Simulation of intracardiac electrograms around acute ablation lesions
Radiofrequency ablation (RFA) is a widely used clinical treatment for many types of cardiac arrhythmias. However, nontransmural lesions and gaps between linear lesions often lead to recurrence of the arrhythmia. Intracardiac electrograms (IEGMs) provide real-time information regarding the state of t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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De Gruyter
2016-09-01
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| Series: | Current Directions in Biomedical Engineering |
| Subjects: | |
| Online Access: | https://doi.org/10.1515/cdbme-2016-0134 |
| _version_ | 1818390650199998464 |
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| author | Greiner Joachim Pollnow Stefan Schuler Steffen Lenis Gustavo Seemann Gunnar Dössel Olaf |
| author_facet | Greiner Joachim Pollnow Stefan Schuler Steffen Lenis Gustavo Seemann Gunnar Dössel Olaf |
| author_sort | Greiner Joachim |
| collection | DOAJ |
| description | Radiofrequency ablation (RFA) is a widely used clinical treatment for many types of cardiac arrhythmias. However, nontransmural lesions and gaps between linear lesions often lead to recurrence of the arrhythmia. Intracardiac electrograms (IEGMs) provide real-time information regarding the state of the cardiac tissue surrounding the catheter tip. Nevertheless, the formation and interpretation of IEGMs during the RFA procedure is complex and yet not fully understood. In this in-silico study, we propose a computational model for acute ablation lesions. Our model consists of a necrotic scar core and a border zone, describing irreversible and reversible temperature induced electrophysiological phenomena. These phenomena are modeled by varying the intra- and extracellular conductivity of the tissue as well as a regulating zone factor. The computational model is evaluated regarding its feasibility and validity. Therefore, this model was compared to an existing one and to clinical measurements of five patients undergoing RFA. The results show that the model can indeed be used to recreate IEGMs. We computed IEGMs arising from complex ablation scars, such as scars with gaps or two overlapping ellipsoid scars. For orthogonal catheter orientation, the presence of a second necrotic core in the near-field of a punctiform acute ablation lesion had minor impact on the resulting signal morphology. The presented model can serve as a base for further research on the formation and interpretation of IEGMs. |
| first_indexed | 2024-12-14T05:01:00Z |
| format | Article |
| id | doaj.art-65e93e1f5b984b4880258a20bccf6089 |
| institution | Directory Open Access Journal |
| issn | 2364-5504 |
| language | English |
| last_indexed | 2024-12-14T05:01:00Z |
| publishDate | 2016-09-01 |
| publisher | De Gruyter |
| record_format | Article |
| series | Current Directions in Biomedical Engineering |
| spelling | doaj.art-65e93e1f5b984b4880258a20bccf60892022-12-21T23:16:13ZengDe GruyterCurrent Directions in Biomedical Engineering2364-55042016-09-012160761010.1515/cdbme-2016-0134cdbme-2016-0134Simulation of intracardiac electrograms around acute ablation lesionsGreiner Joachim0Pollnow Stefan1Schuler Steffen2Lenis Gustavo3Seemann Gunnar4Dössel Olaf5Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76128 Karlsruhe, GermanyInstitute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76128 Karlsruhe, GermanyInstitute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76128 Karlsruhe, GermanyInstitute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76128 Karlsruhe, GermanyInstitute for Experimental Cardiovascular Medicine, University Heart Center Freiburg – Bad Krozingen, Medical Center – University of Freiburg, Germany; and Medical Department, Albert-Ludwigs University, Freiburg, GermanyInstitute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76128 Karlsruhe, GermanyRadiofrequency ablation (RFA) is a widely used clinical treatment for many types of cardiac arrhythmias. However, nontransmural lesions and gaps between linear lesions often lead to recurrence of the arrhythmia. Intracardiac electrograms (IEGMs) provide real-time information regarding the state of the cardiac tissue surrounding the catheter tip. Nevertheless, the formation and interpretation of IEGMs during the RFA procedure is complex and yet not fully understood. In this in-silico study, we propose a computational model for acute ablation lesions. Our model consists of a necrotic scar core and a border zone, describing irreversible and reversible temperature induced electrophysiological phenomena. These phenomena are modeled by varying the intra- and extracellular conductivity of the tissue as well as a regulating zone factor. The computational model is evaluated regarding its feasibility and validity. Therefore, this model was compared to an existing one and to clinical measurements of five patients undergoing RFA. The results show that the model can indeed be used to recreate IEGMs. We computed IEGMs arising from complex ablation scars, such as scars with gaps or two overlapping ellipsoid scars. For orthogonal catheter orientation, the presence of a second necrotic core in the near-field of a punctiform acute ablation lesion had minor impact on the resulting signal morphology. The presented model can serve as a base for further research on the formation and interpretation of IEGMs.https://doi.org/10.1515/cdbme-2016-0134acute ablation lesionsin-silico modellingintracardiac electrogramsradiofrequency ablation |
| spellingShingle | Greiner Joachim Pollnow Stefan Schuler Steffen Lenis Gustavo Seemann Gunnar Dössel Olaf Simulation of intracardiac electrograms around acute ablation lesions Current Directions in Biomedical Engineering acute ablation lesions in-silico modelling intracardiac electrograms radiofrequency ablation |
| title | Simulation of intracardiac electrograms around acute ablation lesions |
| title_full | Simulation of intracardiac electrograms around acute ablation lesions |
| title_fullStr | Simulation of intracardiac electrograms around acute ablation lesions |
| title_full_unstemmed | Simulation of intracardiac electrograms around acute ablation lesions |
| title_short | Simulation of intracardiac electrograms around acute ablation lesions |
| title_sort | simulation of intracardiac electrograms around acute ablation lesions |
| topic | acute ablation lesions in-silico modelling intracardiac electrograms radiofrequency ablation |
| url | https://doi.org/10.1515/cdbme-2016-0134 |
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