Nonoccluding Zero-Thickness Inflatable Sensor Arrays for Conformable Mapping and Ablation
Abstract
This proposal addresses the topics of Women’s Heart Disease and Congenital Heart Disease, developing technology for advanced mapping and ablation of cardiac arrhythmias, particularly atrial fibrillation (AFib). AFib is a disease that affects 2% to 3% of the population and is responsible for one-fifth of all ischemic strokes. Both patient groups addressed here are disproportionately affected by this disease. Congenital heart disease patients present a much greater risk of developing AFib or other similar arrhythmias as a result of many of the complex surgeries they must undergo. Women are also disproportionately affected by AFib, experiencing more severe symptoms and a greater risk of stroke and death than the general population. AFib and other cardiac arrhythmias result when aberrant electrical pathways cause regions of the heart to beat out of rhythm. A common treatment for AFib and other cardiac arrhythmias is catheter ablation and mapping, a procedure where a catheter is used to probe the aberrant electrical pathways and a separate catheter is used to locally ablation damage tissue disrupting the aberrant pathways. However, because of the complexity of the signal pathways, these procedures can be very long, require sophisticated tools for alignment and registration of the catheter position, and have limited effectiveness (roughly 50% after the first procedure, up to 80% after a third procedure). Part of the challenge is that our understanding of the disease is still limited. A primary cause of this difficulty is due to limitations in the equipment for mapping. While existing tools provide excellent spatial resolution, the electrical signal patterns thought to be responsible exhibit complex spatiotemporal patterns, and without electrodes that can map the entire atrium simultaneously, it is difficult to study these signals. Some devices, such as basket catheters have attempted to provide simultaneous mapping of the atrium with multi-electrode sensor arrays, but these systems are poorly adapted to the complex patient anatomy; electrodes often move during deployment, preventing mapping of large regions of the atrium. Further, these devices are made from stiff material that fails to conform to patient anatomy, with an average of 40% of the electrodes not providing meaningful signals, likely due to poor contact. Soft robotics is a field that utilizes pneumatic or hydraulic actuators from soft, compliant materials, which can adapt and conform to objects they interact with. It is especially well-suited for interfacing with biological and organic objects. Separately flexible electronics is a field that utilizes similar materials, with integrated and embedded electronics to create sensor arrays, which can stretch and adapt. The goal of this proposal is to utilize ultrathin catheter deployable soft robotic actuators in conjunction with flexible electronic sensor arrays to create non-occluding balloons with embedded sensor arrays that adapt and conform to the patient anatomy to provide high resolutions, simultaneous mapping of the entire atrium, thus providing new diagnostic and treatment paradigms for AFib patients.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810201
Entities
People
- Simon Dunham
Organizations
- United States Army
- Weill Cornell Medicine