# Optically guided catheter ablation of atrial fibrillation

> **NIH NIH R01** · CASE WESTERN RESERVE UNIVERSITY · 2020 · $709,225

## Abstract

SUMMARY: Atrial fibrillation (AF) affects approximately 3 million patients and its prevalence is expected to rise
as the population ages. Catheter ablation, the preferred treatment strategy for symptomatic patients, creates
local regions of tissue necrosis in the atria called lesions that are meant to abolish abnormal electrical activity
that causes AF. However, AF recurrence is significant in these patients mostly due to inadequate lesions
formed by ablation or by recovery of abnormal electrical activity. Currently, standard-of-care technology to
guide lesion formation relies on surrogates for lesion formation that only marginally improve outcomes.
Additionally, in some patients with AF the abnormal activity responsible cannot be localized, which then
requires adjunctive lesions targeting alternative structural substrates for AF such as fibrosis and scarring.
However, alternative AF substrates are currently identified indirectly based substrate proxies rather than the
substrate itself, which has yet to be proven effective. Therefore, the main barriers to the successful treatment
of AF continue to be: a) creating lesions that completely and permanently block abnormal electrical activity,
and b) accurately identifying substrates that are known to cause AF. Optical coherence tomography (OCT) is
an imaging method that can monitor lesion formation in real-time, and near-infrared spectroscopy (NIRS) can
quantify optical properties from measured diffuse tissue reflectance during RF ablation. When combined,
OCT/NIRS can provide direct information on lesion formation, depth, and tissue composition. Based on our
previous work and preliminary data we hypothesize that compared to standard-of-care methods, combined
OCT/NIRS can be safe and more effective at creating lesions that are complete and durable and for mapping
AF structural substrates. To test this hypothesis, we aim to: 1. Develop and validate real-time optically guided
atrial ablation lesion formation, and 2. Develop and validate real-time optical mapping of AF structural
substrates. For both of these aims, development includes innovative OCT/NIRS software and hardware
methods along with validation in vivo and ex vivo in atria from normal pigs and pigs with AF as well as in atrial
tissue from humans with or without AF. Then, based on these developments we aim to: 3. Compare real-time
optically guided lesion formation and mapping of AF structural substrates against standard-of-care methods.
Outcomes will be determined acutely in vivo and verified ex vivo immediately after the procedure and
chronically to determine durability of lesions. To achieve these aims, we have assembled a uniquely qualified
multi-disciplinary multi-PI team with expertise in OCT (Drs. Rollins and Hendon), NIRS (Dr. Hendon), and basic
cardiac electrophysiology (Dr. Laurita), along with Co-I expertise in clinical AF ablation (Dr. Ziv) and
cardiovascular pathology (Dr. Marboe). Our team's long-term goal is to develop innovative ...

## Key facts

- **NIH application ID:** 9983799
- **Project number:** 5R01HL149369-02
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Christine P Hendon
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $709,225
- **Award type:** 5
- **Project period:** 2019-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9983799

## Citation

> US National Institutes of Health, RePORTER application 9983799, Optically guided catheter ablation of atrial fibrillation (5R01HL149369-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9983799. Licensed CC0.

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