METHODS. A prototype algorithm, developed from first principles of electrostatic field theory, derives charge density (CD) as a spatial representation of the true sources of the cardiac field. The algorithm processes multiple, simultaneous, noncontact voltage measurements within the cardiac chamber to inversely derive the global distribution of CD sources across the endocardial surface. RESULTS. Comparison of CD to an established computer-simulated model of atrial conduction demonstrated feasibility in terms of spatial, temporal, and morphologic metrics. Inverse reconstruction matched simulation with median spatial errors of 1.73 mm and 2.41 mm for CD and voltage, respectively. Median temporal error was less than 0.96 ms and morphologic correlation was greater than 0.90 for both CD and voltage. Activation patterns observed in human atrial flutter reproduced those established through contact maps, with a 4-fold improvement in resolution noted for CD over voltage. Global activation maps (charge density-based) are reported in atrial fibrillation with confirmed reduction of far-field interference. Arrhythmia cycle-length slowing and termination achieved through ablation of critical points demonstrated in the maps indicates both mechanistic and pathophysiological relevance. CONCLUSION. Global maps of cardiac activation based on CD enable classification of conduction patterns and localized nonpulmonary vein therapeutic targets in atrial fibrillation. The measurement capabilities of the approach have roles spanning deep phenotyping to therapeutic application. TRIAL REGISTRATION. ClinicalTrials.gov NCT01875614.

Piezoelectric micromachined ultrasound transducers (pMUTs) are a new approach for the construction of 2-D arrays for forward-looking 3-D intravascular (IVUS) and intracardiac (ICE) imaging. Two-dimensional pMUT test arrays containing 25 elements (5 x 5 arrays) were bulk micromachined in silicon substrates. The devices consisted of lead zirconate titanate (PZT) thin film membranes formed by deep reactive ion etching of the silicon substrate. Element widths ranged from 50 to 200 microm with pitch from 100 to 300 mum. Acoustic transmit properties were measured in de-ionized water with a calibrated hydrophone placed at a range of 20 mm. Measured transmit frequencies for the pMUT elements ranged from 4 to 13 MHz, and mode of vibration differed for the various element sizes. Element capacitance varied from 30 to over 400 pF depending on element size and PZT thickness. Smaller element sizes generally produced higher acoustic transmit output as well as higher frequency than larger elements. Thicker PZT layers also produced higher transmit output per unit electric field applied. Due to flexure mode operation above the PZT coercive voltage, transmit output increased nonlinearly with increased drive voltage. The pMUT arrays were attached directly to the Duke University T5 Phased Array Scanner to produce real-time pulse-echo B-mode images with the 2-D pMUT arrays.

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We present a low-cost, high-speed, retrofitted laser scanning module for microscopy. The cage-mounted system, with various available fiber-coupled sources, offers a real-time imaging alternative to costly commercial systems with capabilities for conventional or confocal reflectance and fluorescence applications as well as advanced laser scanning microscopy implementations. Reflectance images of a resolution target and confocal images of fluorescent polystyrene beads are presented for system characterization. Confocal fluorescence image stacks of T84 epithelial cancer cells are presented to demonstrate application to biological studies. This laser scanning module is a flexible, scalable, high-speed alternative to commercial laser scanning systems suitable for applications requiring a simple imaging tool and for teaching laboratories.