1. Intracardiac radiofrequency ablation in living swine guided by polarization-sensitive optical coherence tomography
- Author
-
Colin Blumenthal, Xiaowei Zhao, Christopher S. Snyder, Orhan U Kilinc, Mauricio Arruda, Michael W. Jenkins, Deniz Dosluoglu, and Andrew M. Rollins
- Subjects
Paper ,medicine.medical_specialty ,Swine ,Radiofrequency ablation ,medicine.medical_treatment ,Biomedical Engineering ,01 natural sciences ,Intracardiac injection ,Imaging ,Pulmonary vein ,law.invention ,010309 optics ,Biomaterials ,Lesion ,cardiac arrhythmia ,Optical coherence tomography ,law ,0103 physical sciences ,medicine ,Animals ,Heart Atria ,polarization-sensitive optical coherence tomography ,Radiofrequency Ablation ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,medicine.disease ,Ablation ,Atomic and Molecular Physics, and Optics ,Electronic, Optical and Magnetic Materials ,Catheter ,surgical procedures, operative ,Pulmonary Veins ,Catheter Ablation ,Radiology ,medicine.symptom ,business ,Tomography, Optical Coherence - Abstract
Significance: Pulmonary vein isolation with catheter-based radiofrequency ablation (RFA) is carried out frequently to treat atrial fibrillation. However, RFA lesion creation is only guided by indirect information (e.g., temperature, impedance, and contact force), which may result in poor lesion quality (e.g., nontransmural) and can lead to reoccurrence or complications. Aim: The feasibility of guiding intracardiac RFA with an integrated polarization-sensitive optical coherence tomography (PSOCT)-RFA catheter in the right atria (RA) of living swine is demonstrated. Approach: In total, 12 sparse lesions were created in the RA of three living swine using an integrated PSOCT-RFA catheter with standard ablation protocol. PSOCT images were displayed in real time to guide catheter-tissue apposition. After experiments, post-processed PSOCT images were analyzed to assess lesion quality and were compared with triphenyltetrazolium chloride (TTC) lesion quality analysis. Results: Five successful lesions identified with PSOCT images were all confirmed by TTC analysis. In two ablations, PSOCT imaging detected gas bubble formation, indicating overtreatment. Unsuccessful lesions observed with PSOCT imaging were confirmed by TTC analysis. Conclusions: The results demonstrate that the PSOCT-RFA catheter provides real-time feedback to guide catheter-tissue apposition, monitor lesion quality, and possibly help avoid complications due to overtreatment, which may enable more effective and safer RFA treatment.
- Published
- 2020