# Photoacoustic Imaging to Guide Catheter Ablation of Cardiac Arrhythmias

> **NIH NIH R21** · METHODIST HOSPITAL RESEARCH INSTITUTE · 2022 · $254,205

## Abstract

Project Summary
Catheter ablation (CA) is a potentially curative treatment for nearly all cardiac arrhythmias, yet clinical outcomes
remain suboptimal, leading to repeat procedures. Success rates would improve if all targets for ablation could
be identified and if real-time assessment of the durability and continuity of ablation lesions could be determined.
These fundamental gaps in knowledge could be overcome by applying spectroscopic photoacoustic imaging
(sPAI) techniques to intraoperatively guide and monitor CA. sPAI can provide insight into tissue characterization
and ablation lesions based on wavelength-dependent optical absorption differences of tissue. By targeting
hemoglobin (total, deoxy-, and oxy-hemoglobin) and water absorption differences, perfused/viable tissue along
with local tissue oxygen saturation (StO2) and water content can be determined. The depth of this imaging can
go beyond the endocardial or epicardial surfaces of the heart and provide novel tissue characterization in the
“mid-myocardial” region of the heart, which is presently unknown via current mapping techniques. Prior work by
our group has shown that sPAI can provide real-time quantification of thermal ablation extent and depth. These
data are currently unavailable with existing technologies used by clinicians. Consequently, the goal of our
research is to develop and validate real-time sPAI techniques assessing tissue oxygen saturation (StO2), total
hemoglobin, and water content to 1) identify and differentiate regions of viable myocardium versus scar and 2)
determine permanently ablated tissue versus temporarily “injured” yet still viable myocardium. Such a capability
promises to identify novel targets for ablation, which would directly improve CA outcomes. Current approaches
often cannot directly identify deeper “mid-myocardial” targets for CA and adjunctive ablation techniques to target
these regions are based either on operator experience and/or prior failed procedures. sPAI would have the ability
to create—for the first time—a standardized workflow for when and how to target currently difficult to access
regions of the myocardium. This would have profound clinical implications for CA success rates while reducing
procedural complications. We intend to accomplish these aims by first optimizing sPAI techniques with
ultrasound (US) incorporation in ex-vivo ventricular tissue. This will determine the specifications needed for
optimal (e.g., maximal depth penetration and StO2 accuracy) tissue imaging. Subsequent work will then be
focused on optimization of in-vivo, sPAI-based, myocardial tissue characterization using an open-chest porcine
infarct model. We intend to identify regions of viable myocardium and scar and validate with grossly co-registered
MRI and independent histopathologic assessment. Finally, building on these initial experiments, we intend to
differentiate permanently ablated tissue from surrounding edematous (“injured”) and normal myocardial tissue
i...

## Key facts

- **NIH application ID:** 10453093
- **Project number:** 1R21HL159534-01A1
- **Recipient organization:** METHODIST HOSPITAL RESEARCH INSTITUTE
- **Principal Investigator:** Nilesh Mathuria
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $254,205
- **Award type:** 1
- **Project period:** 2022-04-18 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10453093

## Citation

> US National Institutes of Health, RePORTER application 10453093, Photoacoustic Imaging to Guide Catheter Ablation of Cardiac Arrhythmias (1R21HL159534-01A1). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10453093. Licensed CC0.

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