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Author: search.filters.author.Haemmerich, DieterSubject: search.filters.subject.Bipolar ablation

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    Finite-element analysis of hepatic multiple probe radio-frequency ablation
    (2002-07-30)
    Haemmerich, Dieter
    ;
    Tungjitkusolmun, Supan
    ;
    Staelin, S. Tyler
    ;
    Lee, Fred T.
    ;
    Mahvi, David M.
    Radio-frequency (RF) ablation is an important means of treatment of nonresectable primary and metastatic liver tumors. RF ablation, unlike cryoablation (a method of tumor destruction that utilizes cold rather than heat), must be performed with a single probe placed serially. The ablation of any but the smallest tumor requires the use of multiple overlapping treatment zones. We evaluated the performance of a configuration incorporating two hooked probes (RITA model 30). The probes were lined up along the same axis in parallel 20 mm apart. Three different modes applied voltage to the probes. The first mode applied energy in monopolar mode (current flows from both probes to a dispersive electrode). The second mode applied the energy to the probes in bipolar mode (current flows from one probe to the other). The third method applied the energy sequentially in monopolar mode (in 2-s intervals switched between the probes). We used the finite-element method (FEM) and analyzed the electric potential profile and the temperature distribution at the end of simulation of a 12-min ablation. The alternating monopolar mode allowed precise independent control of the amount of energy deposited at each probe. The bipolar mode created the highest temperature in the area between the probes in the configuration we examined. The monopolar mode showed the worst performance since the two probes in close vicinity create a disadvantageous electric field configuration. We, thus, conclude that alternating monopolar RF ablation is superior to the other two methods.
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    Modeling bipolar phase-shifted multielectrode catheter ablation
    (2002-01-05)
    Tungjitkusolmun, Supan
    ;
    Haemmerich, Dieter
    ;
    Cao, Hong
    ;
    Tsai, Jang Zern
    ;
    Choy, Young Bin
    Atrial fibrillation (AFIB) is a common clinical problem affecting approximately 0.5-1% of the United States population. Radio-frequency (RF) multielectrode catheter (MEC) ablation has successes in curing AFIB. We utilized finite-element method analysis to determine the myocardial temperature distribution after 30 s, 80 °C temperature-controlled unipolar ablation using three 7F 12.5-mm electrodes with 2-mm interelectrode spacing MEC. Numerical results demonstrated that cold spots occurred at the edges of the middle electrode and hot spots at the side electrodes. We introduced the bipolar phase-shifted technique for RF energy delivery of MEC ablation. We determined the optimal phase-shift (φ) between the two sinusoidal voltage sources of a simplified two-dimensional finite-element model. At the optimal φ, we can achieve a temperature distribution that minimizes the difference between temperatures at electrode edges. We also studied the effects of myocardial electric conductivity (σ), thermal conductivity (κ), and the electrode spacing on the optimal φ. When we varied σ and κ from 50% to 150%, optimal φ ranged from 29.5° to 23.5°, and in the vicinity of 26.5°, respectively. The optimal φ for 3-mm spacing MEC was 30.5°. We show the design of a simplified bipolar phase-shifted MEC ablation system.
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    Hepatic bipolar radio-frequency ablation between separated multiprong electrodes
    (2001-10-01)
    Haemmerich, Dieter
    ;
    Staelin, S. Tyler
    ;
    Tungjitkusolmun, Supan
    ;
    Lee, Fred T.
    ;
    Mahvi, David M.
    Radio-frequency (RF) ablation has become an important means of treatment of nonresectable primary and metastatic liver tumors. Major limitations are small lesion size, which make multiple applications necessary, and incomplete killing of tumor cells, resulting in high recurrence rates. We examined a new bipolar RF ablation method incorporating two probes with hooked electrodes (RITA model 30). We performed monopolar and bipolar in vivo experiments on three pigs. The electrodes were 2.5 cm apart and rotated 45° relative to each other. We used temperature-controlled mode at 95 °C. Lesion volumes were 3.9 ± 1.8 cm <sup>3</sup> (n = 7) for the monopolar case and 12.2 ± 3 cm <sup>3</sup> (n = 10) for the bipolar case. We generated finite-element models (FEMs) of monopolar and bipolar configurations. We analyzed the distribution of temperature and electric field of the finite element model. The lesion volumes for the FEM are 7.95 cm <sup>3</sup> for the monopolar and 18.79 cm <sup>3</sup> for the bipolar case. The new bipolar method creates larger lesions and is less dependent on local inhomogenities in liver tissue-such as blood perfusion-compared with monopolar RF ablation. A limitation of the new method is that the power dissipation of the two probes cannot be controlled independently in response to different conditions in the vicinity of each probe. This may result in nonuniform lesions and decreased lesion size.