In vitro characterization of cardiac radiofrequency ablation lesions using optical coherence tomography

Abstract

Currently, cardiac radiofrequency ablation (RFA) is guided by indirect signals. We demonstrate optical coherence tomography (OCT) characterization of RFA lesions within swine ventricular wedges. Untreated tissue exhibited a consistent birefringence artifact within OCT images due to the organized myocardium, which was not present in treated tissue. Birefringence artifacts were detected by filtering with a Laplacian of Gaussian (LoG) to quantify gradient strength. The gradient strength distinguished RFA lesions from untreated sites (p=5.93 x 10(-15)) with a sensitivity and specificity of 94.5% and 86.7% respectively. This study demonstrates the potential of OCT for monitoring cardiac RFA, confirming lesion formation and providing feedback to avoid complications.

Near-infrared spectroscopy integrated catheter for characterization of myocardial tissues: preliminary demonstrations to radiofrequency ablation therapy for atrial fibrillation

“…High resolution images acquired using a bench top OCT system exhibited distinguishable features that could be used to discriminate between treated and untreated swine cardiac tissue [19]. It was also demonstrated that adipose tissue could be readily discerned from the normal myocardium in an OCT image [18].…”

“…Several groups have demonstrated experimental optical characterization of the myocardium [16][17][18][19][20][21][22][23]. High resolution images acquired using a bench top OCT system exhibited distinguishable features that could be used to discriminate between treated and untreated swine cardiac tissue [19].…”

In vivo intracardiac optical coherence tomography imaging through percutaneous access: toward image-guided radio-frequency ablation

“…Our group has explored the potential of using optical coherence tomography (OCT) to perform real-time guidance and monitoring of RFA therapy. [4][5][6] We have shown that OCT can monitor catheter-tissue contact and lesion formation through catheter-based endocardial and epicardial OCT imaging of excised tissue on the bench 4,6 and in vivo via an open-chest animal study. 5 However, to test the feasibility of intracardiac OCT in a clinical setting, it is important to verify that if diagnostic-quality OCT images can be acquired through remote percutaneous access in the actively beating heart.…”

“…We have previously shown that these polarizationdependent bands can be used as a marker to monitor the process of RFA. 4 Catheter-tissue contact is another critical factor for efficient RFA. OCT can provide in vivo feedback of cathetertissue contact during RFA treatment.…”

Spatiotemporal correlation of optical coherence tomographyin-vivoimages of rabbit airway for the diagnosis of edema

“…There have been numerous studies that have quantitatively evaluated OCT images and systems for various biomedical estimation and classification tasks by calculating ROC curves and AUCs. [18][19][20] Also, the approach of optimizing OCT hardware has investigated based on the use of ROC curves and AUCs for specified tasks, such as detecting the refractive index changes in multiple layers. 21,22 Here, we establish an observer for the task of diagnosing edema, which is called spatiotemporal correlation (STC) that is applied to OCT images using a rabbit airway surgical model.…”