Transoesophageal detection of heart graft rejection by electrical impedance: using Finite Element Method simulations

Abstract

Previous studies have shown that it is possible to evaluate heart graft rejection level using a bioimpedance technique by means of an intracavitary catheter. However, this technique does not present relevant advantages compared to the gold standard for the detection of a heart rejection, which is the biopsy of the endomyocardial tissue. We propose to use a less invasive technique that consists in the use of a transoesophageal catheter and two standard ECG electrodes on the thorax. The aim of this work is to evaluate different parameters affecting the impedance measurement, including: sensitivity to electrical conductivity and permittivity of different organs in the thorax, lung edema and pleural water. From these results, we deduce the best estimator for cardiac rejection detection, and we obtain the tools to identify possible cases of false positive of heart rejection due to other factors. To achieve these objectives we have created a thoracic model and we have simulated, with a FEM program, different situations at the frequencies of 13, 30, 100, 300 and 1000 kHz. Our simulation demonstrates that the phase, at 100 and 300 kHz, has the higher sensitivity to changes in the electrical parameters of the heart muscle.