Yao Sun , Xin Zhu , Wenxi Chen , Weihao Weng , Keijiro Nakamura
{"title":"计算机模拟各种基线阻抗下的低功率和长时间双极射频消融术","authors":"Yao Sun , Xin Zhu , Wenxi Chen , Weihao Weng , Keijiro Nakamura","doi":"10.1016/j.medengphy.2024.104226","DOIUrl":null,"url":null,"abstract":"<div><p>Compared to traditional unipolar radiofrequency ablation (RFA), bipolar RFA offers advantages such as more precise heat transfer and higher ablation efficiency. Clinically, myocardial baseline impedance (BI) is one of the important factors affecting the effectiveness of ablation. We aim at finding suitable ablation protocols and coping strategies by analyzing the ablation effects and myocardial impedance changes of bipolar RFA under different BIs. In this research, a three-dimensional local myocardial computer model was constructed for bipolar RFA simulation, and <em>in vitro</em> experimental data were used to validate accuracy. Four fixed low-power levels (20 W, 25 W, 30 W, and 35 W) and six myocardial BIs (91.02 Ω, 99.83 Ω, 111.03 Ω, 119.77 Ω, 130.03 Ω, and 135.45 Ω) were set as initial conditions, with an ablation duration of 120-s. In the context of low-power and long-duration (LPLD) ablation, the maximum TID (TID<sub>M</sub>) decreased by 21–32 Ω, depending on the BI. In cases where steam pop did not occur, TID<sub>M</sub> increased with the increase in power. For the same power, there was no significant difference in TID<sub>M</sub> for the range of BIs. In cases where steam pop occurred, for every 1 Ω increase in BI, TID<sub>M</sub> increased by 0.34–0.41 Ω. The simulation results also showed that using a higher power resulted in a smaller decrease in TID<sub>M</sub>. This study provided appropriate ablation times and impedance decrease ranges for bipolar LPLD RFA. The combination of 25 W for 120-s offered optimal performance when considering effectiveness and safety simultaneously.</p></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"131 ","pages":"Article 104226"},"PeriodicalIF":1.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Computer simulation of low-power and long-duration bipolar radiofrequency ablation under various baseline impedances\",\"authors\":\"Yao Sun , Xin Zhu , Wenxi Chen , Weihao Weng , Keijiro Nakamura\",\"doi\":\"10.1016/j.medengphy.2024.104226\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Compared to traditional unipolar radiofrequency ablation (RFA), bipolar RFA offers advantages such as more precise heat transfer and higher ablation efficiency. Clinically, myocardial baseline impedance (BI) is one of the important factors affecting the effectiveness of ablation. We aim at finding suitable ablation protocols and coping strategies by analyzing the ablation effects and myocardial impedance changes of bipolar RFA under different BIs. In this research, a three-dimensional local myocardial computer model was constructed for bipolar RFA simulation, and <em>in vitro</em> experimental data were used to validate accuracy. Four fixed low-power levels (20 W, 25 W, 30 W, and 35 W) and six myocardial BIs (91.02 Ω, 99.83 Ω, 111.03 Ω, 119.77 Ω, 130.03 Ω, and 135.45 Ω) were set as initial conditions, with an ablation duration of 120-s. In the context of low-power and long-duration (LPLD) ablation, the maximum TID (TID<sub>M</sub>) decreased by 21–32 Ω, depending on the BI. In cases where steam pop did not occur, TID<sub>M</sub> increased with the increase in power. For the same power, there was no significant difference in TID<sub>M</sub> for the range of BIs. In cases where steam pop occurred, for every 1 Ω increase in BI, TID<sub>M</sub> increased by 0.34–0.41 Ω. The simulation results also showed that using a higher power resulted in a smaller decrease in TID<sub>M</sub>. This study provided appropriate ablation times and impedance decrease ranges for bipolar LPLD RFA. The combination of 25 W for 120-s offered optimal performance when considering effectiveness and safety simultaneously.</p></div>\",\"PeriodicalId\":49836,\"journal\":{\"name\":\"Medical Engineering & Physics\",\"volume\":\"131 \",\"pages\":\"Article 104226\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Engineering & Physics\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1350453324001279\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Engineering & Physics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1350453324001279","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
Computer simulation of low-power and long-duration bipolar radiofrequency ablation under various baseline impedances
Compared to traditional unipolar radiofrequency ablation (RFA), bipolar RFA offers advantages such as more precise heat transfer and higher ablation efficiency. Clinically, myocardial baseline impedance (BI) is one of the important factors affecting the effectiveness of ablation. We aim at finding suitable ablation protocols and coping strategies by analyzing the ablation effects and myocardial impedance changes of bipolar RFA under different BIs. In this research, a three-dimensional local myocardial computer model was constructed for bipolar RFA simulation, and in vitro experimental data were used to validate accuracy. Four fixed low-power levels (20 W, 25 W, 30 W, and 35 W) and six myocardial BIs (91.02 Ω, 99.83 Ω, 111.03 Ω, 119.77 Ω, 130.03 Ω, and 135.45 Ω) were set as initial conditions, with an ablation duration of 120-s. In the context of low-power and long-duration (LPLD) ablation, the maximum TID (TIDM) decreased by 21–32 Ω, depending on the BI. In cases where steam pop did not occur, TIDM increased with the increase in power. For the same power, there was no significant difference in TIDM for the range of BIs. In cases where steam pop occurred, for every 1 Ω increase in BI, TIDM increased by 0.34–0.41 Ω. The simulation results also showed that using a higher power resulted in a smaller decrease in TIDM. This study provided appropriate ablation times and impedance decrease ranges for bipolar LPLD RFA. The combination of 25 W for 120-s offered optimal performance when considering effectiveness and safety simultaneously.
期刊介绍:
Medical Engineering & Physics provides a forum for the publication of the latest developments in biomedical engineering, and reflects the essential multidisciplinary nature of the subject. The journal publishes in-depth critical reviews, scientific papers and technical notes. Our focus encompasses the application of the basic principles of physics and engineering to the development of medical devices and technology, with the ultimate aim of producing improvements in the quality of health care.Topics covered include biomechanics, biomaterials, mechanobiology, rehabilitation engineering, biomedical signal processing and medical device development. Medical Engineering & Physics aims to keep both engineers and clinicians abreast of the latest applications of technology to health care.