High-Definition Conformal Electronics for VT/VF

项目摘要/摘要 室性心律失常包括室性心动过速(VT)和室颤(VF) 在美国每年有30万人因心脏病猝死而死亡。电疗在阻止VT/VF方面是有效的，但 高能双相电击可导致心肌损伤和相关的并发症。此外， 植入型心律转复除颤器技术(ICD)的VT/VF感知分辨率较低，可能导致 不适当的电击和相关的心理痛苦，导致生活质量下降甚至 死亡。因此，对高清晰度VT/VF传感的需求尚未满足，以减少不适当的冲击和 同样，高清晰度超低能量电疗终止室性心动过速/室颤的需求尚未得到满足。在这 项目中，我们提出了一种新的VT/VF传感和电疗方法，并将ICD重新设计为 心血管植入式电子设备(CIED)。我们将采用两项突破性的技术 实现我们新方法的平台：(1)一种新的共形芯片电子实时网络 (CCERN)技术，由合作调查员罗杰斯博士和一个(2)创新的全景， 由PI博士Efimov开发的透光光学标测。我们将进行高清、全景、 透光、光学映射与高清晰度CCERN相结合以(1)表征 跨壁VT/VF动力学，(2)确定动态跟踪所需传感器的最佳数量 VT/VF期间的可激发间隙、相位奇异性和波前，以及(3)使用最优 定义超低能量高清电疗。这项拟议的工作将推进我们的 了解VT/VF并为动态创建有针对性的个体化治疗铺平道路 为每个患者的每个心律失常发作量身定做。

Project Summary/Abstract Ventricular arrhythmias including ventricular tachycardia (VT) and ventricular fibrillation (VF) are responsible for 300,000 sudden cardiac deaths a year in the US. Electrotherapy has been effective in arresting VT/VF but the high-energy biphasic shocks can lead to myocardial damage and associated co-morbidities. Moreover the implantable cardioverter defibrillator technology (ICD) has low VT/VF sensing resolution, which can lead to inappropriate shocks and associated psychological distress, resulting in diminished quality of life or even death. Thus, there is an unmet need for high-definition VT/VF sensing to reduce inappropriate shocks and similarly, an unmet need for high-definition ultra-low energy electrotherapy to terminate VT/VF. In this project, we present a novel approach to VT/VF sensing and electrotherapy and redesign the ICD into cardiovascular implantable electronic device (CIED). We will employ two break-through technological platforms to implement our novel method: (1) A novel conformal chiplet electronics real-time networks (CCERN) technology developed by Co-Investigator Dr. Rogers and an (2) innovative panoramic, transillumination optical mapping developed by PI Dr. Efimov. We will conduct high-definition, panoramic, transillumination, optical mapping in conjunction with high-definition CCERN to (1) characterize the transmural VT/VF dynamics, (2) determine the optimal number of sensors needed to dynamically track the excitable gaps, phase singularities, and wavefronts during VT/VF, and (3) terminate VT/VF using optimal definition ultra low-energy high-definition electrotherapy. This proposed work would advance our understanding of VT/VF and pave the path towards creating a targeted individualized therapy dynamically tailored for each arrhythmia episode for each patient.