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Accuracy of cardiac ablation catheter guidance by means of a single equivalent moving dipole inverse algorithm to identify sites of origin of cardiac electrical activation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

We have developed a system that could potentially be used to identify the site of origin of ventricular tachycardia (VT) and to guide a catheter to that site to deliver radio-frequency ablation therapy. This system employs the Inverse Solution Guidance Algorithm based upon Single Equivalent Moving Dipole (SEMD) localization method. The system was evaluated in in vivo swine experiments. Arrays consisting of 9 or 16 bipolar epicardial electrodes and an additional mid-myocardial pacing lead were sutured to each ventricle. Focal tachycardia was simulated by applying pacing pulses to each epicardial electrode at multiple pacing rates during breath hold at the end-expiration phase. Surface potentials were recorded from 64 surface electrodes and then analyzed using the SEMD method to localize the position of the pacing electrodes. We found a close correlation between the locations of the pacing electrodes as measured in computational and real spaces. The reproducibility error of the SEMD estimation of electrode location was 0.21 ± 0.07 cm. The vectors between every pair of bipolar electrodes were computed in computational and real spaces. At 120 bpm, the lengths of the vectors in the computational and real space had a 95% correlation. Computational space vectors were used in catheter guidance simulations which showed that this method could reduce the distance between the real space locations of the emulated catheter tip and the emulated arrhythmia origin site by approximately 72% with each movement. We have demonstrated the feasibility of using our system to guide a catheter to the site of the emulated VT origin.

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Acknowledgments

This study was supported by NIH grant (R44 HL079726-04).

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Authors and Affiliations

  1. Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

    Wener Lv

  2. Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Room E25-324, Cambridge, MA, 02142, USA

    Kichang Lee & Richard J. Cohen

  3. Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, 02114, USA

    Kichang Lee & Conor D. Barrett

  4. Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, 02114, USA

    Kichang Lee & Antonis A. Armoundas

  5. Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

    Tatsuya Arai

  6. Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

    Maysun M. Hasan

  7. Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

    Alison M. Hayward & Robert P. Marini

  8. Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

    Maya E. Barley

  9. Vivonics Inc., Waltham, MA, 02451, USA

    Anna Galea & Gordon Hirschman

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  1. Wener Lv
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Correspondence to Kichang Lee.

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Lv, W., Lee, K., Arai, T. et al. Accuracy of cardiac ablation catheter guidance by means of a single equivalent moving dipole inverse algorithm to identify sites of origin of cardiac electrical activation. J Interv Card Electrophysiol 58, 323–331 (2020). https://doi.org/10.1007/s10840-019-00605-z

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  • DOI: https://doi.org/10.1007/s10840-019-00605-z

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