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Electrical Impedance Tomography for monitoring cardiac radiofrequency ablation: a scoping review of an emerging technology.
Medical Engineering & Physics ( IF 1.7 ) Pub Date : 2020-08-01 , DOI: 10.1016/j.medengphy.2020.07.025
Duc M Nguyen 1 , Tomas Andersen 2 , Pierre Qian 3 , Tony Barry 3 , Alistair McEwan 2
Affiliation  

Arrhythmias are common cardiac diseases which can be treated effectively by the cardiac radiofrequency ablation (CRFA). However, information regarding the lesion growth within the myocardium is critical to the procedure's safety and efficacy but still unavailable in the current catheterisation lab (CathLab). Over the last 20 years, many efforts have been made in order to track the lesion size during the procedure. Unfortunately, all the approaches have their own limitations preventing them from the clinical translation and hence making the lesion size monitoring during a CRFA still an open issue. Electrical Impedance Tomography (EIT) is an impedance imaging modality that might be able to image the thermal-related impedance changes from which the lesion size can be measured. With the availability of the patient's CT scans, for a detailed model, and the catheter-based electrodes for the internal electrodes, EIT accuracy and sensitivity to the ablated sites can be significantly improved and is worth being explored for this application. Though EIT is still new to CRFA with no in-vivo experiments being done according to our up-to-date searching, many related EIT studies and its extensive research in Hyperthermia and other ablations can reveal many hints for a possibility of the CRFA-EIT application. In this paper, we present a review on multiple aspects of EIT in CRFA. First, the expected CRFA-EIT signal range and frequency are discussed based on various measured impedance results obtained from lesions in the past. Second, the possible noise sources that can happen in a clinical CRFA procedure, along with their signal range and frequency compared to the CRFA-EIT signal, and, third, the available current solutions to separate such noises from the CRFA-EIT signal. Finally, we review the progress of EIT in thermal applications over the last two decades in order to identify the developments that EIT can take advantage of and the current drawbacks that need to be solved for a potential CRFA-EIT application.



中文翻译:

用于监测心脏射频消融的电阻抗断层扫描:一项新兴技术的范围审查。

心律失常是常见的心脏疾病,可通过心脏射频消融术(CRFA)有效治疗。然而,有关心肌内病灶生长的信息对于该程序的安全性和有效性至关重要,但在当前的导管插入实验室 (CathLab) 中仍不可用。在过去的 20 年里,为了在手术过程中跟踪病变大小,已经做出了许多努力。不幸的是,所有方法都有其自身的局限性,阻碍了它们的临床转化,因此使 CRFA 期间的病变大小监测仍然是一个悬而未决的问题。电阻抗断层扫描 (EIT) 是一种阻抗成像模式,它可能能够对热相关的阻抗变化进行成像,从中可以测量病变大小。随着患者 CT 扫描的可用性,对于详细模型,以及用于内部电极的基于导管的电极,EIT 的准确性和对消融部位的灵敏度可以显着提高,值得为此应用进行探索。虽然 EIT 对 CRFA 来说仍然是新手,但没有体内根据我们最新的搜索进行的实验、许多相关的 EIT 研究及其在热疗和其他消融方面的广泛研究可以揭示许多关于 CRFA-EIT 应用可能性的线索。在本文中,我们对 CRFA 中 EIT 的多个方面进行了综述。首先,基于从过去病灶获得的各种测量阻抗结果讨论了预期的 CRFA-EIT 信号范围和频率。其次,临床 CRFA 程序中可能发生的噪声源,以及与 CRFA-EIT 信号相比的信号范围和频率,第三,将此类噪声与 CRFA-EIT 信号分离的可用当前解决方案。最后,

更新日期:2020-08-06
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