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Biophysikalische Grundlagen der Radiofrequenzkatheterablation

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Interventionelle kardiale Elektrophysiologie

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Zusammenfassung

Der Begriff Radiofrequenz bezieht sich auf einen Wechselstrombereich zwischen 30 kHz und 300 MHz (DIN-Norm 40015; Reidenbach 1983). Prinzipiell kann Wechselstrom auf 3 verschiedene Arten auf Gewebe wirken: faradisch, elektrolytisch und thermisch. Beim faradischen Effekt ist die elektrische Erregbarkeit von Zellen, z. B. kardialer oder neuronaler Zellen, entscheidend. Der elektrolytische Effekt beruht auf der Ausrichtung der Ionen, entsprechend ihrer Ladung im Gleichstromfeld. Beide Effekte spielen bei Wechselstromfrequenzen oberhalb von 300 kHz keine Rolle, insbesondere fehlt die depolarisierende Wirkung der Wechselströme (Reth 1986). Damit kommt es nicht zu schmerzhaften Muskelkontraktionen und eine Allgemeinnarkose ist im Vergleich zur Gleichstromanwendung nicht notwendig. Die entscheidende Wirkung von Radiofrequenzstrom im Bereich von 350 bis 750 kHz, wie er für die Ablation kardialer Arrhythmien eingesetzt wird, beruht auf dem thermischen Effekt (Reidenbach 1983). Das Prinzip der Wärmeentstehung bei der Anwendung von hochfrequentem Strom auf Gewebe kommt in der Chirurgie seit mehr als 30 Jahren in Form des Elektrokauterns zum Einsatz. Weiterhin findet dieses Therapieprinzip in der Neurochirurgie bei stereotaktischen Eingriffen und in der Urologie zur transurethralen Prostataresektion Anwendung (Zervas u. Kuwayama 1972). Für die Katheterablation kardialer Arrhythmien wird ein unmodulierter sinusförmiger Strom verwendet, während bei den elektrochirurgischen Systemen zum elektrischen Schneiden und Koagulieren Systeme mit sehr viel höheren Spannungen, modulierten Strömen und kurzer intermittierender Impulsabgabe eingesetzt werden.

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Authors
  1. E. Hoffmann
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Editors and Affiliations

  1. Med. Klinik und Poliklinik I der LMU, Klinikum Großhadern, Marchioninistraße 15, D-81377, München, Germany

    Ellen Hoffmann  & Gerhard Steinbeck  & 

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© 1999 Springer-Verlag Berlin Heidelberg

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Hoffmann, E. (1999). Biophysikalische Grundlagen der Radiofrequenzkatheterablation. In: Hoffmann, E., Steinbeck, G. (eds) Interventionelle kardiale Elektrophysiologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58522-7_5

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  • DOI: https://doi.org/10.1007/978-3-642-58522-7_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63630-1

  • Online ISBN: 978-3-642-58522-7

  • eBook Packages: Springer Book Archive

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