Arrhythmia mapping using electromechanical wave imaging

心律失常是指自然心律的中断。这个不规则的心脏 心律失常会导致心脏突然停止泵血。心律失常会增加 心脏病发作心脏骤停和中风心房病变最常见 以心房颤动和心房扑动为最常见的心律失常。数量 在美国，房颤患者的人数预计将达到1200万， 自2050年以来，患病率随着老龄化而增加。心房扑动，通常是消融的结果 随着更多的此类治疗的实施，上 另一方面，室性心律失常，如室性心动过速和室性心律失常， 纤颤分别表示非常快和混乱的节奏，并可导致 心源性猝死这部分是因为目前没有无创诊断 心律失常的成像。在治疗方面，除了药理学 治疗，大多数心律失常的第一线治疗是直流电复律 （DCCV），其表示心脏的电除颤以恢复其窦性心律。 尽管DCCV在短期内仍然非常成功，但它仍然非常 难以确定哪些受试者将在前24小时内恢复心律失常 小时的治疗，并将不得不返回医疗机构进行额外的治疗。 心脏复律，除了给患者带来不便之外， 破坏，痛苦和悲伤当药物治疗或心脏复律失败时， 射频（RF）消融（RFA）是必要的，目前构成了一个漫长的 手术（2-4小时/疗程），成功率为55%，因此经常导致重复 治疗，以典型地纠正先前的不完全消融。一种成像技术， 因此，有必要提供关于治疗反应信息。为了解决迫切需要 无创心律失常标测，我们的团队开创了机电波 成像（EWI），表征整个四个 心腔，以识别心律失常源（如适用），同时告知 治疗反应。如果拟议研究的结果表明， 临床程序的指导，这种新的成像技术可以很容易地 作为标准超声心动图的一部分在临床环境中实施， 提高目前较低的时间和成本效益以及成功率， 心律失常治疗

Arrhythmias refer to the disruption of the natural heart rhythm. This irregular heart rhythm causes the heart to suddenly stop pumping blood. Arrhythmias increase the risk of heart attack, cardiac arrest and stroke. Atrial pathologies are the most common arrhythmias with atrial fibrillation and atrial flutter being the most prevalent. The number of individuals with atrial fibrillation in the United States is expected to reach 12 million by 2050 since the prevalence increases with aging. Atrial flutter, often a result of ablative treatment, is also expected to rise as more of these treatments are administered. On the other hand, ventricular arrhythmias such as ventricular tachycardia and ventricular fibrillation denote extremely fast and chaotic rhythms, respectively, and can cause sudden cardiac death. This is partly because there is currently no noninvasive diagnostic imaging of arrhythmias. On the therapeutic front, in addition to pharmacological treatment, the first line of treatment of most arrhythmias is direct current cardioversion (DCCV), which denotes electrical defibrillation of the heart to reinstate its sinus rhythm. Despite the fact that DCCV remains highly successful in the short-term, it remains very difficult to determine which subjects will revert to their arrhythmias within the first 24 hours of treatment and will have to return to the healthcare premises for additional cardioversions that, apart from the inconvenience to the patient, result in major life disruption, pain and distress. When pharmacological treatment or cardioversion fail, radiofrequency (RF) ablation (RFA) is warranted, which currently constitutes a lengthy procedure (2-4 h/session) with a 55% success rate and thus often leading to repeated treatments to typically correct prior, incomplete ablations. An imaging technique to better inform on treatment response is thus warranted. To address the urgent need for noninvasive arrhythmia mapping, our group has pioneered Electromechanical Wave Imaging (EWI) that characterizes the electromechanical function throughout the four cardiac chambers to both identify the arrhythmic source (if applicable) but also inform treatment response. Should the findings of the proposed study indicate high reliability in guidance of clinical procedures, this novel imaging technology could be readily implemented in a clinical setting as part of a standard echocardiogram in order to increase the currently low time- and cost-efficiency as well as success rates of arrhythmia treatment.