A cooled intraesophageal balloon to prevent thermal injury during endocardial surgical radiofrequency ablation of the left atrium: a finite element study
A cooled intraesophageal balloon to prevent thermal injury during endocardial surgical radiofrequency ablation of the left atrium: a finite element study
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DOI：
10.1088/0031-9155/50/20/n03
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发表时间：
2005-10-21
影响因子：
3.5
通讯作者：
Hornero, F
中科院分区：
文献类型：
--
作者：
Berjano, EJ;Hornero, F
最近关于房颤术中单极射频消融的临床研究报告了一些食管损伤病例。本研究的目的是使用三维有限元模型进行计算机模拟，以研究适当放置冷却食管内球囊以防止损伤的可行性。模型包括心房组织和由结缔组织连接的食管和肺的片段。使用50 ℃等温线评估食管中的病变深度，并表示为食管壁厚度的百分比。结果如下：（1）与不使用气囊的情况相比，通过放置在管腔中的冷却气囊冷却食管使食管壁中的损伤最小化（塌陷的食管）和非冷却球囊;（2）冷却液的温度比冷却速率对病变最小化的影响更显著（强制对流的热传递系数）;和（3）射频消融之前的预冷却期并不代表显著的改善。最后，结果还表明，使用冷却球囊可能会影响心房病变的透壁性，特别是在心房相当厚的情况下。
Recent clinical studies on intraoperative monopolar radiofrequency ablation of atrial fibrillation have reported some cases of injury to the esophagus. The aim of this study was to perform computer simulations using three-dimensional finite element models in order to investigate the feasibility of a cooled intraesophageal balloon appropriately placed to prevent injury. The models included atrial tissue and a fragment of esophagus and lung linked by connective tissue. The lesion depth in the esophagus was assessed using a 50 degrees C isotherm and expressed as a percentage of thickness of the esophageal wall. The results are as follows: (1) chilling the esophagus by means of a cooled balloon placed in the lumen minimizes the lesion in the esophageal wall compared to the cases in which no balloon is used (a collapsed esophagus) and with a non-cooled balloon; (2) the temperature of the cooling fluid has a more significant effect on the minimization of the lesion than the rate of cooling (the thermal transfer coefficient for forced convection); and (3) pre-cooling periods previous to RF ablation do not represent a significant improvement. Finally, the results also suggest that the use of a cooled balloon could affect the transmurality of the atrial lesion, especially in the cases where the atrium is of considerable thickness.