Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons
Abstract Background Preclinical and clinical studies have utilized periprocedural parameters to optimize cryoballoon ablation dosing, including acute time‐to‐isolation (TTI) of the pulmonary vein, balloon rate of freezing, balloon nadir temperature, and balloon‐thawing time. This study sought to pre...
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crwiley:10.1111/jce.14150 2024-06-09T07:43:33+00:00 Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons Getman, Michael K. Wissner, Erik Ranjan, Ravi Lalonde, Jean‐Pierre 2019 http://dx.doi.org/10.1111/jce.14150 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fjce.14150 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.14150 https://onlinelibrary.wiley.com/doi/full-xml/10.1111/jce.14150 en eng Wiley http://creativecommons.org/licenses/by-nc-nd/4.0/ Journal of Cardiovascular Electrophysiology volume 30, issue 11, page 2274-2282 ISSN 1045-3873 1540-8167 journal-article 2019 crwiley https://doi.org/10.1111/jce.14150 2024-05-16T14:26:21Z Abstract Background Preclinical and clinical studies have utilized periprocedural parameters to optimize cryoballoon ablation dosing, including acute time‐to‐isolation (TTI) of the pulmonary vein, balloon rate of freezing, balloon nadir temperature, and balloon‐thawing time. This study sought to predict the Arctic Front Advance (AFA) vs Arctic Front Advance Pro (AFA Pro) ablation durations required for transmural pulmonary vein isolation at varied tissue depths. Methods A cardiac‐specific, three‐dimensional computational model that incorporates structural characteristics, temperature‐dependent cellular responses, and thermal‐conductive properties was designed to predict the propagation of cold isotherms through tissue. The model assumed complete cryoballoon‐to‐pulmonary vein (PV) circumferential contact. Using known temperature thresholds of cardiac cellular electrical dormancy (at 23°C) and cellular nonviability (at −20°C), transmural time‐to‐isolation electrical dormancy (TTI ED ) and cellular nonviability (TTI NV ) were simulated. Results For cardiac thickness of 0.5, 1.25, 2.0, 3.0, 4.0, and 5.0 mm, the 23°C isotherm passed transmurally in 33, 38, 46, 62, 80, and 95 seconds during cryoablation utilizing AFA and 33, 38, 46, 63, 80, and 95 seconds with AFA Pro. Using the same cardiac thicknesses, the −20°C isotherm passed transmurally in 40, 55, 78, 161, 354, and 696 seconds during cryoablation with AFA and 40, 54, 78, 160, 352, and 722 seconds with AFA Pro. Conclusion This model predicted a minimum duration of cryoballoon ablation (TTI NV ) to obtain a transmural lesion when acute TTI of the PV was observed (TTI ED ). Consequently, the model is a useful tool for characterizing CBA dosing, which may guide future cryoablation dosing strategies. Article in Journal/Newspaper Arctic Wiley Online Library Arctic Journal of Cardiovascular Electrophysiology 30 11 2274 2282 |
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Wiley Online Library |
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English |
description |
Abstract Background Preclinical and clinical studies have utilized periprocedural parameters to optimize cryoballoon ablation dosing, including acute time‐to‐isolation (TTI) of the pulmonary vein, balloon rate of freezing, balloon nadir temperature, and balloon‐thawing time. This study sought to predict the Arctic Front Advance (AFA) vs Arctic Front Advance Pro (AFA Pro) ablation durations required for transmural pulmonary vein isolation at varied tissue depths. Methods A cardiac‐specific, three‐dimensional computational model that incorporates structural characteristics, temperature‐dependent cellular responses, and thermal‐conductive properties was designed to predict the propagation of cold isotherms through tissue. The model assumed complete cryoballoon‐to‐pulmonary vein (PV) circumferential contact. Using known temperature thresholds of cardiac cellular electrical dormancy (at 23°C) and cellular nonviability (at −20°C), transmural time‐to‐isolation electrical dormancy (TTI ED ) and cellular nonviability (TTI NV ) were simulated. Results For cardiac thickness of 0.5, 1.25, 2.0, 3.0, 4.0, and 5.0 mm, the 23°C isotherm passed transmurally in 33, 38, 46, 62, 80, and 95 seconds during cryoablation utilizing AFA and 33, 38, 46, 63, 80, and 95 seconds with AFA Pro. Using the same cardiac thicknesses, the −20°C isotherm passed transmurally in 40, 55, 78, 161, 354, and 696 seconds during cryoablation with AFA and 40, 54, 78, 160, 352, and 722 seconds with AFA Pro. Conclusion This model predicted a minimum duration of cryoballoon ablation (TTI NV ) to obtain a transmural lesion when acute TTI of the PV was observed (TTI ED ). Consequently, the model is a useful tool for characterizing CBA dosing, which may guide future cryoablation dosing strategies. |
format |
Article in Journal/Newspaper |
author |
Getman, Michael K. Wissner, Erik Ranjan, Ravi Lalonde, Jean‐Pierre |
spellingShingle |
Getman, Michael K. Wissner, Erik Ranjan, Ravi Lalonde, Jean‐Pierre Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons |
author_facet |
Getman, Michael K. Wissner, Erik Ranjan, Ravi Lalonde, Jean‐Pierre |
author_sort |
Getman, Michael K. |
title |
Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons |
title_short |
Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons |
title_full |
Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons |
title_fullStr |
Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons |
title_full_unstemmed |
Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons |
title_sort |
relationship between time‐to‐isolation and freeze duration: computational modeling of dosing for arctic front advance and arctic front advance pro cryoballoons |
publisher |
Wiley |
publishDate |
2019 |
url |
http://dx.doi.org/10.1111/jce.14150 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fjce.14150 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.14150 https://onlinelibrary.wiley.com/doi/full-xml/10.1111/jce.14150 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of Cardiovascular Electrophysiology volume 30, issue 11, page 2274-2282 ISSN 1045-3873 1540-8167 |
op_rights |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
op_doi |
https://doi.org/10.1111/jce.14150 |
container_title |
Journal of Cardiovascular Electrophysiology |
container_volume |
30 |
container_issue |
11 |
container_start_page |
2274 |
op_container_end_page |
2282 |
_version_ |
1801372372581744640 |