Evaluation of radio frequency ablation in human left atrial tissues for atrial fibrillation using optical coherence tomography

Despite its widespread adoption, the success of radiofrequency (RF) ablation is often limited by challenges in achieving durable, transmural lesions while avoiding complications such as incomplete ablation or over-ablation. Optical coherence tomography (OCT) offers high-resolution visualization of cardiac tissue, enabling real-time assessment of lesion depth. Therefore, we investigated the impact of RF ablation on donated human left atrial tissue using an OCT imaging system to assess lesion formation in a controlled laboratory setting. RF ablation lesions were created at durations of 20, 40, 60, 80, and 100 seconds (s), and their effects were quantified by calculating the attenuation coefficient from OCT images. To identify tissue regions in the image, a U-Net model was employed for segmentation, achieving a mean intersection over union (IoU) of 0.9748 with an inference time of 82 milliseconds. Our results demonstrated clear differences in tissue response before and after ablation, with distinct lesion characteristics across the tested durations. One-way ANOVA analysis yielded a p-value of 1.09 × 10^-8, confirming statistically significant differences among the ablation durations. These findings highlight the potential of SD-OCT for precise, real-time monitoring of ablation effects. Future work aims to integrate OCT with ablation catheters for clinical applications, enhancing the precision of catheter-based treatments for conditions like atrial fibrillation.