Relation between denaturation time measured by optical coherence reflectometry and thermal lesion depth during radiofrequency cardiac ablation: Feasibility numerical study

González-Suárez, Ana; Herranz, David; Berjano, Enrique; Rubio-Guivernau, José L.; Margallo-Balbás, Eduardo

doi:10.1002/lsm.22771

Cited by 8 publications

(7 citation statements)

References 40 publications

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“…However, there are thick wall areas where PSOCT imaging depth is insufficient. To overcome this limitation, a model was previously developed to estimate lesion depth with the measured denature time of the tissue within the depth of view 45 . Another approach under investigation, NIRS, detects RFA lesion depth as deep as 4 mm 31 , but it doesn’t provide detailed tissue structure information.…”

Section: Discussionmentioning

confidence: 99%

Polarization-sensitive optical coherence tomography monitoring of percutaneous radiofrequency ablation in left atrium of living swine

Zhao

Ziv

Mohammadpour

et al. 2021

Sci Rep

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Radiofrequency ablation (RFA) is commonly used to treat atrial fibrillation (AF). However, the outcome is often compromised due to the lack of direct real-time feedback to assess lesion transmurality. In this work, we evaluated the ability of polarization-sensitive optical coherence tomography (PSOCT) to measure cardiac wall thickness and assess RF lesion transmurality during left atrium (LA) RFA procedures. Quantitative transmural lesion criteria using PSOCT images were determined ex vivo using an integrated PSOCT-RFA catheter and fresh swine hearts. LA wall thickness of living swine was measured with PSOCT and validated with a micrometer after harvesting the heart. A total of 38 point lesions were created in the LA of 5 living swine with the integrated PSOCT-RFA catheter using standard clinical RFA procedures. For all lesions with analyzable PSOCT images, lesion transmurality was assessed with a sensitivity of 89% (17 of 19 tested positive) and a specificity of 100% (5 of 5 tested negative) using the quantitative transmural criteria. This is the first report of using PSOCT to assess LA RFA lesion transmurality in vivo. The results indicate that PSOCT may potentially provide direct real-time feedback for LA wall thickness and lesion transmurality.

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Section: Discussionmentioning

confidence: 99%

Polarization-sensitive optical coherence tomography monitoring of percutaneous radiofrequency ablation in left atrium of living swine

Zhao

Ziv

Mohammadpour

et al. 2021

Sci Rep

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“…A simple 1D analytic model may not be accurate enough to model the tissue temperature changes because it only shows the maximum temperature in the path of the laser light without considering the conduction to the surrounding tissue. Further developments of three‐dimensional analytical or FEM models will be pursued to improve the prediction of the thermal responses of the tissue during the laser ablation .…”

Section: Discussionmentioning

confidence: 99%

Application of Ultrasound Thermal Imaging for Monitoring Laser Ablation in Ex Vivo Cardiac Tissue

et al. 2019

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Background and Objective Laser ablation can be used to treat atrial fibrillation by thermally isolating pulmonary veins. In this study, we evaluated the feasibility of high‐resolution (<1 mm) ultrasound thermal imaging to monitor spatial temperature distribution during laser ablation on ex vivo cardiac tissue. Study Design/Materials and Methods Laser ablation (808 nm) was performed on five porcine cardiac tissue samples. A thermocouple was used to measure the interstitial tissue temperature during the laser ablation process. Tissue‐strain‐based ultrasound thermal imaging was conducted to monitor the spatial distribution of the temperature in the cardiac tissue. The tissue temperature was estimated from the time shifts of ultrasound signals owing to the changes in the speed of sound and was compared with the measured temperature. The temperature estimation coefficient k of porcine cardiac tissue was calculated from the estimated thermal strain and the measured temperature. The degree of tissue coagulation (temperatures > 50°C) was derived from the estimated temperature and was compared with that of the tested cardiac tissue. Results The estimated tissue temperature using strain‐based ultrasound thermal imaging at a depth of 1 mm agreed with thermocouple measurements. During the 30‐second period of the laser ablation process, the estimated tissue temperature increased from 25 to 70°C at a depth of 0.1 mm, while the estimated temperature at a depth of 1 mm increased up to 46°C. Owing to the uncertainty of the coefficient k, the k value of the porcine cardiac tissue varied from 160 to 220°C with temperature changes of up to 20°C. The estimated coagulation region in the ultrasound thermal imaging was 20% wider (+0.6 mm) but 9% shallower (−0.1 mm) than the measured region of the ablated porcine cardiac tissue. Conclusions The current study demonstrated the feasibility of temperature monitoring with the use of ultrasound thermal imaging during the laser ablation on ex vivo porcine cardiac tissue. The high‐resolution ultrasound thermal imaging could map the spatial distribution of the tissue temperature. The proposed method can be used to monitor the temperature and thermal coagulation to achieve effective laser ablation for atrial fibrillation. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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“…Gonzalez-Suarez et al [63] used computer modeling to analyze the relationship between the 50 °C and 70 °C isotherms, which are related to irreversible thermal lesions and the loss of birefringence due to fiber denaturation, respectively. The aim was to explore the feasibility of a new catheter able to conduct measurements by polarization-sensitive optical coherence reflectometry (since changes in accumulated phase retardation occur around 70 °C) to estimate lesion size (which occurs around 50 −55 °C) in real-time.…”

Section: Computer Modeling To Explore New Rfca Systemsmentioning

confidence: 99%

Computer modeling of radiofrequency cardiac ablation: 30 years of bioengineering research

González-Suárez

Pérez

Irastorza

et al. 2022

Computer Methods and Programs in Biomedicine

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Relation between denaturation time measured by optical coherence reflectometry and thermal lesion depth during radiofrequency cardiac ablation: Feasibility numerical study

Cited by 8 publications

References 40 publications

Polarization-sensitive optical coherence tomography monitoring of percutaneous radiofrequency ablation in left atrium of living swine

Polarization-sensitive optical coherence tomography monitoring of percutaneous radiofrequency ablation in left atrium of living swine

Application of Ultrasound Thermal Imaging for Monitoring Laser Ablation in Ex Vivo Cardiac Tissue

Computer modeling of radiofrequency cardiac ablation: 30 years of bioengineering research

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