We propose to clinically evaluate the ability of a novel intracardiac ARFI ultrasound imaging system combined with an electro-anatomic mapping system to guide radio-frequency ablations procedures for treating atrial fibrillation and atrial flutter. In parallel, and in collaboration with our industrial partner Siemens Ultrasound, we will migrate these technologies to a 3D ultrasonic imaging platform and develop two intracardiac probes optimized for combined 3D B-mode/ARFI imaging. Phantom, animal and, ultimately, human studies are proposed to evaluate the 3D scanner/probes and the related pulse sequences, beam forming methods and signal and image processing methods to be developed. If successful, the proposed methods will provide the electrophysiologist with real-time visualization of cardiac ablation lesions and with the ability guide the creation of these lesions. As such, the proposed studies could markedly reduce treatment times for atrial and ventricular cardiac ablation procedures, prevent complications from over ablation and reduce the rates of repeat procedures.

Public Health Relevance

We propose to move from the laboratory to the clinic the technique we developed in Phase I for image guided ablation therapy. This system can show the physician regions of the heart which have already been treated. Currently physicians have no means to examine these regions. In Phase I we successfully built the system and demonstrated its efficacy. In phase II we plan a series of clinical tests to demonstrate its utility for treating atrial arrhythmias in patients.

National Institute of Health (NIH)
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
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Special Emphasis Panel (ZEB1-OSR-B (O1))
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Krosnick, Steven
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Duke University
Biomedical Engineering
Schools of Engineering
United States
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Vejdani-Jahromi, Maryam; Freedman, Jenna; Kim, Young-Joong et al. (2018) Assessment of Diastolic Function Using Ultrasound Elastography. Ultrasound Med Biol 44:551-561
Vejdani-Jahromi, Maryam; Freedman, Jenna; Nagle, Matthew et al. (2017) Quantifying Myocardial Contractility Changes Using Ultrasound-Based Shear Wave Elastography. J Am Soc Echocardiogr 30:90-96
Hollender, Peter; Kuo, Lily; Chen, Virginia et al. (2017) Scanned 3-D Intracardiac ARFI and SWEI for Imaging Radio-Frequency Ablation Lesions. IEEE Trans Ultrason Ferroelectr Freq Control 64:1034-1044
Hollender, Peter; Lipman, Samantha L; Trahey, Gregg E (2017) Thee-Dimensional Single-Track-Location Shear Wave Elasticity Imaging. IEEE Trans Ultrason Ferroelectr Freq Control 64:1784-1794
Vejdani-Jahromi, Maryam; Nagle, Mathew; Jiang, Yang et al. (2016) A Comparison of Acoustic Radiation Force-Derived Indices of Cardiac Function in the Langendorff Perfused Rabbit Heart. IEEE Trans Ultrason Ferroelectr Freq Control 63:1288-95
Vejdani-Jahromi, Maryam; Nagle, Matt; Trahey, Gregg E et al. (2015) Ultrasound shear wave elasticity imaging quantifies coronary perfusion pressure effect on cardiac compliance. IEEE Trans Med Imaging 34:465-73
Hollender, Peter; Bottenus, Nick; Trahey, Gregg (2015) A multiresolution approach to shear wave image reconstruction. IEEE Trans Ultrason Ferroelectr Freq Control 62:1429-39
Eyerly, Stephanie A; Vejdani-Jahromi, Maryam; Dumont, Douglas M et al. (2015) The Evolution of Tissue Stiffness at Radiofrequency Ablation Sites During Lesion Formation and in the Peri-Ablation Period. J Cardiovasc Electrophysiol 26:1009-1018
Hollender, Peter J; Rosenzweig, Stephen J; Nightingale, Kathryn R et al. (2015) Single- and multiple-track-location shear wave and acoustic radiation force impulse imaging: matched comparison of contrast, contrast-to-noise ratio and resolution. Ultrasound Med Biol 41:1043-57
Byram, Brett; Kim, Han; Van Assche, Lowie et al. (2014) The feasibility of myocardial infarct visualization using atrial kick induced strain (AKIS) contrast. Ultrasound Med Biol 40:1104-17

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