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利用计算机模拟评估大功率短时间射频导管消融的病变特征和基础阻抗。

Evaluation of lesion characteristics and baseline impedance on high-power short-duration radiofrequency catheter ablation using computer simulation.

机构信息

Graduate School of Computer Science and Engineering, The University of Aizu, Aizuwakamatsu, Japan.

Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Meguro, Tokyo, 153-8515, Japan.

出版信息

Heart Vessels. 2023 Dec;38(12):1459-1467. doi: 10.1007/s00380-023-02300-6. Epub 2023 Aug 31.

Abstract

Myocardium baseline impedance (BI) is an important factor in ablation effectiveness. This study examined the performance of low-power and long-duration (LPLD), high-power and short-duration (HPSD) ablation at different BIs by computer simulation. A 3D model of the ablation region was constructed for simulation, and in vitro experiments were performed to validate the simulation. Three ablation power and duration configurations of 30 W/30 s, 50 W/10 s, and 90 W/5 s were used for simulation with BI values of 90, 100, 110, 120, 130, and 140 Ω. Roll-off time and ablation volume were measured to evaluate ablation results. The simulation is consistent with the in vitro experiments. When BI is changed from 90 [Formula: see text] to 140 [Formula: see text], the lesion volume over 50 °C with BI of 140 [Formula: see text] was reduced by 6.3%, 6.7%, and 7.3% for 30 W/30 s, 50 W/10 s, and 90 W/5 s configurations, respectively, and the lesion volume over 100 °C was reduced by 62.8%, 49.7%, and 22.5% under 30 W/30 s, 50 W/10 s, and 90 W/5 s, respectively. Simulation results revealed that HPSD (vHPSD) and LPLD ablation were more affected by changes in BI in the lesion volumes over 50 °C and 100 °C, respectively, and demonstrated that resistive and conductive heating were the main heating effects in HPSD (vHPSD) and LPLD, respectively.

摘要

心肌基础阻抗(BI)是消融效果的一个重要因素。本研究通过计算机模拟考察了低功率长时(LPLD)和高功率短时(HPSD)消融在不同 BI 下的性能。构建了消融区域的 3D 模型进行模拟,并进行了体外实验验证模拟。模拟采用 30 W/30 s、50 W/10 s 和 90 W/5 s 三种消融功率和时长组合,BI 值分别为 90、100、110、120、130 和 140 Ω。测量滚降时间和消融体积以评估消融效果。模拟与体外实验结果一致。当 BI 从 90 [Formula: see text] 变为 140 [Formula: see text] 时,BI 为 140 [Formula: see text] 时的 50 [Formula: see text] 以上的病变体积分别减少了 6.3%、6.7%和 7.3%,对于 30 W/30 s、50 W/10 s 和 90 W/5 s 三种配置,而 100 [Formula: see text] 以上的病变体积分别减少了 62.8%、49.7%和 22.5%,对于 30 W/30 s、50 W/10 s 和 90 W/5 s 三种配置。模拟结果表明,HPSD(vHPSD)和 LPLD 消融受 50 [Formula: see text] 和 100 [Formula: see text] 以上病变体积中 BI 变化的影响更大,分别表明电阻和传导加热是 HPSD(vHPSD)和 LPLD 中的主要加热效应。

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