2011 Articles

First in vivo Real-Time Imaging of Endocardial RF Ablation by Optical Coherence Tomography

Fleming, Christine P.; Rosenthal, Noah; Rollins, Andrew M.; Arruda, Mauricio

We report the first in vivo use of optical coherence tomography (OCT), a high-resolution (~10 µm) real-time imaging technology, to scan subendocardial tissue and to monitor radiofrequency (RF) lesion formation. Endocardial imaging during an open chest procedure in a female pig was conducted with a forward imaging catheter with a Fourier Domain OCT system at 20 frames per second. Images of the endocardial surface and subendocardial tissue were obtained when the catheter was in direct contact with the endocardial surface. The formation and progressive increase in size of cavities within the myocardium were observed in the OCT images when a steam pop was audible. Our initial findings suggest that imaging with a forward scanning OCT catheter can assess tip electrode–tissue interface contact, image subsurface myocardial structure, and visualize dynamic effects of intramural RF energy delivery.