Towards this goal, we develop optical coherence tomography (OCT) and near infrared spectroscopy (NIRS) systems and automated processing tools to correlate tissue microstructure to electrical conduction and mechanical contraction. The main clinical driver within our work is addressing unmet needs in cardiac electrophysiology.
Atrial fibrillation (AF), the most common type of arrhythmia, characterized by quivering of the atria due to unorganized electrical activity. Ablation using radiofrequency (RF) energy is now the standard of care for the treatment of many arrhythmias. The goal of RFA is to target and destroy tissue that triggers or supports abnormal electrical pathways, while minimizing or avoiding damage to normal areas of the heart. For conditions such as atrial fibrillation, the success rates for radiofrequency ablation procedures are 56-85%. And, for many patients, they require two treatments to result in chronic successful termination of the arrhythmia. The limited, indirect method of monitoring during ablation procedures often results in delivering more ablation lesions than necessary to achieve a therapeutic effect, prolonging procedure times, thereby limiting the effectiveness and increasing risk of this procedure.
The scientific premise of our work builds upon our experiments and studies from the literature showing that changes in the structure of the myocardium can be optically sensed by optical coherence tomography and near infrared spectroscopy. Our lab is using optical imaging and spectroscopy as a means to monitor and guide RFA treatment of cardiac arrhythmias, which will directly interrogate the tissue in real time. There is typically an underlying substrate due to remodeling that is the cause of the abnormalities in conduction patterns. We aim to develop integrated optical and ablation probes and processing tools for measurement of lesion depth, transmurality, and generation of substrate maps for procedural guidance. In addition, our lab is also working to better understanding how the microstructure of the myocardium influences electrical conduction. If success, this work will form the foundation to enable translation, showing that optical guidance and monitoring of ablation therapy results in improved chronic success rates.
Our work is supported by the National Science Foundation, National Institute of Health, Fieldstein Medical Foundation and new collaborative initiatives from Columbia University. My work has been recognized by Forbes 30 under 30 in Science and Healthcare, MIT Technology Review’s 35 under 35 Innovators, NSF CAREER Award, NIH New Innovator Award, and recently by President Obama, receiving a 2017 Presidential Early Career Award in Science and Engineering.