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Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.

Publication ,  Journal Article
Eyerly, SA; Bahnson, TD; Koontz, JI; Bradway, DP; Dumont, DM; Trahey, GE; Wolf, PD
Published in: Heart Rhythm
November 2012

BACKGROUND: Arrhythmia recurrence after cardiac radiofrequency ablation (RFA) for atrial fibrillation has been linked to conduction through discontinuous lesion lines. Intraprocedural visualization and corrective ablation of lesion line discontinuities could decrease postprocedure atrial fibrillation recurrence. Intracardiac acoustic radiation force impulse (ARFI) imaging is a new imaging technique that visualizes RFA lesions by mapping the relative elasticity contrast between compliant-unablated and stiff RFA-treated myocardium. OBJECTIVE: To determine whether intraprocedure ARFI images can identify RFA-treated myocardium in vivo. METHODS: In 8 canines, an electroanatomical mapping-guided intracardiac echo catheter was used to acquire 2-dimensional ARFI images along right atrial ablation lines before and after RFA. ARFI images were acquired during diastole with the myocardium positioned at the ARFI focus (1.5 cm) and parallel to the intracardiac echo transducer for maximal and uniform energy delivery to the tissue. Three reviewers categorized each ARFI image as depicting no lesion, noncontiguous lesion, or contiguous lesion. For comparison, 3 separate reviewers confirmed RFA lesion presence and contiguity on the basis of functional conduction block at the imaging plane location on electroanatomical activation maps. RESULTS: Ten percent of ARFI images were discarded because of motion artifacts. Reviewers of the ARFI images detected RFA-treated sites with high sensitivity (95.7%) and specificity (91.5%). Reviewer identification of contiguous lesions had 75.3% specificity and 47.1% sensitivity. CONCLUSIONS: Intracardiac ARFI imaging was successful in identifying endocardial RFA treatment when specific imaging conditions were maintained. Further advances in ARFI imaging technology would facilitate a wider range of imaging opportunities for clinical lesion evaluation.

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Published In

Heart Rhythm

DOI

EISSN

1556-3871

Publication Date

November 2012

Volume

9

Issue

11

Start / End Page

1855 / 1862

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Myocardium
  • Intraoperative Period
  • Image Processing, Computer-Assisted
  • Image Enhancement
  • Elasticity Imaging Techniques
  • Dogs
  • Catheter Ablation
  • Cardiovascular System & Hematology
  • Cardiac Surgical Procedures
 

Citation

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Eyerly, S. A., Bahnson, T. D., Koontz, J. I., Bradway, D. P., Dumont, D. M., Trahey, G. E., & Wolf, P. D. (2012). Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions. Heart Rhythm, 9(11), 1855–1862. https://doi.org/10.1016/j.hrthm.2012.07.003
Eyerly, Stephanie A., Tristram D. Bahnson, Jason I. Koontz, David P. Bradway, Douglas M. Dumont, Gregg E. Trahey, and Patrick D. Wolf. “Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.Heart Rhythm 9, no. 11 (November 2012): 1855–62. https://doi.org/10.1016/j.hrthm.2012.07.003.
Eyerly SA, Bahnson TD, Koontz JI, Bradway DP, Dumont DM, Trahey GE, et al. Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions. Heart Rhythm. 2012 Nov;9(11):1855–62.
Eyerly, Stephanie A., et al. “Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.Heart Rhythm, vol. 9, no. 11, Nov. 2012, pp. 1855–62. Pubmed, doi:10.1016/j.hrthm.2012.07.003.
Eyerly SA, Bahnson TD, Koontz JI, Bradway DP, Dumont DM, Trahey GE, Wolf PD. Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions. Heart Rhythm. 2012 Nov;9(11):1855–1862.
Journal cover image

Published In

Heart Rhythm

DOI

EISSN

1556-3871

Publication Date

November 2012

Volume

9

Issue

11

Start / End Page

1855 / 1862

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Myocardium
  • Intraoperative Period
  • Image Processing, Computer-Assisted
  • Image Enhancement
  • Elasticity Imaging Techniques
  • Dogs
  • Catheter Ablation
  • Cardiovascular System & Hematology
  • Cardiac Surgical Procedures