局所多点電極アレイを用いた心外膜広域電気生理マッピング手法の提案

Abstract

Arrhythmia surgery is performed to treat serious arrhythmia such as atrial fibrillation and ventricular tachycardia unable to be treated by catheter ablation. Mapping devices are needed to find electrical abnormal regions. Open heart surgery is invasive for patient's body. Recently, endoscopic arrhythmia surgery is reported as minimally invasive surgery. Existing mapping device can be used only in open heart surgery. There is no mapping device available under endoscopic surgery. We developed a local multi-electrode array to measure epicardial electrophysiological data under endoscopic surgery. However, it can obtain the propagation only in the local area not in the global area. We recorded single beat electrical activities at different time and different location and mapped them onto a three-dimensional heart model. The phase shifts in local potentials were synchronized in reference to the ECG. Location errors due to heart beat and deformation were corrected by a propagation registration method assuming the continuous propagation in the heart. Both registration errors and the distribution of propagation decreased in simulation data. Continuous propagation was obtained in experimental data. Global propagation of excitation can be obtained from local isopotential maps.