Key result
Real-time laser Doppler flowmetry detected a significant decrease in myocardial blood perfusion from 22.92 AU before to 13.64 AU after high-dose (600 Ws) radiofrequency ablation in a porcine model.
Why the study?
Cardiac ablation therapy for supraventricular or ventricular arrhythmia is performed without real-time assessment of whether the intended lesion and lesion size have been achieved.
Does laser Doppler flowmetry accurately detect changes in myocardial microcirculation during radiofrequency ablation in a beating pig heart model?
Does laser Doppler flowmetry accurately detect changes in myocardial microcirculation during radiofrequency ablation in a beating pig heart model?
Laser Doppler flowmetry can detect significant reductions in myocardial microcirculation immediately following radiofrequency ablation in a beating heart model, suggesting potential for real-time lesion monitoring.
Answers are grounded in this paper and cite their sources.
May inform intraprocedural perfusion monitoring; hypothesis-generating in animal models with uncertain human translation.
The intra-operative real-time assessment of tissue viability can potentially improve therapy delivery and clinical outcome in cardiovascular therapies. Cardiac ablation therapy for the treatment of supraventricular or ventricular arrhythmia continues to be done without being able to assess if the intended lesion and lesion size have been achieved. Here, we report a method for continuous measurements of cardiac muscle microcirculation to provide an instrument for real-time ablation monitoring. We performed two acute open chest animal studies to assess the ability to perform real-time monitoring of creation and size of ablation lesion using a standard RF irrigated catheter. Radiofrequency ablation and laser Doppler were applied to different endocardial areas of alive open-chest pig. We performed two experiments at three different RF ablation energy setting and different ablation times. Perfusion signals before and after ablation were found extensively and distinctively different. By increasing the ablation energy and time, the perfusion signal was decreasing. In vivo assessing the local microcirculation during RF ablation by laser Doppler can potentially be useful to differentiate between viable and nonviable ablated beating heart in real time.
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Litvinova et al. (2020) studied Myocardial viability during radiofrequency ablation (n=2). Radiofrequency ablation monitored by laser Doppler flowmetry vs. Pre-ablation baseline was evaluated on Myocardial blood perfusion (LDF signal in arbitrary units) at 600 Ws ablation dose (p=0.011). Real-time laser Doppler flowmetry detected a significant decrease in myocardial blood perfusion from 22.92 AU before to 13.64 AU after high-dose (600 Ws) radiofrequency ablation in a porcine model.
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