Catheter-to-tissue contact angle’s effect on lesion formation and characterisation using multichannel bioimpedance method

Objective. Radiofrequency (RF) catheter ablation is a standard treatment for patients with cardiac arrhythmias, providing an efficient, minimally invasive solution. However, the ablation efficiency remains suboptimal due to numerous contributed factors that are overlooked in the literature and not monitored during the procedure. This paper explores the effect of catheter-to-tissue contact angles on lesion formations and the feasibility of the multichannel bioimpedance method in characterising the angles to inform cardiologists. Approach. Two silico simulations based on a realistic human model were built to: (1) simulate lesion formations with different catheter-to-tissue angles under varying conditions of powers and convection cooling, and (2) simulate multichannel bioimpedances measured at each catheter’s location and angle. 13 locations were picked in all four chambers with 3 contact conditions (catheter lies along the muscle (0° and 180°), in perpendicular to the muscle (90°) and in middle angles (45° and 135°)). 64 electrodes divided into 4 bands were placed on the thorax for multichannel bioimpedances (3-terminal) measured between the catheter’s second electrode E2 ( I +, V +), and each pair of adjacent surface electrodes ( I − , V − ). ANOVA and Tukey’s Honestly Significant Difference (HSD) tests were used to evaluate the contact angle’s effect on the lesion formations and the bioimpedance’s capability in distinguishing between angles. Main results. The results showed that 0° and 180° configurations generated significantly different lesions from other angles. The multichannel bioimpedances could recognise 0°/180° from other angles and correlated moderately to lesion sizes at low ablation power. Significance. This paper concludes that catheter-to-tissue angles can influence the lesion outcomes significantly and the multichannel bioimpedance is able to detect the angles that matter.