Relation between denaturation time measured by optical coherence reflectometry and thermal lesion depth during radiofrequency cardiac ablation: Feasibility numerical study

Lasers Surg Med. 2018 Mar;50(3):222-229. doi: 10.1002/lsm.22771. Epub 2017 Nov 23.

Abstract

Background/objective: Radiofrequency (RF) catheter ablation is a minimally invasive medical procedure used to thermally destroy the focus of cardiac arrhythmias. Novel optical techniques are now being integrated into RF catheters in order to detect the changes in tissue properties. Loss of birefringence due to fiber denaturation at around 70°C is related to changes in accumulated phase retardation and can be measured by polarization-sensitive optical coherence reflectometry (PS-OCR). Since irreversible thermal lesions are produced when the tissue reaches 50°C, our goal was to seek the mathematical relationship between both isotherms.

Materials and methods: A two-dimensional model based on a coupled electric-thermal problem was built and solved using the finite element method. The model consisted of cardiac tissue, blood, and a non-irrigated electrode with a sensor embedded in its tip to maintain a specific target electrode temperature. Computer simulations were conducted by varying the tissue characteristics. Lesion depth was estimated by the 50°C isotherm, while the denaturation time (TD) was taken as the time at which the 70°C isotherm reached a depth of 0.75 mm (which corresponds to the optical depth reached by PS-OCR technology).

Results: A strong correlation (R2 > 0.83) was found between TD and lesion depth and an even stronger correlation (R2 > 0.96) was found between TD and the time required to achieve a specific lesion depth. For instance, the ablation time required to ensure a minimum lesion depth of 3 mm was 1.33 × TD + 3.93 × seconds.

Conclusions: The computer results confirmed the strong relationship between denaturation time and lesion depth and suggest that measuring denaturation time by PS-OCR could provide information on the ablation time required to reach a specific lesion depth. Lasers Surg. Med. 50:222-229, 2018. © 2017 Wiley Periodicals, Inc.

Keywords: cardiac ablation; computer model; polarization-sensitive optical coherence reflectometry; radiofrequency ablation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Atrial Fibrillation / diagnostic imaging*
  • Atrial Fibrillation / surgery*
  • Birefringence
  • Catheter Ablation*
  • Computer Simulation
  • Feasibility Studies
  • Humans
  • Models, Cardiovascular
  • Tomography, Optical Coherence*