NOVEL CATHETER FOR TREATMENT OF VENTRICULAR TACHYCARDIA

用于治疗室性心动过速的新型导管

• 批准号: 6015682
• 负责人: MICHAEL G CURLEY
• 金额: $ 8.95万
• 依托单位: THERMEDICAL, INC.
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-29 至 2002-04-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6015682
• 关键词: biomedical equipment development; dogs; electrodes; heart catheterization; laser therapy; lasers; method development; myocardium; radiowave radiation; saline; tachycardia; temperature; thermometry

Sudden cardiac death kills 300,000 people in the United States yearly. More than half of these deaths are caused by arrhythmias including ventricular tachycardia. Currently there is no safe, effective and inexpensive method for treating most ventricular tachycardias. Thermal ablation using radiofrequency or laser heating can effectively treat supraventricular tachycardia, but the lesions are too small to treat most VTs, especially those that originate from infarct scars. Two effects limit the lesion size. First, the energy is absorbed in a thin layer of tissue surrounding the therapy tool. Second, thermal conduction is too small to carry the energy deeper into the tissue. We have developed saline-enhanced ablation, which uses infusion of warm saline through the myocardium (simultaneous with the application of heating energy) to increase the tissue thermal transport by a factor of 20 or more. We have shown that this method can increase the volume of thermal lesions in liver cancer by a factor of l00. We will adapt our system to test the improvement it provides to RF and laser heating of myocardium. The method that creates the largest, deepest lesions will be used for continued development in Phase 2. PROPOSED COMMERCIAL APPLICATIONS: The goal of this project is to develop a system and associated therapy protocols that can safely heat large regions of myocardium. This will be useful for treating ventricular tachycardia, especially VT following myocardial infarction, which typically requires large ablation lesions.

美国每年有 30 万人死于心源性猝死。其中一半以上的死亡是由包括室性心动过速在内的心律失常引起的。目前还没有安全、有效且廉价的方法来治疗大多数室性心动过速。使用射频或激光加热的热消融可以有效治疗室上性心动过速，但病灶太小，无法治疗大多数室速，尤其是那些源自梗塞疤痕的室速。有两种效应限制病变大小。首先，能量被治疗工具周围的薄层组织吸收。其次，热传导太小，无法将能量带入更深处的组织。我们开发了盐水增强消融，它使用通过心肌输注温盐水（同时施加热能）来将组织热传输增加 20 倍或更多。我们已经证明，这种方法可以使肝癌的热损伤体积增加l00倍。我们将调整我们的系统来测试它对心肌射频和激光加热的改进。产生最大、最深损伤的方法将用于第二阶段的持续开发。 拟议的商业应用：该项目的目标是开发一种可以安全加热大片心肌区域的系统和相关治疗方案。这将有助于治疗室性心动过速，尤其是心肌梗塞后的室性心动过速，这通常需要大的消融病灶。

项目成果

Characterization of warm saline-enhanced radiofrequency ablation lesions in the infarcted porcine ventricular myocardium.

梗死猪心室心肌中温盐水增强射频消融病变的特征。

• 发表时间: 2014-03
• 影响因子: 2.7
• 作者: John, Roy M;Connell, John;Termin, Paul;Houde;Eberl, Gregory;Stohlman, Katharine M;Curley, Michael G
• 通讯作者: Curley, Michael G