A computer simulation of radio-frequency ablation of the endocardium

A computer simulation of radio-frequency (RF) ablation of the endocardium is performed. The objective is to quantify some of the parameters affecting lesion growth, and to obtain theoretical data which can be used as a guide to maximize the lesions obtained with the procedure. The model under consideration consists of a block of heart tissue with the catheter electrode making contact at a right angle on one side (endocardium) and a large grounded electrode on the other side. An RF electrical current flows between the electrodes, heating the tissue. The simulations provide information on the time evolution of the tissue temperature, lesion dimension and tissue resistance. A first set of calculations is based on an applied RF voltage that maintains the maximum tissue temperature at 100°C. The results reveal that: 1) the lesions achievable by RF ablation are considerably larger than those obtained with a hot-tip catheter of the same size; 2) increasing the electrode radius enlarges the lesion because of an associated increase in contact surface area; 3) an increase in electrode length also enlarges the lesion because of the larger convective losses to the blood flow; 4) a large difference in temperature may exist between the electrode and the tissue because of the cooling effect of the blood flow; and 5) the lesions grow as long as power is applied. Other simulations in which the RF voltage is constant show that the lesions can be enlarged by lowering the applied voltage while increasing the duration. Agreement and discrepancies between the simulations and reported experimental results are identified. Finally, suggestions for improving the procedure are given.