Evidence map›Paper›PMID 25141861›Full record

ArticleCirculation. Arrhythmia and electrophysiology2014

Visualization of epicardial cryoablation lesions using endogenous tissue fluorescence.

Luther Swift, Daniel A B Gil, Rafael Jaimes, Matthew Kay, Marco Mercader, Narine Sarvazyan

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Arrhythmia and electrophysiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Luther SwiftFrom the Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC (L.S., D.A.B.G., M.K., N.S.); Department of Electrical and Computer Engineering, George Washington School of Engineering and Applied Science, Washington, DC (D.A.B.G., R.J., M.K.); and Division of Cardiology, George Washington University School of Medicine and Health Sciences and Medical Faculty Associates, Washington, DC (M.M.).
Daniel A B GilFrom the Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC (L.S., D.A.B.G., M.K., N.S.); Department of Electrical and Computer Engineering, George Washington School of Engineering and Applied Science, Washington, DC (D.A.B.G., R.J., M.K.); and Division of Cardiology, George Washington University School of Medicine and Health Sciences and Medical Faculty Associates, Washington, DC (M.M.).
Rafael JaimesFrom the Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC (L.S., D.A.B.G., M.K., N.S.); Department of Electrical and Computer Engineering, George Washington School of Engineering and Applied Science, Washington, DC (D.A.B.G., R.J., M.K.); and Division of Cardiology, George Washington University School of Medicine and Health Sciences and Medical Faculty Associates, Washington, DC (M.M.).
Matthew KayFrom the Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC (L.S., D.A.B.G., M.K., N.S.); Department of Electrical and Computer Engineering, George Washington School of Engineering and Applied Science, Washington, DC (D.A.B.G., R.J., M.K.); and Division of Cardiology, George Washington University School of Medicine and Health Sciences and Medical Faculty Associates, Washington, DC (M.M.).
Marco MercaderFrom the Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC (L.S., D.A.B.G., M.K., N.S.); Department of Electrical and Computer Engineering, George Washington School of Engineering and Applied Science, Washington, DC (D.A.B.G., R.J., M.K.); and Division of Cardiology, George Washington University School of Medicine and Health Sciences and Medical Faculty Associates, Washington, DC (M.M.).
Narine SarvazyanFrom the Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC (L.S., D.A.B.G., M.K., N.S.); Department of Electrical and Computer Engineering, George Washington School of Engineering and Applied Science, Washington, DC (D.A.B.G., R.J., M.K.); and Division of Cardiology, George Washington University School of Medicine and Health Sciences and Medical Faculty Associates, Washington, DC (M.M.). phynas@gwu.edu.

Funding

Low flow reperfusion after acute myocardial ischemia: when too little is too muchR01HL095828 · NHLBI · GEORGE WASHINGTON UNIVERSITY · PI KAY, MATTHEW W. · 2010 to 2014
$1.6M
New generation of catheters for treatment of atrial fibrillationR41HL120511 · NHLBI · NOCTURNAL PRODUCT DEVELOPMENT, LLC · PI SARVAZYAN, NARINE · 2014 to 2014
$200k
NHLBI NIH HHS HL095828NHLBI NIH HHS R01 HL095828NHLBI NIH HHS R41 HL120511
6 · The paper itself

Abstract

backgroundPercutaneous cryoballoon ablation is a commonly used procedure to treat atrial fibrillation. One of the major limitations of the procedure is the inability to directly visualize tissue damage and functional gaps between the lesions. We seek to develop an approach that will enable real-time visualization of tissue necrosis during cryo- or radiofrequency ablation procedures. METHODS AND

resultsCryoablation of either blood-perfused or saline-perfused hearts was associated with a marked decrease in nicotinamide adenine dinucleotide (NADH) fluorescence, leading to a 60% to 70% loss of signal intensity at the lesion site. The total lesion area observed on the NADH channel exhibited a strong correlation with the area identified by triphenyl tetrazolium staining (r=0.89, P<0.001). At physiological temperatures, loss of NADH became visually apparent within 26±8 s after detachment of the cryoprobe from the epicardial surface and plateaued within minutes after which the boundaries of the lesions remained stable for several hours. The loss of electrical activity within the cryoablation site exhibited a close spatial correlation with the loss of NADH (r=0.84±0.06, P<0.001). Cryoablation led to a decrease in diffuse reflectance across the entire visible spectrum, which was in stark contrast to radiofrequency ablation that markedly increased the intensity of reflected light at the lesion sites.

conclusionsWe confirmed the feasibility of using endogenous NADH fluorescence for the real-time visualization of cryoablation lesions in blood-perfused cardiac muscle preparations and revealed similarities and differences between imaging cryo- and radiofrequency ablation lesions when using ultraviolet and visible light illumination.

Indexed as

Catheter AblationCryosurgeryOptical ImagingAction PotentialsAnimalsBiomarkersDown-RegulationFeasibility StudiesFemaleMaleModels, AnimalNADNecrosisPericardiumPredictive Value of TestsRats, Sprague-DawleyBiomarkersNADablationatrial fibrillation arrhythmia

Identifiers

PMID25141861
PMCPMC4206680

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.