BACKGROUND: Visual confirmation of radiofrequency ablation (RFA) lesions during clinical cardiac ablation procedures could improve procedure efficacy, safety, and efficiency. It was previously shown that acoustic radiation force impulse (ARFI) imaging can identify RFA lesions in vitro and in vivo in an animal model. This is the "first-in-human" feasibility demonstration of intracardiac ARFI imaging of RFA lesions in patients undergoing catheter ablation for atrial flutter (AFL) or atrial fibrillation (AF). METHODS AND RESULTS: Patients scheduled for right atrial (RA) ablation for AFL or left atrial (LA) ablation for drug refractory AF were eligible for imaging. Diastole-gated intracardiac ARFI images were acquired using one of two equipment configurations: (1) a Siemens ACUSON S2000™ ultrasound scanner and 8/10Fr AcuNav™ ultrasound catheter, or (2) a CARTO 3™ integrated Siemens SC2000™ and 10Fr SoundStar™ ultrasound catheter. A total of 11 patients (AFL = 3; AF = 8) were imaged. ARFI images were acquired of ablation target regions, including the RA cavotricuspid isthmus (CTI), and the LA roof, pulmonary vein ostia, posterior wall, posterior mitral valve annulus, and the ridge between the pulmonary vein and LA appendage. ARFI images revealed increased relative myocardial stiffness at ablation catheter contact sites after RFA and at anatomical mapping-tagged RFA treatment sites. CONCLUSIONS: ARFI images from a pilot group of patients undergoing catheter ablation for AFL and AF demonstrate the ability of this technique to identify intra-procedure RFA lesion formation. The results encourage further refinement of ARFI imaging clinical tools and continued investigation in larger clinical trials.
BACKGROUND: Visual confirmation of radiofrequency ablation (RFA) lesions during clinical cardiac ablation procedures could improve procedure efficacy, safety, and efficiency. It was previously shown that acoustic radiation force impulse (ARFI) imaging can identify RFA lesions in vitro and in vivo in an animal model. This is the "first-in-human" feasibility demonstration of intracardiac ARFI imaging of RFA lesions in patients undergoing catheter ablation for atrial flutter (AFL) or atrial fibrillation (AF). METHODS AND RESULTS:Patients scheduled for right atrial (RA) ablation for AFL or left atrial (LA) ablation for drug refractory AF were eligible for imaging. Diastole-gated intracardiac ARFI images were acquired using one of two equipment configurations: (1) a Siemens ACUSON S2000™ ultrasound scanner and 8/10Fr AcuNav™ ultrasound catheter, or (2) a CARTO 3™ integrated Siemens SC2000™ and 10Fr SoundStar™ ultrasound catheter. A total of 11 patients (AFL = 3; AF = 8) were imaged. ARFI images were acquired of ablation target regions, including the RA cavotricuspid isthmus (CTI), and the LA roof, pulmonary vein ostia, posterior wall, posterior mitral valve annulus, and the ridge between the pulmonary vein and LA appendage. ARFI images revealed increased relative myocardial stiffness at ablation catheter contact sites after RFA and at anatomical mapping-tagged RFA treatment sites. CONCLUSIONS: ARFI images from a pilot group of patients undergoing catheter ablation for AFL and AF demonstrate the ability of this technique to identify intra-procedure RFA lesion formation. The results encourage further refinement of ARFI imaging clinical tools and continued investigation in larger clinical trials.
Authors: Marc A Miller; Andre d'Avila; Srinivas R Dukkipati; Jacob S Koruth; Juan Viles-Gonzalez; Craig Napolitano; Charles Eggert; Avi Fischer; Joseph A Gomes; Vivek Y Reddy Journal: Europace Date: 2012-03-14 Impact factor: 5.214
Authors: Stephanie A Eyerly; Tristram D Bahnson; Jason I Koontz; David P Bradway; Douglas M Dumont; Gregg E Trahey; Patrick D Wolf Journal: Heart Rhythm Date: 2012-07-03 Impact factor: 6.343
Authors: Gaston R Vergara; Sathya Vijayakumar; Eugene G Kholmovski; Joshua J E Blauer; Mike A Guttman; Christopher Gloschat; Gene Payne; Kamal Vij; Nazem W Akoum; Marcos Daccarett; Christopher J McGann; Rob S Macleod; Nassir F Marrouche Journal: Heart Rhythm Date: 2010-10-27 Impact factor: 6.343
Authors: Ravi Ranjan; Ritsushi Kato; Menekhem M Zviman; Timm M Dickfeld; Ariel Roguin; Ronald D Berger; Gordon F Tomaselli; Henry R Halperin Journal: Circ Arrhythm Electrophysiol Date: 2011-04-14
Authors: Joshua R Doherty; Gregg E Trahey; Kathryn R Nightingale; Mark L Palmeri Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2013-04 Impact factor: 2.725
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: Heart Rhythm Date: 2012-03-01 Impact factor: 6.343
Authors: Vivek Y Reddy; Dipen Shah; Josef Kautzner; Boris Schmidt; Nadir Saoudi; Claudia Herrera; Pierre Jaïs; Gerhard Hindricks; Petr Peichl; Aude Yulzari; Hendrik Lambert; Petr Neuzil; Andrea Natale; Karl-Heinz Kuck Journal: Heart Rhythm Date: 2012-07-20 Impact factor: 6.343
Authors: Vincent Sayseng; Julien Grondin; Vasant A Salgaonkar; Christopher S Grubb; Maryam Basij; Mohammad Mehrmohammadi; Vivek Iyer; Daniel Wang; Hasan Garan; Elaine Y Wan; Elisa E Konofagou Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2020-04-15 Impact factor: 2.725
Authors: Derek Y Chan; D Cody Morris; Thomas J Polascik; Mark L Palmeri; Kathryn R Nightingale Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2021-07-05 Impact factor: 3.267
Authors: Stephanie A Eyerly; Maryam Vejdani-Jahromi; Douglas M Dumont; Gregg E Trahey; Patrick D Wolf Journal: J Cardiovasc Electrophysiol Date: 2015-06-21