Atrial fibrillation is a global epidemic linked to millions of deaths each year. One increasingly relevant treatment for the disease is catheter ablation. In this procedure, an electrophysiologist burns lesions to isolate pathogenic tissue in the pulmonary veins from initiating an ectopic heartbeat. Long term efficacy of the procedure still needs to improve. Current intraprocedural feedback does not allow the clinician to properly visualize individual lesions. We developed an integrated polarization sensitive optical coherence tomography (PSOCT) and near infrared spectroscopy (NIRS) catheter to measure lesions during an ablation procedure. By combining both modalities, we overcome their individual limitations and provide complementary metrics. Using the PSOCT-NIRS catheter to analyze lesions, we show that we can mitigate the imaging depth limitations of PSOCT and inform spectral measurements made by NIRS to provide a more informative view of lesion quality.
Atrial fibrillation (AF) is the most common sustained arrhythmia in the western world. Pulmonary vein isolation (PVI) using radiofrequency ablation (RFA) is frequently conducted to treat AF. However, current PVI procedures for lesion formation are guided only with indirect information, which may lead to non-transmural lesions, and contribute to the high recurrence of AF. Therefore, direct lesion quality feedback may potentially improve PVI efficacy. To study the real-time direct guidance capability of polarization sensitive optical coherence tomography (PSOCT), a custom-designed integrated PSOCT-RFA catheter was prototyped and tested in RFA procedures in the left atria of living swine.
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