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基于图像的心律失常治疗中射频消融损伤的建模与表征

Image-based Modeling and Characterization of RF Ablation Lesions in Cardiac Arrhythmia Therapy.

作者信息

Linte Cristian A, Camp Jon J, Rettmann Maryam E, Holmes David R, Robb Richard A

机构信息

Biomedical Imaging Resource, Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.

出版信息

Proc SPIE Int Soc Opt Eng. 2013 Feb 9;8671. doi: 10.1117/12.2008529.

Abstract

In spite of significant efforts to enhance guidance for catheter navigation, limited research has been conducted to consider the changes that occur in the tissue during ablation as means to provide useful feedback on the progression of therapy delivery. We propose a technique to visualize lesion progression and monitor the effects of the RF energy delivery using a surrogate thermal ablation model. The model incorporates both physical and physiological tissue parameters, and uses heat transfer principles to estimate temperature distribution in the tissue and geometry of the generated lesion in near real time. The ablation model has been calibrated and evaluated using beef muscle tissue in a clinically relevant ablation protocol. To validate the model, the predicted temperature distribution was assessed against that measured directly using fiberoptic temperature probes inserted in the tissue. Moreover, the model-predicted lesions were compared to the lesions observed in the post-ablation digital images. Results showed an agreement within 5°C between the model-predicted and experimentally measured tissue temperatures, as well as comparable predicted and observed lesion characteristics and geometry. These results suggest that the proposed technique is capable of providing reasonably accurate and sufficiently fast representations of the created RF ablation lesions, to generate lesion maps in near real time. These maps can be used to guide the placement of successive lesions to ensure continuous and enduring suppression of the arrhythmic pathway.

摘要

尽管在增强导管导航引导方面做出了巨大努力,但针对消融过程中组织发生的变化作为提供治疗进展有用反馈手段的研究却很少。我们提出一种技术,使用替代热消融模型来可视化病变进展并监测射频能量传递的效果。该模型纳入了物理和生理组织参数,并利用热传递原理近乎实时地估计组织中的温度分布以及所产生病变的几何形状。已在临床相关消融方案中使用牛肉肌肉组织对消融模型进行了校准和评估。为验证该模型,将预测的温度分布与使用插入组织中的光纤温度探头直接测量的温度分布进行了对比。此外,将模型预测的病变与消融后数字图像中观察到的病变进行了比较。结果表明,模型预测的组织温度与实验测量的组织温度之间的差异在5°C以内,并且预测的病变特征和几何形状与观察到的相当。这些结果表明,所提出的技术能够对创建的射频消融病变提供合理准确且足够快速的表征,以近乎实时地生成病变图。这些图可用于指导后续病变的放置,以确保持续且持久地抑制心律失常路径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3466/4576356/3fa25b5d04e6/nihms717228f1.jpg

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Biophysics of radiofrequency ablation.射频消融的生物物理学
Crit Rev Biomed Eng. 2010;38(1):53-63. doi: 10.1615/critrevbiomedeng.v38.i1.50.
9
Flow effect on lesion formation in RF cardiac catheter ablation.
IEEE Trans Biomed Eng. 2001 Apr;48(4):425-33. doi: 10.1109/10.915708.

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