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Published on: November 7, 2019
Visualization of epicardial cryoablation lesions using endogenous tissue fluorescence
Luther Swift1, Daniel A B Gil1, Rafael Jaimes1
1From the Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC (L.S., D.A.B.G., M.K., N.S.); Department of Electrical and Computer Engineering, George Washington School of Engineering and Applied Science, Washington, DC (D.A.B.G., R.J., M.K.); and Division of Cardiology, George Washington University School of Medicine and Health Sciences and Medical Faculty Associates, Washington, DC (M.M.).
Researchers developed a new method using nicotinamide adenine dinucleotide (NADH) fluorescence to visualize tissue damage during atrial fibrillation ablation procedures. This technique allows real-time monitoring of cryoablation lesions, improving procedural accuracy.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Medical Imaging
Background:
- Percutaneous cryoballoon ablation is a standard treatment for atrial fibrillation.
- Current limitations include the inability to visualize tissue damage and gaps in lesions.
- Real-time visualization of tissue necrosis during ablation is needed.
Purpose of the Study:
- To develop an approach for real-time visualization of tissue necrosis during cryoablation and radiofrequency ablation.
- To assess the utility of endogenous nicotinamide adenine dinucleotide (NADH) fluorescence for imaging ablation lesions.
Main Methods:
- Utilized NADH fluorescence imaging in blood-perfused and saline-perfused heart models.
- Correlated NADH signal changes with triphenyl tetrazolium staining and electrical activity.
- Examined diffuse reflectance changes during cryoablation and radiofrequency ablation.
Main Results:
- Cryoablation caused a significant decrease (60-70%) in NADH fluorescence at lesion sites.
- NADH signal loss strongly correlated with lesion area (r=0.89) and loss of electrical activity (r=0.84).
- Cryoablation decreased diffuse reflectance, while radiofrequency ablation increased it.
Conclusions:
- Endogenous NADH fluorescence enables real-time visualization of cryoablation lesions in cardiac muscle.
- Distinct optical signatures were observed for cryoablation versus radiofrequency ablation.
- This technique holds promise for improving ablation procedure guidance.
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