Precise Minimally InvasiveTreatment of VT Using Non-invasive Mapping.

项目摘要 室性心动过速(VT)是一种主要的公共卫生问题，与大多数 美国每年有30万例心脏性猝死。目前最好的治疗方法是 室性心动过速涉及减少室速发作的药物，以及植入心脏除颤器(ICD)， 通过终止室性心动过速发作来延长生命。永久停止室性心动过速可以通过消融来实现 心律失常的起始点(S)和退出途径(S)。尽管这项技术有很多优点， 它的采用受到了限制，因为它目前只适用于少数患有 血流动力学稳定的室速。 该项目将创建一个破坏性的、更便宜、更有效和更安全的系统，用于最低限度地 关键室速部位的侵入性识别和消融。它将结合心脏(HL)心外膜 Walker采用非侵入性标测技术和灵活的针基射频消融 技术。在之前的工作中，我们已经演示了这些技术可以集成到一个 统一了系统，也消除了技术的重大技术风险。 在这个Fast Track SBIR应用中，我们建议完成技术和 然后在一个约克郡猪的VT模型上验证了该系统的有效性。成功后 完成后，我们将准备向临床推进一个更简单、更安全、更可靠和更少的 有效治疗每年500,000例室性心动过速的昂贵方法。我们 还将构建硬件和计算基础设施，以支持其他映射 将能够治疗复杂的多灶性心律失常的方法。

Project Summary Ventricular Tachycardia (VT) is a major public health problem associated with the majority of the 300,000 cases of sudden cardiac death in the United States each year. The best current therapy for VT involves drugs to reduce VT episodes plus implantation of a cardiac defibrilator (ICD) that prolongs life by terminating episodes of VT. Permanent cessation of VT can be achieved by ablation of the origin site(s) and exit pathway(s) of the arrhythmia. Despite the advantages of this technique, its adoption has been limited because it is currently appropriate only for the few patients with hemodynamically stable VT. This project will create a disruptive, less expensive, more effective, and safer system for minimally invasive identification and ablation of critical VT sites. It will combine the HeartLander (HL) epicardial walker with a non-invasive mapping technology and a flexible, needle-based, radio frequency ablation technique. In prior work we have demonstrated that these technologies can be integrated into a unified system and have also eliminated major technical risks of the technologies. In this Fast Track SBIR application, we propose to complete the integration of the technologies and then verify the efficacy of the system in a Yorkshire swine pig model of VT. Upon successful completion, we will be ready to advance to the clinic a simpler, safer, more reliable and less expensive approach to effectively treating the 500,000 annual cases of ventricular tachycardia. We will also have built the hardware and computation infrastructure to support additional mapping methodologies that will enable the treatment of complex multi-focal arrhythmias.