Patient-Specific Cardiac Procedure Planning via Electrophysiological Simulation
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Solution Overview
Problem
Current catheter ablation techniques for ventricular tachyarrhythmia related to myocardial infarction have low success rates and are associated with complications due to limitations in voltage and pace mapping, and insufficient resolution in identifying ablation targets, leading to prolonged procedures and increased risks.
Innovation Solution
A method involving three-dimensional imaging and multiscale electrophysiological modeling to simulate electrophysiological or electromechanical activity of the heart, allowing for precise identification of optimal ablation targets before the procedure, using MRI-based computational models to predict the locations of scroll-wave filaments that sustain ventricular tachycardia.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If current voltage and pace mapping techniques are used to identify ablation targets, then the procedure can be performed with existing technology, but the success rate is low and procedure duration is prolonged
Solution Approach 1:
The system performs preliminary 3D reconstruction of the heart anatomy and simulation of electrophysiological activity before the actual ablation procedure. This allows optimal ablation targets to be identified in advance, eliminating the need for prolonged intra-procedural mapping and enabling the procedure to start directly at the pre-determined target sites.
Solution Approach 2:
The system creates a virtual 3D copy of the patient's heart anatomy using MRI or CT imaging data. This digital twin allows for simulation and planning of ablation pathways without requiring extensive physical mapping during the procedure, significantly reducing procedure time while maintaining or improving success rates.
2Measurement precision
If point-by-point sampling mapping techniques are used, then the procedure can be performed with current technology, but the resolution in identifying ablation targets is insufficient
Solution Approach 1:
Instead of using complex point-by-point sampling during the procedure, the system creates a high-resolution 3D digital copy of the heart anatomy from pre-acquired MRI or CT images. This virtual model provides superior spatial resolution for identifying ablation targets without requiring complex mapping equipment during the procedure.
Solution Approach 2:
The system replaces the mechanical point-by-point mapping approach with computational simulation of electrophysiological activity on the 3D reconstructed heart model. This substitution of mechanical sampling with computational modeling achieves higher resolution target identification while simplifying the procedural equipment needed.
3Measurement precision
If complex 3D pathways are reconstructed from electrical interrogation only, then the procedure can be performed with existing mapping technology, but the accuracy in identifying VT circuits is limited
Solution Approach 1:
The system uses multi-functional 3D imaging data from MRI or CT scans that serve multiple purposes: anatomical reconstruction, fiber orientation determination, and electrophysiological simulation. This multi-functionality enables accurate VT pathway reconstruction without relying solely on electrical interrogation, improving accuracy while reducing procedural complexity.
Solution Approach 2:
The system introduces computational simulation of electrophysiological activity as an intermediary between the 3D anatomical reconstruction and the identification of VT circuits. This simulation layer translates structural information into functional insights, accurately predicting VT pathways and ablation targets without requiring extensive electrical mapping.
4Reliability
If prolonged catheter ablation procedures are performed, then more ablation lesions can be delivered, but the risk of complications such as chamber perforation, thromboemboli, and radiation overexposure increases
Solution Approach 1:
The system performs all target identification and pathway planning before the ablation procedure begins. By pre-determining the optimal ablation targets and pathways, the actual procedure can be completed quickly with minimal catheter manipulation and reduced radiation exposure, thereby maintaining treatment completeness while minimizing complication risks.
Solution Approach 2:
The system delivers ablation energy precisely at pre-identified optimal target sites rather than performing extensive sampling and multiple trial ablations. This localized, targeted approach ensures complete treatment of VT circuits while minimizing the number of catheter movements and reducing exposure to complications such as perforation and thromboemboli.
Data Source
AI summary
A method of planning a patient-specific cardiac procedure according to an embodiment of the current invention includes receiving three-dimensional imaging data of a patient's heart, simulating at least one of electrophysiological or electromechanical activity of at least a portion of the patient's heart using the three-dimensional imaging data, and planning the patient-specific cardiac procedure based on the simulating. The cardiac procedure is for providing a preselected alteration of at least one of electrophysiological or electromechanical behavior of the patient's heart.