Background: Radiofrequency ablation (RFA) is an effective therapy to treat cardiac arrhythmias. The success rate depends on the location and size of ablation lesions. Electroanatomic Mapping and Contact force-sensing catheters have been shown to enhance the success rates of RFA. We used real-time optical tissue interrogation within the NADH fluorescence (fNADH) range to assess the progression of ablation lesion depth in real time during RF delivery (LuxCath catheter). Methods: Multiple RFA lesions (n=20) were made on an intubated and mechanically ventilated canine (Mongrel) thigh muscles using 7 Fr quadripolar RFA catheter with a 3.5 mm tip open 3.5 mm irrigated electrode incorporating imaging optic. Light was delivered at (360+/-25nm), and fluorescence acquired through fiberoptic bundle at (370-660 nm) by a spectrometer and analyzed in real time. Two types of plots were created for each lesion: intensity (in counts) vs. wavelength (nm), and 465nm peak amplitude (normalized) vs. time (sec). The lesions were made at room temperature with fixed power (15W) and four different durations (10, 20,30,40 sec). After ablation the muscle was stained with 2,3,4-triphenyl-2H-tetrazolium chloride (TTC), bisected at the center and measured the with and depth of the lesion using imageJ software. Results: We performed a total of twenty lesions that were divided into four groups based on the duration of the ablation (10, 20, 30, 40 seconds). The mean lesion depth for those groups was 4.05+/-1.28, 4.99+/-0.9, 6.9+/-1.06 and 7.14+/-1.41 mm, respectively. Lesion depth was correlated with the duration of ablation and fNADH signal intensity with a correlation coefficient of 0.93 and 0.99, respectively. Finally, there was a significant correlation between lesion size and fNADH signal intensity with a correlation coefficient of 0.96. Conclusion: Real-time optical tissue characterization can provide an excellent assessment of lesion progression during RF delivery. Lesion depth was directly correlated to the decrease in fNADH signal intensity. This information may be used to optimize the selection of RF power and RF application time to maximize RF lesion formation and improve the success of ablation procedures.
Read full abstract