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Reduced Procedure Time and Variability with Active Esophageal Cooling During Radiofrequency Ablation for Atrial Fibrillation
Published on: August 25, 2022
Numerical study of the influence of water evaporation on radiofrequency ablation
Qing Zhu, Yuanyuan Shen, Aili Zhang1
1State Key Laboratory of Oncogenes and Related Genes, School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China. zhangaili@sjtu.edu.cn.
Background:
Radiofrequency ablation is a promising minimal invasive treatment for tumor. However, water loss due to evaporation has been a major issue blocking further RF energy transmission and correspondently eliminating the therapeutic outcome of the treatment.
Method:
A 2D symmetric cylindrical mathematical model coupling the transport of the electrical current, heat, and the evaporation process in the tissue, has been developed to simulate the treatment process and investigate the influence of the excessive evaporation of the water on the treatment.
Results:
Our results show that the largest specific absorption rate (QSAR) occurs at the edge of the circular surface of the electrode. When excessive evaporation takes place, the water dehydration rate in this region is the highest, and after a certain time, the dehydrated tissue blocks the electrical energy transmission in the radial direction. It is found that there is an interval as long as 65 s between the beginning of the evaporation and the increase of the tissue impedance. The model is further used to investigate whether purposely terminating the treatment for a while allowing diffusion of the liquid water into the evaporated region would help. Results show it has no obvious improvement enlarging the treatment volume. Treatment with the cooled-tip electrode is also studied. It is found that the cooling conditions of the inside agent greatly affect the water loss pattern. When the convection coefficient of the cooling agent increases, excessive evaporation will start from near the central axis of the tissue cylinder instead of the edge of the electrode, and the coagulation volume obviously enlarges before a sudden increase of the impedance. It is also found that a higher convection coefficient will extend the treatment time. Though the sudden increase of the tissue impedance could be delayed by a larger convection coefficient; the rate of the impedance increase is also more dramatic compared to the case with smaller convection coefficient.
Conclusion:
The mathematical model simulates the water evaporation and diffusion during radiofrequency ablation and may be used for better clinical design of radiofrequency equipment and treatment protocol planning.
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