J Biomed Opt. 2011 Nov;16(11):110505. doi: 10.1117/1.3656966.
Complete catheter-tissue contact and permanent tissue destruction are essential for efficient radio-frequency ablation (RFA) during cardiac arrhythmia treatment. Current methods of monitoring lesion formation are indirect and unreliable. The purpose of this study is to evaluate the feasibility of using optical coherence tomography (OCT) catheter to image endocardial wall in actively beating hearts through percutaneous access. We reported the first in vivo intracardiac OCT imaging through percutaneous access with a thin and flexible OCT catheter. This is a critical step toward image-guided RFA in a clinical setting. A cone-scanning forward-viewing OCT catheter was advanced into beating hearts through percutaneous access in four swine. The OCT catheter was steered by an introducer to touch the endocardial wall. We are able to acquire high quality OCT images in beating hearts, observe the polarization-related artifacts induced by the birefringence of myocardium, and readily evaluate catheter-tissue contact. The observations indicate that OCT could be a promising technique for in vivo guidance of RFA.
实现高效的射频消融（RFA）治疗心律失常，导管与组织的完全接触和永久性组织破坏至关重要。目前监测病灶形成的方法是间接的，不可靠的。本研究旨在评估经皮穿刺途径使用光学相干断层扫描（OCT）导管对跳动心脏的心内膜成像的可行性。我们报道了首例经皮穿刺途径的腔内 OCT 成像，使用了薄而灵活的 OCT 导管。这是朝着临床 RFA 图像引导迈出的关键一步。通过经皮穿刺途径，将锥形扫描前视 OCT 导管推进到四只猪的搏动心脏中。OCT 导管通过引入器引导，使其接触心内膜。我们能够在跳动的心脏中获得高质量的 OCT 图像，观察到由心肌双折射引起的与偏振相关的伪影，并能方便地评估导管与组织的接触。观察结果表明，OCT 可能是 RFA 体内引导的一种很有前途的技术。
