Catheter Guidance System for RF Ablation of Arrhythmias

用于心律失常射频消融的导管引导系统

• 批准号: 7278390
• 负责人: GORDON B HIRSCHMAN
• 金额: $ 120.72万
• 依托单位: INFOSCITEX CORPORATION
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7278390
• 关键词: arrhythmia; bioengineering /biomedical engineering; bioimaging /biomedical imaging; biomedical equipment development; clinical biomedical equipment; computer assisted patient care; computer graphics /printing; computer human interaction; computer program /software; computer system design /evaluation; electrical potential; electrocardiography; electrodes; heart catheterization; heart imaging /visualization /scanning; heart surgery; heart ventricle; image guided surgery /therapy; information display; phantom model; radiowave radiation

DESCRIPTION (provided by applicant): Radio frequency (RF) catheter ablation is an established treatment for patients with cardiac arrhythmias. RF ablation of atrio-ventricular nodal reentrant arrhythmias has been highly successful, since the known anatomy of the atrio-ventricular node enables precise identification of the site of origin of the arrhythmia and thus delivery of the ablative energy. Ablation of ventricular tachycardia (VT) presents a greater challenge, since the origin of the arrhythmia could be anywhere in the ventricles, and existing techniques used to locate the site usually require that patients be maintained in arrhythmia for a significant period of time. These factors combine to limit the procedure primarily to treatment of slow VTs in patients who are hemodynamically stable during arrhythmia. In Phase I of this Fast-Track project, concept feasibility will be demonstrated for a new catheter guidance system that will direct the tip of an ablation catheter to the site of origin of an arrhythmia and reduce the time needed to locate the site such that a patient need only be maintained in the arrhythmia for a few beats. The system will feature an innovative "inverse algorithm" analysis code that uses a single equivalent moving dipole (SEMD) to model both electrocardiograph (EGG) potentials from body-surface electrodes and the current pulses delivered from the tip of an ablation catheter. By processing body surface potentials during a few beats of VT, the system will identify the SEMD location that corresponds to the source of the arrhythmia when the bioelectrical source is most localized. Using the same algorithm, it will then identify, in real time, the location of the catheter tip from analysis of potentials resulting from low-energy dipolar current pulses delivered to electrodes located at the tip. The system will also include a real-time graphical display that will allow a clinician to quickly guide the catheter tip to the source of the arrhythmia for precise delivery of RF energy. Even in the presence of realistic levels of noise in the ECG signals, preliminary work has shown that estimation of the SEMD location from body surface potentials is a breakthrough innovation that will allow for precise, rapid guidance of ablation catheters to arrhythmic foci. Phase I will prove feasibility in a breadboard system developed to demonstrate the ability to guide an ablation catheter to the location of an electrical source within a phantom torso. This work will serve as the foundation for development and in-vivo test of a full prototype guidance system in Phase II.

描述（由申请人提供）：射频（RF）导管消融是针对心律不齐患者的既定治疗方法。心室性疾病后心律失常的RF消融非常成功，因为已知的心室室性淋巴结解剖结构，可以精确地识别心律失常的起源部位，从而可以递送流入能量。心室心动过速（VT）的消融提出了更大的挑战，因为心律不齐的起源可能在心室中的任何地方，并且用于定位该部位的现有技术通常要求在心律失常中维持患者长时间。这些因素结合起来，主要限制了在心律不齐过程中血液动力学稳定的患者的慢速VT治疗。 在这个快速轨道项目的第一阶段中，将证明概念可行性将用于新的导管引导系统，该导管引导系统将将消融导管的尖端引导到心律失常的起源部位，并减少定位该部位所需的时间，以使患者只需要在心律失常中维持几个节拍。该系统将采用创新的“反算法”分析代码，该代码使用单个等效的移动偶极子（SEMD）对身体表面电极的心电图（EGG）电势进行建模，以及从消融导管尖端传递的电流脉冲。通过处理VT几个节拍期间的身体表面电势，系统将确定与心律不齐相对应的SEMD位置，当时生物电源源是最局部的。然后，使用相同的算法，将实时识别导管尖端的位置，该位置是通过对递送到位于尖端的电极的低能量偶极电流脉冲产生的电势分析。该系统还将包括一个实时图形显示，该显示器将使临床医生能够快速引导导管尖端到心律失常的来源，以精确地传递RF能量。 即使在ECG信号中存在现实噪声水平的情况下，初步工作也表明，SEMD位置的估计是从身体表面电势中的估计，这是一种突破性的创新，可以准确，快速地指导消融导管对心律失常灶。第一阶段将在开发的面包板系统中证明可行性，以证明能够引导消融导管到幻影躯干内电源的位置。这项工作将成为II阶段完整原型指导系统开发和体内测试的基础。