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

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.