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