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Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.

dc.contributor.author Bahnson, TD
dc.contributor.author Bradway, David P
dc.contributor.author Dumont, DM
dc.contributor.author Eyerly, SA
dc.contributor.author Koontz, JI
dc.contributor.author Trahey, Gregg E
dc.contributor.author Wolf, PD
dc.coverage.spatial United States
dc.date.accessioned 2015-08-12T17:05:40Z
dc.date.issued 2012-11
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/22772134
dc.identifier S1547-5271(12)00726-6
dc.identifier.uri http://hdl.handle.net/10161/10365
dc.description.abstract BACKGROUND: Arrhythmia recurrence after cardiac radiofrequency ablation (RFA) for atrial fibrillation has been linked to conduction through discontinuous lesion lines. Intraprocedural visualization and corrective ablation of lesion line discontinuities could decrease postprocedure atrial fibrillation recurrence. Intracardiac acoustic radiation force impulse (ARFI) imaging is a new imaging technique that visualizes RFA lesions by mapping the relative elasticity contrast between compliant-unablated and stiff RFA-treated myocardium. OBJECTIVE: To determine whether intraprocedure ARFI images can identify RFA-treated myocardium in vivo. METHODS: In 8 canines, an electroanatomical mapping-guided intracardiac echo catheter was used to acquire 2-dimensional ARFI images along right atrial ablation lines before and after RFA. ARFI images were acquired during diastole with the myocardium positioned at the ARFI focus (1.5 cm) and parallel to the intracardiac echo transducer for maximal and uniform energy delivery to the tissue. Three reviewers categorized each ARFI image as depicting no lesion, noncontiguous lesion, or contiguous lesion. For comparison, 3 separate reviewers confirmed RFA lesion presence and contiguity on the basis of functional conduction block at the imaging plane location on electroanatomical activation maps. RESULTS: Ten percent of ARFI images were discarded because of motion artifacts. Reviewers of the ARFI images detected RFA-treated sites with high sensitivity (95.7%) and specificity (91.5%). Reviewer identification of contiguous lesions had 75.3% specificity and 47.1% sensitivity. CONCLUSIONS: Intracardiac ARFI imaging was successful in identifying endocardial RFA treatment when specific imaging conditions were maintained. Further advances in ARFI imaging technology would facilitate a wider range of imaging opportunities for clinical lesion evaluation.
dc.language eng
dc.relation.ispartof Heart Rhythm
dc.relation.isversionof 10.1016/j.hrthm.2012.07.003
dc.subject Animals
dc.subject Cardiac Surgical Procedures
dc.subject Catheter Ablation
dc.subject Dogs
dc.subject Elasticity Imaging Techniques
dc.subject Image Enhancement
dc.subject Image Processing, Computer-Assisted
dc.subject Intraoperative Period
dc.subject Myocardium
dc.subject Sensitivity and Specificity
dc.title Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/22772134
pubs.begin-page 1855
pubs.end-page 1862
pubs.issue 11
pubs.organisational-group Biomedical Engineering
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group Pratt School of Engineering
pubs.organisational-group Radiology
pubs.organisational-group School of Medicine
pubs.organisational-group Staff
pubs.publication-status Published
pubs.volume 9
dc.identifier.eissn 1556-3871


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