BACKGROUND: Radiofrequency ablation is extensively used to achieve pulmonary veins isolation for the cure of atrial fibrillation. Luminal esophageal temperature can be monitored by means of suitable probes to prevent the onset of lesions. OBJECTIVE: To compute the thermal field generated by the ablation, to investigate the interaction between the electromagnetic field and the probe sensors, and to provide a safe interpretation of the temperature detected by the probe, supported by clinical data. METHODS: A mathematical model is formulated and the thermal and electromagnetic fields are computed. Experiments have been performed to assess the the influence of the ablator on the probe sensors. Clinical data have been collected during RF isolation of pulmonary veins in patients with atrial fibrillation. RESULTS: The direct interaction between the radiofrequency source and the probe sensors is found to be negligible. Numerical simulations show that the outer esophageal wall can be much warmer than the lumen. Theoretical heating curves are compared with the clinical data selecting the maximal slope as the reference quantity. The clinical values range between 0.01°C/s and 0.15°C/s agree with the computed predictions and demonstrate that reducing the esophagus-atrium distance by 1mm causes a slope increase of 0.06°C/s. CONCLUSION: The use of esophageal thermal probes is absolutely safe and necessary in order to prevent the occurrence of thermal lesions. The model is reliable, and describes effectively the generated thermal field. The external esophageal temperature can be considerably higher than the luminal one.
BACKGROUND: Radiofrequency ablation is extensively used to achieve pulmonary veins isolation for the cure of atrial fibrillation. Luminal esophageal temperature can be monitored by means of suitable probes to prevent the onset of lesions. OBJECTIVE: To compute the thermal field generated by the ablation, to investigate the interaction between the electromagnetic field and the probe sensors, and to provide a safe interpretation of the temperature detected by the probe, supported by clinical data. METHODS: A mathematical model is formulated and the thermal and electromagnetic fields are computed. Experiments have been performed to assess the the influence of the ablator on the probe sensors. Clinical data have been collected during RF isolation of pulmonary veins in patients with atrial fibrillation. RESULTS: The direct interaction between the radiofrequency source and the probe sensors is found to be negligible. Numerical simulations show that the outer esophageal wall can be much warmer than the lumen. Theoretical heating curves are compared with the clinical data selecting the maximal slope as the reference quantity. The clinical values range between 0.01°C/s and 0.15°C/s agree with the computed predictions and demonstrate that reducing the esophagus-atrium distance by 1mm causes a slope increase of 0.06°C/s. CONCLUSION: The use of esophageal thermal probes is absolutely safe and necessary in order to prevent the occurrence of thermal lesions. The model is reliable, and describes effectively the generated thermal field. The external esophageal temperature can be considerably higher than the luminal one.
Authors: Patrick Müller; Johannes-Wolfgang Dietrich; Philipp Halbfass; Aly Abouarab; Franziska Fochler; Atilla Szöllösi; Karin Nentwich; Markus Roos; Joachim Krug; Anja Schade; Andreas Mügge; Thomas Deneke Journal: Heart Rhythm Date: 2015-04-03 Impact factor: 6.343
Authors: Geoffrey Lee; Paul B Sparks; Joseph B Morton; Peter M Kistler; Jitendra K Vohra; Caroline Medi; Raphael Rosso; Andrew Teh; Karen Halloran; Jonathan M Kalman Journal: J Cardiovasc Electrophysiol Date: 2010-08-19
Authors: Andreas Metzner; Andre Burchard; Peter Wohlmuth; Peter Rausch; Alexander Bardyszewski; Christina Gienapp; Roland Richard Tilz; Andreas Rillig; Shibu Mathew; Sebastian Deiss; Hisaki Makimoto; Feifan Ouyang; Karl-Heinz Kuck; Erik Wissner Journal: Circ Arrhythm Electrophysiol Date: 2013-06-07
Authors: Thomas Deneke; Kathrin Bünz; Annely Bastian; Marcus Päsler; Helge Anders; Rainer Lehmann; Wolfgang Meuser; Joris R de Groot; Marc Horlitz; Ron Haberkorn; Andreas Mügge; Dong-In Shin Journal: J Cardiovasc Electrophysiol Date: 2010-10-11
Authors: Nicolas Doll; Michael A Borger; Alexander Fabricius; Susann Stephan; Jan Gummert; Friedrich W Mohr; Johann Hauss; Hans Kottkamp; Gerd Hindricks Journal: J Thorac Cardiovasc Surg Date: 2003-04 Impact factor: 5.209