Key result
Pulsatile blood flow shows no meaningful effect on RF ablation lesion size versus continuous flow.
Why the study?
The effect of intracardiac blood flow pulsatility on tissue and blood distributions during radiofrequency cardiac ablation was not well characterized.
Does intracardiac blood flow pulsatility affect thermal lesion size and tissue/blood temperature during radiofrequency cardiac ablation in a computer model?
Does intracardiac blood flow pulsatility affect thermal lesion size and tissue/blood temperature during radiofrequency cardiac ablation in a computer model?
Computer models of radiofrequency cardiac ablation can safely ignore intracardiac blood flow pulsatility, as it does not significantly affect thermal lesion size or maximum tissue temperature.
Supports simplified continuous-flow assumptions in ablation models; hypothesis-generating pending in vivo validation.
PURPOSE: To assess the effect of intracardiac blood flow pulsatility on tissue and blood distributions during radiofrequency (RF) cardiac ablation (RFCA). METHODS: A three-dimensional computer model was used to simulate constant power ablations with an irrigated-tip electrode and three possible catheter orientations (perpendicular, parallel and 45°). Continuous flow and three different pulsatile flow profiles were considered, with four average blood velocity values: 3, 5.5, 8.5 and 24.4 cm/s. The 50 °C contour was used to assess thermal lesion size. RESULTS: The differences in lesion size between continuous flow and the different pulsatile flow profiles were always less than 1 mm. As regards maximum tissue temperature, the differences between continuous and pulsatile flow were always less than 1 °C, with slightly higher differences in maximum blood temperature, but never over 6 °C. While the progress of maximum tissue temperature was identical for continuous and pulsatile flow, maximum blood temperature with the pulsatile profile showed small amplitude oscillations associated with blood flow pulsatility. CONCLUSIONS: models can ignore pulsatility in intracardiac blood flow.
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Parés et al. (2021) studied Radiofrequency cardiac ablation. Intracardiac blood flow pulsatility vs. Continuous flow was evaluated on Thermal lesion size and maximum tissue/blood temperature. Intracardiac blood flow pulsatility during radiofrequency cardiac ablation produced <1 mm difference in lesion size and <1 °C difference in maximum tissue temperature compared to continuous flow.
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