心脏射频消融热损伤形成的时空动力学分析

Martina Zaltieri, C. Massaroni, S. Bianchi, F. M. Cauti, E. Schena
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引用次数: 0

摘要

心房颤动(AF)是最常复发的心律失常类型,它造成了与显著发病率和死亡率相关的主要社会经济负担。射频导管消融(RFCA)是治疗房颤的主要临床实践。该手术的目的是通过射频传输引起的温度升高,诱导引起电通路改变的异位病灶坏死。在这种情况下,温度是一个关键因素,它决定了产生的热损伤的大小,进而决定了治疗的成败。因此,有几种方法被用于RFCA温度监测,但存在一些局限性。近年来,利用光纤布拉格光栅(FBG)传感器在离体猪心肌组织中进行高分辨率和分布式温度测量的可行性进行了评估。在本研究中,通过基于多点光纤光栅温度数据生成二维热图来研究组织内的热扩散。此外,还探讨了输出功率和处理时间对产生的热损伤尺寸的影响。本研究为建立描述损伤形成的时空动力学模型奠定了基础。该模型可为临床医生选择合适的RFCA设置提供支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of the Spatio-Temporal Dynamics of Thermal Lesion Formation in Radiofrequency Cardiac Ablation
Atrial fibrillation (AF) is the most recurrent type of cardiac arrhythmia that causes a major socio-economic burden as associated with significant morbidity and mortality. Radiofrequency catheter ablation (RFCA) is a leading clinical practice for the treatment of AF. The aim of the procedure is to induce necrosis in the ectopic foci responsible for the altered electrical pathway through temperature increments provoked by radiofrequency delivery. In this context, temperature is a key factor as determines the size of the produced thermal lesions and, in turn, the success or the failure of the treatment. As consequence, several methods have been exploited for RFCA temperature monitoring, but with several limitations. In recent times, the feasibility of using fiber Bragg grating (FBG) sensors for high-resolved and distributed temperature measurements in ex vivo myocardial swine tissues has been assessed. In this study, the heat diffusion within the tissues was investigated by producing 2D thermal maps based on multipoint FBG temperature data. Furthermore, the influence of both the delivered power and the treatment time on the dimensions of the produced thermal lesion was explored. The present research may lay the basis for the development of a model describing the spatio-temporal dynamics of the lesion formation. Such model may offer support to clinicians in selecting the proper RFCA settings.
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