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Limitations of Baseline Impedance, Impedance Drop and Current for Radiofrequency Catheter Ablation Monitoring: Insights from In Silico Modeling

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Limitations of Baseline Impedance, Impedance Drop and Current for Radiofrequency Catheter Ablation Monitoring: Insights from In Silico Modeling

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dc.contributor.author Irastorza, Ramiro M. es_ES
dc.contributor.author Maher, Timothy es_ES
dc.contributor.author Barkagan, Michael es_ES
dc.contributor.author Liubasuskas, Rokas es_ES
dc.contributor.author Pérez, Juan J es_ES
dc.contributor.author Berjano, Enrique es_ES
dc.contributor.author D Avila, Andre es_ES
dc.date.accessioned 2022-10-21T18:03:21Z
dc.date.available 2022-10-21T18:03:21Z
dc.date.issued 2022-10-03 es_ES
dc.identifier.uri http://hdl.handle.net/10251/188559
dc.description.abstract [EN] Background: Baseline impedance, radiofrequency current, and impedance drop during radiofrequency catheter ablation are thought to predict effective lesion formation. However, quantifying the contributions of local versus remote impedances provides insights into the limitations of indices using those parameters. Methods: An in silico model of left atrial radiofrequency catheter ablation was used based on human thoracic measurements and solved for (1) initial impedance (Z), (2) percentage of radiofrequency power delivered to the myocardium and blood (3) total radiofrequency current, (4) impedance drop during heating, and (5) lesion size after a 25 W¿30 s ablation. Remote impedance was modeled by varying the mixing ratio between skeletal muscle and fat. Local impedance was modeled by varying insertion depth of the electrode (ID). Results: Increasing the remote impedance led to increased baseline impedance, lower system current delivery, and reduced lesion size. For ID = 0.5 mm, Z ranged from 115 to 132 ¿ when fat percentage varied from 20 to 80%, resulting in a decrease in the RF current from 472 to 347 mA and a slight decrease in lesion size from 5.6 to 5.1 mm in depth, and from 9.2 to 8.0 mm in maximum width. In contrast, increasing the local impedance led to lower system current but larger lesions. For a 50% fat¿muscle mixture, Z ranged from 118 to 138 ¿ when ID varied from 0.3 to 1.9 mm, resulting in a decrease in the RF current from 463 to 443 mA and an increase in lesion size, from 5.2 up to 7.5 mm in depth, and from 8.4 up to 11.6 mm in maximum width. In cases of nearly identical Z but different contributions of local and remote impedance, markedly different lesions sizes were observed despite only small differences in RF current. Impedance drop better predicted lesion size (R2 > 0.93) than RF current (R2 < 0.1). Conclusions: Identical baseline impedances and observed RF currents can lead to markedly different lesion sizes with different relative contributions of local and remote impedances to the electrical circuit. These results provide mechanistic insights into the advantage of measuring local impedance and identifies potential limitations of indices incorporating baseline impedance or current to predict lesion quality es_ES
dc.description.sponsorship Spanish Ministerio de Ciencia, Innovación y Universidades / Agencia Estatal de Investigación (MCIN/AEI/10.13039/501100011033) under grant RTI2018-094357-B-C21, and Agencia Nacional de Promoción Científica y Tecnológica de Argentina, grant PICT-2016-2303. Dr. Irastorza was the recipient of a scholarship of the Programa de Becas Externas Postdoctorales para Jóvenes Investigadores del CONICET (Argentina). es_ES
dc.language Inglés es_ES
dc.publisher MDPI AG es_ES
dc.relation.ispartof Journal of Cardiovascular Development and Disease es_ES
dc.rights Reconocimiento (by) es_ES
dc.subject Biophysics es_ES
dc.subject Computer modeling es_ES
dc.subject Impedance es_ES
dc.subject Radiofrequency catheter ablation es_ES
dc.subject.classification TECNOLOGIA ELECTRONICA es_ES
dc.title Limitations of Baseline Impedance, Impedance Drop and Current for Radiofrequency Catheter Ablation Monitoring: Insights from In Silico Modeling es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.3390/jcdd9100336 es_ES
dc.relation.projectID info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020/RTI2018-094357-B-C21/ES/MODELADO Y EXPERIMENTACION PARA TERAPIAS ABLATIVAS INNOVADORAS/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/ANPCyT//PICT-2016-2303/ es_ES
dc.rights.accessRights Abierto es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica es_ES
dc.description.bibliographicCitation Irastorza, RM.; Maher, T.; Barkagan, M.; Liubasuskas, R.; Pérez, JJ.; Berjano, E.; D Avila, A. (2022). Limitations of Baseline Impedance, Impedance Drop and Current for Radiofrequency Catheter Ablation Monitoring: Insights from In Silico Modeling. Journal of Cardiovascular Development and Disease. 9(10):1-12. https://doi.org/10.3390/jcdd9100336 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion https://doi.org/10.3390/jcdd9100336 es_ES
dc.description.upvformatpinicio 1 es_ES
dc.description.upvformatpfin 12 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 9 es_ES
dc.description.issue 10 es_ES
dc.identifier.eissn 2308-3425 es_ES
dc.relation.pasarela S\472706 es_ES
dc.contributor.funder AGENCIA ESTATAL DE INVESTIGACION es_ES
dc.contributor.funder Agencia Nacional de Promoción Científica y Tecnológica, Argentina es_ES
upv.costeAPC 1386,72 es_ES


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