Tissue drives lesion: computational evidence of interspecies variability in cardiac radiofrequency ablation

Radiofrequency catheter ablation (RFCA) is widely used for the treatment of various types of cardiac arrhythmias. Typically, the efficacy and the safety of the ablation protocols used in the clinics are derived from tests carried out on animal specimens, including swines. However, these experimental findings cannot be immediately translated to clinical practice on human patients, due to the difference in the physical properties of the types of tissue. Computational models can assist in the quantification of this variability and can provide insights in the results of the RFCA for different species. In this work, we consider a standard ablation protocol of 10g force, 30W power for 30s. We simulate its application on a porcine cardiac tissue, a human ventricle and a human atrium. Using a recently developed computational model that accounts for the mechanical properties of the tissue, we explore the onset and the growth of the lesion along time by tracking its depth and width, and we compare the lesion size and dimensions at the end of the ablation

A computational model of open-irrigated radiofrequency catheter ablation accounting for mechanical properties of the cardiac tissue

Radiofrequency catheter ablation (RFCA) is an effective treatment for cardiac arrhythmias. Although generally safe, it is not completely exempt from the risk of complications. The great flexibility of computational models can be a major asset in optimizing interventional strategies, if they can produce sufficiently precise estimations of the generated lesion for a given ablation protocol. This requires an accurate description of the catheter tip and the cardiac tissue. In particular, the deformation of the tissue under the catheter pressure during the ablation is an important aspect that is overlooked in the existing literature, that resorts to a sharp insertion of the catheter into an undeformed geometry. As the lesion size depends on the power dissipated in the tissue, and the latter depends on the percentage of the electrode surface in contact with the tissue itself, the sharp insertion geometry has the tendency to overestimate the lesion obtained, especially when a larger force is applied to the catheter. In this paper we introduce a full 3D computational model that takes into account the tissue elasticity, and is able to capture the tissue deformation and realistic power dissipation in the tissue. Numerical results in FEniCS-HPC are provided to validate the model against experimental data, and to compare the lesions obtained with the new model and with the classical ones featuring a sharp electrode insertion in the tissue.La Caixa 2016 PhD grant to M. Leoni, and Abbott non-conditional grant to J.M. Guerra Ramo