Open Access

Martin Krämer, Matthias Heinke, Reinhard Echle, Johannes Hörth

• The electrical field (E-field) of the biventricular (BV) stimulation is important for the success of cardiac resynchronization therapy (CRT) in patients with cardiac insufficiency and widened QRS complex. 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 inThe electrical field (E-field) of the biventricular (BV) stimulation is important for the success of cardiac resynchronization therapy (CRT) in patients with cardiac insufficiency and widened QRS complex. 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). The modeling and simulation was carried out using the electromagnetic simulation software CST. Five multipolar left ventricular (LV) electrodes, four bipolar right atrial (RA) electrodes, two right ventricular (RV) electrodes and one HF ablation catheter were modelled. A selection were integrated into the heart rhythm model (Schalk, Offenburg) for the electrical field simulation. 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. The BV stimulation were performed simultaneously at amplitude of 3 V at the LV electrode and 1 V at the RV electrode with a pulse width of 0.5 ms each. The far-field potential at the RA electrode tip was 32.86 mV and 185.97 mV 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 ablation electrode. The temperature at the catheter tip was 103.87 °C after 5 s ablation time and 37.61 °C at a distance of 2 mm inside the myocardium. After 15 s, the temperature was 118.42 °C and 42.13 °C. 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 and could be used to optimize the CRT and AF ablation.…