集成的RFA / PSOCT导管可实时指导心脏射频消融。,Biomedical Optics Express

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集成的RFA / PSOCT导管可实时指导心脏射频消融。
Biomedical Optics Express ( IF 2.9 ) Pub Date : 2019-05-09 , DOI: 10.1364/boe.9.006400
Xiaowei Zhao _{1,

2} , Xiaoyong Fu _{1,

2} , Colin Blumenthal ₃ , Yves T Wang _{1,

4} , Michael W Jenkins _{1,

4} , Christopher Snyder _{4,

5} , Mauricio Arruda ₆ , Andrew M Rollins ₁

Affiliation

射频消融（RFA）是心律不齐的重要标准疗法，但目前尚缺乏对组织治疗的直接监测。我们演示了集成有偏振敏感光学相干断层扫描（PSOCT）的RFA导管，可直接直接实时监控RFA过程。集成的RFA / OCT导管是从标准的临床RFA导管改良而来的，并包括一个微型的前视锥扫描OCT探针。通过将四分之一波片验证PSOCT系统，同时通过将病变大小与未修改的RFA导管进行比较来验证集成导管的RFA功能。另外，集成导管引导导管组织并置并实时监测心脏组织中RFA病变的形成。结果表明，可以通过观察所获取的OCT图像中血液和组织的特征来表征导管与组织的接触，并且可以通过监测所获取的PSOCT图像中的相位延迟的变化来确认RFA病变的形成。该系统证明了集成RFA / OCT导管同时传递RF能量和对心脏壁成像的可行性，并证明了对该技术辅助RFA治疗心律不齐的进一步研究的合理性。

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Integrated RFA/PSOCT catheter for real-time guidance of cardiac radio-frequency ablation.

Radiofrequency ablation (RFA) is an important standard therapy for cardiac arrhythmias, but direct monitoring of tissue treatment is currently lacking. We demonstrate an RFA catheter integrated with polarization sensitive optical coherence tomography (PSOCT) for directly monitoring the RFA process in real time. The integrated RFA/OCT catheter was modified from a standard clinical RFA catheter and includes a miniature forward-viewing cone-scanning OCT probe. The PSOCT system was validated with a quarter-wave plate while the RFA function of the integrated catheter was validated by comparing lesion sizes with those made with an unmodified RFA catheter. Additionally, the integrated catheter guided catheter-tissue apposition and monitored RFA lesion formation in cardiac tissue in real time. The results show that catheter-tissue contact can be characterized by observing the features of the blood and tissue in the acquired OCT images and that RFA lesion formation can be confirmed by monitoring the change in phase retardance in the acquired PSOCT images. This system demonstrates the feasibility of an integrated RFA/OCT catheter to deliver RF energy and image the cardiac wall simultaneously and justifies further research into use of this technology to aid RFA therapy for cardiac arrhythmias.

更新日期：2019-11-01

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