Virtual Electrical-Anatomical Imaging of the Heart

心脏的虚拟电解剖成像

• 批准号: 6420427
• 负责人: Dirar Shafiq Khoury
• 金额: $ 26.02万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-01-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6420427
• 关键词: anatomy; arrhythmia; atrial fibrillation; biomechanics; diagnosis design /evaluation; diagnostic catheterization; disease /disorder model; dogs; echocardiography; electrical potential; electrodes; electrophysiology; endocardium; heart catheterization; heart disorder diagnosis; heart imaging /visualization /scanning; heart rate; heart ventricle; mathematical model; myocardial infarction; pulmonary veins; tachycardia; technology /technique development

DESCRIPTION: (Provided by Applicant): Atrial fibrillation (AF) is the most common heart rhythm disorder: it affects more than two million Americans, is responsible for one-third of all strokes over the age of 65 years, and annually costs 9 billion dollars to manage. Furthermore, about 300,000 Americans die of sudden cardiac death annually, primarily due to ventricular rhythm disorders (ventricular tachycardia (VT and fibrillation) which result in intractable, extremely rapid heartbeats. Unfortunately, current pharmacological therapy for managing these disorders is often ineffective, thereby shifting emphasis to nonpharmacological therapy (e.g. ablation and pacing). Catheter ablation has been successful in managing many atrial and a few ventricular rhythm disorders. However, due to limitations in present mapping techniques, brief, chaotic, or complex rhythms such as AF and VT cannot be mapped adequately, resulting in their unsuccessful elimination. Advancing the management of abnormal heartbeats is contingent on developing mapping techniques that identify their mechanisms, localize their sites of origin, and elucidate effects of therapy. Our objective is to develop a catheter-based, cardiac electrophysiological imaging technique that simultaneously maps multiple endocardial electrograms on a beat-by-beat basis and combines three-dimensional activation-recovery sequences with endocardial anatomy. The hypothesis is that virtual electrical-anatomical imaging of the heart based on (1) cavitary electrograms that are measured with a noncontact, multielectorde probe and (2) three-dimensional endocardial anatomy that is determined with integrated, intracardiac echocardiography (ICE), provides an effective and efficient means to diagnose abnormal heartbeats and deliver therapy. Therefore, we will: (1) build a noncontact, electrical-anatomical imaging catheter-system that carries both a multielectrode catheter-probe for acquiring cavitary electrograms from multiple directions, and a central ICE catheter for acquiring endocardial anatomical images; (2) advance novel mathematical methods to compute endocardial electrograms and reconstruct three-dimensional activation-recovery sequences based on noncontact cavitary probe electrograms and geometry determined by ICE; and, (3) prove the utility of virtual electrical-anatomical imaging in the canine beating heart by characterizing models of AF, myocardial infarction, and VT and identifying their components, and by quantifying ablation lesions as assessed by both electrical and echocardiographic criteria. The proposed catheter can be introduced into the blood-filled cavity without surgery and provides three-dimensional electrical-anatomical images on a beat-by-beat basis. With this approach, one can pinpoint the site of origin and type of abnormal heartbeats and advance their therapy. In line with a Bioengineering Research Grant, the research develops a system the outcome of which is to improve the benefit-risk and benefit-cost relationships of patient care and advance heart rhythm-related research.

描述：（由申请人提供）：心房颤动（AF）是最多的 常见心律障碍：它影响了超过200万美国人，是 负责65岁以上所有中风的三分之一，每年 费用为90亿美元。此外，约有30万美国人死亡 每年猝死，主要是由于心室节律疾病 （心室心动过速（VT和纤颤），导致顽固性， 心跳非常快。不幸的是，目前的药理治疗 管理这些疾病通常是无效的，从而将重点转移到 非药物疗法（例如消融和起搏）。导管消融有 成功地管理了许多心房和一些心室节律疾病。 但是，由于目前的映射技术的限制，简短，混乱或 无法充分映射复杂的节奏（例如AF和VT），从而导致 他们的淘汰失败。推进异常心跳的管理 取决于开发识别其机制的映射技术， 定位其原产地，并阐明治疗的作用。我们的目标 是开发基于导管的心脏电生理成像技术 同时在节拍中绘制了多个心内膜电图 基础并将三维激活回收序列与 心内解剖学。假设是虚拟电气动物学 基于（1）使用用（1）使用用的腔电位图进行成像的成像 一个非接触，多电视探针和（2）三维心内膜 通过综合，心内超声心动图确定的解剖结构 （ICE），提供了一种有效而有效的手段来诊断异常 心跳并提供治疗。因此，我们将：（1）建立一个非接触， 电气成像导管系统，两种 多电极导管探针，用于从多个获取空白电解电图 方向和中央冰导管，用于获取心内膜解剖学 图像； （2）预先计算心内膜的新型数学方法 电图和重建三维激活恢复序列 基于通过冰确定的非接触式腔探针电图和几何形状； （3）证明虚拟电气成像的实用性 犬通过表征AF，心肌梗塞和 VT并识别其组件，并通过将消融病变量化为 通过电气和超声心动图标准评估。提议 无需手术就可以将导管引入充满血液的腔内 在节拍中提供三维电气图像 基础。通过这种方法，可以查明原产地点和类型 异常心跳并提高其治疗。与生物工程一致 研究赠款，研究开发了一个系统的结果 改善患者护理的利益风险和利益成本关系 提前与心律有关的研究。