Microbubble-Facilitated Ultrasound Catheter Ablation Causes Microvascular Damage and Fibrosis

High-intensity ultrasound (US) ablation produces deeper myocardial lesions than radiofrequency ablation. The presence of intravascular microbubble (MB) contrast agents enhances pulsed-wave US ablation via cavitation-related histotripsy, potentially facilitating ablation in persistently perfused/cond...

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Published inUltrasound in medicine & biology Vol. 47; no. 1; pp. 131 - 138
Main Authors Nazer, Babak, Giraud, David, Zhao, Yan, Qi, Yue, Mason, O'Neil, Jones, Peter D., Diederich, Chris J., Gerstenfeld, Edward P., Lindner, Jonathan R.
Format Journal Article
LanguageEnglish
Published England Elsevier Inc 01.01.2021
Subjects
Animals
Arrhythmias
Catheter Ablation - adverse effects
Catheter Ablation - methods
Electrophysiology
Fibrosis - etiology
Histotripsy
Mice
Microbubbles
Microbubbles - adverse effects
Microvessels - injuries
Phantoms, Imaging
Pulsed ultrasound ablation
Ultrasonic Therapy - adverse effects
Ultrasonic Therapy - methods
Microbubbles
Electrophysiology
Pulsed ultrasound ablation
Histotripsy
Arrhythmias
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Abstract High-intensity ultrasound (US) ablation produces deeper myocardial lesions than radiofrequency ablation. The presence of intravascular microbubble (MB) contrast agents enhances pulsed-wave US ablation via cavitation-related histotripsy, potentially facilitating ablation in persistently perfused/conducting myocardium. US ablation catheters were developed and tested in the presence of MBs using ex vivo and in vivo models. High-frame-rate videomicroscopy and US imaging of gel phantom models confirmed MB destruction by inertial cavitation. MB-facilitated US ablation in an ex vivo perfused myocardium model generated shallow (2 mm) lesions and, in an in vivo murine hindlimb model, reduced perfusion by 42% with perivascular hemorrhage and inflammation, but no myonecrosis.
AbstractList High-intensity ultrasound (US) ablation produces deeper myocardial lesions than radiofrequency ablation. The presence of intravascular microbubble (MB) contrast agents enhances pulsed-wave US ablation via cavitation-related histotripsy, potentially facilitating ablation in persistently perfused/conducting myocardium. US ablation catheters were developed and tested in the presence of MBs using ex vivo and in vivo models. High-frame-rate videomicroscopy and US imaging of gel phantom models confirmed MB destruction by inertial cavitation. MB-facilitated US ablation in an ex vivo perfused myocardium model generated shallow (2 mm) lesions and, in an in vivo murine hindlimb model, reduced perfusion by 42% with perivascular hemorrhage and inflammation, but no myonecrosis.
High-intensity ultrasound ablation produces deeper myocardial lesions than radiofrequency ablation. The presence of intravascular microbubble (MB) contrast agents enhances pulsed-wave US ablation via cavitation-related histotripsy, potentially facilitating ablation in persistently perfused/conducting myocardium. US ablation catheters were developed and tested in the presence of MBs using ex-vivo and in-vivo models. High-frame rate videomicroscopy and ultrasound imaging of gel phantom models confirmed MB destruction by inertial cavitation. MB-facilitated US ablation in ex-vivo, perfused myocardium model generated shallow (2 mm) lesions, and in in-vivo murine hindlimb model reduced perfusion by 42% with perivascular hemorrhage and inflammation, but no myonecrosis.
Author Lindner, Jonathan R.
Diederich, Chris J.
Giraud, David
Jones, Peter D.
Gerstenfeld, Edward P.
Qi, Yue
Zhao, Yan
Mason, O'Neil
Nazer, Babak
AuthorAffiliation c Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California San Francisco, 400 Parnassus Ave, San Francisco, CA 94143, USA
b Thermal Therapy Research Group, Department of Radiation Oncology, University of California San Francisco, Box 1708, 2340 Sutter Street, Room S331, San Francisco, CA 94115, USA
a Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, 3181 SW Sam Jackson Park Rd., OR 97239, Portland
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Keywords Microbubbles
Electrophysiology
Pulsed ultrasound ablation
Histotripsy
Arrhythmias
Language English
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Snippet High-intensity ultrasound (US) ablation produces deeper myocardial lesions than radiofrequency ablation. The presence of intravascular microbubble (MB)...
High-intensity ultrasound ablation produces deeper myocardial lesions than radiofrequency ablation. The presence of intravascular microbubble (MB) contrast...
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StartPage 131
SubjectTerms Animals
Arrhythmias
Catheter Ablation - adverse effects
Catheter Ablation - methods
Electrophysiology
Fibrosis - etiology
Histotripsy
Mice
Microbubbles
Microbubbles - adverse effects
Microvessels - injuries
Phantoms, Imaging
Pulsed ultrasound ablation
Ultrasonic Therapy - adverse effects
Ultrasonic Therapy - methods
Title Microbubble-Facilitated Ultrasound Catheter Ablation Causes Microvascular Damage and Fibrosis
URI https://dx.doi.org/10.1016/j.ultrasmedbio.2020.09.007
https://www.ncbi.nlm.nih.gov/pubmed/33092899
https://www.proquest.com/docview/2454102315
https://pubmed.ncbi.nlm.nih.gov/PMC8211318
Volume 47
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