Schutt David, Berjano Enrique J, Haemmerich Dieter
Medical University of South Carolina, Charleston, South Carolina, Charleston, SC 29425, USA.
Int J Hyperthermia. 2009 Mar;25(2):99-107. doi: 10.1080/02656730802563051.
Radiofrequency (RF ablation) is the treatment of choice for certain types of cardiac arrhythmias. Recent studies have suggested that using gold instead of platinum as the electrode material for cardiac catheter ablation leads to larger thermal lesions due to its higher thermal conductivity. In this study we created computer models to compare the effects of different electrode materials on lesion dimensions using different catheters, insertion depths, and flow rates.
Finite element method (FEM) models of two cardiac ablation electrodes (7Fr, length 4 mm and 8Fr, length 10 mm) made of platinum, gold, and copper were created with tissue insertion depths of 0.75, 1.25, and 2.5 mm. Convective cooling was applied to the electrode and tissue based on measurements from previous studies at different flow rates. RF ablations were simulated with both temperature control and constant power control algorithms to determine temperature profiles after 60 s.
With the constant power algorithm there was no difference in lesion dimensions between the electrode materials over the range of parameters. With the temperature control algorithm, lesion width and depth were only marginally larger ( approximately 0.1-0.7 mm) with the gold and copper electrodes compared to the platinum electrode for all parameter combinations.
Our computer modelling results show only minor increases in thermal lesion dimensions with electrode materials of higher thermal conductivity. These observed differences likely do not provide a significant advantage during clinical procedures.
射频(RF消融)是某些类型心律失常的首选治疗方法。最近的研究表明,使用金而非铂作为心脏导管消融的电极材料,因其更高的热导率会导致更大的热损伤。在本研究中,我们创建了计算机模型,以比较不同电极材料在使用不同导管、插入深度和流速时对损伤尺寸的影响。
创建了由铂、金和铜制成的两种心脏消融电极(7Fr,长度4mm和8Fr,长度10mm)的有限元方法(FEM)模型,组织插入深度分别为0.75、1.25和2.5mm。根据先前研究在不同流速下的测量结果,对电极和组织施加对流冷却。使用温度控制和恒功率控制算法模拟射频消融,以确定60秒后的温度分布。
采用恒功率算法时,在参数范围内电极材料之间的损伤尺寸没有差异。采用温度控制算法时,对于所有参数组合,与铂电极相比,金电极和铜电极的损伤宽度和深度仅略微更大(约0.1 - 0.7mm)。
我们的计算机建模结果表明,具有较高热导率的电极材料只会使热损伤尺寸略有增加。这些观察到的差异在临床操作中可能不会提供显著优势。