Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.
Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.
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DOI：
10.1016/j.hrthm.2012.07.003
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发表时间：
2012-11
期刊：
影响因子：
5.5
通讯作者：
Wolf, Patrick D.
中科院分区：
文献类型：
--
作者：
Eyerly, Stephanie A.;Bahnson, Tristram D.;Koontz, Jason I.;Bradway, David P.;Dumont, Douglas M.;Trahey, Gregg E.;Wolf, Patrick D.
心房颤动 (AF) 心脏射频消融 (RFA) 后心律失常复发与不连续病变线的传导有关。术中可视化和病变线不连续性的校正消融可以减少术后房颤复发。心内声辐射力脉冲 (ARFI) 成像是一种新的成像技术，通过绘制顺应性未消融心肌和僵硬 RFA 治疗心肌之间的相对弹性对比来可视化 RFA 损伤。确定术中 ARFI 图像是否可以识别体内经 RFA 处理的心肌。在 8 只犬齿中，使用电解剖标测 (EAM) 引导心内回声导管 (ICE) 在 RFA 前后沿右心房消融线采集 2D ARFI 图像。 ARFI 图像是在心脏舒张期采集的，心肌位于 ARFI 焦点 (1.5 cm) 处，并与 ICE 传感器平行，以最大程度地均匀地将能量传递到组织。三位评审员将每张 ARFI 图像分类为无病变、不连续或连续病变。为了进行比较，三位独立的评审员根据 EAM 激活图上成像平面位置的功能性传导阻滞确认了 RFA 病变的存在和连续性。百分之十的 ARFI 图像由于运动伪影而被丢弃。 ARFI 图像的审阅者以高灵敏度 (95.7%) 和特异度 (91.5%) 检测到 RFA 处理的部位。评审者对邻近病变的识别具有 75.3% 的特异性和 47.1% 的敏感性。当维持特定的成像条件时，心内 ARFI 成像可成功识别心内膜 RFA 治疗。 ARFI 成像技术的进一步进步将为临床病变评估提供更广泛的成像机会。
Arrhythmia recurrence after cardiac radiofrequency ablation (RFA) for atrial fibrillation (AF) has been linked to conduction through discontinuous lesion lines. Intraprocedural visualization and corrective ablation of lesion line discontinuities could decrease post-procedure AF recurrence. Intracardiac acoustic radiation force impulse (ARFI) imaging is a new imaging technique that visualizes RFA lesions by mapping the relative elasticity contrast between compliant-unablated and stiff-RFA treated myocardium. To determine if intraprocedure ARFI images can identify RFA treated myocardium in vivo. In eight canines, an electroanatomical mapping (EAM) guided intracardiac echo catheter (ICE) was used to acquire 2D ARFI images along right atrial ablation lines before and after RFA. ARFI images were acquired during diastole with the myocardium positioned at the ARFI focus (1.5 cm) and parallel to the ICE transducer for maximal and uniform energy delivery to the tissue. Three reviewers categorized each ARFI image as depicting no lesion, non-contiguous, or contiguous lesion. For comparison, three separate reviewers confirmed RFA lesion presence and contiguity based on functional conduction block at the imaging plane location on EAM activation maps. Ten percent of ARFI images were discarded due to motion artifacts. Reviewers of the ARFI images detected RFA-treated sites with high sensitivity (95.7%) and specificity (91.5%). Reviewer identification of contiguous lesion had 75.3% specificity and 47.1% sensitivity. Intracardiac ARFI imaging was successful in identifying endocardial RFA treatment when specific imaging conditions were maintained. Further advances in ARFI imaging technology would facilitate a wider range of imaging opportunities for clinical lesion evaluation.
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DOI：
10.1109/tuffc.2007.345
发表时间：
2007-05-01
影响因子：
3.6
作者：
Hsu, Stephen J.;Fahey, Brian J.;Trahey, Gregg E.
通讯作者：
Trahey, Gregg E.
DOI：
10.1111/j.1540-8159.1994.tb01348.x
发表时间：
1994-01-01
影响因子：
1.8
作者：
TAI, YT;LEE, LF;LAU, CP
通讯作者：
LAU, CP
DOI：
10.1109/tuffc.2006.1642509
发表时间：
2006-06-01
影响因子：
3.6
作者：
Pinton, Gianmarco F.;Dahl, Jeremy J.;Trahey, Gregg E.
通讯作者：
Trahey, Gregg E.
影响因子：
2.9
作者：
Hsu, Stephen J.;Bouchard, Richard R.;Trahey, Gregg E.
通讯作者：
Trahey, Gregg E.
DOI：
10.1111/j.1540-8167.1994.tb01122.x
发表时间：
1994-10-01
影响因子：
2.7
作者：
NATH, S;REDICK, JA;HAINES, DE
通讯作者：
HAINES, DE