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Boston Scientific — Technical Presentation (2003)

15 slides from Boston Scientific's technical presentation, 2003

  1. Slide 1: Ablation Concepts Using the EPT-1000TC Generator

    Ablation Concepts Using the EPT-1000TC™ Generator Copyright ©2003 by Boston Scientific or its affiliates. All rights reserved. EPT-10038_09/01

  2. Slide 2: Ablation Concepts: What is Radio Frequency (RF) energy?

    Ablation Concepts • What is Radio Frequency (RF) energy?  A form of alternating current (AC)  Similar to a wall socket but at a much higher frequency (500,000 Hz vs. 60 Hz)  Ideal energy form for ablation because it heats tissue but does not cause muscle stimulation Copyright ©2003 by Boston Scie

  3. Slide 3: What is the goal of an RF ablation?

    What is the goal of an RF ablation? • To turn electrically active tissue into electrically unexcitable tissue  Generate sufficient heat to cause thermal injury  When tissue temperature is elevated beyond 45oC cells are vulnerable to irreversible damage Copyright ©2003 by Boston Scientific or its a

  4. Slide 4: Ablation Concepts: Heat is a form of energy

    Ablation Concepts • Heat is a form of energy  Z = impedance (sometimes referred to as resistance or R)  V = voltage (a potential created between opposite charges)  I = current (the flow of electrical charge)  Energy = (power) (time). For ablation, we want to deliver lots of energy quickly -- but

  5. Slide 5: Ablation Concepts: Applying power through the generator

    Ablation Concepts • When we apply power (watts) through the generator:  Electrons will flow easily within the catheter and cable to the ground pad (very low impedance along metal structures)  Between the catheter tip and the ground pad, charge build up causes an electric potential or voltage  Thi

  6. Slide 6: Ablation Concepts: Critical Circuit

    Ablation Concepts • Critical Circuit Copyright ©2003 by Boston Scientific or its affiliates. All rights reserved. EPT-10038_09/01

  7. Slide 7: Energy Flow During Ablation

    Ablation Concepts Energy Flow During Ablation • Ratio of RF energy  Tissue vs. Blood  Determined by tip contact  No contact with tissue means all RF energy is going to blood = no tissue heating = no lesion • Good contact angle is critical to lesion growth Copyright ©2003 by Boston Scientific or i

  8. Slide 8: Ablation Concepts: Energy flows to tissue and blood

    Ablation Concepts Energy flows to both tissue and blood TIP BLOOD BLOOD TISSUE TISSUE Copyright ©2003 by Boston Scientific or its affiliates. All rights reserved. EPT-10038_09/01

  9. Slide 9: Ablation Concepts: Lesion formation

    Ablation Concepts Lesion formation • Lesion size is determined by many factors: – Tip electrode length (4mm or >) – Tip electrode diameter (Fr size) – Power (watts) available to ablate Copyright ©2003 by Boston Scientific or its affiliates. All rights reserved. EPT-10038_09/01

  10. Slide 10: Lesion Formation

    Lesion Formation Copyright ©2003 by Boston Scientific or its affiliates. All rights reserved. EPT-10038_09/01

  11. Slide 11: Lesion Formation

    Lesion Formation • Two major forces at tissue/electrode interface:  Conduction = the transfer of heat from shallow tissue to deeper tissue and from tissue to electrode tip  Convection = the cooling effects from the local blood pool • Lesion size is determined mostly by how much heat is transferred

  12. Slide 12: Lesion Formation

    Lesion Formation BLOOD TIP BLOOD LESION HOTTEST SPOT TISSUE Copyright ©2003 by Boston Scientific or its affiliates. All rights reserved. EPT-10038_09/01

  13. Slide 13: Coagulum Formation

    Coagulum Formation • Coagulum is a “film of coagulated blood” covering the electrode tip • This high temperature causes the blood serum proteins to denature & coagulum forms on the tip • A sudden sharp rise in impedance follows excessive coagulum formation • In ANY system, there can be up to a 20 de

  14. Slide 14: Thrombus Formation

    Thrombus Formation • Thrombus may be used to describe coagulum but they are 2 different events • Coagulum is generally used to describe a “film” covering the electrode tip • Thrombus is also a clotting of blood but is found along the catheter body and can result from:  Using too large of an introdu

  15. Slide 15: Charring and Popping

    Charring and Popping • Charring occurs when voltage levels get too high It is not good because char could break off as  embolic debris in bloodstream • Popping occurs when tissue temperatures exceed 100 degrees C and steam is produced within tissue  Clinical ramifications of emboli, perforations •

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