are affected by both the electrode design and the irrigation flow rate. Smaller surface lesion widths and blood temperatures are obtained with higher irrigation flow rate, while the lesion depth is not affected by changing the irrigation flow rate. Larger lesions are obtained with increasing power and the electrode-tissue contact. Also, larger lesions are obtained when electrode is placed horizontally. Overall, the computational findings are in close agreement with previous experimental results providing an excellent tool for future catheter research.
Purpose: Although theoretical modeling is widely used to study different aspects of radiofrequency ablation (RFA) its utility is directly related to its realism. An important factor in this realism is the use of mathematical functions to model the temperaturedependence of tissue thermal (k) and electrical () conductivities. Our aim was to review the piecewise mathematical functions most commonly used for modeling the temperaturedependence of k and in RFA computational modeling. Materials and methods:We built a hepatic RFA theoretical model of a cooled electrode and compared lesion dimensions and impedance evolution with combinations of mathematical functions proposed in previous studies We employed the thermal damage contour D63 to compute the lesion dimension contour, which corresponds to Ω= 1, Ω being local thermal damage assessed by the Arrhenius damage model. Results:The results were very similar in all cases in terms of impedance evolution and lesion size after 6 minutes of ablation. Although the relative differences between cases in terms of time to first roll-off (abrupt increase in impedance) were as much as 12%, the maximum relative differences in terms of the short lesion (transverse) diameter were below 3.5%. Conclusions:The findings suggest that the different methods of modeling temperature dependence of k and reported in the literature do not significantly affect the computed lesion diameter.3
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