A novel computational model for acute ablation lesions successfully recreated intracardiac electrograms, demonstrating that a second necrotic core in the near-field had minor impact on signal morphology.
A novel computational model successfully simulates intracardiac electrograms around acute ablation lesions, providing a tool for further research on signal interpretation during RFA.
Abstract Radiofrequency ablation (RFA) is a widely used clinical treatment for many types of cardiac arrhythmias. However, nontransmural lesions and gaps between linear lesions often lead to recurrence of the arrhythmia. Intracardiac electrograms (IEGMs) provide real-time information regarding the state of the cardiac tissue surrounding the catheter tip. Nevertheless, the formation and interpretation of IEGMs during the RFA procedure is complex and yet not fully understood. In this in-silico study, we propose a computational model for acute ablation lesions. Our model consists of a necrotic scar core and a border zone, describing irreversible and reversible temperature induced electrophysiological phenomena. These phenomena are modeled by varying the intra- and extracellular conductivity of the tissue as well as a regulating zone factor. The computational model is evaluated regarding its feasibility and validity. Therefore, this model was compared to an existing one and to clinical measurements of five patients undergoing RFA. The results show that the model can indeed be used to recreate IEGMs. We computed IEGMs arising from complex ablation scars, such as scars with gaps or two overlapping ellipsoid scars. For orthogonal catheter orientation, the presence of a second necrotic core in the near-field of a punctiform acute ablation lesion had minor impact on the resulting signal morphology. The presented model can serve as a base for further research on the formation and interpretation of IEGMs.
Greiner et al. (Thu,) conducted a other in Cardiac arrhythmias (n=5). Computational model for acute ablation lesions vs. Existing model and clinical measurements was evaluated on Feasibility and validity of recreating intracardiac electrograms. A novel computational model for acute ablation lesions successfully recreated intracardiac electrograms, demonstrating that a second necrotic core in the near-field had minor impact on signal morphology.