Johann Radon Institute for Computational and Applied Mathematics (RICAM), Austrian Academy of Sciences, Linz, Austria.
Department of Cardiology, Hospital de la Santa Creu i Sant Pau, IIB SANT PAU, Universitat Autónoma de Barcelona, CIBER CV, Barcelona, Spain.
Physiol Meas. 2023 Jun 27;44(6). doi: 10.1088/1361-6579/acdcdd.
Thermal cellular injury follows complex dynamics and subcellular processes can heal the inflicted damage if insufficient heat is administered during the procedure. This work aims to the identification of irreversible cardiac tissue damage for predicting the success of thermal treatments.Several approaches exist in the literature, but they are unable to capture the healing process and the variable energy absorption rate that several cells display. Moreover, none of the existing models is calibrated for cardiomyocytes. We consider a three-state cell death model capable of capturing the reversible damage of a cell, we modify it to include a variable energy absorption rate and we calibrate it for cardiac myocytes.We show how the thermal damage predicted by the model response is in accordance with available data in the literature on myocytes for different temperature distributions. When coupled with a computational model of radiofrequency catheter ablation, the model predicts lesions in agreement with experimental measurements. We also present additional experiments (repeated ablations and catheter movement) to further illustrate the potential of the model.We calibrated a three-state cell death model to provide physiological results for cardiac myocytes. The model can be coupled with ablation models and reliably predict lesion sizes comparable to experimental measurements. Such approach is robust for repeated ablations and dynamic catheter-cardiac wall interaction, and allows for tissue remodelling in the predicted damaged area, leading to more accurate in-silico predictions of ablation outcomes.
热细胞损伤遵循复杂的动力学，并且如果在手术过程中施加的热量不足，则亚细胞过程可以修复所造成的损伤。这项工作旨在识别不可逆的心肌组织损伤，以预测热治疗的成功。文献中存在几种方法，但它们无法捕捉到愈合过程和多个细胞表现出的可变能量吸收率。此外，现有的模型都没有针对心肌细胞进行校准。我们考虑了一种能够捕获细胞可逆损伤的三状态细胞死亡模型，我们对其进行了修改以包括可变的能量吸收率，并对心肌细胞进行了校准。我们展示了模型响应预测的热损伤如何与文献中关于不同温度分布下心肌细胞的可用数据一致。当与射频导管消融的计算模型耦合时，该模型预测的病变与实验测量结果一致。我们还进行了额外的实验（重复消融和导管移动），以进一步说明该模型的潜力。我们对三状态细胞死亡模型进行了校准，以提供心肌细胞的生理结果。该模型可以与消融模型耦合，并可靠地预测与实验测量结果相当的病变大小。这种方法对于重复消融和导管-心肌壁的动态相互作用是稳健的，并且允许在预测的损伤区域进行组织重塑，从而更准确地预测消融结果。
