Key result
Multielectrode unipolar ablation creates deeper lesions while bipolar ablation drives faster contiguous lesion formation.
Why the study?
The circumferential multipolar catheter facilitates pulmonary vein isolation for atrial fibrillation, but its ablation characteristics are not well understood.
Does multielectrode unipolar ablation compared to bipolar ablation create different thermal lesion characteristics using a circumferential multipolar catheter?
Does multielectrode unipolar ablation compared to bipolar ablation create different thermal lesion characteristics using a circumferential multipolar catheter?
Computational modeling suggests that unipolar ablation creates deeper, broader lesions suitable for thick tissue, while bipolar ablation allows faster creation of contiguous lesions for pulmonary vein isolation.
Answers are grounded in this paper and cite their sources.
Informs preclinical optimization of multielectrode catheters; leaves open human validation for thick myocardium.
The circumferential multipolar catheter (CMC) facilitates pulmonary vein isolation (PVI) for the treatment of atrial fibrillation by catheter ablation. However, the ablation characteristics of CMC are not well understood. This study uses the finite element method to conduct a comprehensive analysis of the ablation characteristics of multielectrode unipolar/bipolar (MEU/MEB) modes of the CMC. A three-dimensional computational model of the CMC, including blood, myocardium, connective tissue, lung, and muscle, was constructed. The method was validated by comparing the results of an in vitro experiment with the simulation. Both ablation modes could create contiguous effective lesions, but the MEU mode created a deeper and broader lesion volume than the MEB mode. The MEB mode had an overall higher average temperature field and allowed faster formation of the effective contiguous lesion. The lesion shape tended to be symmetric and spread downward and superficially in the MEU mode and MEB mode, respectively. Results from the simulation for validation agreed with the in vitro experiment. Different ablation trends of the MEU and MEB modes provide different solutions for specific ablation requirements in clinical applications. The MEU mode suits transmural lesion in thick tissue around pulmonary veins (PVs). The MEB mode profits fast and durable creation of circumferential PVI. This study provides a detailed performance analysis of CMC, thereby contributing to the theoretical knowledge base of application of PVI with this emerging technology.
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Gu et al. (2020) studied Atrial fibrillation. Multielectrode unipolar (MEU) ablation mode vs. Multielectrode bipolar (MEB) ablation mode was evaluated on Ablation characteristics (lesion volume, depth, temperature field, formation speed). Multielectrode unipolar ablation created deeper and broader lesions suitable for thick tissue, whereas bipolar ablation generated higher average temperatures for faster contiguous lesion formation.
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