Reliability Assessment of a Cooled Intraesophageal Balloon to Prevent Thermal Injury During RF Cardiac Ablation: An Agar Phantom Study
Reliability Assessment of a Cooled Intraesophageal Balloon to Prevent Thermal Injury During RF Cardiac Ablation: An Agar Phantom Study
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DOI：
10.1111/j.1540-8167.2008.01229.x
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发表时间：
2008-11-01
影响因子：
2.7
通讯作者：
Hornero, Fernando
中科院分区：
文献类型：
--
作者：
Lequerica, Juan L.;Berjano, Enrique J.;Hornero, Fernando
冷却球囊可防止射频消融过程中的热损伤。简介：最近提出使用冷却食管内球囊，以最大限度地减少左心房射频 (RF) 消融过程中食管热损伤的风险。然而，该装置在不同的手术和解剖条件下充分保护食管的能力仍然未知。方法和结果：建立了基于琼脂体模的模型，该模型不仅提供冷却气球上的温度读数（T-b），而且还提供食管腔和心肌之间距离 2 mm 的假设点（T2-mm）的温度读数。进行射频消融时考虑了两个解剖因素（电极和球囊之间的总距离以及电极周围的流速）和两个程序因素（电极和琼脂表面之间的角度和压力）。结果表明，大多数研究参数对冷却气球上测量的温度 (T-b) 没有显着影响，但流速的变化除外，它被发现会影响温度。另一方面，T2-mm在很大程度上受到所有考虑因素的影响，其中最小的影响是接触压力的影响。结果还表明，当使用食管内球囊时，所施加的功率并不能很好地预测球囊上的温度或 2 毫米外测得的温度。 结论：结果表明，冷却的食管内球囊可为食管腔提供有效的热保护。然而，在某些情况下，距离 2 mm 处达到的温度可能会危及食道内层的完整性。（J Cardiovasc Electrophysiol，第 19 卷，第 1188-1193 页，2008 年 11 月）。
Cooled Balloon Prevents Thermal Injury During RF Ablation.Introduction: The use of a cooled intraesophageal balloon has recently been proposed to minimize the risk of thermal injury in the esophagus during radiofrequency (RF) ablation of the left atrium. However, the capacity of this device to adequately protect the esophagus under different procedural and anatomical conditions remains unknown.Methods and Results: An agar phantom-based model was built that provided temperature readings not only on the cooled balloon (T-b) but also at a hypothetical point between the esophageal lumen and myocardium at a distance of 2 mm (T2-mm). The RF ablations were conducted considering two anatomical factors (total distance between the electrode and balloon and flow rate around the electrode) and two procedural factors (angle and pressure between the electrode and agar surface). The results show that most of the parameters studied have no significant influence on the temperature measured on the cooled balloon (T-b), the exception being a variation in the flow rate, which was found to influence the temperature. On the other hand, T2-mm was affected to a great extent by all the factors considered, the smallest influence being that of the contact pressure. The results also suggest that when an intraesophageal balloon is employed, the applied power is not a good predictor either of the temperature on the balloon or of the temperature measured at a distance 2 mm away.Conclusion: The results suggest that a cooled intraesophageal balloon provides effective thermal protection of the esophageal lumen. However, under certain circumstances, the temperature reached at a distance 2 mm away could possibly put at risk the integrity of the inner layers of the esophagus.(J Cardiovasc Electrophysiol, Vol. 19, pp. 1188-1193, November 2008).