Integrated intra-cardiac catheter for polarization sensitive optical coherence tomography-guided radiofrequency ablation (Conference Presentation)

Abstract

Cardiac arrhythmias are a major source of mortality in the United States. Ablation is the only curative therapy for cardiac arrhythmias, and catheter-based radiofrequency ablation (RFA) through percutaneous access has emerged as the standard care for many arrhythmias. However, current procedures only monitor temperature, impedance and pressure measurements during ablation, which results in incomplete lesion formation (e.g., high recurrence rate for atrial fibrillation patients) and complications. In our previous work, we have shown integration of a commercially available RFA catheter with polarization sensitive optical coherence tomography (PSOCT). This was accomplished by housing the PSOCT probe inside of the RFA catheter with a window at the catheter tip that allows for forward viewing PSOCT imaging. Data from ex vivo experiments have shown that the integrated RFA catheter can be used to confirm catheter tissue apposition and monitor tissue change during ablation by measuring retardance. It was also demonstrated that the PSOCT window does not interfere with normal lesion formation. However, only the catheter tip was integrated, enabling only in vitro experiments. Therefore, we have developed a fully integrated PSOCT RFA catheter based on a commercially available catheter to enable experiments in living swine via percutaneous access. By properly choosing a middle layer sheath to house the PSOCT probe, we reduced the non-uniform rotation distortion (NURD), reduced PSOCT probe tip longitudinal movement due to winding back, improved image quality and stability. Further validation of functionality by simulating RFA procedures in living swine through percutaneous access is ongoing.