Precise minimally invasive treatment of VT using non-invasive mapping

描述(申请人提供)：室性心动过速(VT)是一种主要的公共卫生问题，发生在15%的冠状动脉疾病患者、8%的高血压患者和2%的普通人群中。目前的治疗方法是放置植入型心律转复除颤器(ICD)。虽然ICD在终止VT方面是有效的，但它们并不能阻止VT的发生。识别和选择性消融心律失常的起始点(S)可导致室速的永久停止。不幸的是，这项技术只能应用于少数VT患者，因为它要求他们具有缓慢的、血流动力学稳定的VT是安全的。利用三种成熟的技术，我们将创造一种新的方法，以最小的侵入性识别和消融VT起始点，适用于更多的VT患者。通过将非侵入性标测技术与精确的心外膜导航方法和灵活的针基射频消融技术相结合，我们将产生一个独特的系统。在这项工作的第一阶段，我们将展示这些技术可以统一，而在第二阶段，我们将在动物模型中验证其有效性。 公共卫生相关性：室性心动过速(VT)在美国是一个主要的公共卫生问题，每年导致30万人死亡。植入型心律转复除颤器被认为是目前最合适的治疗手段。不幸的是，这并不能预防室性心动过速，而是用一次痛苦的休克来阻止心律失常。要永久治疗室上性心动过速，必须防止其发生，但目前只能在一小部分受VT影响的人群中做到这一点。通过这项提议开发的治疗方法将大大增加可以使用这种永久停止技术的室性心动过速患者的数量，并将使用建立在几项众所周知的技术基础上的安全、成本效益的方法来实现这一点。好了！

DESCRIPTION (provided by applicant): Ventricular Tachycardia (VT) is a major public health problem occurring in 15% of patients with coronary artery disease, 8% of patients with hypertension, and 2% of the general population. Current therapy is placement of an implantable cardioverter- defibrillator (ICD). While ICDs are effective in terminating VT, they do not prevent VT from occurring. Permanent cessation of VT can result from identification and selective ablation of the origination site(s) of the arrhythmia. This technique unfortunately can only be applied to small number of VT patients because it requires their having slow, hemodynamically stable VT to be safe. Using three proven technologies, we will create a novel means of minimally invasively identifying and ablating VT initiation sites that is applicable to a much largr number of VT patients. By combining a non-invasive mapping technology with a precise epicardial navigation approach and a flexible needle- based radio frequency ablation technique, we will produce a uniquely capable system. In Phase I of this work, we will demonstrate that these technologies can be unified while in Phase II we will verify its efficacy in an animal model. PUBLIC HEALTH RELEVANCE: Ventricular Tachycardia (VT) is a major public health issue in the United States resulting in 300,000 deaths each year. An implantable cardioverter-defibrillator is considered the most appropriate means of treatment at present. Unfortunately, this does not prevent VT but rather stops the arrhythmia with a painful shock. To permanently treat VT, its origination must be prevented, but this can presently be done on only a small percentage of the VT-affected population. The therapy that will be developed through this proposal will significantly expand the number of VT patients who can have this permanent cessation technique and will do so using a safe, cost-effective approach that builds upon several well-understood technologies. !