Effect of electrode thermal conductivity in cardiac radiofrequency catheter ablation: A computational modeling study

Purpose: Radiofrequency (RF ablation) is the treatment of choice for certain types of cardiac arrhythmias. Recent studies have suggested that using gold instead of platinum as the electrode material for cardiac catheter ablation leads to larger thermal lesions due to its higher thermal conductivity. In this study we created computer models to compare the effects of different electrode materials on lesion dimensions using different catheters, insertion depths, and flow rates. Materials and methods: Finite element method (FEM) models of two cardiac ablation electrodes (7Fr, length 4 mm and 8Fr, length 10 mm) made of platinum, gold, and copper were created with tissue insertion depths of 0.75, 1.25, and 2.5 mm. Convective cooling was applied to the electrode and tissue based on measurements from previous studies at different flow rates. RF ablations were simulated with both temperature control and constant power control algorithms to determine temperature profiles after 60 s. Results: With the constant power algorithm there was no difference in lesion dimensions between the electrode materials over the range of parameters. With the temperature control algorithm, lesion width and depth were only marginally larger (∼0.1–0.7 mm) with the gold and copper electrodes compared to the platinum electrode for all parameter combinations. Conclusion: Our computer modelling results show only minor increases in thermal lesion dimensions with electrode materials of higher thermal conductivity. These observed differences likely do not provide a significant advantage during clinical procedures.

[1]  J. Wharton,et al.  Radiofrequency Delivery Through a Cooled Catheter Tip Allows the Creation of Larger Endomyocardial Lesions in the Ovine Heart , 1995, Journal of cardiovascular electrophysiology.

[2]  J. Saul,et al.  Catheter Tip Cooling During Radiofrequency Ablation of Intra‐Atrial Reentry: Effects on Power, Temperature, and Impedance , 2002, Journal of cardiovascular electrophysiology.

[3]  Francis A. Duck,et al.  Physical properties of tissue : a comprehensive reference book , 1990 .

[4]  M. Mirotznik,et al.  Comparison of Irrigated Electrode Designs for Radiofrequency Ablation of Myocardium , 2001, Journal of Interventional Cardiac Electrophysiology.

[5]  Hong Cao,et al.  In-vivo measurement of swine myocardial resistivity , 2002, IEEE Transactions on Biomedical Engineering.

[6]  J. Amlie,et al.  Temperature-Controlled Radiofrequency Catheter Ablation with a 10-mm Tip Electrode Creates Larger Lesions without Charring in the Porcine Heart , 1999, Journal of Interventional Cardiac Electrophysiology.

[7]  J. Svendsen,et al.  Tissue Temperatures and Lesion Size During Irrigated Tip Catheter Radiofrequency Ablation: An In Vitro Comparison of Temperature‐Controlled Irrigated Tip Ablation, Power‐Controlled Irrigated Tip Ablation, and Standard Temperature‐Controlled Ablation , 2000, Pacing and clinical electrophysiology : PACE.

[8]  Hong Cao,et al.  Guidelines for predicting lesion size at common endocardial locations during radio-frequency ablation , 2001, IEEE Transactions on Biomedical Engineering.

[9]  B. Lüderitz,et al.  Gold‐Tip Electrodes—A New “Deep Lesion” Technology for Catheter Ablation? In Vitro Comparison of a Gold Alloy Versus Platinum–Iridium Tip Electrode Ablation Catheter , 2005, Journal of cardiovascular electrophysiology.

[10]  Dieter Haemmerich,et al.  Automatic control of finite element models for temperature-controlled radiofrequency ablation , 2005, Biomedical engineering online.

[11]  L. Epstein,et al.  Radiofrequency catheter ablation of type 1 atrial flutter using large-tip 8- or 10-mm electrode catheters and a high-output radiofrequency energy generator: results of a multicenter safety and efficacy study. , 2004, Journal of the American College of Cardiology.

[12]  J. Alió,et al.  Radiofrequency Heating of the Cornea: An Engineering Review of Electrodes and Applicators , 2007, The open biomedical engineering journal.

[13]  GOLDART—Gold Alloy Versus Platinum–Iridium Electrode for Ablation of AVNRT , 2008, Journal of cardiovascular electrophysiology.

[14]  D. Haemmerich,et al.  Convective Cooling Effect on Cooled‐Tip Catheter Compared to Large‐Tip Catheter Radiofrequency Ablation , 2006, Pacing and clinical electrophysiology : PACE.

[15]  D. Haines,et al.  Cellular Electrophysiological Effects of Hyperthermia on Isolated Guinea Pig Papillary Muscle Implications for Catheter Ablation , 1993, Circulation.

[16]  D. Haines Chapter 1 – Biophysics of Radiofrequency Lesion Formation , 2006 .

[17]  E. J. Woo,et al.  Thermal—electrical finite element modelling for radio frequency cardiac ablation: Effects of changes in myocardial properties , 2000, Medical and Biological Engineering and Computing.

[18]  Frank Kreith,et al.  CRC Handbook of Thermal Engineering , 1999 .

[19]  F. Marcus,et al.  Comparison of Gold Versus Platinum Electrodes on Myocardial Lesion Size Using Radiofrequency Energy , 1996, Pacing and clinical electrophysiology : PACE.

[20]  M. Antz,et al.  Why a Large Tip Electrode Makes a Deeper Radiofrequency Lesion: , 1998, Journal of cardiovascular electrophysiology.

[21]  Ralph Lazzara,et al.  Comparison of Electrode Cooling Between Internal and Open Irrigation in Radiofrequency Ablation Lesion Depth and Incidence of Thrombus and Steam Pop , 2005, Circulation.

[22]  M. Haissaguerre,et al.  Prospective Randomized Comparison of 8‐mm Gold‐Tip, Externally Irrigated‐Tip and 8‐mm Platinum‐Iridium Tip Catheters for Cavotricuspid Isthmus Ablation , 2007, Journal of cardiovascular electrophysiology.

[23]  D. Panescu,et al.  Three-dimensional finite element analysis of current density and temperature distributions during radio-frequency ablation , 1995, IEEE Transactions on Biomedical Engineering.