Novel catheter enabling simultaneous radiofrequency ablation and optical coherence reflectometry

Herranz, David; Lloret, Juan Bautista Martí; Jiménez‐Valero, Santiago; Rubio-Guivernau, José L.; Margallo-Balbás, Eduardo

doi:10.1364/boe.6.003268

Cited by 33 publications

(25 citation statements)

References 18 publications

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“…Other optical approaches have been suggested as potential means to enable RFA ablation guidance. One of such promising techniques is optical coherence tomography . While OCT can inherently reveal lesion depth, it can only measure structural changes and does not acquire any functional information about cellular viability within the lesion.…”

Section: Discussionmentioning

confidence: 99%

Autofluorescence hyperspectral imaging of radiofrequency ablation lesions in porcine cardiac tissue

et al. 2016

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Radiofrequency ablation (RFA) is a widely used treatment for atrial fibrillation, the most common cardiac arrhythmia. Here, we explore autofluorescence hyperspectral imaging (aHSI) as a method to visualize RFA lesions and interlesional gaps in the highly collagenous left atrium. RFA lesions made on the endocardial surface of freshly excised porcine left atrial tissue were illuminated by UV light (365 nm), and hyperspectral datacubes were acquired over the visible range (420–720 nm). Linear unmixing was used to delineate RFA lesions from surrounding tissue, and lesion diameters derived from unmixed component images were quantitatively compared to gross pathology. RFA caused two consistent changes in the autofluorescence emission profile: a decrease at wavelengths below 490 nm (ascribed to a loss of endogenous NADH) and an increase at wavelengths above 490 nm (ascribed to increased scattering). These spectral changes enabled high resolution, in situ delineation of RFA lesion boundaries without the need for additional staining or exogenous markers. Our results confirm the feasibility of using aHSI to visualize RFA lesions at clinically relevant locations. If integrated into a percutaneous visualization catheter, aHSI would enable widefield optical surgical guidance during RFA procedures and could improve patient outcome by reducing atrial fibrillation recurrence.

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Section: Discussionmentioning

confidence: 99%

Autofluorescence hyperspectral imaging of radiofrequency ablation lesions in porcine cardiac tissue

et al. 2016

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“…Several groups have proposed optical methods for evaluating acute thermal injury immediately following radiofrequency (RF) treatment. In ventricular tissue, direct visualization of the myocardium by optical coherence tomography (OCT) has been shown to reliably discriminate between ablated, necrotic tissue and untreated tissue . However, the inherent depth limitation of OCT (<1 mm in cardiac tissue) renders the technique unsuitable for lesion transmurality assessment.…”

Section: Introductionmentioning

confidence: 99%

Real‐time optical spectroscopic monitoring of nonirrigated lesion progression within atrial and ventricular tissues

Singh‐Moon

Yao

Iyer

et al. 2018

Journal of Biophotonics

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Despite considerable advances in guidance of radiofrequency ablation (RFA) therapy for the treatment of cardiac arrhythmias, success rates have been hampered by a lack of tools for precise intraoperative evaluation of lesion extent. Near-infrared spectroscopic (NIRS) techniques are sensitive to tissue structural and biomolecular properties, characteristics that are directly altered by RF treatment. In this work, a combined NIRS-RFA catheter is developed for real-time monitoring of tissue reflectance during RF energy delivery. An algorithm is proposed for processing NIR spectra to approximate non-irrigated lesion depth in both atrial and ventricular tissues. The probe optical geometry was designed to bias measurement influence toward absorption enabling enhanced sensitivity to changes in tissue composition. A set of parameters termed "lesion optical indices" are defined encapsulating spectral differences between ablated and unablated tissue. Utilizing these features, a model for real-time tissue spectra classification and lesion size estimation is presented. Experimental validation conducted within freshly excised porcine cardiac specimens showed strong concordance between algorithm estimates and post-hoc tissue assessment. This article is protected by copyright. All rights reserved.

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“…Work on the development of a hybrid catheter as well as the combining of an RFA catheter with a forward-viewing OCT system is currently being performed by different groups. 30,31 This modality has the ability to monitor lesion formation in real time.…”

Section: Discussionmentioning

confidence: 99%

Imaging of Atrioventricular Nodal Conduction Tissue in Porcine Hearts Using Optical Coherence Tomography

Kilinc

Zhao

Jenkins

et al. 2019

J Innov Cardiac Rhythm Manage.

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Optical coherence tomography (OCT) employs near-infrared light to image the microstructure of different tissues. Clinically, it has been used to image the walls of coronary arteries. In research settings, one of the applications for OCT is visualizing endocardial and subendocardial structures. The present experiment sought to determine whether OCT can identify native conduction tissues in adult porcine hearts. During the study, the right atrial endocardial surfaces of excised adult porcine hearts were exposed. The triangle of Koch was imaged with the OCT system and the conduction tissue was identified. The area was then prepared for histologic examination with Masson's trichrome stain. The results of histologic preparations and OCT images were then compared. Ultimately, nine porcine hearts were examined using this methodology. OCT imaging successfully identified subendocardial structures presumed to be the compact atrioventricular node. Histologic images of the preparations delineated the different tissue types and conduction tissue was easily identified. The location of distinctive hyporeflective areas in the OCT images correlated with the location of conduction tissue in the histology images. In light of the findings of this study, it is suggested that atrioventricular nodal tissue can be identified by OCT in freshly dissected unfixed porcine hearts. OCT images distinguished the differentiated conduction tissue in close proximity with the endocardium, myofibers, and fibrous tissue, and the success of this was verified with histology. This technology may be useful for the direct visualization of the native conduction system during procedures in the operating room and electrophysiology laboratory. Further studies with perfused tissue samples and live animal experiments are needed to better assess the efficacy of this novel application.

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Novel catheter enabling simultaneous radiofrequency ablation and optical coherence reflectometry

Cited by 33 publications

References 18 publications

Autofluorescence hyperspectral imaging of radiofrequency ablation lesions in porcine cardiac tissue

Autofluorescence hyperspectral imaging of radiofrequency ablation lesions in porcine cardiac tissue

Real‐time optical spectroscopic monitoring of nonirrigated lesion progression within atrial and ventricular tissues

Imaging of Atrioventricular Nodal Conduction Tissue in Porcine Hearts Using Optical Coherence Tomography

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