Effect of intracardiac blood flow pulsatility during radiofrequency cardiac ablation: computer modeling study

Abstract

Purpose

To assess the effect of intracardiac blood flow pulsatility on tissue and blood distributions during radiofrequency (RF) cardiac ablation (RFCA).

Methods

A three-dimensional computer model was used to simulate constant power ablations with an irrigated-tip electrode and three possible catheter orientations (perpendicular, parallel and 45°). Continuous flow and three different pulsatile flow profiles were considered, with four average blood velocity values: 3, 5.5, 8.5 and 24.4 cm/s. The 50 °C contour was used to assess thermal lesion size.

Results

The differences in lesion size between continuous flow and the different pulsatile flow profiles were always less than 1 mm. As regards maximum tissue temperature, the differences between continuous and pulsatile flow were always less than 1 °C, with slightly higher differences in maximum blood temperature, but never over 6 °C. While the progress of maximum tissue temperature was identical for continuous and pulsatile flow, maximum blood temperature with the pulsatile profile showed small amplitude oscillations associated with blood flow pulsatility.

Conclusions

The findings show that intracardiac blood pulsatility has a negligible effect on lesion size and a very limited impact on maximum tissue and blood temperatures, which suggests that future experimental studies based on ex vivo or in silico models can ignore pulsatility in intracardiac blood flow.

Keywords:

• Blood flow
• cardiac ablation
• computer model
• pulsatility
• radiofrequency ablation

Disclosure statement

The authors have no conflicts of interest or financial disclosures to make relevant to this submission.

Additional information

Funding

This work was supported by the Spanish Ministerio de Ciencia, Innovación y Universidades under ‘Programa Estatal de I + D + i Orientada a los Retos de la Sociedad’, Grant No. ‘RTI2018-094357-B-C21’.