2D ICE LAA Sizing With 3D Validation for Closure Selection
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Solution Overview
Problem
Current imaging methods for measuring the left atrial appendage (LAA) size, such as cardiac CT and transesophageal echocardiogram (TEE), involve ionizing radiation, general anesthesia, and operator dependence, making them inadequate for precise LAA closure device selection in atrial fibrillation treatment.
Innovation Solution
A system utilizing 2D Intracardiac Echo (ICE) imaging to acquire and process images of the left atrium, generate a 3D model, and validate image sufficiency for LAA closure device selection, providing real-time guidance for optimal catheter positioning and device specification.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If cardiac CT is used to measure LAA size, then measurement capability is provided, but ionizing radiation exposure occurs
Solution Approach 1:
The patent replaces CT imaging (which uses ionizing radiation) with intracardiac echocardiography (ICE) that uses ultrasound waves. The ICE system captures 2D images from multiple angles and reconstructs 3D models of the LAA, providing the same measurement capability without radiation exposure. This substitution of imaging modality eliminates the harmful radiation effect while maintaining measurement precision.
2Measurement precision
If TEE is used to measure LAA size, then measurement capability is provided, but general anesthesia and procedural risks increase
Solution Approach 1:
The patent substitutes TEE (which requires general anesthesia and esophageal intubation) with intracardiac echocardiography (ICE) that can be performed under local anesthesia. The ICE catheter is introduced through a vein and positioned in the left atrium, where it captures images of the LAA without requiring general anesthesia, thereby improving procedural safety and reducing associated risks.
Solution Approach 2:
The patent introduces an ICE catheter as an intermediary device that enables image acquisition from within the heart chambers. This catheter-based approach provides direct visualization of the LAA without requiring external esophageal imaging, eliminating the need for general anesthesia while maintaining measurement accuracy through real-time intracardiac imaging.
3Measurement precision
If TEE is used for LAA imaging, then imaging capability is provided, but operator dependence increases
Solution Approach 1:
The patent transforms 2D ICE images into 3D reconstructed models of the LAA through automated image processing algorithms. This parameter transformation from 2D to 3D space, combined with automated measurement extraction, reduces operator dependence by providing objective, reproducible measurements that do not rely on the operator's skill or interpretation, while maintaining high imaging quality.
4Speed
If 2D ICE imaging is used for LAA visualization, then real-time imaging is provided, but image sufficiency for device selection cannot be determined
Solution Approach 1:
The patent enhances 2D ICE images by reconstructing 3D models of the LAA. This dimensional transformation allows the system to assess whether the acquired 2D images contain sufficient information for accurate device specification. The 3D reconstruction provides additional spatial context and enables automated measurement extraction, ensuring measurement precision while maintaining real-time imaging capabilities.
Solution Approach 2:
The patent implements an automated assessment system that evaluates the sufficiency of acquired ICE images for device selection. The system provides feedback on image quality and completeness, and can guide additional image acquisition if needed. This feedback mechanism ensures that only sufficient images are used for device specification, maintaining measurement precision while leveraging real-time imaging capabilities.
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
Enables accurate and non-invasive LAA closure device selection under local anesthesia, reducing procedural risks and turnaround time, while ensuring precise measurements and device suitability.
Implementation Method 1
a 2D ICE imaging system configured to acquire left atrium image data of a patient's heart and left atrial appendage image data of the patient's heart
Data Source
Figure 1
Figure 2
Figure 3A~3B
AI summary
Systems and methods for left atrial appendage closure device specification from two dimensional (2D) Intracardiac Echo imaging (ICE). In an imaging procedure, 2D ICE is used to acquire images of the left atrium (20) of a patient. A model (320) of the left atrium (20) is generated from the images of the left atrium (20). The model (320) of the left atrium (20) is used to validate subsequent imaging of the left atrial appendage (26) of the patient. Anatomical measurements from the validated subsequent imaging may be used to select or specify a left atrial appendage closure device in order to, for example, treat atrial fibrillation patients.