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Sun Y, Zhu X, Nakamura K, Wang S. Evaluation of lesion characteristics and baseline impedance on high-power short-duration radiofrequency catheter ablation using computer simulation. Heart Vessels 2023; 38:1459-1467. [PMID: 37650926 DOI: 10.1007/s00380-023-02300-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023]
Abstract
Myocardium baseline impedance (BI) is an important factor in ablation effectiveness. This study examined the performance of low-power and long-duration (LPLD), high-power and short-duration (HPSD) ablation at different BIs by computer simulation. A 3D model of the ablation region was constructed for simulation, and in vitro experiments were performed to validate the simulation. Three ablation power and duration configurations of 30 W/30 s, 50 W/10 s, and 90 W/5 s were used for simulation with BI values of 90, 100, 110, 120, 130, and 140 Ω. Roll-off time and ablation volume were measured to evaluate ablation results. The simulation is consistent with the in vitro experiments. When BI is changed from 90 [Formula: see text] to 140 [Formula: see text], the lesion volume over 50 °C with BI of 140 [Formula: see text] was reduced by 6.3%, 6.7%, and 7.3% for 30 W/30 s, 50 W/10 s, and 90 W/5 s configurations, respectively, and the lesion volume over 100 °C was reduced by 62.8%, 49.7%, and 22.5% under 30 W/30 s, 50 W/10 s, and 90 W/5 s, respectively. Simulation results revealed that HPSD (vHPSD) and LPLD ablation were more affected by changes in BI in the lesion volumes over 50 °C and 100 °C, respectively, and demonstrated that resistive and conductive heating were the main heating effects in HPSD (vHPSD) and LPLD, respectively.
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Affiliation(s)
- Yao Sun
- Graduate School of Computer Science and Engineering, The University of Aizu, Aizuwakamatsu, Japan
| | - Xin Zhu
- Graduate School of Computer Science and Engineering, The University of Aizu, Aizuwakamatsu, Japan
| | - Keijiro Nakamura
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Meguro, Tokyo, 153-8515, Japan.
| | - Shuyu Wang
- Graduate School of Computer Science and Engineering, The University of Aizu, Aizuwakamatsu, Japan
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Limitations of Baseline Impedance, Impedance Drop and Current for Radiofrequency Catheter Ablation Monitoring: Insights from In silico Modeling. J Cardiovasc Dev Dis 2022; 9:jcdd9100336. [PMID: 36286288 PMCID: PMC9604830 DOI: 10.3390/jcdd9100336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Baseline impedance, radiofrequency current, and impedance drop during radiofrequency catheter ablation are thought to predict effective lesion formation. However, quantifying the contributions of local versus remote impedances provides insights into the limitations of indices using those parameters. Methods: An in silico model of left atrial radiofrequency catheter ablation was used based on human thoracic measurements and solved for (1) initial impedance (Z), (2) percentage of radiofrequency power delivered to the myocardium and blood (3) total radiofrequency current, (4) impedance drop during heating, and (5) lesion size after a 25 W−30 s ablation. Remote impedance was modeled by varying the mixing ratio between skeletal muscle and fat. Local impedance was modeled by varying insertion depth of the electrode (ID). Results: Increasing the remote impedance led to increased baseline impedance, lower system current delivery, and reduced lesion size. For ID = 0.5 mm, Z ranged from 115 to 132 Ω when fat percentage varied from 20 to 80%, resulting in a decrease in the RF current from 472 to 347 mA and a slight decrease in lesion size from 5.6 to 5.1 mm in depth, and from 9.2 to 8.0 mm in maximum width. In contrast, increasing the local impedance led to lower system current but larger lesions. For a 50% fat−muscle mixture, Z ranged from 118 to 138 Ω when ID varied from 0.3 to 1.9 mm, resulting in a decrease in the RF current from 463 to 443 mA and an increase in lesion size, from 5.2 up to 7.5 mm in depth, and from 8.4 up to 11.6 mm in maximum width. In cases of nearly identical Z but different contributions of local and remote impedance, markedly different lesions sizes were observed despite only small differences in RF current. Impedance drop better predicted lesion size (R2 > 0.93) than RF current (R2 < 0.1). Conclusions: Identical baseline impedances and observed RF currents can lead to markedly different lesion sizes with different relative contributions of local and remote impedances to the electrical circuit. These results provide mechanistic insights into the advantage of measuring local impedance and identifies potential limitations of indices incorporating baseline impedance or current to predict lesion quality.
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Qu L, Guo M, Sun M, Wang R, Zhang N, Li X. Effect of Baseline Impedance in Radiofrequency Delivery on Lesion Characteristics and the Relationship Between Impedance and Steam Pops. Front Cardiovasc Med 2022; 9:872961. [PMID: 35571193 PMCID: PMC9094712 DOI: 10.3389/fcvm.2022.872961] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/17/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To explore the effects of baseline impedance (R) and power (P) on radiofrequency ablation (RFA) lesion characteristics and their correlation with steam pops using ThermoCool SmartTouch-SF (STSF) catheters in the porcine heart. Method A porcine left ventricle was submerged in 37°C saline ex vivo, and the experiment was performed with various P (P = 30, 40, 50, and 60 W) and multiple R loads (R = 80–100, 100–140, 140–180, and 180–220 Ω) to reach the target ablation index (AI; AI = 350, 450, and 500) or reach the target ablation time using a fixed contact force (CF; CF = 10–15 g) and the same saline irrigation (30 W/8 ml/min or 40–60 W/15 ml/min), repeated five times under each condition. Results The surface diameter, maximum diameter, depth, and volume of the lesions were strongly correlated with the AI (P = 40 W, R = 100–140 Ω, CF = 10–15 g) (r = 0.5412; r = 0.7889; r = 0.9366; and r = 0.913, respectively; all p < 0.05). As the value of R increased, the maximum diameter, depth, and volume of the lesions significantly increased (AI = 350, P = 30 W). Moreover, the higher the baseline value of R, the greater the absolute value of the R decrease (r = 0.9035, p < 0.05, Y = 0.2759 × X – 18.33). Under high power and high impedance, the occurrence rate of steam pops was high (P = 60 W, R = 180–220 Ω, AI when a steam pop occurred: 480 ± 26.5, ablation time: 11.29 ± 1.04 s). Conclusion Radiofrequency catheter ablation (RFCA) in power-controlled mode resulted in various lesion characteristics that were related to diverse baseline Rs. In addition, the incidence of steam pops was strongly correlated with high baseline R and high P.
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Affiliation(s)
- Lijuan Qu
- Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Third Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Min Guo
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Meng Sun
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Rui Wang
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
- *Correspondence: Rui Wang
| | - Nan Zhang
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xin Li
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
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Sun Y, Xiao X, Yin X, Gao L, Yu X, Zhang R, Wang Z, Dai S, Yang Y, Xia Y. Impact of baseline impedance of pulmonary vein antrum on success of catheter ablation for paroxysmal atrial fibrillation guided by ablation index. BMC Cardiovasc Disord 2022; 22:179. [PMID: 35439961 PMCID: PMC9016960 DOI: 10.1186/s12872-022-02530-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
Objective Ablation index (AI) is an effective ablation quality marker. Impedance is also an important factor for lesion formation. The present study evaluated the influence of the baseline impedance in the effect of ablation for atrial fibrillation (AF) guided by AI. Methods This was a retrospective study. 101 patients with paroxysmal AF (PAF) were enrolled. All patients underwent radiofrequency ablation guided by the same AI strategy. The ablation strategy was pulmonary vein (PV) isolation with non-PV triggers ablation. The baseline impedance of the ablation points was recorded. The patients were followed up every 3 months or so. Results During a median follow-up of 12 (4–14) months, freedom from AF/atrial tachycardia recurrence were 82.2%. No difference existed in baseline characteristics between the success group and the recurrence group. The average baseline impedance was 124.3 ± 9.7 Ω. The baseline impedance of the ablation points in success group was lower compared to the recurrence group (122.9 ± 9.4 vs. 130.5 ± 8.8 Ω, P < 0.01). The ratio of impedance drop in the success group was higher than the recurrence group ([8.8 ± 1.4]% vs. [8.1 ± 1.2]%, P = 0.03). Multivariate analysis revealed that baseline impedance, PAF duration and AI were the independent predictors of AF recurrence. The cumulative free of recurrence rate of low-impedance group (≤ 124 Ω, n = 54) was higher than that of high-impedance group. Conclusion Baseline impedance correlates with clinical outcome of radiofrequency ablation for PAF guided by AI. Higher impedance in the same AI strategy may result in an ineffective lesion which probably causes recurrence. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02530-y.
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Affiliation(s)
- Yuanjun Sun
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China
| | - Xianjie Xiao
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China
| | - Xiaomeng Yin
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China.
| | - Lianjun Gao
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China
| | - Xiaohong Yu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China
| | - Rongfeng Zhang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China
| | - Zhongzhen Wang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China
| | - Shiyu Dai
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China
| | - Yanzong Yang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China
| | - Yunlong Xia
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, 116011, Liaoning, China.
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González-Suárez A, Pérez JJ, Irastorza RM, D'Avila A, Berjano E. Computer modeling of radiofrequency cardiac ablation: 30 years of bioengineering research. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 214:106546. [PMID: 34844766 DOI: 10.1016/j.cmpb.2021.106546] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
This review begins with a rationale of the importance of theoretical, mathematical and computational models for radiofrequency (RF) catheter ablation (RFCA). We then describe the historical context in which each model was developed, its contribution to the knowledge of the physics of RFCA and its implications for clinical practice. Next, we review the computer modeling studies intended to improve our knowledge of the biophysics of RFCA and those intended to explore new technologies. We describe the most important technical details of the implementation of mathematical models, including governing equations, tissue properties, boundary conditions, etc. We discuss the utility of lumped element models, which despite their simplicity are widely used by clinical researchers to provide a physical explanation of how RF power is absorbed in different tissues. Computer model verification and validation are also discussed in the context of RFCA. The article ends with a section on the current limitations, i.e. aspects not yet included in state-of-the-art RFCA computer modeling and on future work aimed at covering the current gaps.
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Affiliation(s)
- Ana González-Suárez
- Electrical and Electronic Engineering, National University of Ireland Galway, Ireland; Translational Medical Device Lab, National University of Ireland Galway, Ireland
| | - Juan J Pérez
- Department of Electronic Engineering, BioMIT, Universitat Politècnica de València, Valencia, Spain
| | - Ramiro M Irastorza
- Instituto de Física de Líquidos y Sistemas Biológicos (CONICET), La Plata, Argentina; Instituto de Ingeniería y Agronomía, Universidad Nacional Arturo Jauretche, Florencio Varela, Argentina
| | - Andre D'Avila
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Enrique Berjano
- Department of Electronic Engineering, BioMIT, Universitat Politècnica de València, Valencia, Spain.
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Steiger NA, Sauer WH. Turn It Up to Eleven: Optimizing Radiofrequency Ablation to Improve Lesion Size and Durability. JACC Clin Electrophysiol 2021; 7:1240-1242. [PMID: 34674837 DOI: 10.1016/j.jacep.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Nathaniel A Steiger
- Cardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - William H Sauer
- Cardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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Barkagan M, Rottmann M, Leshem E, Shen C, Buxton AE, Anter E. Effect of Baseline Impedance on Ablation Lesion Dimensions. Circ Arrhythm Electrophysiol 2018; 11:e006690. [DOI: 10.1161/circep.118.006690] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michael Barkagan
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard-Thorndike Electrophysiology Institute, Harvard Medical School, Boston, MA (M.B., M.R., E.L., A.E.B., E.A.)
| | - Markus Rottmann
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard-Thorndike Electrophysiology Institute, Harvard Medical School, Boston, MA (M.B., M.R., E.L., A.E.B., E.A.)
| | - Eran Leshem
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard-Thorndike Electrophysiology Institute, Harvard Medical School, Boston, MA (M.B., M.R., E.L., A.E.B., E.A.)
| | - Changyu Shen
- Division of Cardiovascular Medicine, Richard A. and Susan F. Smith Center for Cardiovascular Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA (C.S.)
| | - Alfred E. Buxton
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard-Thorndike Electrophysiology Institute, Harvard Medical School, Boston, MA (M.B., M.R., E.L., A.E.B., E.A.)
| | - Elad Anter
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard-Thorndike Electrophysiology Institute, Harvard Medical School, Boston, MA (M.B., M.R., E.L., A.E.B., E.A.)
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González-Suárez A, Pérez JJ, Berjano E. Should fluid dynamics be included in computer models of RF cardiac ablation by irrigated-tip electrodes? Biomed Eng Online 2018; 17:43. [PMID: 29678186 PMCID: PMC5910590 DOI: 10.1186/s12938-018-0475-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background Although accurate modeling of the thermal performance of irrigated-tip electrodes in radiofrequency cardiac ablation requires the solution of a triple coupled problem involving simultaneous electrical conduction, heat transfer, and fluid dynamics, in certain cases it is difficult to combine the software with the expertise necessary to solve these coupled problems, so that reduced models have to be considered. We here focus on a reduced model which avoids the fluid dynamics problem by setting a constant temperature at the electrode tip. Our aim was to compare the reduced and full models in terms of predicting lesion dimensions and the temperatures reached in tissue and blood. Results The results showed that the reduced model overestimates the lesion surface width by up to 5 mm (i.e. 70%) for any electrode insertion depth and blood flow rate. Likewise, it drastically overestimates the maximum blood temperature by more than 15 °C in all cases. However, the reduced model is able to predict lesion depth reasonably well (within 0.1 mm of the full model), and also the maximum tissue temperature (difference always less than 3 °C). These results were valid throughout the entire ablation time (60 s) and regardless of blood flow rate and electrode insertion depth (ranging from 0.5 to 1.5 mm). Conclusions The findings suggest that the reduced model is not able to predict either the lesion surface width or the maximum temperature reached in the blood, and so would not be suitable for the study of issues related to blood temperature, such as the incidence of thrombus formation during ablation. However, it could be used to study issues related to maximum tissue temperature, such as the steam pop phenomenon.
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Affiliation(s)
- Ana González-Suárez
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, Carrer Roc Boronat 138, 08018, Barcelona, Spain.
| | - Juan J Pérez
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, Valencia, Spain
| | - Enrique Berjano
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, Valencia, Spain
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CHINITZ JASONS, KAPUR SUNIL, BARBHAIYA CHIRAG, KUMAR SAURABH, JOHN ROY, EPSTEIN LAURENCEM, TEDROW USHA, STEVENSON WILLIAMG, MICHAUD GREGORYF. Sites With Small Impedance Decrease During Catheter Ablation for Atrial Fibrillation Are Associated With Recovery of Pulmonary Vein Conduction. J Cardiovasc Electrophysiol 2016; 27:1390-1398. [DOI: 10.1111/jce.13095] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/13/2016] [Accepted: 08/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- JASON S. CHINITZ
- Department of Cardiology; Southside Hospital, Northwell Health Physician Partners; Hofstra Northshore-LIJ School of Medicine; Bayshore New York USA
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - SUNIL KAPUR
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - CHIRAG BARBHAIYA
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - SAURABH KUMAR
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - ROY JOHN
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - LAURENCE M. EPSTEIN
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - USHA TEDROW
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - WILLIAM G. STEVENSON
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - GREGORY F. MICHAUD
- Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts USA
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BHASKARAN ABHISHEK, BARRY M, POULIOPOULOS JIM, NALLIAH CHRISHAN, QIAN PIERRE, CHIK WILLIAM, THAVAPALACHANDRAN SUJITHA, DAVIS LLOYD, MCEWAN ALISTAIR, THOMAS STUART, KOVOOR PRAMESH, THIAGALINGAM ARAVINDA. Circuit Impedance Could Be a Crucial Factor Influencing Radiofrequency Ablation Efficacy and Safety: A Myocardial Phantom Study of the Problem and Its Correction. J Cardiovasc Electrophysiol 2016; 27:351-7. [DOI: 10.1111/jce.12893] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 11/20/2015] [Accepted: 11/25/2015] [Indexed: 01/24/2023]
Affiliation(s)
- ABHISHEK BHASKARAN
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
| | - M.A. BARRY
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
- School of Electrical and Information Engineering; University of Sydney; Australia
| | - JIM POULIOPOULOS
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
| | | | - PIERRE QIAN
- Cardiology Department; Westmead Hospital; Sydney Australia
| | - WILLIAM CHIK
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
| | - SUJITHA THAVAPALACHANDRAN
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
| | - LLOYD DAVIS
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
| | - ALISTAIR MCEWAN
- School of Electrical and Information Engineering; University of Sydney; Australia
| | - STUART THOMAS
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
| | - PRAMESH KOVOOR
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
| | - ARAVINDA THIAGALINGAM
- Cardiology Department; Westmead Hospital; Sydney Australia
- Sydney Medical School; University of Sydney; Australia
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González-Suárez A, Trujillo M, Burdío F, Andaluz A, Berjano E. Could the heat sink effect of blood flow inside large vessels protect the vessel wall from thermal damage during RF-assisted surgical resection? Med Phys 2014; 41:083301. [DOI: 10.1118/1.4890103] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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