Abstract
Radiofrequency ablation is a commonly used clinical procedure that destroys arrhythmogenic sources in patients suffering from atrial fibrillation and other types of cardiac arrhythmias. To improve the success of this procedure, new approaches for real-time visualization of ablation sites are being developed. One of these promising methods is hyperspectral imaging, an approach that detects lesions based on changes in the endogenous tissue autofluorescence profile. To facilitate the clinical implementation of this approach, we examined the key variables that can influence ablation-induced spectral changes, including the drop in myocardial NADH levels, the release of lipofuscin-like pigments, and the increase in diffuse reflectance of the cardiac muscle beneath the endocardial layer. Insights from these experiments suggested simpler algorithms that can be used to acquire and post-process the spectral information required to reveal the lesion sites. Our study is relevant to a growing number of multilayered clinical targets to which spectral approaches are being applied.
Highlights
Our group has recently shown that the use of autofluorescence-based hyperspectral imaging (Auf-HSI) enables the circumvention of limitations imposed by the endocardial collagen layer
They fluoresce at longer wavelengths (< 500 nm), but their overall signal from the unablated muscle is weaker compared to the NADH signal
We have previously shown that Auf-HSI can be used to reveal RF ablation lesions in heart tissue from rats, pigs, and cows and that it works in blood-perfused p reparations[8,9,11]
Summary
Our group has recently shown that the use of autofluorescence-based hyperspectral imaging (Auf-HSI) enables the circumvention of limitations imposed by the endocardial collagen layer This approach employs illumination of the tissue surface with UV light while acquiring grayscale images across multiple wavelengths within the visible range. The dimensions and the shape of the lesions delineated by Auf-HSI were in perfect agreement with the conventional post-ablation staining methods such as TTC1 0–14 These promising bench findings have led to our ongoing efforts to incorporate Auf-HSI technology into a percutaneous imaging catheter[11,15,16]. The design of this catheter includes a saline-filled balloon to displace optically dense blood from the endocardial surface. Insights from our studies can be applied to the heart, and to other multilayered body tissues where spectral imaging offers diagnostic promise, including the skin, endovascular or epithelial surfaces
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