Forging ahead: Update on radiofrequency ablation technology and techniques

Sandhu, Amneet; Nguyen, Duy T.

doi:10.1111/jce.14317

Cited by 15 publications

(9 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Radiofrequency ablation has become the preferred method to cure tachyarrhythmia. The efficacy evaluation of radiofrequency ablation in the treatment of tachyarrhythmia is particularly important [ 32 , 33 ]. As a kind of deep neural network, convolutional neural network can convert image data into visual pathological features and obtain information that cannot be directly captured by the human eyes.…”

Section: Discussionmentioning

confidence: 99%

Deep Learning-Based Electrocardiograph in Evaluating Radiofrequency Ablation for Rapid Arrhythmia

Wang¹,

Chen²,

Xue-qin³

et al. 2022

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

This study is aimed at analyzing the important role of deep learning-based electrocardiograph (ECG) in the efficacy evaluation of radiofrequency ablation in the treatment of tachyarrhythmia. In this study, 158 patients with rapid arrhythmia treated by radiofrequency ablation were divided into effective treatment group (142 cases) and ineffective treatment group (16 cases). ECG examination was performed on all patients, and the indicators of ECG examination were quantified by the deep learning-based convolutional neural network model. The indicators of ECG examination of the effective treatment group and the ineffective treatment group were compared. The results showed that compared with the ineffective treatment group, the end-systolic volume (ESV), end-diastolic volume (EDV), end-systolic volume index (ESVI), and end-diastolic volume index (EDVI) of the effective treatment group were significantly decreased, and the left ventricular ejection fraction (LVEF) was significantly increased ( P < 0.05 ). After radiofrequency ablation, the ventricular rate of patients in the effective treatment group was significantly lower than that of the ineffective treatment group at 12 h and 24 h after treatment ( P < 0.05 ). In addition, compared with patients in the ineffective treatment group, the QT dispersion of the ECG in the effective treatment group was significantly higher ( P < 0.05 ). The accuracy, specificity, and sensitivity of ECG in evaluating the therapeutic effect of patients with tachyarrhythmia were 86.81%, 84.29%, and 77.27%, respectively. The area under the curve was determined as 0.798 according to the receiver operating characteristic (ROC) curve of the subjects. In summary, indicators of ECG examination based on deep learning can provide auxiliary reference information for the efficacy evaluation of radiofrequency ablation in the treatment of tachyarrhythmia.

show abstract

Section: Discussionmentioning

confidence: 99%

Deep Learning-Based Electrocardiograph in Evaluating Radiofrequency Ablation for Rapid Arrhythmia

Wang¹,

Chen²,

Xue-qin³

et al. 2022

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

show abstract

“…Radiofrequency radiation is the most often utilized energy source in cardiac catheterization ablation treatments, and it has been effectively utilized in children for many years as a conventional way to treat practically all types of supraventricular tachycardia and certain kinds of ventricular tachycardia. [ 12 ] The main goal of this operation is to effectively erode the essential tissue that causes tachycardia and stop it without causing damage to the surrounding tissue. Ablation causes irreversible damage by raising the temperature over 50°C and causing coagulation necrosis in the targeted tissue.…”

Section: Discussionmentioning

confidence: 99%

A novel technique of pulmonary artery banding by means of radiofrequency ablation: An experimental study in rabbits

Uysal¹,

Akca²,

Genç³

et al. 2022

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

Background: The aim of this study was to evaluate the efficacy and feasibility of a novel method of narrowing pulmonary arteries with catheter angiography using radiofrequency energy in rabbits. Methods: A total of nine New Zealand white rabbits weighing 3.0 to 4.2 kg each were utilized in this experimental study. After the location of pulmonary artery was confirmed by echocardiography and angiography, radiofrequency energy was applied by starting with 5 W energy for the first time and increasing by 5 W, if there was no rupture to a maximum of 20 W. Multiple applications of radiofrequency energy with different durations were performed at different levels of the pulmonary artery. Eight weeks later, surviving rabbits were sacrificed. The pulmonary arteries were removed for histological investigation. Results: Five rabbits remained alive after the experiment. There was a significant correlation between radiofrequency power and the degree of vessel thickness change in the pulmonary artery. The endothelial integrity of the tunica intima was impaired in all groups and the diameter of vessel was thickened by an average of 3.5 times. Conclusion: The narrowing of the pulmonary artery using radiofrequency energy was successfully performed in a small sample size of experimental animals in this study.

show abstract

“…1,2 With substantial worldwide growth in this procedure, [3][4][5] technological advances have primarily focused on the development of new methods to improve the delivery of energy to tissue, ablation efficacy, and efficiency. [6][7][8][9] In contrast to the focus on the development of novel tools, minimal attention has been paid to safety, specifically to anatomically juxtaposed organs (i.e., esophagus) that are often adversely impacted by energy delivered within the heart.…”

Section: Introductionmentioning

confidence: 99%

Evaluating temperature gradients across the posterior left atrium with radiofrequency ablation

Sandhu

Holman

Lammers

et al. 2023

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

Introduction Esophageal injury is a well‐known complication associated with catheter ablation. Though novel methods to mitigate esophageal injury have been developed, few studies have evaluated temperature gradients with catheter ablation across the posterior wall of the left atrium, interstitium, and esophagus. Methods To investigate temperature gradients across the tissue, we developed a porcine heart–esophageal model to perform ex vivo catheter ablation on the posterior wall of the left atrium (LA), with juxtaposed interstitial tissue and esophagus. Circulating saline (5 L/min) was used to mimic blood flow along the LA and alteration of ionic content to modulate impedance. Thermistors along the region of interest were used to analyze temperature gradients. Varying time and power, radiofrequency (RF) ablation lesions were applied with an externally irrigated ablation catheter. Ablation strategies were divided into standard approaches (SAs, 10–15 g, 25–35 W, 30 s) or high‐power short duration (HPSD, 10–15 g, 40–50 W, 10 s). Temperature gradients, time to the maximum measured temperature, and the relationship between measured temperature as a function of distance from the site of ablation was analyzed. Results In total, five experiments were conducted each utilizing new porcine posterior LA wall‐esophageal specimens for RF ablation (n = 60 lesions each for SA and HPSD). For both SA and HPSD, maximum temperature rise from baseline was markedly higher at the anterior wall (AW) of the esophagus compared to the esophageal lumen (SA: 4.29°C vs. 0.41°C, p < .0001 and HPSD: 3.13°C vs. 0.28°C, p < .0001). Across ablation strategies, the average temperature rise at the AW of the esophagus was significantly higher with SA relative to HPSD ablation (4.29°C vs. 3.13°C, p = .01). From the start of ablation, the average time to reach a maximum temperature as measured at the AW of the esophagus with SA was 36.49 ± 12.12 s, compared to 16.57 ± 4.54 s with HPSD ablation, p < .0001. Fit to a linear scale, a 0.37°C drop in temperature was seen for every 1 cm increase in distance from the site of ablation and thermistor location at the AW of the esophagus. Conclusion Both SA and HPSD ablation strategies resulted in markedly higher temperatures measured at the AW of the esophagus compared to the esophageal lumen, raising concern about the value of clinical intraluminal temperature monitoring. The temperature rise at the AW was lower with HPSD. A significant time delay was seen to reach the maximum measured temperature and a modest increase in distance between the site of ablation and thermistor location impacted the accuracy of monitored temperatures.

show abstract

Forging ahead: Update on radiofrequency ablation technology and techniques

Cited by 15 publications

References 56 publications

Deep Learning-Based Electrocardiograph in Evaluating Radiofrequency Ablation for Rapid Arrhythmia

Deep Learning-Based Electrocardiograph in Evaluating Radiofrequency Ablation for Rapid Arrhythmia

A novel technique of pulmonary artery banding by means of radiofrequency ablation: An experimental study in rabbits

Evaluating temperature gradients across the posterior left atrium with radiofrequency ablation

Contact Info

Product

Resources

About