IMAGING ASSISTED INTERACTIVE VENTRICULAR DEFIBRILLATION

心脏除颤的机制是主要的主题 对治疗人类心脏病的兴趣。 显著 在理解消除行动方面取得了进展 最近通过先进的高分辨率绘图研究。 的 研究重点已从传统的实证研究向实证研究迈进 激波与波阵面相互作用机理的探讨 传播 光学成像技术的最新进展 使这些研究能够详细的空间信息， 整个心脏周围的跨膜电位（Vm）分布 在整个除颤过程中， 心外膜波前的全景图 同样地， 利用光学成像的实验结果促进了这一概念 从理论考虑到有效的 代表心肌，从而产生新的假设， 除颤机制和提示重新评估的必要性 传统的。 这项建议的主要目标是研究基本的 从心脏生物酶的角度探讨心脏除颤机制。 此外，该项目是首次尝试使用动态高 分辨率Vm图像交互除颤，包括 成像结果作为实时、智能的反馈组件 多电极电击输送系统。 交互式冲击系统 允许测试与该机制有关的重要假设 除颤，这在历史上已被经验检验 没有这样的能力。 我们将研究 直接激活部位与休克期间的组织状态;（2） 在不同阶段的冲击传递的最佳时机， 再入模式的形成;（3）最佳时机和 在多个螺旋相互作用期间传递冲击的部位 再中心模式 Bu 7结合各种预测和假设 与合胞体心脏双脉连续体的概念有关 组织，预计该提案的结果将提供 基于时空的纤颤机制的新见解 波前相互作用，如心脏双导脉所预测，以及 可以为未来提供实际指导， 心律失常干预

The mechanisms of cardiac defibrillation are subject of major interest in the treatment of human heart disorders. Significant progress in the understanding of defibrillatory action has been made recently through advanced high-resolution mapping studies. The research focus s has now advanced from the traditional empirical approach to the mechanistic interactions of shocks and wavefront propagation. Recent progress in optical imaging techniques has enabled such studies to detailed spatial information of the transmembrane potential (Vm) distribution around the entire heart throughout the defibrillation episode, providing unobstructed panoramic views of the epicardial wavefronts. Similarly, experimental results using optical imaging have promoted the concept of cardiac bidomain from theoretical considerations to a valid representation of myocardium, thus generating new hypotheses in defibrillation mechanism and prompting the necessity to re-evaluate traditional ones. The major goal of this proposal is to study basic defibrillation mechanisms for the perspective of cardiac bidomain. Furthermore, this project is the first attempt to use dynamic high resolution Vm images interactively in defibrillation by including the imaging result as a feedback component in a real-time, intelligent multi-electrode shock delivery system. The interactive shock system allows the test of important hypotheses pertaining to the mechanism of defibrillation, which historically have been examined empirically without such capability. We will investigate 91) the interaction of direct activation sites with the tissue status during the shock; (2) the optimal timing for the shock delivery during different stages of the formation on f a reentry pattern; and (3) the optimal timing and sites to deliver the shock during the interaction of multiple spiral recenter patterns. Bu7 combining various predictions and hypotheses related to the concept of bidomain continuum for sycytial cardiac tissue, it is expected that the results from this proposal will offer new insights of the fibrillation mechanisms based on spatia-temporal wavefront interactions as predicted by the cardiac bidomain, and could provide practical guidelines for the future, improvement of arrhythmia intervention.