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

dc.contributor.author

Eyerly, Stephanie A

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Bahnson, Tristram D

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Koontz, Jason I

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Bradway, David P

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Dumont, Douglas M

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Trahey, Gregg E

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Wolf, Patrick D

dc.coverage.spatial

United States

dc.date.accessioned

2015-08-12T17:05:40Z

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2012-11

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.identifier

http://www.ncbi.nlm.nih.gov/pubmed/22772134

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S1547-5271(12)00726-6

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1556-3871

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https://hdl.handle.net/10161/10365

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eng

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Elsevier BV

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Heart Rhythm

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10.1016/j.hrthm.2012.07.003

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Animals

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Cardiac Surgical Procedures

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Catheter Ablation

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Dogs

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Elasticity Imaging Techniques

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Image Enhancement

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Image Processing, Computer-Assisted

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Intraoperative Period

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Myocardium

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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

duke.contributor.orcid

Bahnson, Tristram D|0000-0001-9001-506X

duke.contributor.orcid

Bradway, David P|0000-0002-6613-2415

pubs.author-url

http://www.ncbi.nlm.nih.gov/pubmed/22772134

pubs.begin-page

1855

pubs.end-page

1862

pubs.issue

11

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Biomedical Engineering

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Clinical Science Departments

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Duke

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Medicine

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Medicine, Cardiology

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Pratt School of Engineering

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Radiology

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School of Medicine

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Staff

pubs.publication-status

Published

pubs.volume

9

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