Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging.
Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging.
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DOI：
10.1111/jce.12514
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发表时间：
2014-12
影响因子：
2.7
通讯作者：
Wolf PD
中科院分区：
文献类型：
--
作者：
Bahnson TD;Eyerly SA;Hollender PJ;Doherty JR;Kim YJ;Trahey GE;Wolf PD
在临床心脏消融术中对射频消融(RFA)病变进行目视确认可以提高手术的有效性、安全性和效率。以往的研究表明，声辐射力脉冲(ARFI)成像技术可以在体外和体内动物模型中识别RFA损伤。这是首次在接受心房扑动(AFL)或心房颤动(AF)导管消融患者的RFA病变的心内ARFI成像的可行性证明。接受右房(RA)消融治疗AFL或左房(LA)消融治疗药物难治性房颤的患者均符合影像诊断标准。(1)西门子ACUSON S2000™超声扫描仪和8/10Fr AcuNav™超声导管，或(2)Carto 3™集成西门子SC2000™和10Fr SoundStar™超声导管。对11例患者(AFL=3例，AF=8例)进行了成像。获得消融靶区的ARFI图像，包括RA三尖瓣峡部(CTI)、LA顶部、肺静脉口、后壁、二尖瓣后环、肺静脉与LA附件之间的隆起。ARFI图像显示RFA后消融导管接触部位和标记性RFA治疗部位的相对心肌硬度增加。一组接受AFL和AF导管消融的先导性患者的ARFI图像显示了这项技术识别术中RFA病变形成的能力。这些结果鼓励进一步改进ARFI成像临床工具，并在更大的临床试验中继续研究。
Visual confirmation of radiofrequency ablation (RFA) lesions during clinical cardiac ablation procedures could improve procedure efficacy, safety, and efficiency. It was previously shown that acoustic radiation force impulse (ARFI) imaging can identify RFA lesions in vitro and in vivo in an animal model. This is the “first-in-human” feasibility demonstration of intracardiac ARFI imaging of RFA lesions in patients undergoing catheter ablation for atrial flutter (AFL) or atrial fibrillation (AF). Patients scheduled for right atrial (RA) ablation for AFL or left atrial (LA) ablation for drug refractory AF were eligible for imaging. Diastole-gated intracardiac ARFI images were acquired using one of two equipment configurations: (1) a Siemens ACUSON S2000™ ultrasound scanner and 8/10Fr AcuNav™ ultrasound catheter, or (2) a CARTO 3™ integrated Siemens SC2000™ and 10Fr SoundStar™ ultrasound catheter. A total of 11 patients (AFL = 3; AF = 8) were imaged. ARFI images were acquired of ablation target regions, including the RA cavotricuspid isthmus (CTI), and the LA roof, pulmonary vein ostia, posterior wall, posterior mitral valve annulus, and the ridge between the pulmonary vein and LA appendage. ARFI images revealed increased relative myocardial stiffness at ablation catheter contact sites after RFA and at anatomical mapping-tagged RFA treatment sites. ARFI images from a pilot group of patients undergoing catheter ablation for AFL and AF demonstrate the ability of this technique to identify intra-procedure RFA lesion formation. The results encourage further refinement of ARFI imaging clinical tools and continued investigation in larger clinical trials.
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影响因子：
2.9
作者：
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通讯作者：
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发表时间：
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影响因子：
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