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: 7304138
• 负责人: PATRICK D WOLF
• 金额: $ 36.2万
• 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 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7304138
• 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; Condition; Custom; Daily; 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; Numbers; Performance; Physicians; Placement; Positioning Attribute; Procedures; Property; Puncture procedure; Qualifying; Quality of Care; Radiation; Research; Scanning; Services; Sheep; Spatial Distribution; Standards of Weights and Measures; System; Tachyarrhythmias; Techniques; Technology; Testing; Time; Tissues; Titrations; Transducers; Ultrasonography; United States; Ventricular; Visual; Wolff-Parkinson-White Syndrome; Wolves; Work; base; clinically relevant; computerized data processing; heart motion; image guided therapy; improved; in vivo; 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）：本项目的目标是将有前途的声辐射力脉冲成像技术（ARFI）应用于临床实践，以指导心脏消融治疗。心脏消融术用于治疗心房和室性心动过速。这种疗法每天使用数百次，没有直接的病变成像。我们提出的多模式系统将实现1)实时评估病变生长，2)视觉评估病变连续性，以及3)引导和放置导管。该系统的成功实施将缩短手术时间，减少重复手术的发生率，并限制因附带损害引起的并发症。复杂的消融依赖于创建跨壁和连续的聚集性病变来阻断再入传导。不完全病变导致手术时间延长和重复手术频繁。过量的能量输送会导致严重的发病率，引起组织内的微爆炸和附带的组织损伤，并可能导致致命的并发症。迫切需要一种成像技术来滴定能量输送和指导消融速性心律失常治疗。我们将使用ARFI成像来表征心脏消融病变。ARFI成像表征弹性特性的空间分布，可用于区分消融心肌与正常心肌。ARFI成像将通过增强（128通道）心内回声（ICE）成像导管实现。这里提出的主要工作是使用ICE导管实施ARFI成像，并将该技术整合到临床的标准介入方案中。电解剖测绘现在是标准的工具，用于引导导管在心脏和定位病变在临床相关的位置。通过与工业界合作，我们将开发技术，通过利用配备CARTO（tm）磁传感器的新型ICE导管，将基于ARFI图像的病变评估整合到临床干预的标准工具中。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例中。最后，我们将充分描述与消融相关的弹性特性的变化，并在动物模型中证明ARFI图像引导治疗可用于增强现有的临床方法，并提供提高护理质量所需的实时图像反馈。我们建议开发一种多模态成像系统来指导心脏消融治疗。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。这项技术将被整合到标准的临床导管引导范例中，为心律失常的消融治疗提供一个完整的工具。