Utilization of optical coherence tomography to assess coronary vessel constriction after ablation

Epicardial ablations are being utilized as alternative techniques to the current endocardial procedures. An epicardial approach offers some advantages, especially when treating ventricular arrhythmias, e.g., those that have epicardial or transmural sites of origin. However the potential collateral damage from these applied myocardial surface ablations has not been fully explored. In order to better visualize and understand such effects on acute coronary functioning, we have employed intracoronary optical coherence tomography (OCT) of ablated cardiac tissues. Ex-vivo swine hearts were reanimated utilizing Visible Heart® Laboratories methodologies, then the midsection of the LAD was anatomically characterized via OCT before and after an applied epicardial ablation: including using irreversible electroporation (IRE), and radiofrequency ablation (RF). Post-ablation OCT scans revealed detectable coronary diameter reductions stemming from applied adjacent epicardial ablations. These initial results demonstrate a need for further explorations to better understand and thus minimize collateral damage during epicardial ablations.