A family of intracardiac ultrasound imaging devices designed for guidance of electrophysiology ablation procedures

Sahn, David J.; Stephens, Douglas N.; Cannata, J.M.; Shung, K. Kirk; Oralkan, Ömer; Nikoozadeh, Amin; Khuri‐Yakub, Butrus T.; Nguyen, H; Chen, Peter; Dentinger, Aaron; Wildes, Douglas; Thomenius, Kai E.; Mahajan, Aman; Shivkumar, Kalyanam; O’Donnell, Matthew

doi:10.1109/iembs.2009.5332380

Cited by 3 publications

(3 citation statements)

References 18 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The smaller imaging depth caused by higher frequencies is not restrictive for catheter-based ablation (e.g., RF ablation). For example, a “MicroLinear” catheter using a 24-element, 14 MHz phased array with integrated RF probe has been reported for forward looking imaging to detect ablation using changes in strain rate (Sahn et al 2009). Most recently, a proof-of-concept catheter system has been developed that combines an ultrasound transducer (25–33 MHz) with RF ablation electrode to allow for real-time M-mode monitoring of lesion formation at 20 Hz line rate (Wright et al 2011).…”

Section: Discussionmentioning

confidence: 99%

High-Frequency Ultrasound M-Mode Imaging for Identifying Lesion and Bubble Activity During High-Intensity Focused Ultrasound Ablation

Kumon¹,

Gudur²,

Zhou³

et al. 2012

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

Effective real-time monitoring of high-intensity focused ultrasound (HIFU) ablation is important for application of HIFU technology in interventional electrophysiology. This study investigated rapid, high-frequency M-mode ultrasound imaging for monitoring spatiotemporal changes during HIFU application. HIFU (4.33 MHz, 1 kHz PRF, 50% duty cycle, 1 s, 2600 – 6100 W/cm2) was applied to ex-vivo porcine cardiac tissue specimens with a confocally and perpendicularly aligned high-frequency imaging system (Visualsonics Vevo 770, 55 MHz center frequency). Radiofrequency (RF) data from M-mode imaging (1 kHz PRF, 2 s × 7 mm) was acquired before, during, and after HIFU treatment (n = 12). Among several strategies, the temporal maximum integrated backscatter with a threshold of +12 dB change showed the best results for identifying final lesion width (receiver-operating characteristic curve area 0.91 ± 0.04, accuracy 85 ± 8%, as compared to macroscopic images of lesions). A criterion based on a line-to-line decorrelation coefficient is proposed for identification of transient gas bodies.

show abstract

Section: Discussionmentioning

confidence: 99%

High-Frequency Ultrasound M-Mode Imaging for Identifying Lesion and Bubble Activity During High-Intensity Focused Ultrasound Ablation

Kumon¹,

Gudur²,

Zhou³

et al. 2012

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

show abstract

“…The first generation of ML‐PZT catheters had 9F catheter shafts and rather large 15F tip enclosures 41 . With a similar early history, the current second‐generation ML‐CMUT prototype catheter is now much smaller than the first‐generation catheter with improved steerability, although we encountered catheter shaft kinking in 1 of the 5 catheters used, which restricted intracardiac maneuverability.…”

Section: Resultsmentioning

confidence: 92%

First In Vivo Use of a Capacitive Micromachined Ultrasound Transducer Array–Based Imaging and Ablation Catheter

Stephens¹,

Truong²,

Nikoozadeh³

et al. 2012

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives The primary objective was to test in vivo for the first time the general operation of a new multifunctional intracardiac echocardiography (ICE) catheter constructed with a microlinear capacitive micromachined ultrasound transducer (ML-CMUT) imaging array. Secondarily, we examined the compatibility of this catheter with electroanatomic mapping (EAM) guidance and also as a radiofrequency ablation (RFA) catheter. Preliminary thermal strain imaging (TSI)-derived temperature data were obtained from within the endocardium simultaneously during RFA to show the feasibility of direct ablation guidance procedures. Methods The new 9F forward-looking ICE catheter was constructed with 3 complementary technologies: a CMUT imaging array with a custom electronic array buffer, catheter surface electrodes for EAM guidance, and a special ablation tip, that permits simultaneous TSI and RFA. In vivo imaging studies of 5 anesthetized porcine models with 5 CMUT catheters were performed. Results The ML-CMUT ICE catheter provided high-resolution real-time wideband 2-dimensional (2D) images at greater than 8 MHz and is capable of both RFA and EAM guidance. Although the 24-element array aperture dimension is only 1.5 mm, the imaging depth of penetration is greater than 30 mm. The specially designed ultrasound-compatible metalized plastic tip allowed simultaneous imaging during ablation and direct acquisition of TSI data for tissue ablation temperatures. Postprocessing analysis showed a first-order correlation between TSI and temperature, permitting early development temperature-time relationships at specific myocardial ablation sites. Conclusions Multifunctional forward-looking ML-CMUT ICE catheters, with simultaneous intracardiac guidance, ultrasound imaging, and RFA, may offer a new means to improve interventional ablation procedures.

show abstract

“…Although with shorter penetration depth, high-frequency ultrasound imaging can be particularly useful for catheter-based ablation such as applications for interventional cardiology. A "MicroLinear" catheter using a 24-element, 14 MHz phased array with integrated RF ablation probe has been reported for forward-looking imaging [46]. Real-time proof-of-concept catheter system [47].…”

Section: Introductionmentioning

confidence: 99%

High-frequency rapid B-mode ultrasound imaging for real-time monitoring of lesion formation and gas body activity during high-intensity focused ultrasound ablation

Gudur

Kumon

Zhou

et al. 2012

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

View full text Add to dashboard Cite

The goal of this study was to examine the ability of high-frame-rate, high-resolution imaging to monitor tissue necrosis and gas-body activities formed during high-intensity focused ultrasound (HIFU) application. Ex vivo porcine cardiac tissue specimens (n = 24) were treated with HIFU exposure (4.33 MHz, 77 to 130 Hz pulse repetition frequency (PRF), 25 to 50% duty cycle, 0.2 to 1 s, 2600 W/cm(2)). RF data from B-mode ultrasound imaging were obtained before, during, and after HIFU exposure at a frame rate ranging from 77 to 130 Hz using an ultrasound imaging system with a center frequency of 55 MHz. The time history of changes in the integrated backscatter (IBS), calibrated spectral parameters, and echo-decorrelation parameters of the RF data were assessed for lesion identification by comparison against gross sections. Temporal maximum IBS with +12 dB threshold achieved the best identification with a receiver-operating characteristic (ROC) curve area of 0.96. Frame-to-frame echo decorrelation identified and tracked transient gas-body activities. Macroscopic (millimeter-sized) cavities formed when the estimated initial expansion rate of gas bodies (rate of expansion in lateral-to-beam direction) crossed 0.8 mm/s. Together, these assessments provide a method for monitoring spatiotemporal evolution of lesion and gas-body activity and for predicting macroscopic cavity formation.

show abstract

A family of intracardiac ultrasound imaging devices designed for guidance of electrophysiology ablation procedures

Cited by 3 publications

References 18 publications

High-Frequency Ultrasound M-Mode Imaging for Identifying Lesion and Bubble Activity During High-Intensity Focused Ultrasound Ablation

High-Frequency Ultrasound M-Mode Imaging for Identifying Lesion and Bubble Activity During High-Intensity Focused Ultrasound Ablation

First In Vivo Use of a Capacitive Micromachined Ultrasound Transducer Array–Based Imaging and Ablation Catheter

High-frequency rapid B-mode ultrasound imaging for real-time monitoring of lesion formation and gas body activity during high-intensity focused ultrasound ablation

Contact Info

Product

Resources

About