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心房颤动冷冻消融的热力学特性:一种基于模型的方法,可提高对能量传递的认识。

Thermodynamic properties of atrial fibrillation cryoablation: a model-based approach to improve knowledge on energy delivery.

机构信息

Department of Energy, Politecnico di Torino, Italy.

Division of Cardiology, 'Città della Salute e della Scienza di Torino' Hospital, Department of Medical Sciences, University of Turin, Turin, Italy.

出版信息

J R Soc Interface. 2019 Sep 27;16(158):20190318. doi: 10.1098/rsif.2019.0318. Epub 2019 Sep 18.

Abstract

The objective of this study is to describe a suitable model of atrial fibrillation cryoablation thermodynamic properties. Three different thermal loads were applied to a cylindrical copper element simulating the cryoprobe, thermally coupled with a Peltier stack producing the freezing effect, and in contact with a bovine liver sample. Thermal events occurring inside the samples were measured using mirror image technique. Heat subtracted flux during ice formation and minimum temperature measured at probe-tissue interface were, respectively, 1.33 W cm and -27.8°C for Sample#0, 1.88 W cm and -35.6°C for Sample#1 and 1.82 W cm and 1.44 W cm before and after the ice trigger, respectively, and -29.3°C for Sample#2. Ice trigger temperature was around -8.5°C for Sample#0 and Sample#2, and -10.4°C for Sample#1. In all the investigated samples, ice front penetration was proportional to the square root of time and its velocity depended on the heat flux subtracted. The fraction of the useful energy spent for ice formation was less than 60% for Sample#0, and about 80% for Sample#1 and for Sample#2, before the reduction of the removed heat flux. Freezing time exceeding a cut-off, according to the heat subtracted flux, does not improve the procedure effectiveness and is detrimental to the surrounding tissues.

摘要

本研究的目的是描述一种适合心房颤动冷冻消融热物理特性的模型。三种不同的热负荷施加到一个圆柱形铜元件上,该元件模拟冷冻探针,与产生冷冻效应的珀耳帖堆热耦合,并与牛肝样本接触。使用镜像技术测量样品内部发生的热事件。在冰形成过程中减去的热通量和在探针-组织界面处测量到的最低温度分别为 0 号样品 1.33 W cm 和-27.8°C,1 号样品 1.88 W cm 和-35.6°C,在冰触发之前和之后分别为 1.82 W cm 和 1.44 W cm,2 号样品为-29.3°C。0 号和 2 号样品的冰触发温度约为-8.5°C,1 号样品为-10.4°C。在所有研究的样本中,冰前沿的穿透与时间的平方根成正比,其速度取决于减去的热通量。在去除热通量减少之前,用于冰形成的有用能量的分数小于 0 号样本的 60%,约为 80%,用于 1 号样本和 2 号样本。根据减去的热通量,冻结时间超过截止值不会提高手术的有效性,反而会对周围组织造成损害。

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