Key result
Bipolar phase-shifted ablation modeling optimizes temperature distribution and minimizes electrode edge differences vs unipolar delivery.
Computational modeling demonstrates that a bipolar phase-shifted technique can optimize temperature distribution during multielectrode catheter ablation for atrial fibrillation.
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Hypothesis-generating for multielectrode catheter design; leaves open in vivo safety and efficacy in AF ablation.
Atrial fibrillation (AFIB) is a common clinical problem affecting approximately 0.5-1% of the United States population. Radio-frequency (RF) multielectrode catheter (MEC) ablation has successes in curing AFIB. We utilized finite-element method analysis to determine the myocardial temperature distribution after 30 s, 80 degrees C temperature-controlled unipolar ablation using three 7F 12.5-mm electrodes with 2-mm interelectrode spacing MEC. Numerical results demonstrated that cold spots occurred at the edges of the middle electrode and hot spots at the side electrodes. We introduced the bipolar phase-shifted technique for RF energy delivery of MEC ablation. We determined the optimal phase-shift (phi) between the two sinusoidal voltage sources of a simplified two-dimensional finite-element model. At the optimal phi, we can achieve a temperature distribution that minimizes the difference between temperatures at electrode edges. We also studied the effects of myocardial electric conductivity (sigma), thermal conductivity (k), and the electrode spacing on the optimal phi. When we varied sigma and kappa from 50% to 150%, optimal phi ranged from 29.5 degrees to 23.5 degrees, and in the vicinity of 26.5 degrees, respectively. The optimal phi for 3-mm spacing MEC was 30.5 degrees. We show the design of a simplified bipolar phase-shifted MEC ablation system.
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Tungjitkusolmun et al. (2002) studied Atrial fibrillation. Bipolar phase-shifted multielectrode catheter ablation vs. Unipolar ablation was evaluated on Myocardial temperature distribution and optimal phase-shift. Finite-element modeling demonstrated that a bipolar phase-shifted technique for multielectrode catheter ablation can achieve an optimal temperature distribution that minimizes differences at electrode edges.
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