BACKGROUND Complete catheter-tissue contact and permanent tissue destruction are
essential for efficient radio-frequency ablation (RFA) during cardiac arrhythmia treatment.
Current methods of monitoring lesion formation are indirect and unreliable. We aim to develop
optical coherence tomography (OCT) as an imaging guidance for RFA.
OBJECTIVES The purpose of this study is to evaluate the feasibility of using OCT catheter to
image endocardia wall in active beating hearts through percutaneous access. This is a critical
step toward image guided RFA in a clinic setting.
METHODS A cone-scanning forward-viewing OCT catheter was advanced into active beating
hearts through percutaneous access in four swine. The OCT catheter was steered by an
introducer to touch the endocardia wall. The images were then acquired at 10 frames per
second at an axial resolution and lateral resolution of 15 μm.
RESULTS We report the first in vivo intracardiac OCT imaging through percutaneous access
with a thin and flexible OCT catheter. We are able to acquire high quality OCT images in active
beating hearts, observe the polarization-related artifacts induced by the birefringence of
myocardium and readily evaluate catheter-tissue contact.
CONCLUSIONS It is feasible to acquire OCT images in beating hearts through percutaneous
access. The observations indicate that OCT could be a promising technique for in vivo guidance
of RFA.
Complete catheter-tissue contact and permanent tissue destruction are essential for efficient radio-frequency ablation (RFA) during cardiac arrhythmia treatment. Current methods of monitoring lesion formation are indirect and unreliable. The purpose of this study is to evaluate the feasibility of using optical coherence tomography (OCT) catheter to image endocardial wall in actively beating hearts through percutaneous access. We reported the first in vivo intracardiac OCT imaging through percutaneous access with a thin and flexible OCT catheter. This is a critical step toward image-guided RFA in a clinical setting. A cone-scanning forward-viewing OCT catheter was advanced into beating hearts through percutaneous access in four swine. The OCT catheter was steered by an introducer to touch the endocardial wall. We are able to acquire high quality OCT images in beating hearts, observe the polarization-related artifacts induced by the birefringence of myocardium, and readily evaluate catheter-tissue contact. The observations indicate that OCT could be a promising technique for in vivo guidance of RFA.
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