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Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging.

Publication ,  Journal Article
Bahnson, TD; Eyerly, SA; Hollender, PJ; Doherty, JR; Kim, Y-J; Trahey, GE; Wolf, PD
Published in: J Cardiovasc Electrophysiol
December 2014

BACKGROUND: Visual confirmation of radiofrequency ablation (RFA) lesions during clinical cardiac ablation procedures could improve procedure efficacy, safety, and efficiency. It was previously shown that acoustic radiation force impulse (ARFI) imaging can identify RFA lesions in vitro and in vivo in an animal model. This is the "first-in-human" feasibility demonstration of intracardiac ARFI imaging of RFA lesions in patients undergoing catheter ablation for atrial flutter (AFL) or atrial fibrillation (AF). METHODS AND RESULTS: Patients scheduled for right atrial (RA) ablation for AFL or left atrial (LA) ablation for drug refractory AF were eligible for imaging. Diastole-gated intracardiac ARFI images were acquired using one of two equipment configurations: (1) a Siemens ACUSON S2000™ ultrasound scanner and 8/10Fr AcuNav™ ultrasound catheter, or (2) a CARTO 3™ integrated Siemens SC2000™ and 10Fr SoundStar™ ultrasound catheter. A total of 11 patients (AFL = 3; AF = 8) were imaged. ARFI images were acquired of ablation target regions, including the RA cavotricuspid isthmus (CTI), and the LA roof, pulmonary vein ostia, posterior wall, posterior mitral valve annulus, and the ridge between the pulmonary vein and LA appendage. ARFI images revealed increased relative myocardial stiffness at ablation catheter contact sites after RFA and at anatomical mapping-tagged RFA treatment sites. CONCLUSIONS: ARFI images from a pilot group of patients undergoing catheter ablation for AFL and AF demonstrate the ability of this technique to identify intra-procedure RFA lesion formation. The results encourage further refinement of ARFI imaging clinical tools and continued investigation in larger clinical trials.

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Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

December 2014

Volume

25

Issue

12

Start / End Page

1275 / 1283

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery, Computer-Assisted
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Middle Aged
  • Male
  • Humans
  • Female
  • Feasibility Studies
  • Elasticity Imaging Techniques
 

Citation

APA
Chicago
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MLA
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Bahnson, T. D., Eyerly, S. A., Hollender, P. J., Doherty, J. R., Kim, Y.-J., Trahey, G. E., & Wolf, P. D. (2014). Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging. J Cardiovasc Electrophysiol, 25(12), 1275–1283. https://doi.org/10.1111/jce.12514
Bahnson, Tristram D., Stephanie A. Eyerly, Peter J. Hollender, Joshua R. Doherty, Young-Joong Kim, Gregg E. Trahey, and Patrick D. Wolf. “Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging.J Cardiovasc Electrophysiol 25, no. 12 (December 2014): 1275–83. https://doi.org/10.1111/jce.12514.
Bahnson TD, Eyerly SA, Hollender PJ, Doherty JR, Kim Y-J, Trahey GE, et al. Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging. J Cardiovasc Electrophysiol. 2014 Dec;25(12):1275–83.
Bahnson, Tristram D., et al. “Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging.J Cardiovasc Electrophysiol, vol. 25, no. 12, Dec. 2014, pp. 1275–83. Pubmed, doi:10.1111/jce.12514.
Bahnson TD, Eyerly SA, Hollender PJ, Doherty JR, Kim Y-J, Trahey GE, Wolf PD. Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging. J Cardiovasc Electrophysiol. 2014 Dec;25(12):1275–1283.
Journal cover image

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

December 2014

Volume

25

Issue

12

Start / End Page

1275 / 1283

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery, Computer-Assisted
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Middle Aged
  • Male
  • Humans
  • Female
  • Feasibility Studies
  • Elasticity Imaging Techniques