Virtual Electrophysiology Laboratory

描述（由申请人提供）：我提议开发一种高度创新的基于患者特定MRI的心脏建模环境，该环境代表从分子过程到器官水平的电生理和机电相互作用的心脏功能。我将这种环境称为“虚拟电生理实验室”，并建议将其转化为临床，应用于结构性心脏病患者心律和收缩功能障碍的无创诊断和治疗。这一开创性的努力提供了整合，为第一次，心脏的计算建模，传统的基础科学学科，withn当代病人护理的环境。本文提出的用于个体化心律失常风险分层和电生理治疗指导的稳健且廉价的非侵入性方法将导致优化治疗递送和降低医疗保健成本，并将对社会产生巨大的个人、医疗和经济影响。 该项目旨在通过在三个与心肌梗死患者相关的应用中利用虚拟电生理实验室环境来改变心脏病患者护理的范式：1。无创性预测梗死相关性室性心动过速的最佳消融靶点。在临床手术之前，将使用生命电生理实验室以无创方式准确识别每例患者心脏中的最佳消融靶点。然后，消融的输送将是快速和精确的，以最小的损伤尺寸根除所有梗死相关的室性心动过速。这将导致治疗效果和耐受性的显著改善，以及术后并发症的减少。2.心律失常风险评估，以确定是否需要植入除颤器部署。心律失常诱导的个性化模拟将被用作临床选择的非侵入性，廉价和无风险的替代品。

DESCRIPTION (provided by applicant): I propose to develop a highly innovative patient-specific MRI-based heart modeling environment that represents cardiac functions from molecular processes to electrophysiological and electromechanical interactions at the organ level. I term this environment "virtual electrophysiology lab", and propose to translate it into th clinic and apply it to the non-invasive diagnosis and treatment of heart rhythm and contractile disorders in patients with structural heart disease. This pioneering effort offers to integrate, fo the first time, computational modeling of the heart, traditionally a basic-science discipline, withn the milieu of contemporary patient care. The robust and inexpensive non-invasive approaches for individualized arrhythmia risk stratification and guidance of electrophysiological therapies proposed here will lead to optimized therapy delivery and reduction in health care costs, and will have a dramatic personal, medical and economic impact on society. This project seeks to shift the paradigm of cardiac patient care by utilizing the virtual electrophysiology laboratory environment in three applications pertinent to patients with myocardial infarction: 1. Noninvasive prediction of the optimal ablation targets for infarct-related ventricular tachycardia. The vital electrophysiology lab will be used to accurately identify the optimal targets of ablation in each patient heart non-invasively prior to the clinical procedure. Delivery of ablation will then be swit and precise, eradicating all infarct-related ventricular tachycardias with minimum lesion sizes. This will result in a dramatic improvement in the efficacy of and tolerance for the therapy, as wel as in reduction of post-procedure complications. 2. Arrhythmia risk assessment to determine the need for implantable defibrillator deployment. Personalized simulations of arrhythmia inducibility will be used as a noninvasive, inexpensive, and risk-free surrogate for a clinical elect