Contact geometry affects lesion formation in radio-frequency cardiac catheter ablation

PLoS One. 2013 Sep 23;8(9):e73242. doi: 10.1371/journal.pone.0073242. eCollection 2013.

Abstract

One factor which may be important for determining proper lesion creation during atrial ablation is catheter-endocardial contact. Little information is available that relates geometric contact, depth and angle, to ablation lesion formation. We present an electrothermal computer model of ablation that calculated lesion volume and temperature development over time. The Pennes bioheat equation was coupled to a quasistatic electrical problem to investigate the effect of catheter penetration depth, as well as incident catheter angle as may occur in practice. Biological experiments were performed to verify the modelling of electrical phenomena. Results show that for deeply penetrating tips, acute catheter angles reduced the rate of temperature buildup, allowing larger lesions to form before temperatures elevated excessively. It was also found that greater penetration did not lead to greater transmurality of lesions. We conclude that catheter contact angle plays a significant role in lesion formation, and the time course must be considered. This is clinically relevant because proper identification and prediction of geometric contact variables could improve ablation efficacy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arrhythmias, Cardiac / therapy*
  • Catheter Ablation / methods*
  • Computer Simulation
  • Humans

Grants and funding

This research was partly supported by a grant from the Natural Sciences and Engineering Research Councils of Canada (http://www.nserc-crsng.gc.ca/), and the French Government through the Agence National de la Recherche (http://www.agence-nationale-recherche.fr/) programme «Investissements d'Avenir with grant ANR-10-IAHU-04. No additional external funding was received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.