Thanks to the CANTAS (Computer Assisted Non-Thermal Ablation System) project, the main beneficiary of which is the International Clinical Research Centre of St. Anne’s University Hospital in Brno (FNUSA-ICRC), a successful contact between St. Anne’s University Hospital in Brno and the French Ecole Centrale de Nantes has been established. Exchanges, mutual training and technical training of the analytical systems were carried out.
Dr. Guido Caluori from FNUSA-ICRC presented the long-term goal of integrating the predictive digital twin model into 3D EAM systems and making it a tool of common use for physicians in dealing with cardiac arrhythmia ablation. This integration would provide surgeons with increased confidence when combining radiofrequency ablation with thermal energy or pulsed electric field (PEF).
In 2020, an experimental setup was implemented to measure the acute effects of irreversible electroporation in cardiac tissue. A voltage-dependent decrease in impedance was successfully observed without a significant change in temperature at the contact area, suggesting that the PEF ablation performed was not thermal and that impedance is indeed a potential marker of energy titration for sustained lesion formation. Immunohistochemistry showed several autolytic, necrotic, and staurosporine-induced apoptotic lesions labeled with the selected antibody for Caspase3.
Using cardiac magnetic resonance imaging, several geometry extraction protocols (manual and semi-automated) were developed, on which local biophysical features were applied according to the presence of fibrosis, in order to create a tailored “digital twin” of the patient for therapy testing. Dr. Caluori prepared, with French partners, a numerical simulation of specific twins from left atrial scans with simplified geometry; he implemented the model account using an existing anatomical atlas to personalize and parameterize the model, for tissue orientation and dishomogenicity.
In 2020-2021, joint face-to-face encounters were limited due to travel restrictions. However, the work has not stopped after the end of the project and a joint grant application to Horizon Europe is already in the pipeline this year.