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Laser Induced Fluorescence Identification of Sinoatrial and Atrioventricular Nodal Conduction Tissue
Author(s) -
PERK MASIS,
FLYNN GREGORY J.,
GULAMHUSEIN SAJAD,
WEN YUE,
SMITH CAROLYN,
BATHGATE BEN,
TULIP JOHN,
PARFREY NOLLAIG A.,
LUCAS ALEXANDRA
Publication year - 1993
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1993.tb01041.x
Subject(s) - sinoatrial node , nodal , medicine , endocardium , atrioventricular node , fluorescence , ablation , nuclear magnetic resonance , optics , heart rate , physics , blood pressure , tachycardia
Transcatheter ahlation of nodal tissue is used for the treatment of arrhythmia resistant to medical therapy. We have investigated the use of laser induced fluorescence spectroscopy for the in vitro recognition of nodal conduction tissue. Twelve fresh human necropsy specimens (< 48 hours)were obtained from sinoatrial node and atrioventricular node areas. Spectra were recorded during excitation at 308 nm (XeCl excimer iaser, 1.5–2.0 mJ/puJse, 10 Hz). Each area examined was marked for subsequent histoiogic examination. Four hundred eleven spectra were obtained, of which 37 contained nodai conduction tissue (21 sinoatrial, 16 atrioventricular node). Normalized fluorescence emission intensity from these areas was compared with that of surrounding endomyocardial tissue at 18 wavelengths and 35 ratios of fluorescence intensity at selected wavelengths. Spectra recorded from nodal tissue could be clearly distinguished hy a visible decrease in fluorescence emission intensity at wavelengths from 440 to 500 nm (P < 0.0006 at 450 nm), peak area, and peak width when compared to that of adjacent atrial endomyocardial tissue. Nodal conduction tissue was also distinguished from ventricular endocardium (14 spectra) by an increase in fluorescence emission at 430 to 550 nm (P < 0.0001). The specificity was 73% and 88% and the sensitivity was 73% and 60% for sinus nodal and atrioventricular nodal conduction tissue identification, respectively. A ratio of fluorescence emission intensity > 1.3 for 380/475 nm was able to detect nodal conducfion tissue (P < 0.001). Conclusion. Laser induced fluorescence can differentiate nodal conduction tissue from atrial and ventricular endocardium and may provide a new diagnostic tool for the recognition and subsequent ablation of nodal conduction tissue.