5-D Image Guided Cardiac Ablation Therapy

5 维图像引导心脏消融治疗

• 批准号: 7281016
• 负责人: RICHARD A ROBB
• 金额: $ 8.87万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-20 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7281016
• 关键词: arrhythmia; atrial fibrillation; bioimaging /biomedical imaging; cardiovascular disorder therapy; cardiovascular imaging /visualization; computed axial tomography; dogs; electrocardiography; fluoroscopy; heart catheterization; image guided surgery /therapy; three dimensional imaging /topography; ultrasonography; arrhythmia; atrial fibrillation; bioimaging /biomedical imaging; cardiovascular disorder therapy; cardiovascular imaging /visualization; computed axial tomography; dogs; electrocardiography; fluoroscopy; heart catheterization; image guided surgery /therapy; three dimensional imaging /topography; ultrasonography

DESCRIPTION (provided by applicant): Cardiac arrhythmias are a major clinical problem. We propose a significant and unique solution. Based on our preliminary results and progress with minimally invasive, multi dimensional image-guided interventions for myocardial ablation of cardiac arrhythmias in experimental animals, we have developed a theoretical basis and shown significant promise for proving the hypothesis that real-time, anatomy-based imaging and accurate fusion with electrophysiologic recordings will significantly improve the outcomes of catheter-based ablation of cardiac arrhythmias. In addition to greater success with less risk of morbidity/mortality, other important benefits will include reduced procedure time, less x-ray exposure, and lower cost. Our multi-disciplinary team (biomedical engineering, cardiology, radiology, computer science) will focus on atrial fibrillation (AF) where current treatment strategies are ineffective. However, our approach and system will be adaptable to treatment of any cardiac arrhythmias that can be reached by a catheter. The target goal is to achieve outcomes with catheter-based ablation comparable to surgical procedures, which can be 80-90% effective for AF, primarily due to direct visualization of the target cardiac anatomy through the surgically opened chest. But surgical procedures are undesirably invasive and accompanied by significant risk and cost. We will test our hypothesis by developing and validating a complete prototype system for image-guided catheter-based cardiac ablation featuring accurate real-time and on-line localization, visualization and targeting of the treatment region. This new system will be based on rapid volume image acquisition, real-time computer image processing and interactive display of three-dimensional anatomical images registered and mapped with electrophysiological data during successive cardiac cycles - a five-dimensional image guided intervention system. The system will be constructed using currently available microprocessors, display technology, mapping hardware and standard interfaces for 3D imaging modalities, including electron beam, CT, multirow spiral CT, MRI and ultrasound. Image processing steps, including segmentation, registration, modeling and rendering will be performed by customizing and optimizing algorithms previously developed and evaluated in our laboratory. The systems engineering task will essentially be one of designing, assembling and testing the integration of physical components (hardware, software and data) and procedural components (tasks) which have been separately developed and successfully demonstrated. This prototype system will then be thoroughly validated in the animal laboratory, with modifications and refinements for improved performance and user interface incorporated as these are indicated during the evaluation studies. We firmly believe that development, validation and optimization of this prototype system will herald a new generation of advanced technology for minimally invasive treatment of cardiac arrhythmias that will dramatically and positively impact the field.

描述（由申请人提供）： 心律不齐是一个主要的临床问题。我们提出了一个重要而独特的解决方案。根据我们的初步结果和进展，在实验动物中对心脏心律失常的心肌消融的微创，多维图像引导的干预措施，我们建立了理论上的基础，并表明了证明实时，基于解剖学的成像和基于电源录像机的实时融合的假设有明显地改善了降低的降低。除了较小的发病率/死亡率风险较小之外，其他重要的好处还将包括减少程序时间，减少X射线暴露和降低的成本。我们的多学科团队（生物医学工程，心脏病学，放射学，计算机科学）将重点关注当前治疗策略无效的房颤（AF）。但是，我们的方法和系统将适应于导管可以达到的任何心律不齐的治疗。目标目标是通过基于导管的消融与外科手术相媲美的结果，这对AF的有效效果可能为80-90％，这主要是由于通过手术开放的胸部直接可视化了目标心脏解剖结构。但是，手术程序是不可思议的，并且伴随着很大的风险和成本。我们将通过开发和验证完整的原型系统来检验我们的假设，用于基于图像引导的基于导管的心脏消融，具有准确的实时和在线定位，可视化和治疗区域的靶向。该新系统将基于快速体积图像采集，实时计算机图像处理以及在连续的心脏周期期间注册并用电生理数据映射的三维解剖图像的交互式显示 - 五维图像引导干预系统。该系统将使用当前可用的微处理器，显示技术，映射硬件和标准接口，用于3D成像模式，包括电子束，CT，Multirow Spiral CT，MRI和超声。图像处理步骤（包括分割，注册，建模和渲染）将通过自定义和优化先前在我们的实验室中开发和评估的算法来执行。系统工程任务本质上将是设计，组装和测试物理组件（硬件，软件和数据）的集成以及已分别开发并成功证明的程序组件（任务）的集成。然后，该原型系统将在动物实验室中进行彻底验证，并进行了改进和改进，以改善性能，并在评估研究中指出了这些原型。我们坚信，该原型系统的开发，验证和优化将预示新一代的先进技术，用于对心律不齐的最低侵入性治疗，这将极大地和积极影响该领域。