SPATIAL MAPPING OF ENDOCARDIAL ELECTRICAL ACTIVATION

描述（改编自申请人摘要）：过去， 详细的心律失常图需要外科手术暴露心脏。 通过导管标测心脏电活动现在是可能的，但 受到可展开的电极数量少的限制， 记录电极位置的困难。 因此，基于导管的 诸如射频消融的心律失常治疗也受到限制， 简单心律失常的成功率很高， 更复杂的心律失常回路 拟议项目的目标是 开发和验证基于导管的技术， 精确的高密度内皮细胞激活序列图， 适用于心导管检查中遇到的临床心律失常 实验室 使用计算机辅助图像和信号分析，荧光透视和 在心导管插入术期间获得的电数据将被合成 使临床和研究电生理学家能够绘制和可视化 具有高度空间分辨率的稳定心律失常电路。 的 映射站点的分散位置将近似于 可以在内窥镜表面上进行，并且可以叠加在内窥镜的荧光图像上。 心脏作为导管导向治疗的“路线图”。 验证 并扩展这种方法，这种映射技术的准确性将是 根据电生理学“金标准”技术进行测试，心房 使用植入电极的形态测量和激活序列确定 阵列，在房性心律失常的动物模型。 更多的研究 建议应用类似的信号处理技术来增强 使用多电极导管对心律失常回路进行功能评估。 结合起来，这些技术的应用将允许功能 对心动过速回路的解剖进行充分表征和解释 在实验性心律失常研究的背景下。 的结果 这些调查将用于改进和应用这种方法， 在已知的人类患者中识别特定的心律失常机制， 都有类似的顽固性房性心律失常

DESCRIPTION (Adapted from the applicant's abstract): In the past, creation of detailed arrhythmia maps has required surgical exposure of the heart. Mapping of cardiac electrical activity by catheter is now possible, but is limited by the small number of electrodes which can be deployed and by difficulties in recording electrode locations. Thus, catheter-based arrhythmia therapies such as radiofrequency ablation have also been limited, with high success rates achieved for simple arrhythmias not reproducible for more complex arrhythmia circuits. The goal of the proposed project is to develop and validate catheter-based techniques for the creation of spatially accurate, high-density endocardial activation sequence maps which can be applied to clinical arrhythmias encountered in the cardiac catheterization laboratory. Using computer-assisted image and signal analyses, fluoroscopic and electrical data acquired during cardiac catheterization will be synthesized to allow clinical and research elecrophysiologists to map and to visualize stable arrhythmia circuits with a high degree of spatial resolution. The scattered positions of the mapped sites will approximate the geometry of the endocardial surface, and may be superimposed on fluoroscopic images of the heart to serve as a "roadmap" for catheter-directed therapies. To validate and extend this approach, the accuracy of this mapping technique will be tested against the electrophysiologic "gold standard" techniques, atrial morphometry and activation sequence determination using implanted electrode arrays, in an animal model of atrial arrhythmia. Additional studies are proposed to apply similar signal processing techniques to enhance the functional assessment of arrhythmia circuits using multielectrode catheters. In combination, application of these techniques will allow the functional anatomy of tachycardia circuits to be fully characterized and interpreted within the context of experimental arrhythmia research. The results of these investigations will be used to refine and apply this approach to the identification of specific arrhythmia mechanisms in human patients known to have similar, intractable atrial arrhythmias.