Deming Liang1,2, Dominik Taeschler3, Christine Goepfert4, Patrik Arnold3, Adrian Zurbuchen5, Romy Sweda1, Tobias Reichlin1, Hildegard Tanner1, Laurent Roten1, Andreas Haeberlin1,2,5,6. 1. Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 2. ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland. 3. HuCE - optoLab, Bern University of Applied Sciences, Biel, Switzerland. 4. COMPATH, Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. 5. SITEM - Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland. 6. Department of Cardiology, Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac, France.
Abstract
BACKGROUND: Radiofrequency catheter ablation (RFA) is an effective treatment for atrial fibrillation. However, ablation lesions are usually only assessed functionally. The immediate effect of RFA on the tissue is not directly visualized. Optical coherence tomography (OCT) is an imaging technique that uses light to capture high-resolution images with histology-like quality. Therefore, it might be used for high-precision imaging of ablation lesions. METHODS AND RESULTS: Radiofrequency ablation lesions (n = 25) were produced on the freshly excised left and right ventricular porcine endocardium. A Thermocool ST SF NAV ablation catheter (Biosense Webster Inc) and an EP-Shuttle ablation generator (Stockert GmbH) were used to produce ablation lesions with powers from 10 to 40 W (energies ranging from 100 Ws to 900 Ws). After ablation, the tissue was imaged with a swept source OCT system (at a wavelength of 1300 nm). Subsequently, the ablation lesions underwent the histological analysis. The ablation lesions could be visualized by OCT in all 17 samples with ablation powers ≥20 W, meanwhile, no lesion could be observed in the other eight samples with lower power (10 W). Lesion depths and lesion radiuses, as assessed by OCT, correlated well with those observed on the subsequent histological analysis (Spearman's r = 0.94, P < 0.001 and r = 0.84, P < 0.001). In addition, successful three-dimensional reconstructions of ablation lesions were performed. CONCLUSION: OCT can provide a visual high-resolution assessment of ablation lesions.
BACKGROUND: Radiofrequency catheter ablation (RFA) is an effective treatment for atrial fibrillation. However, ablation lesions are usually only assessed functionally. The immediate effect of RFA on the tissue is not directly visualized. Optical coherence tomography (OCT) is an imaging technique that uses light to capture high-resolution images with histology-like quality. Therefore, it might be used for high-precision imaging of ablation lesions. METHODS AND RESULTS: Radiofrequency ablation lesions (n = 25) were produced on the freshly excised left and right ventricular porcine endocardium. A Thermocool ST SF NAV ablation catheter (Biosense Webster Inc) and an EP-Shuttle ablation generator (Stockert GmbH) were used to produce ablation lesions with powers from 10 to 40 W (energies ranging from 100 Ws to 900 Ws). After ablation, the tissue was imaged with a swept source OCT system (at a wavelength of 1300 nm). Subsequently, the ablation lesions underwent the histological analysis. The ablation lesions could be visualized by OCT in all 17 samples with ablation powers ≥20 W, meanwhile, no lesion could be observed in the other eight samples with lower power (10 W). Lesion depths and lesion radiuses, as assessed by OCT, correlated well with those observed on the subsequent histological analysis (Spearman's r = 0.94, P < 0.001 and r = 0.84, P < 0.001). In addition, successful three-dimensional reconstructions of ablation lesions were performed. CONCLUSION: OCT can provide a visual high-resolution assessment of ablation lesions.
Authors: Sophinese Iskander-Rizk; Pieter Kruizinga; Robert Beurskens; Geert Springeling; Frits Mastik; Natasja M S de Groot; Paul Knops; Antonius F W van der Steen; Gijs van Soest Journal: Photoacoustics Date: 2019-11-30