Validation of noncontact mapping and evaluation of catheter intramural ablation for ventricular tachycardia

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Sudden death is the most common mode of death in patients who have had scarring in their hearts due to a heart attack. Sudden death is usually caused by a very rapid, abnormal heart rhythm called ventricular tachycardia. The most effective treatment is the implantation of a device called an implantable defibrillator. These devices are only palliative and are very expensive. Each device costs $15,000 - $30,000 and the cost of treating a patient during his-her lifetime could be as much as $150,000. New methods need to be developed to eradicate these abnormal rhythms completely. Ventricular tachycardia is usually due to reentrant electrical circuits deep within the heart muscle. The project aims to develop and evaluate a non-operative technique to eradicate these abnormal electrical circuits. Noncontact mapping is a promising new technology capable of detecting electrical signals from multiple sites in the heart simultaneously. This project aims to validate this technology using the gold-standard contact mapping. We have already developed two prototypes of catheters that will be evaluated in sheep and developed further. These catheters are specially designed to introduce a needle into the heart muscle to perform radiofrequency ablation. Radiofrequency ablation is a technique of destroying, in a well-controlled manner, a small area of heart muscle. If this technique is found to be successful, it might cure ventricular tachycardia in some patients or eradicate the most troublesome reentrant circuits in other patients. It is likely to negate the need for implantable defibrillator in a significant number of patients, resulting in a tremendous saving in health care costs. Patients who have the procedure after already having an implantable defibrillator will benefit from increased longevity of their device because of eradication of the most troublesome reentrant circuits.