A theoretical model of ventricular reentry and its radiofrequency ablation therapy

We have developed a theoretical model to predict the outcome (i.e. failure/success) of radio-frequency ablation (RFA) therapy via computer calculations of the propagation of action potential in the presence of a ventricular reentry circuit. Our results show that the anatomy (i.e. infarct scar sizes) and the electrical conductivity of the channel between the scars (named isthmus) are critical to inducibility of reentry. Simulations also show that even a small gap in the final lesion relative to the isthmus will result in perpetuation of reentry following RF ablation. The model has potential utility in RF treatment planning for reentry associated with ventricular structural disease (e.g. infarct). A realistic patient-specific model will be parameterized using magnetic resonance imaging (MRI) data to define the tissue anatomy (i.e. infarct areas)

[1]  Hervé Delingette,et al.  Preliminary Validation Using in vivo Measures of a Macroscopic Electrical Model of the Heart , 2003, IS4TH.

[2]  David J. Christini,et al.  Critical role of inhomogeneities in pacing termination of cardiac reentry. , 2002, Chaos.

[3]  O. Simonetti,et al.  Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. , 1999, Circulation.

[4]  Bernhard Tilg,et al.  Reentry Anchoring at a Pair of Pulmonary Vein Ostia , 2005, FIMH.

[5]  R. Aliev,et al.  A simple two-variable model of cardiac excitation , 1996 .

[6]  W. Stevenson,et al.  Radiofrequency catheter ablation of ventricular tachycardia , 2000, Heart.

[7]  Y. Rudy,et al.  Basic mechanisms of cardiac impulse propagation and associated arrhythmias. , 2004, Physiological reviews.

[8]  Dominique Lacroix,et al.  Isthmus Characteristics of Reentrant Ventricular Tachycardia After Myocardial Infarction , 2002, Circulation.

[9]  Gerhard Hindricks,et al.  Catheter Ablation of Ventricular Tachycardia in Remote Myocardial Infarction: , 2003, Journal of cardiovascular electrophysiology.

[10]  A V Panfilov,et al.  Modeling of heart excitation patterns caused by a local inhomogeneity. , 1996, Journal of theoretical biology.

[11]  Joan M. Craney Radiofrequency Ablation of Ventricular Tachycardia , 1995 .

[12]  H Calkins,et al.  Visualization and temporal/spatial characterization of cardiac radiofrequency ablation lesions using magnetic resonance imaging. , 2000, Circulation.