Comparison of Monopolar and Bipolar Cox-Maze Ablation Based on Clinical Data and Mathematical Modeling

Authors

DOI:

https://doi.org/10.20535/RADAP.2020.83.55-61

Keywords:

heart, arrhythmia, radiofrequency ablation, monopolar electrode, bipolar electrode, mathematical modeling

Abstract

Purpose: Today radiofrequency heart ablation is gold standard for the radical surgical treatment of different types of heart rhythm disturbances.The purpose of the research is a comparative analysis of monopolar and bipolar electrodes for ablation during open heart surgery (Cox-Maze ablation).

Methods: The analysis is made based on clinical data and mathematical modeling. By the use of system of electro-anatomical mapping of radiofrequency ablation zones a three-dimensional model of left atrium is created. Then a potential map, which represents the amplitude of myocardium activity, is imposed on this model. The amplitude of myocardium activity, the width and depth of the electro-thermal destruction zone and the ablation line continuity are main parameters of clinical data analysis. For mathematical modeling the COMSOL Multiphysics 5.4 software is used. Two variation of mathematical model for monopolar and bipolar ablation are created. Main analysis parameters of mathematical modeling are: diagrams of thermal field distribution, size of myocardial tissue destruction, and duration of the ablation procedure.

Results: Both monopolar and bipolar ablation can be used for Cox-Maze procedure. But potential map and mathematical modeling show that with monopolar ablation the destruction zone has a hemispherical shape and scar line is not uniform along the depth of a heated myocardial tissue. It can lead to a recovery of pathological signals conduction from the pulmonary veins to the atrium. Uneven distribution of thermal fields with a clearly defined maximum increases the risk of evaporation and microexplosions. At the same time the duration of monopolar ablation is significantly longer.

Conclusion: It is shown that bipolar ablation has advantages in pulmonary veins isolation. This type of instruments allows creation of effective and safe uniform thermal transmural destruction with only one application of radiofrequency current energy.

Author Biographies

M. M. Sychyk, M. Amosov National Institute of Cardiovascular Surgery NAMS of Ukraine ; National Technical University of Ukraine "Igor Sikorsky Kyiv Polytechnic Institute"

Leading engineer of the department of arrhythmias treatment with X-ray operating room, assistant of the department of biomedical engineering

V. B. Maksymenko, M. Amosov National Institute of Cardiovascular Surgery NAMS of Ukraine ; National Technical University of Ukraine "Igor Sikorsky Kyiv Polytechnic Institute"

Doc of Sci (Tech), Professor of Biomedical Engineering

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Published

2020-12-30

How to Cite

Stasiuk, Y. P., Sychyk, M. M., Maksymenko, V. B. and Kravchuk, B. B. . (2020) “Comparison of Monopolar and Bipolar Cox-Maze Ablation Based on Clinical Data and Mathematical Modeling”, Visnyk NTUU KPI Seriia - Radiotekhnika Radioaparatobuduvannia, (83), pp. 55-61. doi: 10.20535/RADAP.2020.83.55-61.

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Section

Radioelectronics Medical Technologies