MEMS Sensors for Arrhythmia Detection and Interventions

描述（由申请人提供）：尽管进行了数十年的深入研究，但继发于室颤（VF）的猝死仍然是美国和其他发达国家的主要死亡原因。最近，一些有前途的假说，VF的机制已经推出。然而，它还没有可能使用目前可用的实验技术，以确定哪一个理论（或理论）是最适用于VF。为了解决这个问题，我们建议：1）用纳米制造组件构建一个心脏标测系统，能够以高空间和时间分辨率以及最小的组织损伤评估心脏激动和复极化; 2）使用新型相位标测技术来分析标测数据，目的是识别窦性心律、室性心动过速和VF期间相位奇异点的位置和数量; 3）使用相位奇异性数据来区分VF的三种假定机制-具有传导性传导的锚定转子、曲折转子或多个转子。MEMS技术将用于构建具有集成电极的微型机械针状结构，这些电极被超声激活，以最大限度地减少插入过程中的组织损伤。在固定起搏和VF期间，电极阵列将用于标测体外犬心室肌以及正常和急性缺血猪心脏原位的激活和复极。将使用快速傅立叶解调技术分析标测数据，以识别VF期间的奇点和波矢量。二维和三维心肌的计算机模型也将用于生成替代数据集，以测试分析算法。本研究的结果将导致三个关键领域的重大进展：设备的开发，以前所未有的空间分辨率映射心脏电活动;应用更新和更复杂的技术来分析大型映射数据集;解释高分辨率映射数据的背景下，新的假设有关的起源室性心动过速和室颤。总之，这些在数据采集，分析和解释的进步，预计将导致新的和更有效的手段，识别和治疗患者的致命性室性快速性心律失常的发展风险。

DESCRIPTION (provided by applicant): Despite decades of intensive investigation, sudden death secondary to ventricular fibrillation (VF) remains a leading cause of mortality in the US and other developed countries. Recently, several promising hypotheses regarding the mechanism for VF have been introduced. However, it has not been possible using currently available experimental techniques to determine which theory (or theories) is most applicable to VF. To address this issue, we propose to: 1) construct a cardiac mapping system from nanofabricated components that is capable of assessing cardiac activation and repolarization with high spatial and temporal resolution and with minimal tissue damage; 2) use a novel phase mapping technique to analyze the mapping data, with the objective of identifying the location and number of phase singularities during sinus rhythm, ventricular tachycardia and VF; 3) use the phase singularity data to distinguish between three putative mechanisms for VF - an anchored rotor with fibrillatory conduction, a meandering rotor or multiple rotors. MEMs technology will be used to construct microscale mechanical needle-like structures with integrated electrodes that are ultrasonically activated, to minimize tissue damage during insertion. The electrode arrays will be used to map activation and repolarization in canine ventricular myocardium in vitro and in normal and acutely ischemic pig hearts in situ during fixed pacing and during VF. The mapping data will be analyzed using a fast Fourier-demodulation technique to identify singularities and wave vectors during VF. Computer models of 2- and 3-D myocardium also will be used to generate surrogate data sets for testing the analysis algorithms. The results of this study will lead to significant advances in three key areas: development of devices to map cardiac electrical activity with unprecedented spatial resolution; application of newer and more sophisticated techniques to analyze large mapping data sets; interpretation of high resolution mapping data within the context of novel hypotheses regarding the genesis of ventricular tachycardia and fibrillation. Taken together, these advances in data acquisition, analysis and interpretation are expected to lead to new and more effective means of identifying and treating patients at risk for the development of lethal ventricular tachyarrhythmias.