Real-time photoacoustic assessment of radiofrequency ablation lesion formation in the left atrium

Sophinese Iskander-Rizk; Pieter Kruizinga; Robert Beurskens; Geert Springeling; Frits Mastik; Natasja M S de Groot; Paul Knops; Antonius F W van der Steen; Gijs van Soest

doi:10.1016/j.pacs.2019.100150

Real-time photoacoustic assessment of radiofrequency ablation lesion formation in the left atrium

Photoacoustics. 2019 Nov 30:16:100150. doi: 10.1016/j.pacs.2019.100150. eCollection 2019 Dec.

Authors

Sophinese Iskander-Rizk¹, Pieter Kruizinga², Robert Beurskens¹, Geert Springeling³, Frits Mastik¹, Natasja M S de Groot¹, Paul Knops¹, Antonius F W van der Steen^{1

4}, Gijs van Soest¹

Affiliations

¹ Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
² Department of Neuroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
³ Department of Experimental Medical Instruments, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
⁴ Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands.

Abstract

In interventional electrophysiology, catheter-based radiofrequency (RF) ablation procedures restore cardiac heart rhythm by interrupting aberrant conduction paths. Real-time feedback on lesion formation and post-treatment lesion assessment could overcome procedural challenges related to ablation of underlying structures and lesion gaps. This study aims to evaluate real-time visualization of lesion progression and continuity during intra-atrial ablation with photoacoustic (PA) imaging, using clinically deployable technology. A PA-enabled RF ablation catheter was used to ablate and illuminate porcine left atrium, both excised and intact in a passive beating heart ex-vivo, for photoacoustic signal generation. PA signals were received with an intracardiac echography catheter. Using the ratio of PA images acquired with excitation wavelengths of 790 nm and 930 nm, ablation lesions were successfully imaged through circulating saline and/or blood, and lesion gaps were identified in real-time. PA-based assessment of RF-ablation lesions was successful in a realistic preclinical model of atrial intervention.

Keywords: Atrial fibrillation; Lesion monitoring; Photoacoustic imaging; Photoacoustic-enabled RF ablation catheter; RF ablation.