Validation of a novel catheter guiding method for the ablative therapy of ventricular tachycardia in a phantom model.
Validation of a novel catheter guiding method for the ablative therapy of ventricular tachycardia in a phantom model.
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对幻影模型中心室心动过速的消融治疗的新型导管指导方法的验证。
DOI：
10.1109/tbme.2008.2006274
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Cohen RJ
中科院分区：
文献类型：
--
作者：
Barley ME;Choppy KJ;Galea AM;Armoundas AA;Rosbury TS;Hirschman GB;Cohen RJ
在室性心动过速的射频消融中，消融导管的准确引导至关重要。利用当前技术，快速且准确地定位心律失常的起源部位是具有挑战性的，这通常限制了对具有血流动力学稳定的心律失常的患者的治疗。我们研究了一种新的指导方法的有效性，逆解指导算法（ISGA），这是基于心脏电活动的单等效偶极子表示，适用于血流动力学不稳定的VT患者。在均匀和不均匀的盐水填充躯干体模中进行成像，其中导管尖端被引导朝向固定电偶极子源超过5 cm的距离。使用ISGA，将移动导管尖端分别引导到均匀和不均匀体模中的固定源的0.61±0.43 mm和0.55±0.39 mm内。导管移动不到10次即可达到该精度。这些结果表明，ISGA有可能为血流动力学不稳定心律失常患者人群的射频消融术提供准确有效的指导。
Accurate guidance of an ablation catheter is critical in the radio-frequency ablation of ventricular tachycardia. With current technologies it is challenging to rapidly and accurately localize the site of origin of an arrhythmia, often restricting treatment to patients with hemodynamically stable arrhythmias. We investigated the effectiveness of a new guidance method, the Inverse Solution Guidance Algorithm (ISGA), which is based on a single-equivalent dipole representation of cardiac electrical activity and is suitable for patients with hemodynamically unstable VT. Imaging was performed in homogeneous and inhomogeneous saline-filled torso phantoms in which a catheter tip was guided towards a stationary electrical dipole source over distances of more than 5 cm. Using ISGA, the moving catheter tip was guided to within 0.61±0.43 mm and 0.55±0.39 mm of the stationary source in the homogeneous and inhomogeneous phantoms, respectively. This accuracy was achieved with less than 10 movements of the catheter. These results suggest that ISGA has potential to provide accurate and efficient guidance for radio-frequency ablation procedures in the patient population with hemodynamically unstable arrhythmias.