Quantitative evaluation of atrial radio frequency ablation using intracardiac shear‐wave elastography

Kwiecinski, Wojciech; Provost, Jean; Dubois, Rémi; Sacher, Frédéric; Haı̈ssaguerre, Michel; Legros, Mathieu; An, Ning; Dufait, R.; Tanter, Mickaël; Pernot, Mathieu

doi:10.1118/1.4896820

Cited by 24 publications

(19 citation statements)

References 62 publications

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“…Other imaging modalities that were explored for ablation lesion monitoring are conventional ultrasound [12][13][14][15] as well as ultrasound elastography [16][17][18]. Visibility of lesions on grayscale ultrasound has been disputed in literature, with contradictory reports of both decrease and increase in echogenicity in lesion areas.…”

Section: Rf Ablation Lesion Imaging In the Literaturementioning

confidence: 99%

“…Elastography, on the other hand, seems more successful at lesion identification and looks quite promising. However, monitoring lesion progression with shear wave elastography is still a challenge due to the estimation of atrial wall curvature for wave propagation progression and the difficulty in aligning the ultrasound beam to the lesion site across the ablation catheter [18].…”

Section: Rf Ablation Lesion Imaging In the Literaturementioning

confidence: 99%

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Spectroscopic photoacoustic imaging of radiofrequency ablation in the left atrium

Iskander-Rizk¹,

Kruizinga²,

Steen³

et al. 2018

Biomed. Opt. Express

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Catheter-based radiofrequency ablation for atrial fibrillation has long-term success in 60-70% of cases. A better assessment of lesion quality, depth, and continuity could improve the procedure's outcome. We investigate here photoacoustic contrast between ablated and healthy atrial-wall tissue in vitro in wavelengths spanning from 410 nm to 1000 nm. We studied single-and multi-wavelength imaging of ablation lesions and we demonstrate that a two-wavelength technique yields precise detection of lesions, achieving a diagnostic accuracy of 97%. We compare this with a best single-wavelength (640 nm) analysis that correctly identifies 82% of lesions. We discuss the origin of relevant spectroscopic features and perspectives for translation to clinical imaging.

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Section: Rf Ablation Lesion Imaging In the Literaturementioning

confidence: 99%

Section: Rf Ablation Lesion Imaging In the Literaturementioning

confidence: 99%

Spectroscopic photoacoustic imaging of radiofrequency ablation in the left atrium

Iskander-Rizk¹,

Kruizinga²,

Steen³

et al. 2018

Biomed. Opt. Express

View full text Add to dashboard Cite

show abstract

“…Nevertheless, multiple groups have now shown that deformability as indexed by these techniques drops immediately following RF ablation in vivo. (Bahnson et al, 2014; Kwiecinski et al, 2014) Interestingly, this shear stiffness is quite stable from 2-30 minutes after ablation in the center of the lesion, while the stiffness of adjacent myocardium increases more slowly; (Eyerly et al, 2015) Eyerly et al suggested that the immediate response may reflect changes in tissue properties due to thermal damage, while the slower response in adjacent tissue reflects edema. (Eyerly et al, 2015) Less is known about the evolution of mechanical properties beyond the first few minutes post-ablation, other than the fact that scar tissue forms in damaged regions and is presumably stiffer than the surrounding myocardium.…”

Section: Ablation Of Atrial Fibrillationmentioning

confidence: 99%

Making better scar: Emerging approaches for modifying mechanical and electrical properties following infarction and ablation

Holmes

Laksman

Gepstein

2016

Progress in Biophysics and Molecular Biology

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Following myocardial infarction (MI), damaged myocytes are replaced by collagenous scar tissue, which serves an important mechanical function – maintaining integrity of the heart wall against enormous mechanical forces – but also disrupts electrical function as structural and electrical remodeling in the infarct and borderzone predispose to re-entry and ventricular tachycardia. Novel emerging regenerative approaches aim to replace this scar tissue with viable myocytes. Yet an alternative strategy of therapeutically modifying selected scar properties may also prove important, and in some cases may offer similar benefits with lower risk or regulatory complexity. Here, we review potential goals for such modifications as well as recent proof-of-concept studies employing specific modifications, including gene therapy to locally increase conduction velocity or prolong the refractory period in and around the infarct scar, and modification of scar anisotropy to improve regional mechanics and pump function. Another advantage of scar modification techniques is that they have applications well beyond MI. In particular, ablation treats electrical abnormalities of the heart by intentionally generating scar to block aberrant conduction pathways. Yet in diseases such as atrial fibrillation (AF) where ablation can be extensive, treating the electrical disorder can significantly impair mechanical function. Creating smaller, denser scars that more effectively block conduction, and choosing the location of those lesions by balancing their electrical and mechanical impacts, could significantly improve outcomes for AF patients. We review some recent advances in this area, including the use of computational models to predict the mechanical effects of specific lesion sets and gene therapy for functional ablation. Overall, emerging techniques for modifying scar properties represents a potentially important important set of tools for improving patient outcomes across a range of heart diseases, whether used in place of or as an adjunct to regenerative approaches.

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“…In order to visualize the thermal lesion with ultrasound, evaluation of tissue stiffness has recently been introduced as an effective means to map ablated regions [3][4][5][6][7], providing stiffness contrasts between normal and ablated tissues of more than a factor of 2. It was shown in vivo that the stiffening of a thermally ablated tissue is linked to the applied thermal dose [8], and thus, to its viability.…”

Section: Introductionmentioning

confidence: 99%

Validation of an intracardiac ultrasonic therapy–imaging dual mode transducer

Kwiecinski

Provost

Dubois

et al. 2015

IRBM

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Quantitative evaluation of atrial radio frequency ablation using intracardiac shear‐wave elastography

Abstract: By its quantitative and real-time capabilities, Intracardiac SWE is a promising intraoperative imaging technique for the evaluation of thermal ablation during RFCA.

Cited by 24 publications

References 62 publications

Spectroscopic photoacoustic imaging of radiofrequency ablation in the left atrium

Spectroscopic photoacoustic imaging of radiofrequency ablation in the left atrium

Making better scar: Emerging approaches for modifying mechanical and electrical properties following infarction and ablation

Validation of an intracardiac ultrasonic therapy–imaging dual mode transducer

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