Abstract
Radio frequency (RF) current delivered through a thin catheter can be used to perforate the pulmonary valve or the atrial septum to treat pulmonary atresia in newborns. To understand better the mechanisms of RF perforation, a numerical model is developed, and experiments are performed in isolated canine cardiac tissue. The model consists of a cylindrical domain with a tissue layer between two blood layers. The finite-difference method is used to compute both the potential and temperature distributions. When the tissue temperature exceeds 100°C in all points that are directly in front of the catheter, these points are considered to be instantly vaporised, and the catheter advances over these points. The computed temperature time course coincides with measured temperature at small voltages (<16 V). Simulated perforation occurs when the voltage exceeds a threshold of 70–80V for a catheter diameter of 0.30–0.44 mm, which coincides with experimental observations in the myocardium. A voltage exceeding this perforation threshold tends to decrease tissue damage. Shorter electrodes (0.7 mm as against 2.4 mm) with smaller diameters produce a more rapid perforation. In conclusion, numerical simulations provide insights into aspects of RF perforation, such as electrode size, current, speed of perforation and collateral damage.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
An, H., Saksena, S., Janssen, M., andOsypka, P. (1989): ‘Radiofrequency ablation of ventricular myocardium using active fixation and passive contact catheter delivery systems’,Am. Heart J.,118, pp. 69–77
Barlow, D. E. (1982): ‘Endoscopic applications of electrosurgery. Review of basic principles’,Gastrointestinal Endosc.,28, pp. 73–76
Bhavaraju, N. C., andValvano, J. W. (1997): ‘Thermal conductivity and diffusivity in swine myocardium’. Proc. 19th Int. Conf. IEEE/EMBS, Oct.–Nov., Chicago, Illinois, USA
Curtiss, L. E. (1973): ‘High frequency current in endoscopy: a review of principles and precautions’,Gastrointestinal Endosc.,20, pp. 9–12
Duffy, S., andCobb, G. V. (1995): ‘Practical electrosurgery’, (Chapman and Hall Medical, London), pp. 15–61
Fontes, V. F., Esteves, C. A., Braga, S. L., Acuna, U., Santana, M. V., De Oliveira, L. M., Pedra, S. R., andSousa, J. E. (1995): ‘Pulmonary atresia with intact ventricular septum. Valvar perforation by radiofrequency (in Portuguese)’,Arquivos Brasileiros de Cardiologia,64, pp. 231–233
Giusti, S., Spadoni, I., De Simone, L., andCarminati, M. (1996): ‘Radiofrequency perforation in pulmonary valve atresia and intact ventricular septum (in Italian)’,Giornale Italiano di Cardiologia,26, pp. 391–397
Hausdorf, G., andSchneider, M. (1993): ‘Interventional high frequency perforation and enlargement of the outflow tract of pulmonary atresia (in German)’,Zeitschrift fur Kardiologie,82, pp. 123–130
Hausdorf, G., Schulze-Neick, I., andLange, P. E. (1993): ‘Radiofrequency-assisted “reconstruction” of the right ventricular outflow tract in muscular pulmonary atresia with ventricular septal defect’,Br. Heart J.,69, pp. 343–346
Hayt, W. (1981): ‘Engineering electromagnetics, 4th edn.’ (McGraw-Hill, New-York)
Hayt, W. (1989): ‘Engineering electromagnetics’ (McGraw-Hill, New-York), pp. 169–200
Hindricks, G., Haverkamp, W. et al. (1989): ‘Radiofrequency coagulation of ventricular myocardium: Improved prediction of lesion size by monitoring catheter tip temperature’,Eur. Heart J.,10, pp. 972–984
Hofbeck, M., Wild, F., andSinger, H. (1994): ‘Interventional treatment of pulmonary atresia with intact ventricular septum by high frequency perforation and balloon dilatation of the pulmonary valve (in German)’,Klinische Pediatrie,206, pp. 157–160
Honig, W. M. (1975): ‘The mechanism of cutting in electrosurgery’,IEEE Trans.,BME-22, pp. 58–62
Kaouk, Z., Vahid Shahidi, A., Savard, P., andMolin, F. (1996): ‘Modeling of myocardial temperature distribution during radiofrequency ablation’,Med. Biol. Eng. Comput.,34, pp. 165–170
Kinosita, K., andTsong, T. (1977): ‘Voltage induced pore formation and hemolysis of human erythrocytes’,Biochimica Biophysica Acta,471, pp. 227–242
Labonté, S. (1994): ‘Numerical model for radio-frequency ablation of the endocardium and its experimental validation’,IEEE Trans.,BME-41, pp. 108–115
Melnik, I., Dupouy, P., Kvasnicka, J., Bratia, A., andGeschwind, H. J. (1994): ‘In vitro study of a radiofrequency guidewire aimed at recanalization of totally occluded peripheral arteries’,Catheteriz. Cardiovasc. Diagnosis,33, pp. 189–196
Pearce, J. A. (1986): ‘Electrosurgery’ (Chapman and Hall, London), pp. 62–129
Pearce, J. A. (1988): ‘Electrosurgery’ in ‘Handbook of biomedical engineering’ (Academic Press Inc.), pp. 99–121
Perloff, J. K. (1987): ‘The clinical recognition of congenital heart disease’, (Saunders Company, Philadelphia), pp. 540–551
Press, W., Flannery, B., Teukolsky, S., andVetterling, W. (1992): ‘Numerical recipes in C′ (Cambridge University Press), pp. 866–869
Schneider, M., Schranz, D., Michel-Behnke, I., andOelert, H. (1995): ‘Transcatheter radiofrequency perforation and stent implantation for palliation of pulmonary atresia in a 3060g infant’,Catheterization Cardiovasc. Diagnosis,34, pp. 42–45
Schwan, H. P. (1983a): ‘Therapeutic heat and cold’, in ‘Biophysics of diathermy’, (Waverly Press, Baltimore), Chap. 3
Schwan, H. P. (1983b): ‘Biophysics of interaction of electromagnetic energy with cells and membranes’ inGrandolfo, M., Michaelson, S. M., andRindi, A. (Eds): ‘Biological effects and dosimetry of nonionizing radiation’ (Plenum Rose, New York), pp. 213–231
Tanel, E. (1977): ‘Five years experience with radio frequency catheter ablation’,J. Pediatr.,131, pp. 878–887
Thomas, L. (1980): ‘Fundamentals of heat transfer’, (Prentice Inc., Englewood), pp. 120–207
Tovar, O., andTung, L. (1991): ‘Electroporation of cardiac cell membrane with monophasic or biphasic rectangular pulses’,PACE,14, pp. 1887–1892
Tsong, T. Y. (1991): ‘Electroporation of cell membranes’,Biophys. J.,60, pp. 297–306
Tucker, R. D., Schmitt, O. H., Sievert, C. E., andSilvis, S. E. (1984): ‘Demodulated low frequency current from electrosurgical procedures’,Surg. Gynecol. Obstet.,159, pp. 39–43
Tucker, R. D., Sievert, C. E., Kramolowsky, E. V., andSilvis, S. E. (1992): ‘The interaction between electrosurgical generators, endoscopic electrodes and tissue’,Gastrointest. Endosc.,38, pp. 118
Valvano, J. M., Cochran, J. R., andDiller, K. R. (1985): ‘Thermal conductivity and diffusivity of biomaterials measured with selfheated thermistors’,Int. J. Thermophys.,6, pp. 301–311
Weaver, J. C. (1993): ‘Electroporation: a general phenomenon for manipulating cells and tissues’,J. Cell. Biochem.,51, pp. 426–435
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shimko, N., Savard, P. & Shah, K. Radio frequency perforation of cardiac tissue: Modelling and experimental results. Med. Biol. Eng. Comput. 38, 575–582 (2000). https://doi.org/10.1007/BF02345756
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02345756