Biophysical- and Engineering-Oriented Approaches to Energy-Based Cardiac Ablation Techniques

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Electrophysiology and Cardiovascular Physiology".

Deadline for manuscript submissions: 15 June 2024 | Viewed by 6387

Special Issue Editors


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Guest Editor
School of Engineering, University of Galway, H91 TK33 Galway, Ireland
Interests: cardiac ablation; computational modeling; pulsed field ablation; radiofrequency; thermal ablation
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Guest Editor
UT Southwestern Medical Center, Dallas, TX, USA
Interests: resuscitation; cardiac arrest; atrial fibrillation; medical devices

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Guest Editor
BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, 46022 Valencia, Spain
Interests: cardiac ablation; computational modeling; radiofrequency; thermal ablation; bioimpedance

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Guest Editor
Instituto de Física de Líquidos y Sistemas Biológicos, Consejo Nacional de Investigaciones Científicas y Técnicas, La Plata B1900BTE, Argentina
Interests: dielectric and thermal properties of tissues; cardiac ablation; computational modeling; radiofrequency; thermal ablation

Special Issue Information

Dear Colleagues,

Despite the fact that ablative therapies based on electromagnetic energy are currently a minimally invasive option for treating some of the most common cardiac arrhythmias, there is still a lack of knowledge about the physical principles that govern the interaction between these energies and biological tissues. This applies to the well-known radiofrequency (RF) power as well as the more recent application of high-voltage pulses (pulsed field ablation), and includes others such as laser and microwave ablation. Therefore, this Special Issue will include new advances, perspectives, research and reviews of the biophysical mechanisms regarding these energy-based ablative techniques, aiming to improve our understanding of the physical principles underlying the use of electromagnetic energies to improve the safety and efficacy of the current treatments of cardiac arrhythmias. Although contributions are expected to have a significant engineering and physics component, as well as mathematical modeling, they should be sufficiently comprehensible and understandable to clinicians and physicians involved in the use of the aforementioned techniques.

Dr. Ana González-Suárez
Prof. Dr. Erik B. Kulstad
Dr. Juan J. Pérez
Dr. Ramiro Miguel Irastorza
Guest Editors

Manuscript Submission Information

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Keywords

  • cardiac ablation
  • radiofrequency ablation (RFA)
  • thermal ablation
  • pulsed field ablation (PFA)
  • microwave ablation (MWA)
  • laser ablation
  • thermal protection devices

Published Papers (3 papers)

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Research

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18 pages, 4301 KiB  
Article
The Effects of Interphase and Interpulse Delays and Pulse Widths on Induced Muscle Contractions, Pain and Therapeutic Efficacy in Electroporation-Based Therapies
by Aleksandra Cvetkoska, Alenka Maček-Lebar, Tamara Polajžer, Matej Reberšek, Weston Upchurch, Paul A. Iaizzo, Daniel C. Sigg and Damijan Miklavčič
J. Cardiovasc. Dev. Dis. 2023, 10(12), 490; https://doi.org/10.3390/jcdd10120490 - 07 Dec 2023
Cited by 1 | Viewed by 1600
Abstract
Electroporation is used in medicine for drug and gene delivery, and as a nonthermal ablation method in tumor treatment and cardiac ablation. Electroporation involves delivering high-voltage electric pulses to target tissue; however, this can cause effects beyond the intended target tissue like nerve [...] Read more.
Electroporation is used in medicine for drug and gene delivery, and as a nonthermal ablation method in tumor treatment and cardiac ablation. Electroporation involves delivering high-voltage electric pulses to target tissue; however, this can cause effects beyond the intended target tissue like nerve stimulation, muscle contractions and pain, requiring use of sedatives or anesthetics. It was previously shown that adjusting pulse parameters may mitigate some of these effects, but not how these adjustments would affect electroporation’s efficacy. We investigated the effect of varying pulse parameters such as interphase and interpulse delay while keeping the duration and number of pulses constant on nerve stimulation, muscle contraction and assessing pain and electroporation efficacy, conducting experiments on human volunteers, tissue samples and cell lines in vitro. Our results show that using specific pulse parameters, particularly short high-frequency biphasic pulses with short interphase and long interpulse delays, reduces muscle contractions and pain sensations in healthy individuals. Higher stimulation thresholds were also observed in experiments on isolated swine phrenic nerves and human esophagus tissues. However, changes in the interphase and interpulse delays did not affect the cell permeability and survival, suggesting that modifying the pulse parameters could minimize adverse effects while preserving therapeutic goals in electroporation. Full article
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12 pages, 2648 KiB  
Article
A Predictive and an Optimization Mathematical Model for Device Design in Cardiac Pulsed Field Ablation Using Design of Experiments
by Eoghan Dunne, Jara M. Baena-Montes, Kevin Donaghey, Cormac Clarke, Marcin J. Kraśny, Bilal Amin, Tony O’Halloran, Leo R. Quinlan, Adnan Elahi and Martin O’Halloran
J. Cardiovasc. Dev. Dis. 2023, 10(10), 423; https://doi.org/10.3390/jcdd10100423 - 11 Oct 2023
Cited by 1 | Viewed by 1414
Abstract
Cardiac catheter ablation (CCA) is a common method used to correct cardiac arrhythmia. Pulsed Field Ablation (PFA) is a recently-adapted CCA technology whose ablation is dependent on electrode and waveform parameters (factors). In this work, the use of the Design of Experiments (DoE) [...] Read more.
Cardiac catheter ablation (CCA) is a common method used to correct cardiac arrhythmia. Pulsed Field Ablation (PFA) is a recently-adapted CCA technology whose ablation is dependent on electrode and waveform parameters (factors). In this work, the use of the Design of Experiments (DoE) methodology is investigated for the design and optimization of a PFA device. The effects of the four factors (input voltage, electrode spacing, electrode width, and on-time) and their interactions are analyzed. An empirical model is formed to predict and optimize the ablation size responses. Based on the ranges tested, the significant factors were the input voltage, the electrode spacing, and the on time, which is in line with the literature. Two-factor interactions were found to be significant and need to be considered in the model. The resulting empirical model was found to predict ablation sizes with less than 2.1% error in the measured area and was used for optimization. The findings and the strong predictive model developed highlight that the DoE approach can be used to help determine PFA device design, to optimize for certain ablation zone sizes, and to help inform device design to tackle specific cardiac arrhythmias. Full article
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Review

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21 pages, 2880 KiB  
Review
Cardioneuroablation Using Epicardial Pulsed Field Ablation for the Treatment of Atrial Fibrillation
by Barry O’Brien, John Reilly, Ken Coffey, Ana González-Suárez, Leo Quinlan and Martin van Zyl
J. Cardiovasc. Dev. Dis. 2023, 10(6), 238; https://doi.org/10.3390/jcdd10060238 - 29 May 2023
Cited by 3 | Viewed by 2586
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting millions of people worldwide. The cardiac autonomic nervous system (ANS) is widely recognized as playing a key role in both the initiation and propagation of AF. This paper reviews the background and development [...] Read more.
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting millions of people worldwide. The cardiac autonomic nervous system (ANS) is widely recognized as playing a key role in both the initiation and propagation of AF. This paper reviews the background and development of a unique cardioneuroablation technique for the modulation of the cardiac ANS as a potential treatment for AF. The treatment uses pulsed electric field energy to selectively electroporate ANS structures on the epicardial surface of the heart. Insights from in vitro studies and electric field models are presented as well as data from both pre-clinical and early clinical studies. Full article
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