Contact geometry affects lesion formation in radio-frequency cardiac catheter ablation

One factor which may be important for determining proper lesion creation during atrial ablation is catheter-endocardial contact. Little information is available that relates geometric contact, depth and angle, to ablation lesion formation. We present an electrothermal computer model of ablation that...

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Bibliographic Details
Published in:PloS one 2013-09, Vol.8 (9), p.e73242-e73242
Main Authors: Gallagher, Neal, Fear, Elise C, Byrd, Israel A, Vigmond, Edward J
Format: Article
Language:English
Subjects:
Ablation
Ablation (Surgery)
Analysis
Angles (geometry)
Arrhythmias, Cardiac - therapy
Blood
Cardiac arrhythmia
Cardiology
Catheter Ablation - methods
Catheters
Computer engineering
Computer Simulation
Contact angle
Dielectric properties
Electric contacts
Electrical phenomena
Electrodes
Geometry
Heart
Heart diseases
Heat
Humans
Lesions
Medical instruments
Penetration depth
Radio frequency
Radiofrequency ablation
Temperature
Tips
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Summary:One factor which may be important for determining proper lesion creation during atrial ablation is catheter-endocardial contact. Little information is available that relates geometric contact, depth and angle, to ablation lesion formation. We present an electrothermal computer model of ablation that calculated lesion volume and temperature development over time. The Pennes bioheat equation was coupled to a quasistatic electrical problem to investigate the effect of catheter penetration depth, as well as incident catheter angle as may occur in practice. Biological experiments were performed to verify the modelling of electrical phenomena. Results show that for deeply penetrating tips, acute catheter angles reduced the rate of temperature buildup, allowing larger lesions to form before temperatures elevated excessively. It was also found that greater penetration did not lead to greater transmurality of lesions. We conclude that catheter contact angle plays a significant role in lesion formation, and the time course must be considered. This is clinically relevant because proper identification and prediction of geometric contact variables could improve ablation efficacy.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0073242