In Silico Modelling to Assess the Electrical and Thermal Disturbance Provoked by a Metal Intracoronary Stent during Epicardial Pulsed Electric Field Ablation

Figures

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  Figure 1. Physical situation modelled in the study. Anatomical picture (A) and histological image (B) showing the spatial relation between the ablation electrode and the left circumflex coronary artery –LCx–. Reprinted adapted with permission from [10]. Copyright © 2014 Damián Sánchez-Quintana et al. (it is an open access article distributed under the Creative Commons Attribution License (Attribution 3.0 Unported (CC BY 3.0)).

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  Figure 2. (A): Geometry of the 2D limited-domain model which only considers a fragment of the region of interest around the ablation device. The ablation device is embedded on a saline layer (S = 0.5 mm) and placed over an epicardial fat surface (F), myocardium (C = 2.7 mm) and blood layers. The metal stent is within the left circumflex coronary artery (LCx) with a wall thickness of 100 μm at 1 mm below the centre of the ablation device. The dispersive pad is placed on the bottom surface of the model. (B): Detail of the ablation device (AtriAN Medical, Galway, Ireland) with a hole in its centre for saline infusion [1,4,11].

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  Figure 3. PEF pulse trains applied in the active electrode based on 10 consecutive pulses of 1000 V for 100 µs with an inter-pulse interval of 100 µs (A) and 10 µs (B).

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  Figure 4. Electric field distributions after a train of ten PEF pulses (100 μs between them) for a distance of 1 mm between ablation electrode and artery/stent. Different scenarios were compared: (A) epicardial fat layer without artery, (B) artery without stent, and (C) artery with stent. The white contour corresponds to the 1000 V/cm electric field isoline and defines the PEF-zone.

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  Figure 5. Electric field distributions after a train of ten PEF pulses (100 μs between them) for a distance of 0.25 mm between ablation electrode and artery/stent. Different scenarios were compared: (A) epicardial fat layer without artery, (B) artery without stent, and (C) artery with stent. The white contour corresponds to the 1000 V/cm electric field isoline and defines the PEF-zone.

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  Figure 6. Temperature distributions just after applying a pulse train with an interval between pulses of 100 μs comparing different conditions: epicardial fat layer without artery (A), artery at 1 mm from the ablation device without (B) and with (C) metal stent, and artery at 0.25 mm without (D) and with (E) with metal stent.

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  Figure 7. Temperature distributions just after applying a pulse train with time between pulses of 10 μs (see Figure 3B) comparing different conditions: (A) epicardial fat layer without LCx, the LCx at 1 mm from the ablation device without (B) and with (C) with the metal stent, and the LCx at 0.25 mm without (D) and with (E) the metal stent.