Electrocardiology Modeling After Catheter Ablations for Atrial Fibrillation.

Catheter-based cardiac ablation, such as radiofrequency ablation (RFA) and pulsed electric field ablation (PFA), is the treatment of choice for atrial fibrillation (AF). However, the underlying phenomena and differences between RFA and PFA are not well understood. In this paper, we propose mathematical modeling of the cardiac electric signal of a cardiac domain containing an ablated area by RFA or PFA. Both types of ablation consist of the isolation of the pulmonary vein, but we describe them differently by using appropriate transmission conditions. More specifically, we assume that in the case of RFA, both intracellular and extracellular potentials are affected, leading to Kedem-Katchalsky type conditions at the interface. In contrast, in the case of PFA, we assume an isolation of the intracellular potential (due to the cardiomyocytes death induced by electroporation) whereas the extracellular potential is continuous. Numerical simulations in a context of AF show that PFA and RFA lead to isolation of the pulmonary vein. Our modeling also enables to propose a numerical explanation for the higher rate of fibrillation recurrence after RFA compared with PFA.