Method of destruction of the pathological excitation sources in the heart by original monopolar electrode
Keywords:radiofrequency ablation, monopolar electrode, electric current, power, duration of exposure, myocardial tissue temperature
AbstractPurpose. This work is devoted to the study of destruction of the pathological excitation sources in the heart by the original monopolar electrode and the high-frequency electrosurgical generator Erbe VIO-100 S (Germany) in the coagulation mode in order to optimize technology of their using in surgical practice for Maze surgery.
Methodology. Experimental study of the effect of electric current on the myocardium were performed in the laboratory on the endocardial part of four remote pig hearts in the cold hibernation state. Temperature evaluation of myocardial contact with the electrode was carried out using mathematical modeling of temperature fields of radio frequency current interaction with the tissue in the program Comsol Multiphysics.
Results. Safe and effective destruction size, nature of histological and temperature changes in the interaction region of myocardial tissue with a source of electrical current depending on the duration and power application to stop the spread of pathological excitation sources in the heart were defined. Originality. The recommendations on the choice of the optimal parameters for the application of the generator Erbe and the original monopolar electrode were developed and adapted to radiofrequency ablation of myocardial tissue in the open heart for the arrhythmias treatment in order to reduce the total duration of surgery with cardiopulmonary bypass.
Practical value. The results have been introduced in surgical practice of the State Institution «M. M. Amosov National Institute of Cardiovascular Surgery Ukraine NAMS of Ukraine». The work has great practical importance, because the expanding of the functional range of generator Erbe VIO-100 S (Germany) applications and reducing of the cost of radio frequency ablation procedure in comparison with the use of specialized disposable bipolar electrodes.
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Сичик М. М. Моделювання електричного та термодинамічного впливу радіочастотної абляції на міокард в програмі Comsol Multiphysics 4.3a. / М. М. Сичик, В. Б. Максименко, Ю. П. Стасюк, Є. Г. Сорочан, М. В. Савкіна // Вісник Кременчуцького національного університету імені Михайла Остроградського. – 2015. – Вип. 5/2015 (94). – С. 72-78. – Режим доступу : http://www.kdu.edu.ua/PUBL/statti/2015_5_72-5-2015.pdf
Akca F., Janse P., Theuns D.A.M.J., and Szili-Torok T. (2014) A prospective study on safety of catheter ablation procedures: Contact force guided ablation could reduce the risk of cardiac perforation. International Journal of Cardiology, Vol. 179, рр. 441-448.
Anter E., Tschabrunn C.M., Contreras-Valdes F.M., Buxton A.E., and Josephson M.E. (2014) Radiofrequency ablation annotation algorithm reduces the incidence of linear gaps and reconnection after pulmonary vein isolation. Heart Rhythm, Vol. 11, Issue 5, рр. 783–790.
Biase L.D., Perini A.P., Mohanty P., Goldenberg A.S., Grifoni G., Santangeli P., Santoro F., Sanchez J.E., Horton R., Gallinghouse G.J., Conti S., Mohanty S., Bailey S., Trivedi C., Garg A., Grogan A.P., Wallace D.T., Padeletti L., Reddy V., and Jais P. (2014) Visual, tactile, and contact force feedback: Which one is more important for catheter ablation? Results from an in vitro experimental study. Heart Rhythm, Vol. 11, Iss. 3, рр. 506-513.
Park J., Park C.H., Lee H.J., Wi J., Uhm J.S., Pak H.N., Lee M., and Kim Y.J. (2014) Left atrial wall thickness rather than epicardial fat thickness is related to complex fractionated atrial electrogram. International Journal of Cardiology, Vol. 172, Iss. 3, рр. 411-413.
Melby S.J., Schuessler R.B., and Damiano R.J. (2013) Ablation Technology for the Surgical Treatment of Atrial Fibrillation. ASAIO Journal, Vol. 59, Issue 5, рр. 461-468.
Rossmann C., Garrett-Mayer E., Rattay F., and Haemmerich D. (2014) Dynamics of tissue shrinkage during ablative temperature exposures. Physiological Measurement, Vol. 35, No 1, рр. 55-67.
Trujillo M., and Berjano E. (2013) Review of the mathematical functions used to model the temperature dependence of electrical and thermal conductivities of biological tissue in radiofrequency ablation. International Journal of Hyperthermia, Vol. 29, Iss. 6, рр. 590-597.
Sychyk М.М., Maksymenko V.B., Stasyk Y.P., Sorochan E.G., and Savkina M.V. (2015) Modelling of electrical and thermodynamical exposure of radiofrequency ablation on myocardium in Comsol Multiphysics 4.3a. Transaction of Kremenchuk Mykhailo Ostrohradskyi National University, Iss. 5/2015 (94), pp. 72-78. (in Ukrainian)
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