Localizing and quantifying ablation lesions in the left ventricle by myocardial contrast echocardiography

Journal of Cardiovascular Electrophysiology
Dirar S KhourySherif F Nagueh

Abstract

The inability to determine the extent and intramural depth of ablation lesions can hamper the success of catheter ablation. The study tested the feasibility of differentiating radiofrequency ablation lesions from normal myocardium and quantifying their dimensions by myocardial contrast echocardiography (MCE). In 11 normal dogs, we created 14 focal and 4 linear lesions at different left ventricular sites. MCE was performed both before and after ablation by using an intracardiac echocardiography catheter (9 MHz) and infusing contrast microbubbles through the left coronary artery. We initially used two-dimensional MCE to image focal lesions and subsequently three-dimensional MCE to image linear lesions. An independent observer examined the lesion pathology. We found that intracardiac echocardiography alone could not delineate lesion dimensions. However, after ablation, MCE localized the lesions as well-defined, low-contrast areas within the normally opacified myocardium. Lesion dimensions by MCE immediately after ablation and 30 minutes later were similar. In 12 focal lesions, the average maximum depth (5.55 +/- 1.38 mm) and average maximum diameter (10.38 +/- 2.09 mm) by MCE were in excellent agreement with the pathologic depth (...Continue Reading

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Citations

Sep 1, 2005·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·James D MaloneyRobert Glueck
Mar 13, 2012·American Journal of Physiology. Heart and Circulatory Physiology·Marco MercaderNarine Sarvazyan
May 26, 2007·IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control·Stephen J HsuGregg E Trahey
Sep 1, 2011·IEEE Pulse·D S KhouryDorin Panescu
Oct 7, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Andrea M Russo
Mar 19, 2011·JACC. Cardiovascular Imaging·Erin E GirardRebecca Fahrig
Sep 15, 2004·Journal of Cardiovascular Electrophysiology·Franz X Roithinger
Aug 22, 2014·Circulation. Arrhythmia and Electrophysiology·Luther SwiftNarine Sarvazyan
May 3, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Carla LázaroJesús Almendral
Aug 23, 2016·Journal of Biophotonics·Daniel A GilNarine A Sarvazyan

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