Orthogonal Electrode Catheter Mapping for Targeted AF Ablation
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Solution Overview
Problem
Current ablation techniques for cardiac fibrillation are less than desirable, with success rates around 70% for atrial fibrillation and 95% for other heart arrhythmias, due to the complexity of identifying the ever-changing electrical activities, leading to potential harm and new abnormal electrical circuits, and existing catheters face challenges with electrode size, spacing, and contact stability during arrhythmias.
Innovation Solution
A catheter system with an array of stacked electrode pairs, configured orthogonally to the cardiac tissue surface, uses electrogram analysis to determine electrode contact and orientation, enabling accurate frequency mapping and optimized ablation lesion placement based on patient-specific electrophysiologic principles.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of manufacture
If generalized ablation strategies are applied based on basic research principles, then the treatment can be performed without patient-specific mapping, but the success rate decreases to around 70% due to inability to accurately identify individual patient's electrical activity patterns
Solution Approach 1:
The system performs preliminary electrophysiologic mapping and identification of electrical circuit cores before ablation treatment. By pre-characterizing the patient's specific arrhythmia mechanisms and creating a customized ablation strategy based on mapped data, the system enables targeted treatment that achieves higher success rates while maintaining procedural efficiency
Solution Approach 2:
The system incorporates real-time feedback through continuous monitoring of electrogram signals during the ablation procedure. This feedback loop allows dynamic adjustment of ablation parameters and lesion placement based on observed electrical activity changes, improving both success rate and procedural adaptability
2Productivity
If ablation lesions are applied to treat cardiac fibrillation, then the treatment can be performed, but additional harm occurs including steam pops, cardiac perforation, thrombus formation, pulmonary vein stenosis, and atrio-esophageal fistula
Solution Approach 1:
The system applies ablation lesions with precise spatial localization based on mapped electrical circuit cores. By concentrating ablation energy only at specific identified locations rather than applying it broadly, the system treats the arrhythmia while minimizing damage to surrounding healthy tissue, thereby reducing complications such as steam pops, perforation, and fistula formation
Solution Approach 2:
The system replaces mechanical contact-based ablation with contactless radiofrequency delivery guided by electrophysiologic mapping. This substitution allows precise energy delivery to targeted locations without mechanical contact, reducing the risk of mechanical complications while maintaining ablation effectiveness
3Ease of manufacture
If existing catheters with large electrodes are used, then the catheter can be manufactured with standard components, but the electrode spacing is too great and the catheter must be moved to many locations to acquire sufficient data, increasing procedure time
Solution Approach 1:
The catheter employs an array of multiple small electrodes segmented along its length, with each electrode capable of independent recording. This segmentation allows the catheter to acquire comprehensive electrophysiologic data from multiple locations simultaneously without requiring manual repositioning, thereby reducing procedure time while maintaining manufacturing feasibility through modular electrode array construction
Solution Approach 2:
The system transitions from single-point measurement to multi-point spatial mapping by arranging electrodes in a distributed array along the catheter. This dimensional expansion from one measurement point to multiple simultaneous measurement points enables comprehensive characterization of electrical activity across the cardiac tissue substrate without increasing procedure time
4Measurement precision
If the catheter electrodes are positioned to touch the endocardium for accurate mapping, then diagnostic acuity improves, but the procedure becomes technically challenging and time-consuming due to the need to move the catheter to many different locations
Solution Approach 1:
The system employs automated detection algorithms that self-assess electrode-tissue contact status and guide catheter positioning. The mapping system automatically identifies when electrodes are in contact with the endocardium based on signal characteristics, eliminating the need for manual operator judgment and reducing the technical challenge of achieving and maintaining accurate contact
Solution Approach 2:
The system utilizes changes in electrical signal parameters (such as impedance, signal amplitude, and waveform morphology) to detect and confirm electrode-tissue contact. By monitoring these parameter changes in real-time, the system automatically identifies optimal contact positions without requiring manual manipulation, thereby improving measurement precision while simplifying operation
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
Enhances the success rate of ablation treatments by minimizing the amount of ablation required, reduces complications, and improves diagnostic acuity and therapeutic efficacy by ensuring electrode contact and orthogonal orientation.
Implementation Method 1
measuring electrograms (EGMs) from the array of electrodes during sinus rhythm and during atrial fibrillation
Implementation Method 2
obtain one or more measurements from at least a first electrogram and a second electrogram in response to electrical activity in the cardiac tissue substrate indicative of a frequency of electrical circuit cores
Data Source
AI summary
Catheters, systems, and related methods for optimized for mapping, minimizing, and treating cardiac fibrillation in a patient, including an array of at least one stacked electrode pair, each electrode pair including a first electrode and a second electrode, wherein each electrode pair is configured to be orthogonal to a surface of a cardiac tissue substrate, wherein each first electrode is in contact with the surface to record a first signal, and wherein each second electrode is separated from the first electrode by a distance which enables the second electrode to record a second signal, wherein the catheter is configured to obtain one or more measurements from at least a first signal and a second signal in response to electrical activity in the cardiac tissue substrate indicative of a number of electrical circuit cores and distribution of the electrical circuit cores for a duration across the cardiac tissue substrate.