Background:
Electrical impedance measurements have become an accepted tool for monitoring intracardiac radio frequency ablation. Recently, the long-established generator impedance was joined by novel local impedance measurement capabilities with all electrical circuit terminals being accommodated within the catheter.
Objective:
This work aims at
in silico
quantification of distinct influencing factors that have remained challenges due to the lack of ground truth knowledge and the superposition of effects in clinical settings.
Methods:
We introduced a highly detailed
in silico
model of two local impedance enabled catheters, namely IntellaNav MiFi OI and IntellaNav Stablepoint, embedded in a series of clinically relevant environments. Assigning material and frequency specific conductivities and subsequently calculating the spread of the electrical field with the finite element method yielded
in silico
local impedances. The
in silico
model was validated by comparison to
in vitro
measurements of standardized sodium chloride solutions. We then investigated the effect of the withdrawal of the catheter into the transseptal sheath, catheter-tissue interaction, insertion of the catheter into pulmonary veins, and catheter irrigation.
Results:
All simulated setups were in line with
in vitro
experiments and
in human
measurements and gave detailed insight into determinants of local impedance changes as well as the relation between values measured with two different devices.
Conclusion:
The
in silico
environment proved to be capable of resembling clinical scenarios and quantifying local impedance changes. Significance: The tool can assists the interpretation of measurements in humans and has the potential to support future catheter development.
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关键词
Ablation,atrial substrate,bioimpedance,cardiac electrophysiology,local impedance,radio frequency ablation
