RF Ablation Catheter for Correcting Heart Rhythms 3D Cross View

This is the tip of an RF ablation catheter which is used to correct abnormal heart rhythms. Examples of rhythms that it can correct are atrial flutter, atrial fibrillation, AVNRT, etc. An electrophysiologist (cardiologist who specializes in the electrical conduction of the heart) will insert these catheters and many others at the same time into a patient's veins and guided into their heart using fluoroscopy (video x-rays). They can then use these wires and sensors to measure the electrical signals being conducted in the heart in order to find the area that is producing the abnormal heart signals. Some arrhythmias are caused by loops in the heart that can be corrected by breaking the loop. Once identified, these abberant areas can then be ablated or destroyed via burning with increased temperature in this case. Other types of catheters which are not pictured here may use liquid nitrogen balloons to burn via decreased temperature / freezing instead. This results in breaking the loop that produces the abnormal heart signals, thereby fixing the heart rhythm.

The design of this ablation catheter is very complex and is jam packed into a tube only 8 Fr or 2.667mm in diameter. This model is the TactiFlex™ Sensor Enabled™ Ablation Catheter from the medical device company, Abbott. It has a few interesting features: electromagnetic sensing of the tip position with an associated computer guidance system using other electrode sensors, an integrated force sensor, a flexible metal tip, integrated fluid irrigation to reduce / control the tip's temperature so that other structures are less likely to be damaged accidentally, and three more integrated electrodes. It also has knob that the doctor can twist to bidirectionally articulate the tip of the catheter.

#1 Computer software allows creation of a realtime 3D map of the ablation catheter's position in relation to the other catheters and what voltages / cardiac signals it is picking up. This allows mapping of areas such as the CTI or cavotricuspid isthmus in the right atrium where atrial flutter (a cardiac arrhthmia) most commonly originates. Other areas include the pulmonary veins as a source for atrial fibrillation, and around the AV node & bundle of HIS for AVNRT (atrioventricular nodal reentry tachycardia).

#2 The force sensor in this catheter is especially cool in design. It uses a simple concept from quantum mechanics: the wave property of light to achieve miniscule measurements on the order of nanometers or less. The tip of the catheter houses a tiny titanium structure containing mirrors that deflects very slightly with application of force. This can be measured using lasers that create an interference pattern caused by overlapping light waves. This is known as a technique called Fabry–Pérot interferometry and light interferometry. This allows the doctor to ensure good contact with the tissue that they wish to burn by applying the appropriate force as they cannot visualize any of what the tip of the catheter is doing directly. This is in conjunction to ultrasound imaging, x-ray fluoroscopy, and the electromagnetic sensing maps created.

#3 The newly designed metal tip is laser cut to have a specific pattern that allows for flexion and acts as a spring to provide better tissue contact.

#4 This catheter is an RF or radiofrequency catheter. It produces high power radio waves of electrical energy that radiate out of its tip. The frequencies typically used are in the hundreds of kilohertz (kHz). This allows for localized heating of nearby tissue that absorb this concentrated radio energy similar in idea to a microwave but with lower frequency waves. The tip itself should remain cool to avoid damaging other unintended structures when being moved after ablating a certain location in the heart. This is measured from a thermocouple near the catheter tip. The tip also should remain cool to prevent boiling of the blood which could lead to a "steam pop". This may lead to production of gas within the circulatory system which could be dangerous to the patient if it is produced in sufficient quantities. If the gas bubble is near enough to sensitive structures such as capillaries or arterioles, it could form an air embolus that blocks normal blood flow to a structure in the body. To prevent these complications and reduce risk, the pictured catheter uses fluid that flows out of holes in tip to cool itself.

www.cardiovascular.abbott/int/en/hcp/products/electrophys...
www.cardiovascular.abbott/int/en/hcp/products/electrophys...
www.cardiovascular.abbott/int/en/hcp/products/electrophys...

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Stereo Viewer for all my photos: jongames.com/stereophoto/

Taken on: August 3, 2024

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