Arrhythmia mapping using electromechanical wave imaging

心律失常指的是自然心律的紊乱。这颗不规则的心脏 节律使心脏突然停止泵血。心律失常会增加风险。 心脏病发作、心脏骤停和中风。心房病理是最常见的 心律失常以心房颤动和心房扑动最为常见。数字 预计到2020年，美国房颤患者的人数将达到1200万 2050年，因为患病率随着年龄的增长而增加。心房扑动，通常是消融的结果 随着更多此类治疗的实施，预计治疗费用也将上升。论 另一方面，室性心律失常，如室性心动过速和室性 纤颤分别表示极快和混乱的节律，并可引起 心源性猝死。这在一定程度上是因为目前没有非侵入性诊断 心律失常的成像。在治疗方面，除了药理学 大多数心律失常的治疗一线是直流电复律。 (DCCV)，表示心脏电除颤以恢复其窦性心律。 尽管DCCV在短期内仍然非常成功，但它仍然非常 很难确定哪些受试者会在前24天内恢复心律失常 几个小时的治疗，并将不得不返回医疗保健场所进行额外的 心脏复律，除了给患者带来不便外，还会导致重大生命 混乱、痛苦和苦恼。当药物治疗或心脏复律失败时， 射频消融(RFA)是必要的，目前这构成了一个漫长的 程序(2-4小时/次)，成功率为55%，因此经常导致重复 通常用于纠正先前不完全消融的治疗方法。一种成像技术，可以更好地 因此，告知治疗反应是必要的。为了解决……的迫切需要 无创性心律失常标测，我们小组开创了机电波 成像(EWI)，描述了四个部件的机电功能 心腔既要识别心律失常来源(如果适用)，又要通知 治疗反应。如果拟议的研究结果表明 在临床操作的指导下，这种新的成像技术可以很容易地 作为标准超声心动图的一部分在临床环境中实施，以便 提高目前较低的时间和成本效益以及成功率 心律失常的治疗。

Arrhythmias refer to the disruption of the natural heart rhythm. This irregular heart rhythm causes the heart to suddenly stop pumping blood. Arrhythmias increase the risk of heart attack, cardiac arrest and stroke. Atrial pathologies are the most common arrhythmias with atrial fibrillation and atrial flutter being the most prevalent. The number of individuals with atrial fibrillation in the United States is expected to reach 12 million by 2050 since the prevalence increases with aging. Atrial flutter, often a result of ablative treatment, is also expected to rise as more of these treatments are administered. On the other hand, ventricular arrhythmias such as ventricular tachycardia and ventricular fibrillation denote extremely fast and chaotic rhythms, respectively, and can cause sudden cardiac death. This is partly because there is currently no noninvasive diagnostic imaging of arrhythmias. On the therapeutic front, in addition to pharmacological treatment, the first line of treatment of most arrhythmias is direct current cardioversion (DCCV), which denotes electrical defibrillation of the heart to reinstate its sinus rhythm. Despite the fact that DCCV remains highly successful in the short-term, it remains very difficult to determine which subjects will revert to their arrhythmias within the first 24 hours of treatment and will have to return to the healthcare premises for additional cardioversions that, apart from the inconvenience to the patient, result in major life disruption, pain and distress. When pharmacological treatment or cardioversion fail, radiofrequency (RF) ablation (RFA) is warranted, which currently constitutes a lengthy procedure (2-4 h/session) with a 55% success rate and thus often leading to repeated treatments to typically correct prior, incomplete ablations. An imaging technique to better inform on treatment response is thus warranted. To address the urgent need for noninvasive arrhythmia mapping, our group has pioneered Electromechanical Wave Imaging (EWI) that characterizes the electromechanical function throughout the four cardiac chambers to both identify the arrhythmic source (if applicable) but also inform treatment response. Should the findings of the proposed study indicate high reliability in guidance of clinical procedures, this novel imaging technology could be readily implemented in a clinical setting as part of a standard echocardiogram in order to increase the currently low time- and cost-efficiency as well as success rates of arrhythmia treatment.