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Simulation of electrical fields in cardiac resynchronization therapy and temperature spread in HF ablation

  • Background: The electrical field (E-field) of the biventricular (BV) stimulation is essential for the success of cardiac resynchronization therapy (CRT) in patients with cardiac insufficiency and widened QRS complex. 3D modeling allows the simulation of CRT and high frequency (HF) ablation. Purpose: The aim of the study was to model different pacing and ablation electrodes and to integrate themBackground: The electrical field (E-field) of the biventricular (BV) stimulation is essential for the success of cardiac resynchronization therapy (CRT) in patients with cardiac insufficiency and widened QRS complex. 3D modeling allows the simulation of CRT and high frequency (HF) ablation. Purpose: The aim of the study was to model different pacing and ablation electrodes and to integrate them into a heart model for the static and dynamic simulation of BV stimulation and HF ablation in atrial fibrillation (AF). Methods: The modeling and simulation was carried out using the electromagnetic simulation software. Five multipolar left ventricular (LV) electrodes, one epicardial LV electrode, four bipolar right atrial (RA) electrodes, two right ventricular (RV) electrodes and one HF ablation catheter were modeled. Different models of electrodes were integrated into a heart rhythm model for the electrical field simulation (fig.1). The simulation of an AV node ablation at CRT was performed with RA, RV and LV electrodes and integrated ablation catheter with an 8 mm gold tip. Results: The RV and LV stimulation were performed simultaneously at amplitude of 3 V at the LV electrode and 1 V at the RV electrode, each with a pulse width of 0.5 ms. The far-field potentials generated by the BV stimulations were perceived by the RA electrode. The far-field potential at the RA electrode tip was 32.86 mV. A far-field potential of 185.97 mV resulted at a distance of 1 mm from the RA electrode tip. AV node ablation was simulated with an applied power of 5 W at 420 kHz at the distal 8 mm ablation electrode. The temperature at the catheter tip was 103.87 ° C after 5 s ablation time, 44.17 ° C from the catheter tip in the myocardium and 37.61 ° C at a distance of 2 mm. After 10 s, the temperature at the three measuring points described above was 107.33 ° C, 50.87 ° C, 40.05 ° C and after 15 seconds 118.42 ° C, 55.75 ° C and 42.13 ° C. Conclusions: Virtual heart and electrode models as well as the simulations of electrical fields and temperature profiles allow the static and dynamic simulation of atrial synchronous BV stimulation and HF ablation at AF. The 3D simulation of the electrical field and temperature profile may be used to optimize the CRT and AF ablation.show moreshow less

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Metadaten
Author:Martin Krämer, Reinhard Echle, Matthias Heinke
Year of Publication:2017
Date of first Publication:2017/06/20
Language:English
GND Keyword:CRT; CST; HF-Ablation
Tag:CRT; CST; HF-Ablation
Parent Title (German):EHRA EUROPACE - CARDIOSTIM 2017 Abstract supplement June 18-21, 2017 - Vienna
Volume:19
Issue:Suppl. 3, 2017
ISSN:1099-5129
First Page:185
Last Page:186
Document Type:Other
Institutes:Hochschule Offenburg / Bibliografie
Release Date:2018/01/18
Licence (German):License LogoEs gilt das UrhG
URL:https://academic.oup.com/europace/article/19/suppl_3/iii185/3872845
DOI:https://doi.org/10.1093/ehjci/eux151.106