Impact of the dispersive patch placement on dissipated power in radiofrequency ablation for pulmonary vein isolation via a virtual patient study

Abstract

Radiofrequency ablation (RFA) is a minimally invasive technique for treating arrhythmias by interrupting abnormal electrical signals in the heart. Through a catheter tip, it delivers an alternating current that flows through the heart muscle tissue and the blood to a dispersive patch on the patient's skin. This study aims to test the hypothesis that the placement of the dispersive patch affects the efficacy and safety of RFA. By optimizing the patch position, the procedure could be made more effective and less risky for patients. A 3D in-silico model, based on patient imaging data, was developed to examine the effects of dispersive patch (DP) positioning on electric field distribution within cardiac tissue and the torso during RFA. We conducted 80 computer simulations using a CT-segmented torso model, exploring various DP and electrode configurations while applying standard (25 W) and high (90 W) power settings. For each configuration, we assessed the effectiveness of the DP in delivering power to cardiac tissue near the electrode. The main finding indicates that DP efficacy is significantly influenced by the current delivered to cardiac tissue. Notably, using an anterior patch during ablation proved more effective for the posterior left atrium compared to a posterior patch.