Correlation between estimated balloon contact by computer-aided engineering analysis and lesion area by hot balloon abla
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Correlation between estimated balloon contact by computer-aided engineering analysis and lesion area by hot balloon ablation Akio Chikata 1,2 & Takeshi Kato 2 & Hiroaki Nakagoe 3 & Kazuo Usuda 1 & Masayuki Takamura 2 Received: 10 July 2020 / Accepted: 4 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Keywords Hot balloon ablation . CAE analysis
A 60-year-old man was referred for catheter ablation for atrial fibrillation (AF). Pulmonary vein (PV) isolation was performed using a hot balloon (HB) via a single-shot technique under real-time PV potential monitoring. The left superior and inferior PV (LSPV, LIPV) were isolated in one application (time to isolation: 23 and 26 s, respectively). All PVs were isolated using HB. No AF recurrence was noted 1 year later. Post hoc simulation by computer-aided engineering (CAE) analysis using LS-DYNA (LSTC Inc., Livermore, CA) indicated effective balloon contact to the LSPV and LIPV antrum with an overlap at the carina. LS-DYNA is an advanced generalpurpose multiphysics simulation software package, which is suitable for solving phenomena in which force propagates with time history. A high-contact-pressure area was indicated at the anterior and carina lesion of the left PV (LPV). The isolated area evaluated by high-resolution electro-anatomical mapping correlated with the contact area identified in the CAE analysis (Fig. 1 and Supplemental Movies 1, 2).
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10840-020-00862-3) contains supplementary material, which is available to authorized users. * Takeshi Kato [email protected] 1
Department of Cardiology, Toyama Prefectural Central Hospital, Toyama, Japan
2
Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa 920-8641, Japan
3
Engineering Development Center, Toray Industries, Inc, Tokyo, Japan
Although HB ablation for AF is effective, touch-up ablation is occasionally required, especially in the LSPV and carina [1]. CAE analysis might be useful to estimate balloon contact and to improve the HB ablation procedure. Further studies would be needed to determine whether CAE analysis might predict lesion formation during HB ablation.
Reference 1.
Nagashima K, Okumura Y, Watanabe I, Nakahara S, Hori Y, Iso K, et al. Hot balloon versus cryoballoon ablation for atrial fibrillation: lesion characteristics and middle-term outcomes. Circ Arrhythm Electrophysiol. 2018;11:e005861.
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J Interv Card Electrophysiol
Fig. 1 a, b Periprocedural fluoroscopy. The volume of fluid injected into the hot balloon was 12 mL for the LSPV and 11 mL for the LIPV. c, d Distribution of balloon contact in LSPV and LIPV according to CAE analysis. e, f Inner view of LPV according to CAE analysis (yellow-
and blue-shaded areas indicate a balloon contact pressur
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