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Baena-Montes JM, Kraśny MJ, O’Halloran M, Dunne E, Quinlan LR. In Vitro Models for Improved Therapeutic Interventions in Atrial Fibrillation. J Pers Med 2023; 13:1237. [PMID: 37623487 PMCID: PMC10455620 DOI: 10.3390/jpm13081237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
Atrial fibrillation is the most common type of cardiac arrhythmias in humans, mostly caused by hyper excitation of specific areas in the atrium resulting in dyssynchronous atrial contractions, leading to severe consequences such as heart failure and stroke. Current therapeutics aim to target this condition through both pharmacological and non-pharmacological approaches. To test and validate any of these treatments, an appropriate preclinical model must be carefully chosen to refine and optimise the therapy features to correctly reverse this condition. A broad range of preclinical models have been developed over the years, with specific features and advantages to closely mimic the pathophysiology of atrial fibrillation. In this review, currently available models are described, from traditional animal models and in vitro cell cultures to state-of-the-art organoids and organs-on-a-chip. The advantages, applications and limitations of each model are discussed, providing the information to select the appropriate model for each research application.
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Affiliation(s)
- Jara M. Baena-Montes
- Physiology and Cellular Physiology Research Laboratory, School of Medicine, Human Biology Building, University of Galway, H91 TK33 Galway, Ireland
| | - Marcin J. Kraśny
- Smart Sensors Lab, Lambe Institute for Translational Research, School of Medicine, University of Galway, H91 TK33 Galway, Ireland
- Translational Medical Device Lab (TMDLab), Lambe Institute for Translational Research, School of Medicine, University of Galway, H91 TK33 Galway, Ireland
| | - Martin O’Halloran
- Translational Medical Device Lab (TMDLab), Lambe Institute for Translational Research, School of Medicine, University of Galway, H91 TK33 Galway, Ireland
- Electrical & Electronic Engineering, School of Engineering, University of Galway, H91 TK33 Galway, Ireland
| | - Eoghan Dunne
- Translational Medical Device Lab (TMDLab), Lambe Institute for Translational Research, School of Medicine, University of Galway, H91 TK33 Galway, Ireland
| | - Leo R. Quinlan
- Physiology and Cellular Physiology Research Laboratory, School of Medicine, Human Biology Building, University of Galway, H91 TK33 Galway, Ireland
- CÚRAM SFI Centre for Research in Medical Devices, University of Galway, H91 TK33 Galway, Ireland
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Wu Z, Kumon RE, Laughner JI, Efimov IR, Deng CX. Electrophysiological changes correlated with temperature increases induced by high-intensity focused ultrasound ablation. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:432-448. [PMID: 25516446 PMCID: PMC4297512 DOI: 10.1016/j.ultrasmedbio.2014.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 08/30/2014] [Accepted: 09/04/2014] [Indexed: 06/04/2023]
Abstract
To gain better understanding of the detailed mechanisms of high-intensity focused ultrasound (HIFU) ablation for cardiac arrhythmias, we investigated how the cellular electrophysiological (EP) changes were correlated with temperature increases and thermal dose (cumulative equivalent minutes [CEM43]) during HIFU application using Langendorff-perfused rabbit hearts. Employing voltage-sensitive dye di-4-ANEPPS, we measured the EP and temperature during HIFU using simultaneous optical mapping and infrared imaging. Both action potential amplitude (APA) and action potential duration at 50% repolarization (APD50) decreased with temperature increases, and APD50 was more thermally sensitive than APA. EP and tissue changes were irreversible when HIFU-induced temperature increased above 52.3 ± 1.4°C and log10(CEM43) above 2.16 ± 0.51 (n = 5), but were reversible when temperature was below 50.1 ± 0.8°C and log10(CEM43) below -0.9 ± 0.3 (n = 9). EP and temperature/thermal dose changes were spatially correlated with HIFU-induced tissue necrosis surrounded by a transition zone.
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Affiliation(s)
- Ziqi Wu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Ronald E Kumon
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Jacob I Laughner
- Department of Biomedical Engineering, Washington University at Saint Louis, MO, USA
| | - Igor R Efimov
- Department of Biomedical Engineering, Washington University at Saint Louis, MO, USA
| | - Cheri X Deng
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
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Tsai MT, Chang FY, Lee CK, Gong CSA, Lin YX, Lee JD, Yang CH, Liu HL. Investigation of temporal vascular effects induced by focused ultrasound treatment with speckle-variance optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2014; 5:2009-2022. [PMID: 25071945 PMCID: PMC4102345 DOI: 10.1364/boe.5.002009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 05/28/2014] [Accepted: 05/28/2014] [Indexed: 05/30/2023]
Abstract
Focused ultrasound (FUS) can be used to locally and temporally enhance vascular permeability, improving the efficiency of drug delivery from the blood vessels into the surrounding tissue. However, it is difficult to evaluate in real time the effect induced by FUS and to noninvasively observe the permeability enhancement. In this study, speckle-variance optical coherence tomography (SVOCT) was implemented for the investigation of temporal effects on vessels induced by FUS treatment. With OCT scanning, the dynamic change in vessels during FUS exposure can be observed and studied. Moreover, the vascular effects induced by FUS treatment with and without the presence of microbubbles were investigated and quantitatively compared. Additionally, 2D and 3D speckle-variance images were used for quantitative observation of blood leakage from vessels due to the permeability enhancement caused by FUS, which could be an indicator that can be used to determine the influence of FUS power exposure. In conclusion, SVOCT can be a useful tool for monitoring FUS treatment in real time, facilitating the dynamic observation of temporal effects and helping to determine the optimal FUS power.
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Affiliation(s)
- Meng-Tsan Tsai
- Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302 Taiwan
- Graduate Institute of Electro-Optical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302 Taiwan
| | - Feng-Yu Chang
- Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302 Taiwan
| | - Cheng-Kuang Lee
- Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302 Taiwan
| | - Cihun-Siyong Alex Gong
- Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302 Taiwan
| | - Yu-Xiang Lin
- Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302 Taiwan
| | - Jiann-Der Lee
- Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302 Taiwan
| | - Chih-Hsun Yang
- Department of Dermatology, Chang Gung Memorial Hospital, 5 Fusing Street, Kwei-Shan, Tao-Yaun 33302, Taiwan
| | - Hao-Li Liu
- Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302 Taiwan
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Wu Z, Gudur MSR, Deng CX. Transmural ultrasound imaging of thermal lesion and action potential changes in perfused canine cardiac wedge preparations by high intensity focused ultrasound ablation. PLoS One 2013; 8:e82689. [PMID: 24349337 PMCID: PMC3861459 DOI: 10.1371/journal.pone.0082689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 11/04/2013] [Indexed: 11/19/2022] Open
Abstract
Intra-procedural imaging is important for guiding cardiac arrhythmia ablation. It is difficult to obtain intra-procedural correlation of thermal lesion formation with action potential (AP) changes in the transmural plane during ablation. This study tested parametric ultrasound imaging for transmural imaging of lesion and AP changes in high intensity focused ultrasound (HIFU) ablation using coronary perfused canine ventricular wedge preparations (n = 13). The preparations were paced from epi/endocardial surfaces and subjected to HIFU application (3.5 MHz, 11 Hz pulse-repetition-frequency, 70% duty cycle, duration 4 s, 3500 W/cm2), during which simultaneous optical mapping (1 kframes/s) using di-4-ANEPPS and ultrasound imaging (30 MHz) of the same transmural surface of the wedge were performed. Spatiotemporally correlated AP measurements and ultrasound imaging allowed quantification of the reduction of AP amplitude (APA), shortening of AP duration at 50% repolarization, AP triangulation, decrease of optical AP rise, and change of conduction velocity along tissue depth direction within and surrounding HIFU lesions. The threshold of irreversible change in APA correlating to lesions was determined to be 43±1% with a receiver operating characteristic (ROC) area under curve (AUC) of 0.96±0.01 (n = 13). Ultrasound imaging parameters such as integrated backscatter, Rayleigh (α) and log-normal (σ) parameters, cumulative extrema of σ were tested, with the cumulative extrema of σ performing the best in detecting lesion (ROC AUC 0.89±0.01, n = 13) and change of APA (ROC AUC 0.79±0.03, n = 13). In conclusion, characteristic tissue and AP changes in HIFU ablation were identified and spatiotemporally correlated using optical mapping and ultrasound imaging. Parametric ultrasound imaging using cumulative extrema of σ can detect HIFU lesion and APA reduction.
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Affiliation(s)
- Ziqi Wu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Madhu S. R. Gudur
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Cheri X. Deng
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail:
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Couppis A, Damianou C, Kyriacou P, Lafon C, Chavrier F, Chapelon JY, Birer A. Heart ablation using a planar rectangular high intensity ultrasound transducer and MRI guidance. ULTRASONICS 2012; 52:821-829. [PMID: 22525419 DOI: 10.1016/j.ultras.2012.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 01/31/2012] [Accepted: 03/26/2012] [Indexed: 05/31/2023]
Abstract
The aim of this study was to evaluate a flat rectangular (3×10mm(2)) MRI compatible transducer operating at 5MHz. The main task was to explore the feasibility of creating deep lesions in heart at a depth of at least 15mm. The size of thermal necrosis in heart tissue was estimated as a function of power and time using a simulation model. The system was then tested in an excised lamb heart. In this study, we were able to create lesions of 15mm deep with acoustic power of 6W for an exposure of approximately 1min. The contrast to noise ratio (CNR) between lesion and heart tissue was evaluated using fast spin echo (FSE). The CNR value was approximately 22 using T1W FSE. Maximum CNR was achieved with repetition time (TR) between 300 and 800ms. Using T2W FSE, the corresponding CNR was approximately 13 for the 14 in vivo experiments. The average lesion depth was 11.93mm with a standard deviation of 0.62mm. In vivo irradiation conditions were 6W for 60s. The size of the lesion in the other two dimensions was close to 3×10mm(2) (size of the transducer element).
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Hsu SJ, Fahey BJ, Dumont DM, Wolf PD, Trahey GE. Challenges and implementation of radiation-force imaging with an intracardiac ultrasound transducer. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2007; 54:996-1009. [PMID: 17523564 PMCID: PMC2813778 DOI: 10.1109/tuffc.2007.345] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Intracardiac echocardiography (ICE) has been demonstrated to be an effective imaging modality for the guidance of several cardiac procedures, including radiofrequency ablation (RFA). However, assessing lesion size during the ablation with conventional ultrasound has been limited, as the associated changes within the B-mode images often are subtle. Acoustic radiation force impulse (ARFI) imaging is a promising modality to monitor RFAs as it is capable of visualizing variations in local stiffnesses within the myocardium. We demonstrate ARFI imaging with an intracardiac probe that creates higher quality images of the developing lesion. We evaluated the performance of an ICE probe with ARFI imaging in monitoring RFAs. The intracardiac probe was used to create high contrast, high resolution ARFI images of a tissue-mimicking phantom containing stiffer spherical inclusions. The probe also was used to examine an excised segment of an ovine right ventricle with a RFA-created surface lesion. Although the lesion was not visible in conventional B-mode images, the ARFI images were able to show the boundaries between the lesion and the surrounding tissue. ARFI imaging with an intracardiac probe then was used to monitor cardiac ablations in vivo. RFAs were performed within the right atrium of an ovine heart, and B-mode and ARFI imaging with the intracardiac probe was used to monitor the developing lesions. Although there was little indication of a developing lesion within the B-mode images, the corresponding ARFI images displayed regions around the ablation site that displaced less.
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Kuma F, Ueda N, Ito H, Maruyama T, Kaji Y, Fujino T, Harada M. Effects of ultrasound energy application on cardiac performance in open-chest Guinea pigs. Circ J 2006; 70:1356-61. [PMID: 16998272 DOI: 10.1253/circj.70.1356] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although ultrasound (US) is widely used in cardiology, little is known about the effects of US energy on cardiac performance. This study aimed to investigate the mechanical effects of high-intensity continuous US energy (1.0 MHz with 3 different intensities) on cardiac performance. METHODS AND RESULTS Either left ventricular (LV) pressure or aortic blood flow (ABF) was evaluated in open-chest guinea pigs (n=30) under surface ECG monitoring. LV systolic pressure and ABF increased significantly (ie, maximum percent increases in these parameters were 2.5%, 3.1% and 7.1% for LV systolic pressure and 9.4%, 4.9% and 8.8% for mean ABF at intensities of 0.06, 0.67 and 2.90 W/cm2, respectively). LV end-diastolic pressure was reduced significantly by US (5.3+/-0.9 to 4.8+/-0.8, 5.5 +/-1.3 to 4.8+/-1.0 and 5.8+/-2.0 to 5.0+/-1.2 mmHg, respectively), indicating positive inotropic and lusitropic effects and resultant ABF augmentation. Local temperature was not significantly changed. ECG showed neither chronotropic action nor arrhythmogenesis. CONCLUSIONS Although the basic mechanisms of these phenomena remain unclear, this pilot study of the short-term effects of US energy on cardiac performance suggests the possibility of physical therapy for heart failure.
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Affiliation(s)
- Fumiaki Kuma
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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