Ablation Lesion Contiguity Index for Gap-Free Cardiac Lines

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Solution Overview

Problem

Current intracardiac ablation systems lack a comprehensive method to evaluate the contiguity and integrity of lesions created during minimally-invasive procedures, leading to potential gaps in tissue blockage and excessive tissue damage.

Innovation Solution

The development of an ablation line contiguity index (ALCI) is computed using lesion size measures and location coordinates, providing a weighted comparison to assess the overlap between adjacent lesions, ensuring effective tissue blockage without excessive overlap or tissue damage.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If ablation energy is applied to create lesions in cardiac tissue, then arrhythmia treatment is achieved, but gaps between lesions may occur leading to incomplete tissue blockage

Engineering Contradiction:
Improvetissue blockage effectivenessVSAvoidlesion placement precision
Core Design Contradiction:
ReliabilityVSManufacturing precision

Solution Approach 1:

The system computes an ablation line contiguity index by comparing the distance between adjacent lesions with the sum of their radii, providing real-time feedback on lesion overlap. This feedback mechanism allows the operator to adjust ablation parameters to ensure complete tissue blockage without gaps between lesions.

Inventive Principle:
Principle #23Feedback

Solution Approach 2:

The patent replaces manual visual assessment of lesion contiguity with an automated computational system that calculates the contiguity index based on lesion location coordinates and sizes. This computational approach provides objective, quantitative assessment rather than subjective visual evaluation.

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

2Reliability

If ablation energy is applied to create overlapping lesions, then complete tissue blockage is achieved, but excessive tissue damage may occur

Engineering Contradiction:
Improvetissue blockage completenessVSAvoidtissue damage
Core Design Contradiction:
ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The contiguity index provides feedback on the degree of lesion overlap by comparing inter-lesion distance with the sum of lesion radii. This feedback enables optimization of lesion spacing to achieve complete blockage while minimizing excessive overlap that could cause unnecessary tissue damage.

Inventive Principle:
Principle #23Feedback

Solution Approach 2:

The system uses the contiguity index to guide adjustments in ablation parameters such as power, duration, and lesion spacing. By changing these parameters based on contiguity feedback, the system achieves optimal balance between complete tissue blockage and minimal tissue damage.

Inventive Principle:
Principle #35Parameter changes

3Ease of operation

If manual tracking of ablation progress is used, then procedure flexibility is maintained, but comprehensive evaluation of lesion contiguity is lacking

Engineering Contradiction:
Improveprocedure flexibilityVSAvoidlesion contiguity information
Core Design Contradiction:
Ease of operationVSLoss of information

Solution Approach 1:

The patent replaces manual tracking and visual assessment with an automated computational system that calculates the ablation line contiguity index. This substitution preserves operator flexibility while eliminating information loss by providing comprehensive, objective quantification of lesion contiguity based on recorded lesion parameters.

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

Solution Approach 2:

The contiguity index serves as an intermediary metric that bridges manual ablation procedures with quantitative evaluation. It translates lesion location and size data into a meaningful measure of contiguity, enabling comprehensive evaluation without restricting procedural flexibility.

Inventive Principle:
Principle #24Intermediary (Mediator)

4Productivity

If ablation lesions are created without quantitative assessment, then treatment speed is maintained, but quality control of ablation line integrity is compromised

Engineering Contradiction:
Improvetreatment speedVSAvoidablation line integrity
Core Design Contradiction:
ProductivityVSManufacturing precision

Solution Approach 1:

The contiguity index provides rapid computational feedback on ablation line integrity by comparing lesion spacing with lesion sizes. This feedback enables quality control without significantly slowing treatment, as the calculation is performed automatically based on already-recorded lesion parameters.

Inventive Principle:
Principle #23Feedback

Solution Approach 2:

The system performs self-assessment of ablation line quality by automatically computing the contiguity index from recorded lesion data. This self-service capability provides quality control without requiring additional manual measurement or assessment steps, maintaining treatment speed while ensuring integrity.

Inventive Principle:
Principle #25Self-service

Applied Scientific Principles

This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.

Function Achieved in This Case

The ALCI index enhances the quality of ablation treatments by providing a quantitative assessment of lesion contiguity, reducing the risk of arrhythmic reconnection and tissue damage, and guiding the application of energy to achieve optimal lesion placement and depth.

Implementation Method 1

applying the energy includes applying radio-frequency electrical energy through the probe while the probe contacts the tissue at each of the sites

Methodology Applied
Scientific EffectRadio-frequency electrical energy: Dielectric Heating

Implementation Method 2

energizes one or more electrodes at or near the distal end in order to create tissue necrosis

Methodology Applied
Scientific EffectThermal heating: Heating

Implementation Method 3

recording the treatment parameters includes measuring a force exerted by the probe against the tissue

Methodology Applied
Scientific EffectForce measurement: Mechanical Force

Data Source

PatentEP3175807B1Ablation line contiguity index
Publication Date: 2021.01.20 BIOSENSE WEBSTER (ISRAEL) LTD
  • EP3175807B1 patent drawingFigure 1
  • EP3175807B1 patent drawingFigure 2
  • EP3175807B1 patent drawing

AI summary

An apparatus for performing a medical treatment, comprising an invasive probe and a processor coupled to the probe. Energy is applied through the probe to ablate tissue at a plurality of sites in an organ in a body of a patient, thereby creating lesions in the tissue including at least first and second lesions at respective first and second, mutually-adjacent sites. The processor is configured to record location coordinates and respective treatment parameters at each of the sites with respect to the applied energy. Based on the recorded treatment parameters, respective measures of size of the lesions are computed, including at least respective first and second measures of the first and second lesions. An indication of contiguity between at least the first and second lesions is generated responsively to the first and second measures and to a distance between the location coordinates of the first and second sites.