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Heart rhythm model and simulation of electrophysiological studies and high-frequency ablations
(2017)
Background: Target of the study was to create an accurate anatomic CAD heart rhythm model, and to show its
usefulness for cardiac electrophysiological studies and high-frequency ablations. The method is more careful for
the patients’ health and has the potential to replace clinical studies due to its high efficiency regarding time and
costs
Methods: All natural heart components of the new HRM were based on MRI records, which guaranteed
electronic functionality. The software CST was used for the construction, while CST’s material library assured
genuine tissue properties. It should be applicable to simulate different heart rhythm diseases as well as various
diffusions of electromagnetic fields, caused by electrophysiological conduction, inside the heart tissue.
Results: It was achievable to simulate sinus rhythm and fourteen different heart rhythm disturbance with
different atrial and ventricular conduction delays. The simulated biological excitation of healthy and sick HRM
were plotted by simulated electrodes of four polar right atrial catheter, six polar His bundle catheter, ten polar
coronary sinus catheter, four polar ablation catheter and eight polar transesophageal left cardiac catheter.
Accordingly, six variables were rebuilt and inserted into the anatomic HRM in order to establish heart catheters
for ECG monitoring and HF ablation. The HF ablation catheters made it possible to simulate various types of
heart rhythm disturbance ablations with different HF ablation catheters and also showed a functional
visualisation of tissue heating. The use of tetrahedral meshing HRM made it attainable to store the results faster
accompanied by a higher degree of space saving. The smart meshing function reduced unnecessary high
resolutions for coarse structures.
Conclusions: The new HRM for EPS simulation may be additional useful for simulation of heart rhythm
disturbance, cardiac pacing, HF ablation and for locating and identification of complex fractioned signals within
the atrium during atrial fibrillation HF ablation.
Die Simulation komplexer kardialer Strukturen und kardialer Elektroden ist von Bedeutung für die
Optimierung langatmiger und kostspieliger klinischer Studien. Das Risiko der Patientengefährdung
wird durch diese Methode auf ein Minimum reduziert. Das Ziel der Studie besteht im Entwurf eines
anatomisch korrekten 3D CAD Herzrhythmusmodells (HRM) zur Simulation von elektrophysiologi-
schen Untersuchungen (EPU) und Hochfrequenz-(HF-)Ablationen.
The simulation of complex cardiologic structures and cardiac electrodes have the potential to repla-
ce clinical studies due to its high efficiency regarding time and costs. Furthermore, the method is
more careful for the patients’ health than the conventional ways. The aim of the study was to create
an anatomic 3D-CAD-heart rhythm model (HRM) as accurate as possible, and to show its usefulness
for cardiac electrophysiological studies (EPS) and high-frequency (HF) ablations.
Heart rhythm model and simulation of electrophysiological studies and high-frequency ablations
(2017)
Background: The simulation of complex cardiologic structures has the potential to replace clinical studies due to its high efficiency regarding time and costs. Furthermore, the method is more careful for the patients’ health than the conventional ways. The aim of the study was to create an anatomic CAD heart rhythm model (HRM) as accurate as possible, and to show its usefulness for cardiac electrophysiological studies (EPS) and high-frequency (HF) ablations.
Methods: All natural heart components of the new HRM were based on MRI records, which guaranteed electronic functionality. The software CST (Computer Simulation Technology, Darmstadt) was used for the construction, while CST’s material library assured genuine tissue properties. It should be applicable to simulate different heart rhythm diseases as well as various diffusions of electromagnetic fields, caused by electrophysiological conduction, inside the heart tissue.
Results: It was achievable to simulate normal sinus rhythm and fourteen different heart rhythm disturbance with different atrial and ventricular conduction delays. The simulated biological excitation of healthy and sick HRM were plotted by simulated electrodes of four polar right atrial catheter, six polar His bundle catheter, ten polar coronary sinus catheter, four polar ablation catheter and eight polar transesophageal left cardiac catheter (Fig.). Accordingly, six variables were rebuilt and inserted into the anatomic HRM in order to establish heart catheters for ECG monitoring and HF ablation. The HF ablation catheters made it possible to simulate various types of heart rhythm disturbance ablations with different HF ablation catheters and also showed a functional visualisation of tissue heating. The use of tetrahedral meshing HRM made it attainable to store the results faster accompanied by a higher degree of space saving. The smart meshing function reduced unnecessary high resolutions for coarse structures.
Conclusions: The new HRM for EPS simulation may be additional useful for simulation of heart rhythm disturbance, cardiac pacing, HF ablation and for locating and identification of complex fractioned signals within the atrium during atrial fibrillation HF ablation.
Figure 1: Position of the electrophysiological conduction system and electrode catheters in the heart rhythm model (top left), HF ablation of a Kent bundle between the lateral left atrium and left ventricle in a WPW Syndrom (top right), Left anterior fascicular block during the excitation of Tawara branches (bottom left), pacing with the tip of the right ventricle catheter in a total atrioventricular block.
Heart rhythm model and simulation of electrophysiological studies and high-frequency ablations
(2017)
Background: The simulation of complex cardiologic structures has the potential to replace clinical studies due to its high efficiency regarding time and costs. Furthermore, the method is more careful for the patients’ health than the conventional ways. The aim of the study was to create an anatomic CAD heart rhythm model (HRM) as accurate as possible, and to show its usefulness for cardiac electrophysiological studies (EPS) and high-frequency (HF) ablations.
Methods: All natural heart components of the new HRM were based on MRI records, which guaranteed electronic functionality. The software CST (Computer Simulation Technology, Darmstadt) was used for the construction, while CST’s material library assured genuine tissue properties. It should be applicable to simulate different heart rhythm diseases as well as various diffusions of electromagnetic fields, caused by electrophysiological conduction, inside the heart tissue.
Results: It was achievable to simulate normal sinus rhythm and fourteen different heart rhythm disturbance with different atrial and ventricular conduction delays. The simulated biological excitation of healthy and sick HRM were plotted by simulated electrodes of four polar right atrial catheter, six polar His bundle catheter, ten polar coronary sinus catheter, four polar ablation catheter and eight polar transesophageal left cardiac catheter (Fig.). Accordingly, six variables were rebuilt and inserted into the anatomic HRM in order to establish heart catheters for ECG monitoring and HF ablation. The HF ablation catheters made it possible to simulate various types of heart rhythm disturbance ablations with different HF ablation catheters and also showed a functional visualisation of tissue heating. The use of tetrahedral meshing HRM made it attainable to store the results faster accompanied by a higher degree of space saving. The smart meshing function reduced unnecessary high resolutions for coarse structures.
Conclusions: The new HRM for EPS simulation may be additional useful for simulation of heart rhythm disturbance, cardiac pacing, HF ablation and for locating and identification of complex fractioned signals within the atrium during atrial fibrillation HF ablation.
Die Erfindung betrifft eine Ösophaguselektrodensonde bzw. einen Ösophaguskatheter 10 zur Bioimpedanzmessung und/oder zur Neurostimulation, eine Vorrichtung 100 zur transösophagealen kardiologischen Behandlung und/oder kardiologischen Diagnose und ein Verfahren zum Steuern oder Regeln einer Ablationseinrichtung zum Durchführen einer Herzablation. Die Ösophaguselektrodensonde 10 umfasst eine Bioimpedanzmesseinrichtung zur Messung der Bioimpedanz von zumindest einem Teil des die Ösophaguselektrodensonde 10 umgebenden Gewebes. Die Bioimpedanzmesseinrichtung umfasst mindestens eine erste Elektrode 12A und mindestens eine zweite Elektrode 12B, wobei die mindestens eine erste Elektrode 12A auf einer dem Herzen zugewandten Seite 14 der Ösophaguselektrodensonde 10 angeordnet ist, und die mindestens eine zweite Elektrode 12B auf einer vom Herzen abgewandten Seite 16 der Ösophaguselektrodensonde 10 angeordnet ist.Die Vorrichtung 100 umfasst die Ösophaguselektrodensonde 10 und eine Steuer- und/oder Auswerteinrichtung 30. Die Steuer- und/oder Auswerteinrichtung 30 ist eingerichtet, ein erstes Bioimpedanzmesssignal von der mindestens einen ersten Elektrode 12A und ein zweites Bioimpedanzmesssignal von der mindestens einen zweiten Elektrode 12B zu empfangen und zu vergleichen, und ein Kontrollsignal auf Basis des Vergleichs zu generieren. Das Kontrollsignal kann ein Signal zum Steuern oder Regeln einer Ablationseinrichtung zum Durchführen einer Herzablation sein.