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Method for guiding ablative therapy of cardiac arrythmias

指导心律失常消融治疗的方法

基本信息

批准号：
8470224
负责人：
ANTONIS A ARMOUNDAS
金额：
$ 40.62万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-15 至 2015-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8470224
关键词：
Ablation Accounting Adverse effects Affect Algorithms Anatomy Animals Anti-Arrhythmia Agents Applications Grants Arrhythmia Arts Body Surface Cardiac Cardiac ablation Cardiovascular system Catheters Cessation of life Charge Complication Contracts Developed Countries Electrocardiogram Electrodes Endocardium Frequencies Heart Image Incidence Length Location Maps Methodology Methods Modality Modeling Monitor Movement Patients Performance Pharmaceutical Preparations Phase Physicians Physiologic pulse Population Procedures Process Property Radio Radiofrequency Catheter Ablation Relative (related person)Saline Sampling Shock Site Solutions Supraventricular tachycardia Surface System Systole Techniques Time United States Ventricular Ventricular Arrhythmia Ventricular Tachycardia arm atrioventricular node cost experience heart rhythm patient safety prototype public health relevance success sudden cardiac death time use tool two-dimensional

项目摘要

DESCRIPTION (provided by applicant): Ventricular catheter ablation has been established as the most desirable from cost and patient safety point of view approach in treating cardiac arrhythmias, yet its success rate has not broad acceptance. This is primarily because this treatment modality relies almost entirely on the experience and abilities of the physician in charge to identify the ablative site through endocardial mapping. In this grant application we aim to investigate the ability of a new method to rapidly, reliably and safely identify the site of origin of the arrhythmia. Our method relies on assigning properties of an equivalent moving dipole to each phase of the cardiac cycle and then inversely resolving the properties (location and strength) of the dipole. Our hypothesis is that the inverse dipole solution will accurately locate the arrhythmogenic focus at the point in the cardiac cycle when electrical activity is still focal, as the depolarization wave emerges from the focus. We will build a state-of-art system aimed to provide the cardiac electrophysiologist with a tool that will facilitate the identification of the site of the arrhythmia in the heart and will enable the accurate guiding of the ablation catheter to the site of origin of that arrhythmia. We will evaluate its performance by means of saline tank and animal studies. In the latter study, we will ultimately compare the location of the site identified by means of the equivalent dipole solution with the site initially identified by the operator as well as the site which ultimately results in the abolition of inducibility of ventricular tachycardia. The ability to perform three dimensional mapping and view the arrhythmia in real-time represents a step ahead from the standard fluoroscopic two-dimensional imaging or activation mapping. Furthermore our methodology promises to reduce the time required to perform the mapping and make it well tolerated from the patient. The impact of successful catheter ablation of ventricular tachycardia may be to (i) reduce the incidence of sudden cardiac death, (ii) reduce the frequency of implantable cardioverter shocks, and (iii) decrease the need of anti-arrhythmic medications with their potentially pro-arrhythmic and/or other side effects.

描述（由申请人提供）：

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Alcohol ablation at the posterior papillary muscle prevents ventricular fibrillation in swine without affecting mitral valve function.

后乳头肌的酒精消融可预防猪的心室颤动，而不影响二尖瓣功能。

DOI：
10.1093/europace/euq337
发表时间：
2010
期刊：
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
影响因子：
0
作者：
Guo,Lei-Sheng;Zhou,Xu;Li,Yan-Hui;Cai,Jun;Wei,Dong-Mei;Shi,Liang;Yang,Gang;Armoundas,AntonisA;Yang,Xin-Chun
通讯作者：
Yang,Xin-Chun

On the efficiency and accuracy of the single equivalent moving dipole method to identify sites of cardiac electrical activation.

DOI：
10.1007/s11517-015-1437-x
发表时间：
2016-10
期刊：
Medical & biological engineering & computing
影响因子：
3.2
作者：
Sohn K;Armoundas AA
通讯作者：
Armoundas AA

Role of substrate and triggers in the genesis of cardiac alternans, from the myocyte to the whole heart: implications for therapy.

DOI：
10.1161/circulationaha.111.033563
发表时间：
2012-01-24
期刊：
Circulation
影响因子：
37.8
作者：
Merchant FM;Armoundas AA
通讯作者：
Armoundas AA

On the estimation of T-wave alternans using the spectral fast fourier transform method.

利用谱快速傅立叶变换方法估计T波交替。

DOI：
10.1016/j.hrthm.2011.10.013
发表时间：
2012
期刊：
Heart rhythm
影响因子：
5.5
作者：
Armoundas,AntonisA;Mela,Theofanie;Merchant,FaisalM
通讯作者：
Merchant,FaisalM

Clinical utility of microvolt T-wave alternans testing in identifying patients at high or low risk of sudden cardiac death.

DOI：
10.1016/j.hrthm.2012.03.014
发表时间：
2012-08
期刊：
Heart rhythm
影响因子：
5.5
作者：
Merchant FM;Ikeda T;Pedretti RF;Salerno-Uriarte JA;Chow T;Chan PS;Bartone C;Hohnloser SH;Cohen RJ;Armoundas AA
通讯作者：
Armoundas AA