Abstract
Catheter-based cardiac ablation, such as radiofrequency ablation (RFA) and pulsed electric field ablation (PFA), is the treatment of choice for atrial fibrillation (AF). However, the underlying phenomena and differences between RFA and PFA are not well understood. In this paper, we propose mathematical modeling of the cardiac electric signal of a cardiac domain containing an ablated area by RFA or PFA. Both types of ablation consist of the isolation of the pulmonary vein, but we describe them differently by using appropriate transmission conditions. More specifically, we assume that in the case of RFA, both intracellular and extracellular potentials are affected, leading to Kedem-Katchalsky type conditions at the interface. In contrast, in the case of PFA, we assume an isolation of the intracellular potential (due to the cardiomyocytes death induced by electroporation) whereas the extracellular potential is continuous. Numerical simulations in a context of AF show that PFA and RFA lead to isolation of the pulmonary vein. Our modeling also enables to propose a numerical explanation for the higher rate of fibrillation recurrence after RFA compared with PFA.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Babuška, I.: The finite element method with penalty. Math. Comput. 27(122), 221–228 (1973)
Bulvik, B.E., et al.: Irreversible electroporation versus radiofrequency ablation: a comparison of local and systemic effects in a small-animal model. Radiology 280(2), 413–424 (2016)
Caluori, G., et al.: AC pulsed field ablation is feasible and safe in atrial and ventricular settings: a proof-of-concept chronic animal study. Front. Bioeng. Biotechnol. 8, 552357 (2020)
Chapelle, D., Collin, A., Gerbeau, J.F.: A surface-based electrophysiology model relying on asymptotic analysis and motivated by cardiac atria modeling. Math. Models Methods Appl. Sci. 23(14), 2749–2776 (2013)
Franzone, P.C., Pavarino, L.F., Scacchi, S.: Mathematical Cardiac Electrophysiology, vol. 13. Springer, Heidelberg (2014). https://doi.org/10.1007/978-3-319-04801-7
Geuzaine, C., Remacle, J.F.: Gmsh: a 3-D finite element mesh generator with built-in pre-and post-processing facilities. Int. J. Numer. Meth. Eng. 79(11), 1309–1331 (2009)
Hecht, F., Pironneau, O., Le Hyaric, A., Ohtsuka, K.: FreeFEM++ manual (2005)
Ho, S.Y., Anderson, R.H., Sánchez-Quintana, D.: Atrial structure and fibres: morphologic bases of atrial conduction. Cardiovasc. Res. 54(2), 325–336 (2002)
Hubert, F.B.F.: Méthodes de décomposition de domaine de type schwarz (2014)
Joseph, J., Rajappan, K.: Radiofrequency ablation of cardiac arrhythmias: past, present and future. QJM Int. J. Med. 105(4), 303–314 (2012)
Kedem, O., Katchalsky, A.: A physical interpretation of the phenomenological coefficients of membrane permeability. J. Gen. Physiol. 45(1), 143–179 (1961)
Koruth, J., et al.: Preclinical evaluation of pulsed field ablation: electrophysiological and histological assessment of thoracic vein isolation. Circ. Arrhythmia Electrophysiol. 12(12), e007781 (2019)
Krueger, M.W., et al.: Modeling atrial fiber orientation in patient-specific geometries: a semi-automatic rule-based approach. In: Metaxas, D.N., Axel, L. (eds.) FIMH 2011. LNCS, vol. 6666, pp. 223–232. Springer, Heidelberg (2011). https://doi.org/10.1007/978-3-642-21028-0_28
Mitchell, C.C., Schaeffer, D.G.: A two-current model for the dynamics of cardiac membrane. Bull. Math. Biol. 65(5), 767–793 (2003)
Reddy, V.Y., et al.: Pulsed field ablation of paroxysmal atrial fibrillation: 1-year outcomes of IMPULSE, PEFCAT, and PEFCAT II. Clin. Electrophysiol. 7(5), 614–627 (2021)
Schenone, E., Collin, A., Gerbeau, J.F.: Numerical simulation of electrocardiograms for full cardiac cycles in healthy and pathological conditions. Int. J. Numer. Methods Biomed. Eng. 32(5), e02744 (2016)
Skanes, A.C., Klein, G., Krahn, A., Yee, R.: Cryoablation: potentials and pitfalls. J. Cardiovasc. Electrophysiol. 15, S28–S34 (2004)
Tung, L.: A bi-domain model for describing ischemic myocardial dc potentials. Ph.D. thesis, Massachusetts Institute of Technology (1978)
Wittkampf, F.H., Nakagawa, H.: RF catheter ablation: lessons on lesions. Pacing Clin. Electrophysiol. 29(11), 1285–1297 (2006)
Acknowledgement
The authors gratefully acknowledge support from the French Agence Nationale de la Recherche (ANR) (grant ANR-22-CE45-0014-01, project MIRE4VTach), from the Atrial Fibrillation Chair of the IHU Liryc, from the Fondation Bordeaux Université, from the Fondation Lefoulon-Delalande, and from the French Federation of Cardiology - Grands projets - 2022 (project DIELECTRIC).
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this paper
Cite this paper
Nati Poltri, S., Caluori, G., Jaïs, P., Collin, A., Poignard, C. (2023). Electrocardiology Modeling After Catheter Ablations for Atrial Fibrillation. In: Bernard, O., Clarysse, P., Duchateau, N., Ohayon, J., Viallon, M. (eds) Functional Imaging and Modeling of the Heart. FIMH 2023. Lecture Notes in Computer Science, vol 13958. Springer, Cham. https://doi.org/10.1007/978-3-031-35302-4_19
Download citation
DOI: https://doi.org/10.1007/978-3-031-35302-4_19
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-35301-7
Online ISBN: 978-3-031-35302-4
eBook Packages: Computer ScienceComputer Science (R0)