Related Experiment Video
Updated: May 15, 2026
Simultaneous Brightfield, Fluorescence, and Optical Coherence Tomographic Imaging of Contracting Cardiac Trabeculae Ex Vivo
Published on: October 2, 2021
High resolution imaging of the human cardiac conduction system using reflectance confocal microscopy
Jonas Venius1, Edvardas Zurauskas, Ricardas Rotomskis
1Laboratory of Biomedical Physics of Vilnius University Institute of Oncology, Vilnius, Lithuania. Jonas.Venius@vuoi.lt
Insights
Reflection confocal microscopy (RCM) can now visually distinguish the cardiac conduction system (CCS) from surrounding heart tissues. This breakthrough offers a new method for non-destructive cardiac investigations and surgical guidance.
Area of Science:
- Biomedical Engineering
- Cardiology
- Microscopy
Background:
- The cardiac conduction system (CCS) controls heart rhythm but is visually indistinguishable from myocardium (MC) and connective tissue (CT).
- Lack of reliable in vivo or ex vivo identification methods for CCS poses risks of damage during surgery.
- There is a critical need for advanced imaging techniques to visualize the CCS.
Purpose of the Study:
- To investigate the potential of Reflection Confocal Microscopy (RCM) for non-destructive imaging and identification of the cardiac conduction system (CCS).
- To determine if RCM can differentiate CCS from surrounding cardiac tissues like myocardium and connective tissue.
Main Methods:
- Utilized Reflection Confocal Microscopy (RCM) to image cardiac tissues.
- Analyzed the microscopic reflections generated by infrared laser illumination.
- Assessed the resolution capabilities of RCM for cellular and structural differentiation.
Main Results:
- RCM successfully distinguished individual myocardial (MC) cells and cardiac conduction system (CCS) cells.
- The method also identified the network-like structures characteristic of connective tissue (CT).
- Demonstrated RCM's capability to visualize distinct cardiac tissue components at cellular resolution.
Conclusions:
- Reflection Confocal Microscopy (RCM) shows significant potential for non-destructive cardiac investigations.
- RCM offers a promising new method for the in vivo and ex vivo imaging of the cardiac conduction system (CCS).
- This technique could improve surgical safety and diagnostic capabilities in cardiology.
Abstract:
Rhythmical contraction of the heart is controlled by the cardiac conduction system (CCS) that consists of the three main parts: the sino-atrial node, the atrioventricular node and the His-Purkinje system. A heartbeat signal, originated from CCS, spreads through its branches to the different parts of the heart, initiating depolarization of the ventricles. However, this highly important system could not be distinguished visually from the surrounding heart tissues: myocardium (MC) and connective tissue (CT). Thus, during surgical procedures, CCS could be easily damaged; namely, the reliable method for identification of CCS either in vivo or ex vivo does not exist. Accordingly, there is a definite need for developing a CCS imaging method. Reflection confocal microscopy (RCM) offers non-destructive imaging of the tissue at depths of up to 0.35 mm with the capability of identification of a single cell. During the visualization procedure, a given tissue is illuminated with infrared laser light and the image is obtained because of different reflections from the tissue structures. However, the reflective structures in the heart tissues are still not identified. In the present study, for the first time we investigated cardiac tissues by RCM. The resolution of the method allowed us to distinguish MC cells and CCS cells. The method also allowed us to distinguish the network-like structures that are main components of CT. The ability to visualize different tissue components indicates a great potential for RCM to be used in non-destructive cardiac investigations and for imaging CCS.
