Artículo
Effect of dispersive electrode position (anterior vs. posterior) in epicardial radiofrequency ablation of ventricular wall: A computer simulation study
Fecha de publicación:
07/2024
Editorial:
Wiley
Revista:
International Journal for Numerical Methods in Biomedical Engineering
ISSN:
2040-7939
e-ISSN:
2040-7947
Idioma:
Inglés
Tipo de recurso:
Artículo publicado
Clasificación temática:
Resumen
An epicardial approach is often used in radiofrequency (RF) catheter ablation to ablate ventricular tachycardia when an endocardial approach fails. Our objective was to analyze the effect of the position of the dispersive patch (DP) on lesion size using computer modeling during epicardial approach. We compared the posterior position (patient's back), commonly used in clinical practice, to the anterior position (patient's chest). The model considered ventricular wall thicknesses between 4 and 8 mm, and electrode insertion depths between .3 and .7 mm. RF pulses were simulated with 20 W of power for 30 s duration. Statistically significant differences (P < .001) were found between both DP positions in terms of baseline impedance, RF current (at 15 s) and thermal lesion size. The anterior position involved lower impedance (130.8 ± 4.7 vs. 146.2 ± 4.9 Ω) and a higher current (401.5 ± 5.6 vs. 377.5 ± 5.1 mA). The anterior position created lesion sizes larger than the posterior position: 8.9 ± 0.4 vs. 8.4 ± 0.4 mm in maximum width, 8.6 ± 0.4 vs. 8.1 ± 0.4 mm in surface width, and 4.5 ± 0.4 vs. 4.3 ± 0.4 mm in depth. Our results suggest that: (1) the redirection of the RF currents due to repositioning the PD has little impact on lesion size and only affects baseline impedance, and (2) the differences in lesion size are only 0.5 mm wider and 0.2 mm deeper for the anterior position, which does not seem to have a clinical impact in the context of VT ablation.
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Colecciones
Articulos(IFLYSIB)
Articulos de INST.FISICA DE LIQUIDOS Y SIST.BIOLOGICOS (I)
Articulos de INST.FISICA DE LIQUIDOS Y SIST.BIOLOGICOS (I)
Citación
Irastorza, Ramiro Miguel; Hadid, Claudio; Berjano, Enrique; Effect of dispersive electrode position (anterior vs. posterior) in epicardial radiofrequency ablation of ventricular wall: A computer simulation study; Wiley; International Journal for Numerical Methods in Biomedical Engineering; 40; 8; 7-2024; 1-13
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