Ablation strategies to prevent episodes of paroxysmal atrial fibrillation (AF) have been subject to many clinical studies. The issues mainly concern pattern and transmurality of the lesions. This paper investigates ten different ablation strategies on a multilayered 3-D anatomical model of the atria with respect to 23 different setups of AF initiation in a biophysical computer model. There were 495 simulations carried out showing that circumferential lesions around the pulmonary veins (PVs) yield the highest success rate if at least two additional linear lesions are carried out. The findings compare with clinical studies as well as with other computer simulations. The anatomy and the setup of ectopic beats play an important role in the initiation and maintenance of AF as well as the resulting therapy. The computer model presented in this paper is a suitable tool to investigate different ablation strategies. By including individual patient anatomy and electrophysiological measurement, the model could be parameterized to yield an effective tool for future investigation of tailored ablation strategies and their effects on atrial fibrillation.
Magnetic particle imaging (MPI) is a new imaging modality using oscillating magnetic fields in the frequency range of 10 kHz to 100 kHz. The duration of data acquisition becomes smaller, and signal-to-noise ratio improves if the amplitude of these fields is increased - technically amplitudes of up to 100 mT might be feasible for human-sized systems. On the other hand, with increasing field strength, adverse health effects must be expected: oscillating magnetic fields can stimulate nerves and muscle and heat up tissue. Thresholds for stimulation with magnetic fields in this frequency range are not precisely known, neither is the local temperature rise following exposure. The ICNIRP guidelines define reference levels for magnetic field exposure for the general public that contain large safety factors - for medical diagnostics, they might be exceeded for a short time. In this article, research and guidelines in this field are briefly reviewed, and new results are presented in order to contribute to a future definition of safety limits for oscillating magnetic fields in MPI.
Exposure to time-varying magnetic fields evokes two effects in biological tissue: Firstly, an electric field is induced that generates eddy currents in conductive tissues, and, secondly, power deposit might increase local temperatures. Field effects of frequencies up to 1 kHz and above 1 MHz are well known. The intermediate frequency range lacks intensive research. Only little attention has been paid so far. Yet due to recent innovations in medical diagnostics and therapies like Magnetic Particle Imaging or RF-Hyperthermia, the need arises to investigate the frequency range from 1kHz to 1 MHz. This work presents results of numerical field calculations of a human body model placed within simple coil configurations. Induced current densities, generated by alternating coil currents, are simulated. The effect of current densities are demonstrated and evaluated on schematic cell models of excitable tissue. In order to generate an action potential at the cell membrane, a difference in electric potential from intra- to extracellular space must be present. It can be shown that in case of sufficient field strength, stimulation of nerves and muscles is possible up to a frequency of 100 kHz. The aim of this paper is to transfer simulation results from the macroscopic model to the microscopic model in order to estimate field effects of big field generating coils.
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