Electro-anatomical Model Rotor Characterization for Atrial Fibrillation
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Solution Overview
Problem
Current surgical techniques for treating atrial fibrillation by ablating rotors have inconsistent results, as some rotor ablations significantly impact heart rhythm while others do not, highlighting a need for effective methods to identify and characterize rotors associated with arrhythmias.
Innovation Solution
The development of a system that creates an electro-anatomical model of the heart using conduction patterns and voltage maps to identify and characterize rotors, distinguishing between substrate and non-substrate rotors based on stability, voltage transitions, and complex fractionated electrograms, allowing for targeted ablation of substrate rotors.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If rotor ablation is performed without characterization, then treatment time is reduced, but treatment effectiveness decreases due to inconsistent results
Solution Approach 1:
The system performs preliminary characterization of rotors using electro-anatomical modeling and voltage mapping before ablation treatment. This allows identification of substrate rotors versus non-substrate rotors in advance, enabling selective ablation of only those rotors likely to be effective, thereby improving treatment effectiveness while maintaining efficiency through targeted rather than exhaustive ablation.
Solution Approach 2:
The system incorporates feedback mechanisms through real-time electro-anatomical modeling and voltage map analysis during the ablation process. This feedback allows continuous assessment of rotor stability and response to ablation, enabling dynamic adjustment of treatment strategy to optimize both effectiveness and treatment time.
2Reliability
If all rotors are treated, then arrhythmia termination is maximized, but cardiac tissue is damaged and treatment time increases
Solution Approach 1:
The system applies local quality by differentiating between substrate rotors and non-substrate rotors based on their electrical characteristics and anatomical location. Only substrate rotors exhibiting specific voltage transition patterns and electrogram features are selected for ablation, while non-substrate rotors are spared. This localized approach preserves healthy cardiac tissue while targeting only those rotors most likely to contribute to arrhythmia maintenance.
Solution Approach 2:
The system extracts and isolates substrate rotors from the total rotor population through sophisticated electro-anatomical modeling. By separating substrate rotors (which drive arrhythmias) from non-substrate rotors (which do not), the treatment can selectively remove only the harmful rotors, minimizing tissue loss while maximizing arrhythmia termination probability.
3Manufacturing precision
If rotor characterization is performed, then treatment precision is improved, but system complexity increases
Solution Approach 1:
The electro-anatomical modeling system serves multiple functions simultaneously: it creates 3D heart models, maps voltage distributions, identifies rotor locations, characterizes rotor stability, and guides ablation therapy. This multi-functionality consolidates what would otherwise require separate systems into a single integrated platform, improving treatment precision while limiting the increase in overall system complexity through functional consolidation.
Data Source
AI summary
Some embodiments described herein relate to a method that includes defining an electro-anatomical model of a heart. The electro-anatomical model can include conduction patterns for multiple patterns or phases identified by a measurement instrument. The electro-anatomical model can also include a voltage map of the heart. A portion of the heart containing a rotor can be identified based on circulation in one phase of the model. The rotor can be determined to be stable based on that portion of the heart having circulation in another phase of the model. The rotor can be characterized as a substrate rotor based on the rotor being stable and based on the voltage or a change in voltage at the portion of the heart containing the rotor. The rotor can be treated or ablated when the rotor is determined to be a substrate rotor.