Ultrasound Based Multimodal Imaging System for Guiding Cardiac Ablation Therapy

用于指导心脏消融治疗的超声多模态成像系统

• 批准号: 7664492
• 负责人: PATRICK D WOLF
• 金额: $ 38.82万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7664492
• 关键词: Ablation; Academic Medical Centers; Acoustics; Animal Model; Arrhythmia; Atrial Fibrillation; Atrial Flutter; Atrioventricular Nodal Reentry Tachycardia; Cardiac; Cardiac ablation; Cartoons; Cataloging; Catalogs; Catheters; Clinic; Clinical; Coagulation Process; Complex; Custom; Development; Electromagnetic Fields; Elements; Evaluation; Explosion; Feedback; Goals; Growth; Hand; Heart; Heart Atrium; Hour; Hybrids; Image; Imaging technology; In Vitro; Incidence; Industry; Intervention; Kidney; Left; Lesion; Letters; Liver; Location; Magnetism; Maps; Measures; Medical; Methods; Modeling; Morbidity - disease rate; Morphologic artifacts; Motion; Movement; Multimodal Imaging; Myocardium; Normal tissue morphology; Performance; Physicians; Positioning Attribute; Procedures; Property; Puncture procedure; Qualifying; Quality of Care; Radiation; Research; Scanning; Services; Sheep; Spatial Distribution; System; Tachyarrhythmias; Techniques; Technology; Testing; Time; Tissues; Titrations; Transducers; Ultrasonography; United States; Ventricular; Visual; Wolff-Parkinson-White Syndrome; Wolves; Work; base; clinical practice; clinically relevant; computerized data processing; heart motion; image guided therapy; improved; in vivo; meetings; multimodality; new technology; repaired; sensor; tool

DESCRIPTION (provided by applicant): The goal of this project is to bring to the verge of clinical practice the promising technique of acoustic radiation force impulse (ARFI) imaging for guiding cardiac ablation therapy. Cardiac ablation is used to treat atrial and ventricular tachyarrhythmias. This therapy is used hundreds of times daily with no direct lesion imaging. The multimodal system we are proposing will enable 1) real time evaluation of lesion growth, 2) visual evaluation of lesion continuity, and 3) guidance and placement of catheters. The successful implementation of this system will shorten procedure times, reduce the incidence of repeat procedures and limit complications due to collateral damage. Complex ablations rely on the creation of transmural and contiguous aggregate lesions to block reentrant conduction. Incomplete lesions result in extended procedure times and frequent repeat procedures. Excess energy delivery leads to significant morbidity causing micro-explosions within the tissue and collateral tissue damage with potentially fatal complications. There is an urgent need for an imaging technology to titrate energy delivery and guide ablation tachyarrhythmia therapy. We will use ARFI imaging to characterize cardiac ablation lesions. ARFI imaging characterizes the spatial distribution of elastic properties that can be used to differentiate ablated from normal myocardium. ARFI imaging will be implemented from an enhanced (128 channel) intracardiac echo (ICE) imaging catheter. The major work proposed here is the implementation of ARFI imaging with the ICE catheter and the integration of this technology into the standard interventional regime of the clinic. Electroanatomical mapping is now the standard tool used to guide catheters in the heart and position lesions at clinically relevant locations. Working in concert with industry, we will develop the technology to integrate ARFI image based lesion evaluation into this standard tool for clinical intervention by exploiting a new ICE catheter equipped with a CARTO(tm) magnetic sensor. This tool will enable registration of the two technologies and allow integration of lesion evaluation into the clinical paradigm. Finally, we will fully characterize the change in elastic properties associated with ablation and demonstrate in an animal model that ARFI image guided therapy can be used to augment existing clinical methods and provide the real time image feedback needed to improve the quality of care. We propose to develop a multimodality imaging system to guide cardiac ablation therapy. The system will exploit catheter based acoustic radiation force impulse imaging to characterize lesion growth. This technology will be integrated into the standard clinical catheter guidance paradigm yielding a complete tool for ablative therapy of cardiac tachyarrhythmias.

描述（由申请人提供）：该项目的目的是使临床实践的边缘有前途的声学辐射力脉冲（ARFI）成像，以指导心脏消融疗法。心脏消融用于治疗房屋和心室心律失常。这种疗法每天使用数百次，没有直接病变成像。我们提出的多模式系统将实现1）病变生长的实时评估，2）病变连续性的视觉评估； 3）导管的指导和放置。该系统的成功实施将缩短程序时间，减少重复程序的发生率并限制由于附带损害而造成的并发症。复杂的消融依赖于透壁和连续的骨料病变的创造来阻止重入传导。不完整的病变导致延长的过程时间和频繁的重复程序。过量的能量输送导致明显的发病率，导致组织内的微观探索和潜在的致命并发症。迫切需要采用成像技术来滴定能量输送并指导消融心律失常治疗。我们将使用ARFI成像来表征心脏消融病变。 ARFI成像表征了弹性特性的空间分布，可用于区分正常心肌。 ARFI成像将通过增强的（128通道）心内回声（ICE）成像导管实施。这里提出的主要工作是用冰导管实施ARFI成像，并将该技术整合到诊所的标准介入状态中。现在，电解映射是用于引导临床相关位置的心脏和位置病变中导管的标准工具。与行业协同合作，我们将开发该技术，将基于ARFI图像的病变评估整合到该标准工具中，以利用配备了Carto（TM）磁性传感器的新冰导管。该工具将实现两种技术的注册，并允许将病变评估整合到临床范式中。最后，我们将充分表征与消融相关的弹性特性的变化，并在动物模型中证明ARFI图像指导疗法可用于增强现有的临床方法，并提供改善护理质量所需的实时图像反馈。我们建议开发一种多模式成像系统来指导心脏消融疗法。该系统将利用基于导管的声辐射力脉冲成像来表征病变的生长。该技术将集成到标准的临床导管指导范式中，该指导范式提供了一种完整的工具，用于烧蚀心律失常的疗法。

项目成果

Contrast in intracardiac acoustic radiation force impulse images of radiofrequency ablation lesions.

• DOI: 10.1177/0161734613519602
• 发表时间: 2014-04
• 期刊: Ultrasonic imaging
• 影响因子: 2.3
• 作者: Eyerly SA;Bahnson TD;Koontz JI;Bradway DP;Dumont DM;Trahey GE;Wolf PD
• 通讯作者: Wolf PD

Feasibility of near real-time lesion assessment during radiofrequency catheter ablation in humans using acoustic radiation force impulse imaging.

• DOI: 10.1111/jce.12514
• 发表时间: 2014-12
• 期刊: Journal of cardiovascular electrophysiology
• 影响因子: 2.7
• 作者: Bahnson TD;Eyerly SA;Hollender PJ;Doherty JR;Kim YJ;Trahey GE;Wolf PD
• 通讯作者: Wolf PD

Assessment of Diastolic Function Using Ultrasound Elastography.

使用超声弹性成像评估舒张功能。

• DOI: 10.1016/j.ultrasmedbio.2017.11.011
• 发表时间: 2018
• 期刊: Ultrasound in medicine & biology
• 影响因子: 2.9
• 作者: Vejdani-Jahromi,Maryam;Freedman,Jenna;Kim,Young-Joong;Trahey,GreggE;Wolf,PatrickD
• 通讯作者: Wolf,PatrickD

Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.

• DOI: 10.1016/j.hrthm.2012.07.003
• 发表时间: 2012-11
• 期刊: HEART RHYTHM
• 影响因子: 5.5
• 作者: Eyerly, Stephanie A.;Bahnson, Tristram D.;Koontz, Jason I.;Bradway, David P.;Dumont, Douglas M.;Trahey, Gregg E.;Wolf, Patrick D.
• 通讯作者: Wolf, Patrick D.