Abstract 8428: Percutaneous Intrapericardial Echocardiographic Imaging with CMUT Based Imaging Catheters: First In Vivo Results

Abstract

Background: The standard approach for the catheter ablation of arrhythmias and the accompanying guidance of intracardiac echocardiography (ICE) is performed from the endocardial aspect of the heart. This approach may now also include percutaneous epicardial mapping which has been developed and utilized in several electrophysiology (EP) laboratories. Previous research using percutaneous pericardial procedures has been safely and effectively applied to a range of supraventricular arrhythmia substrates. Methods: Our family of ICE devices now includes a new 9F forward-looking catheter which is constructed with a silicon based capacitive micromachined ultrasonic transducer (CMUT) technology. Several CMUT ML catheters have been tested in 3 porcine experiments. The percutaneous epicardial approach was tested with successful imaging of heart chambers from the oblique sinus of the pericardial space. Results: This micro-linear (ML) catheter provides high-resolution, real-time, 2D ultrasound images at 14 MHz, and is capable of both electrical mapping and electroanatomical guidance. Although the 24 element array aperture is small (1.6 mm), the imaging depth of penetration is considerable (> 3 cm). A thin metalized cap can be placed over the array for performing radiofrequency ablation without distorting imaging. Conclusions: This silicon based technology has the unique prospect of enhancing both miniaturization and multiple modalities of operation.