Technical advance in silico and in vitro development of a new bipolar radiofrequency ablation device for renal denervation

• Published in: BMC cardiovascular disorders 2021-10, Vol.21 (1), p.500-500, Article 500
• Main Authors: Pérez, Noel, Muffly, Karl, Saddow, Stephen E
• Format: Article
• Language: English
• Subjects: Ablation; Antihypertensives; Basket catheter; Blood Pressure; Boundary conditions; Care and treatment; Catheter Ablation - instrumentation; Catheters; Computer applications; Computer Simulation; Connective tissue; Denervation; Diagnosis; Drug resistance; Electric Conductivity; Electric fields; Electrodes; Equipment Design; Finite Element Analysis; Geometry; Heat; High blood pressure; Humans; Hypertension; Hypertension - physiopathology; Hypertension - surgery; Innovations; Kidney - blood supply; Kidneys; Methods; Nervous system; Partial differential equations; Polyacrylamide; Radiofrequency ablation; Renal artery; Renal Artery - innervation; Renal denervation; Renal hypertension; Resistant hypertension; Sympathectomy - instrumentation; Temperature; Ultrasonic imaging; Veins & arteries
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-021-02305-x

Renal denervation with radiofrequency ablation has become an accepted treatment for drug-resistant hypertension. However, there is a continuing need to develop new catheters for high-accuracy, targeted ablation. We therefore developed a radiofrequency bipolar electrode for controlled, targeted ablation through Joule heating induction between 60 and 100 °C. The bipolar design can easily be assembled into a basket catheter for deployment inside the renal artery. Finite element modeling was used to determine the optimum catheter design to deliver a minimum ablation zone of 4 mm (W) × 10 mm (L) × 4 mm (H) within 60 s with a 500 kHz, 60 Vp-p signal, and 3 W maximum. The in silico model was validated with in vitro experiments using a thermochromic phantom tissue prepared with polyacrylamide gel and a thermochromic ink additive that permanently changes from pink to magenta when heated over 60 °C. The in vitro ablation zone closely matched the size and shape of the simulated area. The new electrode design directs the current density towards the artery walls and tissue, reducing unwanted blood temperature increases by focusing energy on the ablation zone. In contrast, the basket catheter design does not block renal flow during renal denervation. This computational model of radiofrequency ablation can be used to estimate renal artery ablation zones for highly targeted renal denervation in patients with resistant hypertension. Furthermore, this innovative catheter has short ablation times and is one of the lowest power requirements of existing designs to perform the ablation.