Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons
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...
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ftpubmed:oai:pubmedcentral.nih.gov:6899473 2023-05-15T14:51:58+02:00 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 2019-09-17 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899473/ http://www.ncbi.nlm.nih.gov/pubmed/31502304 https://doi.org/10.1111/jce.14150 en eng John Wiley and Sons Inc. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899473/ http://www.ncbi.nlm.nih.gov/pubmed/31502304 http://dx.doi.org/10.1111/jce.14150 © 2019 The Authors. Journal of Cardiovascular Electrophysiology Published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. CC-BY-NC-ND Original Articles Text 2019 ftpubmed https://doi.org/10.1111/jce.14150 2019-12-22T01:20:54Z 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. Text Arctic PubMed Central (PMC) Arctic Journal of Cardiovascular Electrophysiology 30 11 2274 2282 |
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Original Articles 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 |
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Original Articles |
description |
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 |
Text |
author |
Getman, Michael K. Wissner, Erik Ranjan, Ravi Lalonde, Jean‐Pierre |
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 |
John Wiley and Sons Inc. |
publishDate |
2019 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899473/ http://www.ncbi.nlm.nih.gov/pubmed/31502304 https://doi.org/10.1111/jce.14150 |
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Arctic |
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Arctic |
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Arctic |
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Arctic |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899473/ http://www.ncbi.nlm.nih.gov/pubmed/31502304 http://dx.doi.org/10.1111/jce.14150 |
op_rights |
© 2019 The Authors. Journal of Cardiovascular Electrophysiology Published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
op_rightsnorm |
CC-BY-NC-ND |
op_doi |
https://doi.org/10.1111/jce.14150 |
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Journal of Cardiovascular Electrophysiology |
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30 |
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11 |
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2274 |
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2282 |
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