Abstract 15004: Real Time Lesion Assessment Using a Novel Combined Polarization-Sensitive Optical Coherence Reflectometry
Introduction: Real-time lesion assessment could improve ablation efficiency and safety by allowing energy titration for transmurality. Incorporating polarization sensitive OCT (PS-OCT) within a custom-RF catheter could allow one to take advantage of the high resolution and ability to differentially images ablated vs healthy tissue.
Objectives: To determine if RF lesion formation could be visualized in real time using this novel catheter.
Methods: In 3 healthy swine, 28 ablations were performed on the epicardial ventricular surface (open-chest). RF was delivered with different settings ranging from 10-40 Watts & 5-60 seconds. PS-OCT based lesion assessment was recorded continuously. All swine were then sacrificed and gross lesion dimensions were assessed after TTC staining.
Results: 26/28 RF applications resulted in identifiable lesions on necropsy. Power settings included 10, 20, 30 and 40 seconds and durations included 5, 10, 20 and 30 seconds. PS-OCT based lesion assessment indicated no lesion formation for two RF applications @10W/5 seconds and 10W/10 seconds; which was also confirmed on necropsy. All other RF settings led to significant changes (Figure) based on the optical signal related to thermal denaturation of collagen fibers. Substantial RF lesions were identified at the necropsy for all 26 lesions. Lesion depth varied from 3.42mm to 8.53mm (mean depth 5.89±1.51mm; mean volume 64.5±67.9mm3). The mean impedance drop was 55.5±21Ω
Conclusion: Real-time lesion assessment using PS-OCT integrated into an ablation catheter is feasible and readily identifies RF lesion formation. The signature loss of the birefringence that results from fibers denaturation is easily identified. These preliminary findings suggest a potential use to prevent gaps that may occur when placing continuous and contiguous lesions sets.
Author Disclosures: Y. Enomoto: None. J.S. Koruth: Research Grant; Modest; ACT, BIOSENSE WEBSTER, Vytronus. Consultant/Advisory Board; Modest; Biosense Webster, St Jude. Research Grant; Significant; MODEST, Significant, Significant. Consultant/Advisory Board; Significant; Significant, Signifcant. J.G. Panizo: None. J. Iwasawa: None. D. Herranz: Employment; Significant; 10001. J. Sancho Dura: Employment; Significant; 10001. J.L. Rubio: Employment; Significant; 10001. Ownership Interest; Significant; 10001. E. Margallo Balbas: Employment; Significant; 10001. Ownership Interest; Significant; 10001. D. Sharma: None. C. Palaniswamy: None. A. Gomes: None. M.A. Miller: None. S. Choudry: None. S.R. Dukkipati: None. V.Y. Reddy: None.
- © 2016 by American Heart Association, Inc.