Bench testing and modeling of cryoballoon therapy
Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in 1–2% of the general population. Over 6 million Europeans suffer from this arrhythmia, and its prevalence is estimated to at least double in the next 50 years as the population ages. Cryoballoon based therapy is an established therapy for the treatment of (paroxysmal) atrial fibrillation and is centered on electrical isolation of pulmonary veins (PVs) through circumferential lesions around PV ostia. However, with the rapid evolution in cryoablation technique and its increased effectiveness, the risk of complications increases. When ablating the PVs using a cryoballoon the wall of the vein is frozen. A so called ice cap is created at the ablation site inside the atrium. However not only the inside of the heart is exposed to the low temperatures, the structures that surround the heart will be exposed too. So at the outer side of the atrium wall a second ice cap will be formed. The vagal nerve runs past the right inferior pulmonary vein to the stomac and the gastric sphincter, anatomically explaining the etiology of gastroparesis as a complication of cryo PVI.
Objective: To create a bench test (lab) model for the atrium (using a small piece of porcine heart) and its surroundings in which the dimensions of the ice cap inside and outside the atrium can be measured. Several durations of ablation will be tested in this lab model to be able to predict the optimal ablation time (safety vs efficacy). Eventually the results of the lab testing will be used to create a mathemathical model.
Location: The research project is a project at the UT and the bench model is situated in a lab room in Carré. The project is supervised by the NIM (Neuroimaging - Magnetic Detection) group and is initiated by and in collaboration with the cardiology department of the Thoraxcentre Twente Medisch Spectrum Twente.