Unmet Need
Abnormal cardiac rhythms are often fatal. Specifically, ventricular arrhythmias, caused by abnormal electrical signals in the ventricles, cause 75 to 80% of sudden cardiac deaths every year. To prevent abnormal electrical activity in patients with various idiopathic ventricular tachycardias (IVA), radiofrequency intracardiac catheter ablation is used to create scars, which is effective and safe in preventing adverse events. However, the proper identification of treatment site can take a long time. During the procedure, a 3D non-fluoroscopic electroanatomic mapping (EAM) system is used to acquire intracardiac electrical information at different locations, and each candidate site is tested to identify engaged tissue locations until the IVA origin site is found. Not only is this a time-consuming procedure, but there is also limited localization accuracy in identifying the exact origin of the IVA. Thus, a new method is urgently needed for identifying the origin of IVAs accurately and timely during radiofrequency intracardiac catheter ablation procedures.
Technology Overview
Johns Hopkins researchers have developed an improved system, known as the Automatic Arrhythmia Origin Localization (AAOL) system, for localizing the origin of IVAs in real time. The system is an intraprocedural 3D cardiac localization system that computes the site of early electrical activation of the ventricles in real time with improved accuracy on cardiac structures where pace-mapping is challenging, such as the right ventricle and aortic root. The approach takes advantage of 3-lead ECG (leads III, V2, V6) recordings and intracardiac patient-specific EAM geometry (partial or full geometry) to acquire patient-specific pacing information, which is used to predict IVA origin sites. In preliminary testing, it has achieved a mean localization accuracy of 3.6mm for 23 IVAs, which is significantly better than previous systems.
Stage of Development
Clinical testing.
Patent
N/A
Publication
Zhou S, AbdelWahab A, Sapp JL, Sung E, Aronis KN, Warren JW, MacInnis PJ, Shah R, Horáček BM, Berger R, Tandri H, Trayanova NA, Chrispin J. Prospective Multicenter Assessment of a New Intraprocedural Automated System for Localizing Idiopathic Ventricular Arrhythmia Origins. JACC: Clinical Electrophysiology. 2021 March;7(3):395-407
