Atrial Fibrillation Ablation Target Identification Using Fibrosis Spatial Distribution

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Solution Overview

Problem

Current methods for treating atrial fibrillation, particularly in patients with persistent AF and extensive fibrosis, are ineffective due to invasive and time-consuming electro-anatomical mapping procedures, and rely solely on quantifying fibrosis without considering its spatial distribution for ablation targets.

Innovation Solution

A method that involves receiving imaging data, processing it to characterize tissue as fibrotic or non-fibrotic, calculating metrics of spatial distribution, and identifying cardiac tissue ablation targets based on these metrics to create a personalized treatment plan, potentially reducing the need for invasive procedures and improving treatment efficacy.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If electro-anatomical mapping is used to determine ablation targets in patients with persistent AF and fibrotic remodeling, then ablation targets can be identified, but the procedure becomes invasive, time-consuming, and tedious

Engineering Contradiction:

Improveablation target identification accuracyVSAvoidprocedure duration

Core Design Contradiction:

Measurement precisionVSLoss of time

Solution Approach 1:

The patent performs fibrosis quantification and spatial distribution analysis using LGE-MRI imaging before the ablation procedure. This preliminary characterization of fibrotic tissue patterns allows the treatment team to pre-identify potential ablation targets and plan the procedure in advance, eliminating the need for time-consuming intra-procedural electro-anatomical mapping while maintaining target identification accuracy

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The patent replaces the mechanical/invasive electro-anatomical mapping system with a non-invasive LGE-MRI imaging and computational analysis system. The MRI-based fibrosis characterization provides equivalent or superior target identification capability without requiring invasive catheter insertion and real-time electrical mapping during the procedure

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

2Ease of manufacture

If only the observed amount of fibrosis is used for risk assessment, then the assessment is simple, but it lacks the spatial distribution information needed for effective treatment planning

Engineering Contradiction:

Improveassessment simplicityVSAvoidspatial distribution information

Core Design Contradiction:

Ease of manufactureVSLoss of information

Solution Approach 1:

The patent segments the atrial tissue into fibrotic and non-fibrotic regions based on LGE-MRI signal intensity thresholds. This segmentation creates a spatial map of fibrosis distribution that quantifies both the amount and location of fibrotic tissue, providing comprehensive information for treatment planning while maintaining computational efficiency

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The patent transitions from one-dimensional fibrosis quantification (total amount) to three-dimensional spatial distribution mapping by analyzing LGE-MRI data in 3D space. This dimensional expansion reveals the anatomical location, extent, and pattern of fibrosis, enabling precise identification of ablation targets that would be invisible with simple scalar measurements

Inventive Principle:

Principle #17Another dimension (Dimensionality change)

3Object-affected harmful factors

If LGE-MRI is used to quantify fibrosis amount, then non-invasive assessment is achieved, but only the amount of fibrosis is measured without spatial distribution characteristics

Engineering Contradiction:

ImproveinvasivenessVSAvoidspatial distribution pattern

Core Design Contradiction:

Object-affected harmful factorsVSLoss of information

Solution Approach 1:

The patent makes the LGE-MRI imaging system multi-functional by using the same non-invasive images for both fibrosis quantification and spatial distribution analysis. The LGE-MRI scanner serves dual purposes: assessing the amount of fibrosis for risk stratification and mapping the spatial patterns for ablation target identification, eliminating the need for additional invasive procedures

Inventive Principle:

Principle #6Universality (Multi-functionality)

Data Source

PatentUS10687898B2Systems and methods for atrial fibrillation treatment and risk assessment

Publication Date: 2020.06.23 JOHNS HOPKINS UNIVERSITY

AI summary

According to some embodiments of the invention, a method for providing an atrial fibrillation (AF) ablation treatment plan includes receiving imaging data for at least a portion of an atrial region of a subject's heart, and processing the imaging data to characterize tissue as one of fibrotic tissue or non-fibrotic tissue. The method further includes calculating a metric of spatial distribution of at least a portion of the tissue characterized as fibrotic tissue from the processing the imaging data, identifying a cardiac tissue ablation target based on the metric, and providing an AF treatment plan that includes the cardiac tissue ablation target as at least a portion of the AF treatment plan.