Validation of noncontact mapping and evaluation of catheter intramural ablation for ventricular tachycardia

猝死是心脏因心脏病发作而留下疤痕的患者最常见的死亡模式。猝死通常是由一种称为室性心动过速的非常快速、异常的心律引起的。最有效的治疗方法是植入一种名为植入式除颤器的装置。这些设备只是治标不治本，而且非常昂贵。每台设备的成本为15,000-30,000美元，患者一生中的治疗成本可能高达150,000美元。需要开发新的方法来彻底消除这些异常节律。室性心动过速通常是由于心脏肌肉深处的折返性电路引起的。该项目旨在开发和评估一种非手术技术来根除这些异常电路。非接触标测是一种很有前途的新技术，能够同时检测心脏多个部位的电信号。该项目旨在使用黄金标准联系人映射来验证这项技术。我们已经开发了两种导管原型，将在绵羊身上进行评估，并进一步开发。这些导管是专门设计的，用来将针插入心脏肌肉进行射频消融。射频消融是一种以良好控制的方式破坏一小块心肌的技术。如果这项技术被发现是成功的，它可能会治愈一些患者的室性心动过速，或者根除其他患者最麻烦的折返回路。它可能会使相当数量的患者不再需要植入式除颤器，从而极大地节省医疗成本。已经植入除颤器的患者将受益于设备寿命的延长，因为最麻烦的折返电路被根除了。

Sudden death is the most common mode of death in patients who have had scarring in their hearts due to a heart attack. Sudden death is usually caused by a very rapid, abnormal heart rhythm called ventricular tachycardia. The most effective treatment is the implantation of a device called an implantable defibrillator. These devices are only palliative and are very expensive. Each device costs $15,000 - $30,000 and the cost of treating a patient during his-her lifetime could be as much as $150,000. New methods need to be developed to eradicate these abnormal rhythms completely. Ventricular tachycardia is usually due to reentrant electrical circuits deep within the heart muscle. The project aims to develop and evaluate a non-operative technique to eradicate these abnormal electrical circuits. Noncontact mapping is a promising new technology capable of detecting electrical signals from multiple sites in the heart simultaneously. This project aims to validate this technology using the gold-standard contact mapping. We have already developed two prototypes of catheters that will be evaluated in sheep and developed further. These catheters are specially designed to introduce a needle into the heart muscle to perform radiofrequency ablation. Radiofrequency ablation is a technique of destroying, in a well-controlled manner, a small area of heart muscle. If this technique is found to be successful, it might cure ventricular tachycardia in some patients or eradicate the most troublesome reentrant circuits in other patients. It is likely to negate the need for implantable defibrillator in a significant number of patients, resulting in a tremendous saving in health care costs. Patients who have the procedure after already having an implantable defibrillator will benefit from increased longevity of their device because of eradication of the most troublesome reentrant circuits.