Patient-specific simulation guidance of infarct-related ventricular ablation and cardiac resynchronization therapy

Value Proposition

·       Non-invasive: MRI-based computational modeling provides guidance for catheter-based ablation or LV electrode placement in the treatment of hear disease.

·       Personalized: Predicts location of optimal ablation or LV electrode placement for each patient.

Unmet Need

·       Ventricular tachycardia (VT) in the setting of myocardial infarction is associated with increased risk of sudden cardiac death.

o  Catheter-based ablation, which has become a safe and effective first-line therapy for other types of cardiac arrythmias is associated with low levels of success in eliminating infarct-related VT.

o  Low response rates are due to numerous limitations to current voltage and pace mapping techniques that often miss critical sites for ablation.

·       Similarly, cardiac resynchronization therapy (CRT) has been shown to reduce morbidity and mortality in patients, yet 30% of patients fail to respond to CRT.

o  The location of the left ventricular (LV) pacing lead plays an important role in CRT efficacy, but determining this location in a patient-specific manner is not currently possible.

·       Therefore, there is a need for better identification of optimal targets of ablation or CRT in order to achieve better patient outcomes.

Technology Description

·       Researchers at Johns Hopkins have developed a non-invasive in-silico methodology for MRI-based guidance of infarct-related VT ablation and placement of the LV electrode for CRT.

Stage of Development

·       Proof of concept

Publication

[1] Prakosa, A. et al. Personalized virtual-heart technology for guiding the ablation of infarct-related ventricular tachycardia. Nature Biomedical Engineering 2, 732-740 (2018). DOI: https://doi.org/10.1038/s41551-018-0282-2