Session IV: Noninvasive Diagnosis and Treatment-6156-Biophysics of Catheter Ablation

Video Transcription

Video Summary

In this video, Dr. Ed Gerstenfeld discusses the biophysics of catheter ablation. He starts by explaining that radiofrequency (RF) ablation is the most common form of ablation, which uses heat to create lesions. He discusses the electromagnetic wave spectrum and how RF waves heat up tissue at lower frequencies. He then explains the two ways heat is delivered during RF ablation: resistive heating and conductive heating. He also shows an example of an RF lesion in an animal heart.<br /><br />Dr. Gerstenfeld explains that tissue temperature is an important factor in lesion formation during RF ablation. He discusses the importance of temperature in irreversible cell death and lesion size. He emphasizes that tissue temperature above 50 degrees Celsius is required for irreversible injury. He also explains the risks associated with heating tissue above 100 degrees Celsius, such as coagulum formation and steam pop.<br /><br />Dr. Gerstenfeld then discusses the use of larger RF electrodes and irrigated RF ablation to optimize lesion formation. He explains that larger electrodes allow for greater power delivery, but may result in smaller lesions due to heat dissipation. He also explains that irrigated RF ablation allows for greater power delivery due to active cooling, but the lesion size is not different from non-irrigated ablation at the same power.<br /><br />Dr. Gerstenfeld briefly mentions cryoablation, which uses freezing temperatures to ablate tissue. He explains that cryoablation is more forgiving than RF ablation, as it allows for reversible electroporation and preserves tissue architecture. Lastly, he mentions electroporation as a new form of non-thermal ablation that shows promise for pulmonary vein isolation.<br /><br />In conclusion, Dr. Gerstenfeld provides an overview of the biophysics of catheter ablation, including RF ablation, cryoablation, and electroporation. He highlights the importance of temperature and power delivery in lesion formation and discusses the advantages and limitations of different ablation techniques.

Keywords

biophysics

catheter ablation

radiofrequency ablation

RF waves

lesion formation

tissue temperature

irreversible cell death

cryoablation

electroporation