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Proceedings Paper

Catheter-based high-intensity ultrasound for epicardial ablation of the left ventricle: device design and in vivo feasiblity
Author(s): Vasant A. Salgaonkar; Babak Nazer; Peter D. Jones; Yasuaki Tanaka; Alastair Martin; Bennett Ng; Srikant Duggirala; Chris J. Diederich; Edward P, Gerstenfeld
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Paper Abstract

The development and in vivo testing of a high-intensity ultrasound thermal ablation catheter for epicardial ablation of the left ventricle (LV) is presented. Scar tissue can occur in the mid-myocardial and epicardial space in patients with nonischemic cardiomyopathy and lead to ventricular tachycardia. Current ablation technology uses radiofrequency energy, which is limited epicardially by the presence of coronary vessels, phrenic nerves, and fat. Ultrasound energy can be precisely directed to deliver targeted deep epicardial ablation while sparing intervening epicardial nerve and vessels.

The proof-of-concept ultrasound applicators were designed for sub-xyphoid access to the pericardial space through a steerable 14-Fr sheath. The catheter consists of two rectangular planar transducers, for therapy (6.4 MHz) and imaging (5 MHz), mounted at the tip of a 3.5-mm flexible nylon catheter coupled and encapsulated within a custom-shaped balloon for cooling.

Thermal lesions were created in the LV in a swine (n = 10) model in vivo. The ultrasound applicator was positioned fluoroscopically. Its orientation and contact with the LV were verified using A-mode imaging and a radio-opaque marker. Ablations employed 60-s exposures at 15 – 30 W (electrical power). Histology indicated thermal coagulation and ablative lesions penetrating 8 – 12 mm into the left ventricle on lateral and anterior walls and along the left anterior descending artery.

The transducer design enabled successful sparing from the epicardial surface to 2 – 4 mm of intervening ventricle tissue and epicardial fat. The feasibility of targeted epicardial ablation with catheter-based ultrasound was demonstrated.

Paper Details

Date Published: 12 March 2015
PDF: 8 pages
Proc. SPIE 9326, Energy-based Treatment of Tissue and Assessment VIII, 93260H (12 March 2015); doi: 10.1117/12.2079629
Show Author Affiliations
Vasant A. Salgaonkar, Univ. of California, San Francisco (United States)
Babak Nazer, Univ. of California, San Francisco (United States)
Peter D. Jones, Univ. of California, San Francisco (United States)
Yasuaki Tanaka, Univ. of California, San Francisco (United States)
Alastair Martin, Univ. of California, San Francisco (United States)
Bennett Ng, Univ. of California, San Francisco (United States)
Univ. of California, Berkeley (United States)
Srikant Duggirala, Univ. of California, San Francisco (United States)
Chris J. Diederich, Univ. of California, San Francisco (United States)
Univ. of California, Berkeley (United States)
Edward P, Gerstenfeld, Univ. of California, San Francisco (United States)


Published in SPIE Proceedings Vol. 9326:
Energy-based Treatment of Tissue and Assessment VIII
Thomas P. Ryan, Editor(s)

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