A cooled water-irrigated intraesophageal balloon to prevent thermal injury during cardiac ablation: experimental study based on an agar phantom
A cooled water-irrigated intraesophageal balloon to prevent thermal injury during cardiac ablation: experimental study based on an agar phantom
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DOI：
10.1088/0031-9155/53/4/n01
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发表时间：
2008-02-21
影响因子：
3.5
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
目前大量的研究是针对寻找一种方法，以尽量减少热损伤的食管在射频导管消融术的心房。最近一项采用冷却食管内球囊的临床研究报告了食管腔温度的降低。然而，无法确定食管的深层肌肉层是否足够冷却以防止损伤。我们建立了一个基于琼脂体模的模型，以便通过测量不仅在球囊上的温度，而且在食管腔和心肌（2 mm距离）之间的假设点处的温度来实验研究该球囊的热行为。进行受控温度（55 ℃）消融120 s。结果表明：（1）冷却气球降低了气球表面和距离2 mm处的最终温度;（2）冷却剂温度对离食管腔2 mm处测量的温度有显著影响（它对在球囊表面上测量的温度具有较小的影响）和（3）预-冷却时间对球囊表面测得的温度有显著影响（对2 mm处测得的温度影响很小）。结果与先前临床研究中获得的结果一致。该研究表明，当在5 ℃或更低的冷却剂温度下编程2 min的最小预冷期时，冷却球囊为食管提供热保护。
A great deal of current research is directed to finding a way to minimize thermal injury in the esophagus during radiofrequency catheter ablation of the atrium. A recent clinical study employing a cooling intraesophageal balloon reported a reduction of the temperature in the esophageal lumen. However, it could not be determined whether the deeper muscular layer of the esophagus was cooled enough to prevent injury. We built a model based on an agar phantom in order to experimentally study the thermal behavior of this balloon by measuring the temperature not only on the balloon, but also at a hypothetical point between the esophageal lumen and myocardium (2 mm distant). Controlled temperature (55 degrees C) ablations were conducted for 120 s. The results showed that (1) the cooling balloon provides a reduction in the final temperature reached, both on the balloon surface and at a distance of 2 mm; (2) coolant temperature has a significant effect on the temperature measured at 2 mm from the esophageal lumen (it has a less effect on the temperature measured on the balloon surface) and (3) the pre- cooling period has a significant effect on the temperature measured on the balloon surface (the effect on the temperaturemeasured 2mmaway is small). The results were in good agreement with those obtained in a previous clinical study. The study suggests that the cooling balloon gives thermal protection to the esophagus when a minimum pre- cooling period of 2 min is programmed at a coolant temperature of 5 degrees C or less.