A chamber velocity ablation navigation system and method based on false tendon attachment point

Abstract

The application discloses a kind of room speed ablation navigation system and method based on false tendon attachment point, belong to cardiovascular intervention treatment and medical image processing technical field, room speed ablation navigation system based on false tendon attachment point, comprising: image data acquisition module, electrophysiological data acquisition module, space registration module, processing module, navigation information output module.The application establishes the unified coordinate system of intracardiac ultrasound and three-dimensional electrical anatomic model by space registration module, and the extracted false tendon attachment point anatomic coordinates and the electrophysiological coordinates of earliest characteristic potential are accurately superimposed, and the certainty and accuracy of ablation target positioning are improved.

Description

Technical Field

[0001] This invention relates to the field of cardiovascular interventional therapy and medical image processing technology, specifically to a ventricular tachycardia ablation navigation system and method based on pseudochordae tendineae attachment points. Background Technology

[0002] Left ventricular idiopathic ventricular tachycardia (LVVT) is a common rapid arrhythmia in clinical practice, with the vast majority originating from reentry circuits involving the false tendineae and their attachment sites. Currently, ablation for this type of LVVT in clinical practice mainly relies on three-dimensional electroanatomical mapping systems to perform intracardiac electrophysiological activation mapping. By acquiring intracardiac electrograms point by point on the endocardial surface of the left ventricle, the earliest P1 potential representing the slow conduction region of the reentry circuit or the earliest P2 potential representing the activation of the left posterior fascicle is identified to determine the ablation target. In recent years, intracardiac echocardiography (ICE) has also been gradually introduced into the operating room to assist in observing intracardiac structures and catheter apposition.

[0003] However, existing three-dimensional electroanatomical mapping systems and intracardiac ultrasound imaging systems operate independently, lacking a unified spatial coordinate reference and real-time data fusion mechanism. During ventricular tachycardia mapping, operators must rely on their eyes to locate the anatomical image of the false chordae tendineae on a two-dimensional ICE ultrasound plane and subjectively associate it with the electrophysiological activation points in the three-dimensional mapping system based on personal experience. This subjective mapping method cannot achieve the registration and quantitative superposition of the anatomical matrix of the false chordae tendineae attachment point with the electrophysiological target point in three-dimensional space. Furthermore, due to the lack of a systematic anatomical and electrophysiological dual-anchoring navigation mechanism, operators are like blind men feeling an elephant when performing electrophysiological mapping within the vast left ventricular cavity, unable to be directly guided to the definite target area of ​​the false chordae tendineae attachment point, resulting in insufficient certainty and accuracy in ablation target location. Therefore, we propose a ventricular tachycardia ablation navigation system and method based on the false chordae tendineae attachment point to alleviate or solve the above problems.

[0004] The information disclosed above in this background section is only for enhancing the understanding of the background section of this invention, and therefore may include prior art that is not known to those skilled in the art. Summary of the Invention

[0005] To address the aforementioned technical problems, this invention provides a ventricular tachycardia ablation navigation system and method based on pseudochordae tendineae attachment points, thereby resolving issues such as insufficient determinacy and accuracy in ablation target localization caused by the lack of a precise spatial registration and superposition navigation mechanism between pseudochordae tendineae anatomical attachment points and electrophysiological target points in existing technologies.

[0006] To achieve the above objectives, the present invention provides a ventricular tachycardia ablation navigation system based on pseudochordae tendineae attachment points, comprising:

[0007] The image data acquisition module is used to acquire left ventricular intracavitary ultrasound image data in real time from the intracardiac ultrasound (ICE) device.

[0008] The electrophysiological data acquisition module is used to acquire left ventricular three-dimensional electroanatomical model data and intracardiac electrocardiogram signal data collected by the three-dimensional electroanatomical mapping system in real time;

[0009] The spatial registration module is communicatively connected to the image data acquisition module and the electrophysiological data acquisition module. It is used to perform real-time spatial registration of the intracavitary ultrasound image data of the left ventricle with the three-dimensional electroanatomical model data of the left ventricle to establish a unified three-dimensional spatial coordinate system.

[0010] The processing module, which is communicatively connected to the spatial registration module, is configured to perform the following steps:

[0011] Based on the registered ultrasound image data, the false tendineae of the left ventricle and their course were identified, and the spatial coordinates of the attachment points at both ends of the false tendineae connecting to the myocardium were extracted.

[0012] Based on the origin and termination of the false tendineae within the left ventricular cavity, the false tendineae are classified into three anatomical types: Type I, where the false tendineae connect the interventricular septum to the base of the posteromedial papillary muscle; Type II, where the false tendineae connect the interventricular septum to the head of the posteromedial papillary muscle; and Type III, where the false tendineae connect the interventricular septum to the apex of the left ventricle or the free wall of the left ventricle.

[0013] Based on the registered intracardiac electrocardiogram signal data, characteristic potentials are identified, and the electrophysiological coordinates of the earliest characteristic potential are determined; the characteristic potentials include the P1 potential representing the slow conduction region of the reentrant circuit and the P2 potential representing the activation of the left posterior branch;

[0014] Using the spatial coordinates of the pseudotendin attachment point as anatomical coordinates and the electrophysiological coordinates of the earliest characteristic potential as electrophysiological coordinates, the anatomical coordinates and electrophysiological coordinates are superimposed according to the preset target recommendation rules to calculate and determine the recommended ablation target.

[0015] The navigation information output module is used to output the recommended ablation target, the corresponding recommended contact force range, and the recommended ablation parameters to the display device or ablation console in real time.

[0016] A navigation method for ventricular tachycardia ablation based on pseudochordae tendineae attachment points, used to assist in the localization of ablation target points for left ventricular idiopathic ventricular tachycardia, is executed by a computer device and includes the following steps:

[0017] S1: Real-time acquisition of intracardiac ultrasound (ICE) imaging data and left ventricular three-dimensional electroanatomical model data and intracardiac electrocardiogram signal data from the three-dimensional electroanatomical mapping system;

[0018] S2: Perform real-time spatial registration between the ICE image data and the left ventricular three-dimensional electroanatomical model data to establish a unified three-dimensional spatial coordinate system;

[0019] S3: Identify the false tendons of the left ventricle based on the registered ICE image data, extract the course of the false tendons and the spatial coordinates of the false tendon-myocardial attachment point, and classify them into type I, type II or type III according to the origin and termination connection relationship of the false tendons.

[0020] S4: Detect the presence of a persistent monomorphic ventricular tachycardia signal. If a persistent monomorphic ventricular tachycardia signal is detected, proceed to steps S5-S7:

[0021] S5: Identify characteristic potentials based on the registered intracardiac electrocardiogram signal data and calculate the electrophysiological coordinates of the earliest characteristic potential; the characteristic potentials include the P1 potential representing the slow conduction region of the reentrant circuit and the P2 potential representing the activation of the left posterior branch;

[0022] S6: Using the spatial coordinates of the false tendineae-myocardial attachment point as anatomical coordinates and the electrophysiological coordinates of the earliest characteristic potential as electrophysiological coordinates, the two are spatially superimposed.

[0023] S7: Based on the preset target recommendation rules and the superposition results, calculate and output the recommended ablation target coordinates, the corresponding recommended contact force range and recommended ablation parameters;

[0024] If no sustained monomorphic ventricular tachycardia signal is detected, proceed to step S8:

[0025] S8: Directly retrieve the spatial coordinates of the false tendon attachment point as the anatomical target point, output the preferred anatomical target point as the recommended ablation target point based on the false tendon classification, and output the corresponding ablation endpoint evaluation reference information.

[0026] Compared with the prior art, the beneficial effects of the present invention are:

[0027] This invention establishes a unified coordinate system between intracardiac ultrasound and a three-dimensional electroanatomical model through a spatial registration module, and superimposes the extracted anatomical coordinates of the pseudochordae tendineae attachment point with the electrophysiological coordinates of the earliest characteristic potential, achieving a leap from empirical subjective mapping to objective registration. This mechanism directly anchors ablation navigation onto the deterministic anatomical and electrophysiological matrix of the pseudochordae tendineae attachment point, improving the certainty and accuracy of ablation target localization.

[0028] Based on the pseudochordae tendineae classification rules and conflict determination logic, this invention not only provides an anatomical matrix ablation path for uninducible ventricular tachycardia, expanding the surgical indications, but also automatically outputs differentiated contact force and ablation parameter recommendations through a built-in parameter mapping function, ensuring the stability of the contact and the effectiveness of damage at different anatomical sites. At the same time, for high-risk ventricular septal attachment point ablation, a safety protection mechanism based on the real-time calculation model of the HV interval is implemented with low-level logic control to achieve power titration and automatic emergency stop, avoiding serious complications such as atrioventricular block.

[0029] The above overview is for illustrative purposes only and is not intended to be limiting in any way. In addition to the illustrative aspects, embodiments, and features described above, further aspects, embodiments, and features of the invention will become readily apparent from the accompanying drawings and the following detailed description. Attached Figure Description

[0030] Figure 1 This is a schematic diagram of the overall process of the ventricular tachycardia ablation navigation method based on pseudochordae tendineae attachment points according to the present invention;

[0031] Figure 2 This is a flowchart illustrating the non-inducible matrix ablation navigation path of the present invention.

[0032] Figure 3 This is a schematic diagram of the safety protection control process for ablation of interventricular septal attachment points according to the present invention. Detailed Implementation

[0033] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. It should be noted that the drawings are schematic and not illustrated to scale. For clarity and convenience, the relative sizes and proportions of the parts shown in the drawings have been exaggerated or reduced in size. Any size is only exemplary and not limiting.

[0034] Example 1: A ventricular tachycardia ablation navigation system based on pseudochordae tendineae attachment points. The system workflow of this example is shown in the attached figure. Figure 1 The overall navigation process shown includes: image data acquisition module, electrophysiological data acquisition module, spatial registration module, processing module, and navigation information output module.

[0035] Specifically, the image data acquisition module communicates with the intracardiac ultrasound (ICE) device through a high-frequency data transmission interface to acquire in real time the two-dimensional sector image data stream generated by the ICE probe scanning in the left ventricular cavity, with a sampling rate of ≥30 frames / second, as well as the position and orientation data of the ICE probe in three-dimensional space.

[0036] The electrophysiological data acquisition module communicates with the three-dimensional electroanatomical mapping system to acquire in real time: left ventricular three-dimensional electroanatomical model data; intracardiac electrocardiogram signal data, with a sampling frequency of 1-2 kHz and a bandpass filter of 30-300 Hz; and the real-time position coordinates of the catheter in three-dimensional space.

[0037] In the spatial registration module, since the ICE image coordinate system and the 3D electroanatomical mapping coordinate system are independent, this module is used to establish a unified 3D spatial coordinate system. Let the coordinates of the attachment point in the ICE image coordinate system be... The corresponding coordinates in the three-dimensional electroanatomical coordinate system are: The spatial registration module uses a rigid body transformation model, and the mapping relationship is as follows:

[0038]

[0039] in, It is a 3×3 rotation matrix. The translation vector is 3×1. The registration module extracts anatomical landmarks and uses the least squares method to solve for the registration error. Minimized and This allows the subsequently identified pseudotendin attachment points to be uniformly mapped onto a three-dimensional electroanatomical coordinate system.

[0040] The processing module, as the core computing unit of the system, is configured to execute image segmentation, potential recognition, spatial overlay, and target recommendation algorithms.

[0041] The navigation information output module outputs the recommended target point, recommended contact force, and recommended ablation parameters to the display device or ablation console in real time in the form of visual overlay and data instruction packets.

[0042] More specifically, when a patient successfully develops sustained monomorphic ventricular tachycardia through intraoperative programmed stimulation, the method for fusing cardiac imaging and electrophysiological signals includes the following steps:

[0043] S1-S2: The imaging and electrophysiological data acquisition modules acquire data synchronously, and the spatial registration module completes spatial alignment according to the rigid body transformation formula mentioned above.

[0044] Specifically, the processing module first converts the pixel coordinates of the attachment points identified in the ICE two-dimensional image into local three-dimensional coordinates with the probe as the origin, based on the transducer geometric parameters and fan-shaped scanning angle of the ultrasound probe, and then maps them to the three-dimensional electroanatomical coordinate system through the rigid body transformation model.

[0045] S3: The processing module identifies false tendineae in the registered ICE image sequence. Specifically, it first performs noise reduction and edge enhancement preprocessing on the ultrasound images to extract the hyperechoic cord-like structures within the cardiac chambers. Then, based on the anatomical morphological characteristics of the false tendineae, it sets target fibrous cords with an aspect ratio >3, a thickness of 1-2 mm, and both ends connected to the myocardial wall or papillary muscles. It uses a segmentation algorithm based on region growth and morphological filtering, or a U-Net convolutional neural network model, to segment the cord regions that meet the criteria. Finally, it tracks the course of the cord in continuous ultrasound sections and extracts its three-dimensional envelope and the extreme points at the junctions with the myocardial tissue at both ends as the spatial coordinates of the false tendineae's course and attachment points.

[0046] S4: During continuous ventricular tachycardia, the processing module processes the intracardiac electrocardiograms acquired along the FT route of the false tendineae. Assume a total of [number missing] electrocardiograms are acquired in the false tendineae region. Each set of measurement points constitutes a measurement point set. For each measurement point The processing module identifies the initial excitation timestamp of the P1 potential (a high-frequency sharp peak potential during diastole) as... Define the earliest calibration point for the P1 potential. satisfy:

[0047]

[0048] Should The corresponding spatial coordinates are electrophysiological coordinates. The system is simultaneously in The drag-and-drop verification logic is executed automatically.

[0049] S5: Processing module calculation With preferred anatomical coordinates (FT-PPM cephalic attachment point, set as...) Euclidean distance :

[0050]

[0051] The calculation in this example yields... =6mm. System set deviation threshold. =10mm, due to The overlap was determined to be successful, and the preferred anatomical coordinates were confirmed as the recommended ablation target.

[0052] S6: The navigation information output module highlights the attachment point of the FT-PPM (posteromedial papillary muscle) head. This is due to the target point's location attributes. The system outputs recommended values ​​based on its built-in parameter mapping function:

[0053]

[0054] The system outputs a recommended contact force of 2.0-3.0g, and recommends ablation parameters of 35W power and 55℃ temperature. Navigation is then used to complete precise ablation.

[0055] Example 2, as shown in the appendix Figure 2 As shown, the matrix ablation navigation path for non-inducible ILVT is implemented as follows:

[0056] When the electrophysiological data acquisition module fails to detect a continuous monomorphic ventricular tachycardia signal within a preset time window, the system automatically triggers the uninducible matrix ablation navigation path.

[0057] Since the electrophysiological coordinates during ventricular tachycardia are lacking, the processing module directly retrieves the spatial coordinates of the pseudochordae tendineae attachment point identified based on ICE images as the anatomical target.

[0058] When ICE imaging identifies the presence of type I false chordae tendineae (connecting the interventricular septum and the base of the PPM) in the patient's left ventricle, the processing module directly outputs the preferred anatomical target point, the attachment point of the FT-PPM base, as the recommended ablation target point based on the classification rules.

[0059] When generating and outputting ablation endpoint assessment reference information, if ventricular tachycardia termination cannot be used as the endpoint, the system provides alternative electrophysiological assessment criteria. The navigation information output module synchronously outputs the ablation endpoint assessment reference information to the display device, prompting monitoring of the following quantitative indicators during sinus rhythm ablation:

[0060] Local potential changes: At the same time, the corresponding ablation endpoint assessment reference information is output. Local diastolic potentials disappear, or local myocardial voltage amplitude decreases with fragmented potentials appear, and the HV interval and QRS complex morphology do not deteriorate under sinus rhythm.

[0061] Local voltage amplitude: Local myocardial bipolar voltage amplitude after discharge And accompanied by fragmentation potential;

[0062] Conduction safety: Real-time monitoring of HV interval prolongation Furthermore, the QRS group time limit is not widened.

[0063] This embodiment demonstrates that targeted ablation can still be performed based on a well-defined anatomical matrix even in the absence of ventricular tachycardia, and the endpoint can be determined with reference to objective quantitative indicators.

[0064] Example 3: Logic for Determining Conflicts Between Anatomical and Electrophysiological Coordinates and Safety Protection for Ablation of Ventricular Septal Attachment Points

[0065] When a patient is identified as having type II false tendons, anatomical coordinates are the preferred method. This is the attachment point at the tip of the FT-PPM head. The earliest P1 electrophysiological coordinates calculated by the processing module are... Calculate the overlap deviation distance:

[0066]

[0067] The system calculates =14mm. Because... The system determines that the overlap has failed and triggers the conflict determination logic:

[0068]

[0069] After relocation is triggered, the system calculates the electrophysiological coordinates. The shortest distance to the myocardial interface where the FT-ventricular septum attachment point of the candidate target is located. .when , If the tolerance radius is set to 5mm, the electrophysiological coordinates are determined to be located on the pseudochordae tendineae path, and the system automatically updates the recommended ablation target to the FT-ventricular septum attachment point; when If so, the output mechanism will re-evaluate the prompt.

[0070] Due to the location attributes of the new target (Interventricular septum), adjacent to the conduction system, the safety protection module is activated, implementing dual protection; the control process is attached. Figure 3 As shown.

[0071] Specifically, the system uses the mapping function (Titration start) Generates a power titration control signal and outputs it to the ablation control console, forcing the ablation device to start at a low power of 15-20W. After the system monitors for 10-15 seconds without any conduction abnormalities, it gradually increases the power in 5W increments to the target power of 35W.

[0072] The safety protection module uses high-frequency acquisition of surface electrocardiograms and intracardiac His bundle electrocardiograms. The baseline HV interval is set as... Real-time monitoring value When any of the following logical conditions are met: If QRS wave widening or atrioventricular block is detected, the safety protection module will immediately output an alarm signal to stop discharging and a hardware cut-off command to the ablation control console within a delay of <50ms, forcibly terminating the energy output.

[0073] In the system, the myocardial interface of the left ventricular three-dimensional electroanatomical model is composed of triangular mesh patches, and the pseudotendinosus course is fitted by a three-dimensional spline curve; the shortest distance , which is the Euclidean distance from the point in the electrophysiological coordinate space to the triangular mesh surface where the candidate target point is located, or the perpendicular distance to the pseudotendinosus spline curve.

[0074] The conflict determination mathematical model and safety protection mechanism in Example 3 solve the problem of target selection when anatomy and electrophysiology are inconsistent, and build a firewall to prevent serious complications from the underlying control logic.

[0075] Comparative Example 1: Comparison with traditional pure electrophysiological activation mapping methods

[0076] Traditional ablation of idiopathic ventricular tachycardia (ILVT) mainly relies on a three-dimensional electroanatomical mapping system, which manually drags a catheter to find the earliest P1 or P2 potential inside the left ventricle.

[0077] Experimental subjects and groups

[0078] Two hundred patients diagnosed with intra-arterial ventricular tachycardia (ILVT) upon admission and whose intraoperative sustained ventricular tachycardia could be induced were selected. They were randomly divided into two groups:

[0079] 100 cases in the experimental group: The ventricular tachycardia ablation navigation system of Embodiment 1 of the present invention was used to first identify the FT and attachment point through ICE, and then guide the mapping and superposition.

[0080] 100 control group: Traditional pure electrophysiological activation mapping method was used, relying solely on the CARTO system for blind or empirical activation mapping.

[0081] Evaluation criteria

[0082] Mapping time: The time from successful induction of ventricular tachycardia to identification of the ablation target.

[0083] Acute surgery success rate: ventricular tachycardia cannot be induced within 30 minutes after isoproterenol stimulation following ablation.

[0084] Recurrence rate during follow-up: Ventricular tachycardia recurred during a 6-month follow-up period after surgery and Holter monitoring was recorded.

[0085] Success rate of uninducible ventricular tachycardia surgery: a subgroup analysis focusing on patients for whom ventricular tachycardia could not be induced intraoperatively. The results are shown in Table 1.

[0086] Table 1 Comparison of surgical outcomes between the experimental group and the control group

[0087] Observation indicators experimental group control group p-value Measurement time 8.5±3.2 22.7±8.6 <0.001 Acute surgery success rate 98.0%(98 / 100) 87.0%(87 / 100) 0.006 Recurrence rate during follow-up (6 months) 2.0%(2 / 100) 12.0%(12 / 100) 0.014 Uninduced success rate 95.0%(19 / 20) 45.0%(9 / 20) <0.001

[0088] As shown in Table 1, the system of this invention, by pre-anchoring the FT and attachment point via ICE, reduces the vast left ventricular cavity mapping range to a micro-domain of 10 mm around the attachment point, drastically reducing the mapping time from an average of 22.7 minutes to 8.5 minutes, thus improving surgical efficiency. Because anatomical and electrophysiological coordinates are superimposed, target point deviation caused by experience bias in traditional methods is avoided, increasing the acute success rate to 98% and reducing the recurrence rate during follow-up. Especially in the uninducible ILVT subgroup, traditional methods cannot map the P1 potential due to the absence of ventricular tachycardia episodes, resulting in extremely low success rates; while this invention can directly target ablation based on the anatomical matrix, achieving a success rate as high as 95%.

[0089] Comparative Example 2: Comparison with conventional ICE-assisted empirical ablation methods

[0090] With the increasing prevalence of ICE (Interventional Radiographic Testing) systems, some surgeons have begun to observe false chordae tendineae with ICE assistance. However, this observation is limited to visual inspection and lacks systematic spatial registration, differentiated parameter recommendations, and automated safety protection logic. Improper contact force during ablation of papillary muscle (PPM) or interventricular septum (IVS) attachments can easily lead to ineffective damage or serious complications.

[0091] Experimental subjects and groups

[0092] One hundred and fifty patients with intermittent thrombotic tachycardia (ILVT) confirmed by ICE (Intraventricular Emissions and Treatment) and whose attachment points involved the ventricular septum were selected. They were randomly divided into two groups:

[0093] 75 experimental cases: The system of Example 3 of this invention was used. The system automatically outputs the recommended differential contact force: 2-3g at PPM and >5g at IVS. The system also activates the safety protection module during IVS ablation, and automatically monitors and stops the power titration and HV interval.

[0094] 75 control group cases: routine ICE-assisted empirical ablation, with the operator setting the contact force and discharge power based on personal experience, without system-level power titration and automatic emergency stop logic.

[0095] Evaluation criteria

[0096] Effective ablation discharge count: The number of discharges required to achieve the disappearance of local potential or termination of ventricular tachycardia.

[0097] Catheter slippage rate: The percentage of times the catheter slips off the target site during ablation.

[0098] Transient atrioventricular block (AVB) incidence: The number of events in which transient atrioventricular block occurs during discharge.

[0099] Incidence of permanent AVB: Permanent atrioventricular block requiring pacemaker implantation after surgery. The experimental results are shown in Table 2.

[0100] Table 2. Comparison of safety and efficacy between the experimental group and the control group.

[0101] Observation indicators experimental group control group p-value Effective ablation discharge times 1.2±0.4 2.8±1.1 <0.001 catheter slippage rate 4.0%(3 / 75) 18.7%(14 / 75) 0.004 Transient AVB incidence 1.3%(1 / 75) 14.7%(11 / 75) 0.003 Permanent AVB incidence 0%(0 / 75) 4.0%(3 / 75) 0.082

[0102] As shown in Table 2, a low contact force of 2.0-3.0g is recommended for PPM attachment points to avoid excessive catheter embedding or slippage caused by large movements of the papillary muscles during the cardiac cycle; a high contact force of >5g is recommended for IVS attachment points to ensure transmural damage to dense ventricular septum tissue and reduce ineffective discharge.

[0103] More importantly, the safety protection module of this invention, through rigorous power titration and real-time monitoring using a mathematical model of the HV interval during IVS ablation, reduces the incidence of transient atrioventricular block from 14.7% to 1.3%. In contrast, the control group, which relies on the operator's visual observation of ECG changes and manual shutdown, often experiences a reaction delay of hundreds of milliseconds, leading to irreversible conduction damage.

[0104] In summary, the comparative experimental data show that the ventricular tachycardia ablation navigation system and method based on pseudochordae tendineae attachment points provided by this invention solves the problems of blind mapping, unstable attachment, and high complication rate in existing technologies through spatial registration, coordinate overlay algorithm, differentiated parameter mapping, and automatic safety protection mechanism.

[0105] In the description of this specification, the references to terms such as "one embodiment," "some embodiments," "example," "specific example," or "some examples," etc., indicate that a specific feature, structure, material, or characteristic described in connection with that embodiment or example is included in at least one embodiment or example of the present invention. In this specification, the illustrative expressions of the above terms do not necessarily refer to the same embodiment or example. Furthermore, the specific features, structures, materials, or characteristics described may be combined in any suitable manner in one or more embodiments or examples. Moreover, without contradiction, those skilled in the art can combine and integrate the different embodiments or examples described in this specification, as well as the features of different embodiments or examples.

[0106] Although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art can still modify the technical solutions described in the foregoing embodiments or make equivalent substitutions for some of the technical features. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principles of the present invention should be included within the protection scope of the present invention.

Claims

1. A ventricular tachycardia ablation navigation system based on pseudochordae tendineae attachment points, characterized in that, include: The image data acquisition module is used to acquire left ventricular intracavitary ultrasound image data in real time from the intracardiac ultrasound equipment. The electrophysiological data acquisition module is used to acquire left ventricular three-dimensional electroanatomical model data and intracardiac electrocardiogram signal data collected by the three-dimensional electroanatomical mapping system in real time; The spatial registration module is communicatively connected to the image data acquisition module and the electrophysiological data acquisition module. It is used to perform real-time spatial registration of the intracavitary ultrasound image data of the left ventricle with the three-dimensional electroanatomical model data of the left ventricle to establish a unified three-dimensional spatial coordinate system. The processing module, which is communicatively connected to the spatial registration module, is configured to perform the following steps: Based on the registered ultrasound image data, the false tendineae of the left ventricle and their course were identified, and the spatial coordinates of the attachment points at both ends of the false tendineae connecting to the myocardium were extracted. Based on the origin and termination of the false tendineae within the left ventricular cavity, the false tendineae are classified into three anatomical types: Type I, where the false tendineae connect the interventricular septum to the base of the posteromedial papillary muscle; Type II, where the false tendineae connect the interventricular septum to the head of the posteromedial papillary muscle; and Type III, where the false tendineae connect the interventricular septum to the apex of the left ventricle or the free wall of the left ventricle. Based on the registered intracardiac electrocardiogram signal data, characteristic potentials are identified, and the electrophysiological coordinates of the earliest characteristic potential are determined; the characteristic potentials include the P1 potential representing the slow conduction region of the reentrant circuit and the P2 potential representing the activation of the left posterior branch; Using the spatial coordinates of the pseudotendin attachment point as anatomical coordinates and the electrophysiological coordinates of the earliest characteristic potential as electrophysiological coordinates, the anatomical coordinates and electrophysiological coordinates are superimposed according to the preset target recommendation rules to calculate and determine the recommended ablation target. The navigation information output module is used to output the recommended ablation target, the corresponding recommended contact force range, and the recommended ablation parameters to the display device or ablation console in real time.

2. The ventricular tachycardia ablation navigation system based on pseudochordae tendineae attachment points according to claim 1, characterized in that, The preset target recommendation rules and conflict determination logic executed by the processing module are as follows: For type I, the preferred target site is the false chordae tendineae-posteromedial papillary muscle base attachment point, and the alternative target site is the false chordae tendineae-ventricular septum attachment point; for type II, the preferred target site is the false chordae tendineae-posteromedial papillary muscle head attachment point, and the alternative target site is the false chordae tendineae-ventricular septum attachment point; for type III, the preferred target site is the false chordae tendineae-ventricular septum attachment point; when the false chordae tendineae are not identified, the recommended target site is the earliest P2 potential site in the left posterior septum. If the electrophysiological coordinates of the earliest characteristic potential are found to be offset from the anatomical coordinates of the preferred target point by more than 10 mm, a conflict determination is triggered, with the electrophysiological coordinates as the primary reference. If the electrophysiological coordinates are located on the myocardial interface or the path of the pseudochordae tendineae of the candidate target point, the location of the electrophysiological coordinates is updated as the recommended ablation target point. If the electrophysiological coordinates are completely removed from the pseudochordae tendineae region, a prompt message for reassessing the ventricular tachycardia mechanism is output.

3. The ventricular tachycardia ablation navigation system based on pseudochordae tendineae attachment points according to claim 1, characterized in that, The processing module is also configured to: Based on the location attributes of the recommended ablation target, a corresponding recommended contact force range and recommended ablation parameters are generated; When the recommended ablation target is the pseudochordae tendineae-posteromedial papillary muscle attachment point, the recommended contact force range is 2.0-3.0g, the recommended ablation power is 30-40W, the temperature is 50-60℃, and the single discharge time is 60-120s. When the recommended ablation target is the pseudochordae tendineae-ventricular septum attachment point, the recommended output contact force range is greater than 5g, the recommended ablation power is 30-40W, the temperature is 50-60℃, and the single discharge is 60-120s.

4. The ventricular tachycardia ablation navigation system based on pseudochordae tendineae attachment points according to claim 1, characterized in that, The processing module is also configured to provide a non-inducible matrix ablation navigation path: When the electrophysiological data acquisition module does not receive a continuous monomorphic ventricular tachycardia signal, it directly retrieves the spatial coordinates of the pseudochordae tendineae attachment point identified by ultrasound imaging as the anatomical target point, and outputs the preferred anatomical target point as the recommended ablation target point according to the anatomical classification; at the same time, it outputs the corresponding ablation endpoint assessment reference information: the local P1 potential disappears or the amplitude decreases by ≥50%, or the local myocardial voltage amplitude decreases with the appearance of fragmented potentials, and the HV interval and QRS complex morphology under sinus rhythm do not deteriorate.

5. The ventricular tachycardia ablation navigation system based on pseudochordae tendineae attachment points according to claim 1, characterized in that, It also includes a safety protection module, which is communicatively connected to the processing module and the navigation information output module, and is configured as follows: During the ablation of the pseudochordae tendineae-ventricular septum attachment site, a power titration control signal is generated and output to the ablation console so that the radiofrequency energy generator starts the discharge with an initial power of 15-20W. After monitoring for 10-15 seconds without conduction abnormalities, the power is gradually increased to the target power. Real-time acquisition of surface electrocardiogram and intracardiac His bundle electrocardiogram; when HV interval prolongation >20%, QRS wave widening or atrioventricular block is detected, an alarm signal to stop discharge is immediately output to the ablation control console.

6. A navigation method for ventricular tachycardia ablation based on pseudochordae tendineae attachment points, used to assist in the localization of ablation target points for left ventricular idiopathic ventricular tachycardia, characterized in that, The method is executed by a computer device and includes the following steps: S1: Real-time acquisition of intracardiac ultrasound (ICE) imaging data and left ventricular three-dimensional electroanatomical model data and intracardiac electrocardiogram signal data from the three-dimensional electroanatomical mapping system; S2: Perform real-time spatial registration between the ICE image data and the left ventricular three-dimensional electroanatomical model data to establish a unified three-dimensional spatial coordinate system; S3: Identify the false tendons of the left ventricle based on the registered ICE image data, extract the course of the false tendons and the spatial coordinates of the false tendon-myocardial attachment point, and classify them into type I, type II or type III according to the origin and termination connection relationship of the false tendons. S4: Detect the presence of a persistent monomorphic ventricular tachycardia signal. If a persistent monomorphic ventricular tachycardia signal is detected, proceed to steps S5-S7: S5: Identify characteristic potentials based on the registered intracardiac electrocardiogram signal data and calculate the electrophysiological coordinates of the earliest characteristic potential; the characteristic potentials include the P1 potential representing the slow conduction region of the reentrant circuit and the P2 potential representing the activation of the left posterior branch; S6: Using the spatial coordinates of the false tendineae-myocardial attachment point as anatomical coordinates and the electrophysiological coordinates of the earliest characteristic potential as electrophysiological coordinates, the two are spatially superimposed. S7: Based on the preset target recommendation rules and the superposition results, calculate and output the recommended ablation target coordinates, the corresponding recommended contact force range and recommended ablation parameters; If no sustained monomorphic ventricular tachycardia signal is detected, proceed to step S8: S8: Directly retrieve the spatial coordinates of the false tendon attachment point as the anatomical target point, output the preferred anatomical target point as the recommended ablation target point based on the false tendon classification, and output the corresponding ablation endpoint evaluation reference information.

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