Improved Ablation Efficiency in PVI Guided by Contact Force and Local Impedance: Chronic Canine Model

Background: The purpose of this study was to assess the effect local impedance (LI) has on an ablation workflow when combined with a contact force (CF) ablation catheter.Methods: Left pulmonary vein isolation was performed in an in vivo canine model (N = 8) using a nominal (30 W) or an elevated (50 W) power strategy with a CF catheter. The catheter was enabled to measure LI prior to and during ablation. LI was visible for only one of the vein isolations.Results: Chronic block was achieved in all animals when assessed 30 ± 5 days post-ablation procedure with a median LI drop during RF ranging from 23.0 to 34.0 Ω. In both power cohorts, the median radiofrequency (RF) duration decreased if LI was visible to the operator (30 W only CF: 17.0 s; 30 W CF + LI: 14.0 s, p = 0.009; 50 W only CF: 6.0 s; 50 W CF + LI: 4.0 s, p = 0.019). An inverse relationship between the LI prior to RF delivery and the RF duration required to achieve an effective lesion was observed. There was no correlation between the magnitude of the applied force and the drop in LI, once at least 5 g was achieved.Conclusions: An elevated power strategy with the context of CF and LI led to the most efficient titration of successful RF energy delivery. The combination of feedback allows for customization of the ablation strategy based on local tissue variation rather than a uniform approach that could potentially lead to overtreatment. Higher LI drops were more readily achievable when an elevated power strategy was utilized, especially in conditions where the catheter was coupled against tissue with low resistivity. Clinical study is warranted to determine if there is an additive safety benefit to visualizing the dynamics of the tissue response to RF energy with LI when an elevated power strategy is used.

A nanosecond pulsed discharge circuit model for engine applications

Non-equilibrium plasma discharges in spark gaps have been an increasingly studied method for alleviating cycle to cycle variation in lean and dilute combustion environments. However, ignition models that account for streamer propagation, cathode fall, and transmission line amplification over nanosecond time scales have so far not been developed. The present study develops such a model, with emphasis on the energy delivered from circuit to cylinder. Key pieces of the relevant physics and chemistry are summarized, simplified, and systematically coupled to one another. The set of parameters is limited to a handful of key observables and modeled using Modelica. Results show non-trivial behavior in the energy delivery characteristics of such discharges with important implications for ignition.

Hybrid Photovoltaic/Thermal (PVT) Collector Systems With Different Absorber Configurations For Thermal Management – A Review

Thermal management in hybrid Photovoltaic/Thermal (PVT) collectors is essential to derive electrical and thermal energy from a single system. Effective removal of heat gained by the photovoltaic module during its operation is possible with a proper thermal absorber design. Hence, thermal absorber design has gained prominence, and various design techniques were attempted in the literature to enhance energy delivery among different stakeholders. Most research groups tried to design absorber configurations attached to the PV panel's front or rear side. Absorber design configurations include various channel materials and geometry as well as other physical parameter combinations. The quantitative thermal energy delivery from the system could vary based on the absorber configuration and be useful for different applications. This study reports a detailed review to understand the relation between thermal absorber design configurations and the potential energy recovery from PVT systems. This study helps the designers identify channel designs, materials, and adequate working fluids for enhanced heat transfer to anticipate better thermal management of PVT systems. Challenges and suggestions to develop state of the art thermal absorber designs for relative commercial thermal applications using PVT systems are conveyed.

671 First-in-man mapping and ablation of ventricular tachycardia using a novel ablation catheter with microelectrodes and thermocouples

Aims Catheter ablation (CA) is an important therapeutic option for patients with recurrent ventricular tachycardia (VT). Recently, a novel contact-force sensing catheter (QDOT, Biosense Webster) allowing radiofrequency ablation in a temperature-controlled fashion, equipped with microelectrodes and thermocouples has been developed and tested in very-high power short duration CA of atrial fibrillation. As of today, this catheter has never been used for VT ablation. To describe the safety and short-term clinical performance of the novel QDOT catheter for the ablation of recurrent VT/electrical storm. Methods and results Case 1: a 43-year-old male patient with prior anterior myocardial infarction (MI), left ventricular (LV) dysfunction with an apical aneurysm, and recurrent VT episodes was admitted to our hospital for CA of VT. The patient underwent high-density electroanatomical mapping of the left ventricle using a multipolar catheter (PentaRay, Biosense Webster), which showed an extensive apical dense scar region, corresponding to the ventricular aneurysm. When the QDOT catheter was advanced in that region, late/fragmented potentials were detected by microelectrodes as well as by conventional electrodes. During the procedure, a sustained VT with right bundle branch block (RBBB)-inferior axis morphology and transition in V2 could be induced. We recorder diastolic fragmented potentials inside the aneurysm, where the novel catheter previously showed late/fragmented potentials; radiofrequency energy delivery with conventional settings (40 W) in that area led to rapid arrhythmia termination (Figure A). At the end of the procedure, VTs were no more inducible. Case 2: a 79-year-old male patient with prior inferior MI, mild LV dysfunction with a 5 cm × 5 cm × 3 cm aneurysm of the basal-mid inferior wall, and two previous CAs for recurrent VT presented to our hospital for electrical storm due to multiple episodes of slow VT (cycle, 470 ms, RBBB morphology, inferior axis, transition in V6), which were refractory to antiarrhythmic drug treatment. We decided to perform redo CA using the QDOT catheter, which revealed long and fragmented low-amplitude diastolic potentials inside the LV aneurysm (Figure B). VT was rapidly terminated by means of radiofrequency energy delivery with usual settings (40 W) in this region, and was no more inducible afterwards. Conclusions The novel ablation catheter showed favourable manoeuverability in the ventricle, while also allowing a precise characterization of the tachycardia circuitry and of the arrhythmogenic myocardial substrate, which was enhanced by the availability of microelectrodes. We believe that this preliminary experience may pave the way for further assessments of this new technology in the so far unexplored ventricular milieu.

A comparative review of artificial muscles for microsystem applications

Artificial muscles are capable of generating actuation in microsystems with outstanding compliance. Recent years have witnessed a growing academic interest in artificial muscles and their application in many areas, such as soft robotics and biomedical devices. This paper aims to provide a comparative review of recent advances in artificial muscle based on various operating mechanisms. The advantages and limitations of each operating mechanism are analyzed and compared. According to the unique application requirements and electrical and mechanical properties of the muscle types, we suggest suitable artificial muscle mechanisms for specific microsystem applications. Finally, we discuss potential strategies for energy delivery, conversion, and storage to promote the energy autonomy of microrobotic systems at a system level.