Clinical application and technical challenges for intracardiac ultrasound imaging - catheter based ICE imaging with EP mapping

Stephens, Douglas N.; Shung, K. Kirk; Cannata, J.M.; Jianzhong, Zhao; Chia, R.; Nguyen, H; Thomenius, Kai E.; Dentinger, Aaron; Wildes, Douglas; Chen, Xunchang; O’Donnell, M.; Lowe, Robert I.; Pemberton, James; Burch, Grant H.; Sahn, David J.

doi:10.1109/ultsym.2004.1417836

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…The first of 3 devices, the “HockeyStick” (HS) [53], is a 9Fr (3 mm) combination EP mapping and ICE catheter designed to be easily deployed with standard introducer sheaths, possess dual direction steering capability, and incorporate fully integrated EP mapping electrodes near the imaging tip. A 64-element array was chosen in the first design to operate at a center frequency in the range of 7 to 12 MHz with a fractional bandwidth of 50% or greater.…”

Section: Methodsmentioning

confidence: 99%

Multifunctional catheters combining intracardiac ultrasound imaging and electrophysiology sensing

Stephens

Cannata

Liu

et al. 2008

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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A family of 3 multifunctional intracardiac imaging and electrophysiology (EP) mapping catheters has been in development to help guide diagnostic and therapeutic intracardiac EP procedures. The catheter tip on the first device includes a 7.5 MHz, 64-element, side-looking phased array for high resolution sector scanning. The second device is a forward-looking catheter with a 24-element 14 MHz phased array. Both of these catheters operate on a commercial imaging system with standard software. Multiple EP mapping sensors were mounted as ring electrodes near the arrays for electrocardiographic synchronization of ultrasound images and used for unique integration with EP mapping technologies. To help establish the catheters’ ability for integration with EP interventional procedures, tests were performed in vivo in a porcine animal model to demonstrate both useful intracardiac echocardiographic (ICE) visualization and simultaneous 3-D positional information using integrated electroanatomical mapping techniques. The catheters also performed well in high frame rate imaging, color flow imaging, and strain rate imaging of atrial and ventricular structures. The companion paper of this work discusses the catheter design of the side-looking catheter with special attention to acoustic lens design. The third device in development is a 10 MHz forward-looking ring array that is to be mounted at the distal tip of a 9F catheter to permit use of the available catheter lumen for adjunctive therapy tools.

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Section: Methodsmentioning

confidence: 99%

Multifunctional catheters combining intracardiac ultrasound imaging and electrophysiology sensing

Stephens

Cannata

Liu

et al. 2008

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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“…The first of 3 devices, the “HockeyStick” (HS) [17], is a 9 French (Fr, where 3Fr = 1 mm) combination EP mapping and ICE catheter designed to be easily deployed with standard introducer sheaths, possess dual direction steering capability, and incorporate fully integrated EP mapping electrodes near the imaging tip. A 64-element array was chosen in the first design to operate at a center frequency in the range of 7 to 12 MHz with a fractional bandwidth of 50% or greater.…”

Section: A Family Of Integrated Ice Cathetersmentioning

confidence: 99%

A family of intracardiac ultrasound imaging devices designed for guidance of electrophysiology ablation procedures

Sahn

Stephens

Cannata

et al. 2009

2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Our Bioengineering Research Partnership grant, “High Frequency Ultrasound Arrays for Cardiac Imaging”, including the individuals cited at the end of this paper - Douglas N. Stephens (UC Davis), Matthew O’Donnell (UW Seattle), Kai Thomenius (GE Global Research), Aaron M. Dentinger (GE Global Research), Douglas Wildes (GE Global Research), Peter Chen (St. Jude Medical), K. Kirk Shung (University of Southern California), Jonathan M. Cannata (University of Southern California), Butrus (Pierre) T. Khuri-Yakub (Stanford University), Omer Oralkan (Stanford University), Aman Mahajan (UCLA School of Medicine), Kalyanam Shivkumar (UCLA School of Medicine) and David J. Sahn (Oregon Health & Science University) – is in its sixth year of NIH funding, having proposed to develop a family of high frequency miniaturized forward and side-looking ultrasound imaging devices equipped with electrophysiology mapping and localization sensors and eventually to include a family of capactive micromachined ultrasonic transducer (cMUT) devices – a forward-looking cMUT MicroLinear array and a ring array capable of 3-dimensional imaging and a 5Fr lumen large enough to admit an electrode and ablation devices.

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“…Sahn has developed a side-looking "hockeystick" catheter with electrodes for monitoring intracardiac potentials [40], [41]. Although this device has shown highquality images of cardiac structures, there are potential difficulties in localizing the treatment catheter and region of interest within the same imaging plane of the therapy catheter.…”

Section: Ultrasound-guided Ablation Devicesmentioning

confidence: 99%

Feasibility of noncontact intracardiac ultrasound ablation and imaging catheter for treatment of atrial fibrillation

Wong

Scott

Conolly

et al. 2006

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Atrial fibrillation (AF) affects 1% of the population and results in a cost of $2.8 billion from hospitalizations alone. Treatments that electrically isolate portions of the atria are clinically effective in curing AF. However, such minimally invasive catheter treatments face difficulties in mechanically positioning the catheter tip and visualizing the anatomy of the region. We propose a noncontact, intracardiac transducer that can ablate tissue and provide rudimentary imaging to guide therapy. Our design consists of a high-power, 20 mm by 2 mm, 128-element, transducer array placed on the side of 7-French catheter. The transducer will be used in imaging mode to locate the atrial wall; then, by focusing at that location, a lesion can be formed. Imaging of previously formed lesions could potentially guide placement of subsequent lesions. Successive rotations of the catheter will potentially enable a contiguous circular lesion to be created around the pulmonary vein. The challenge of intracardiac-sized transducers is achieving high intensities (300-5000 W/cm 2 ) needed to raise the temperature of the tissue above 43 C. In this paper, we demonstrate the feasibility of an intracardiac-sized transducer for treatment of atrial fibrillation. In simulations and proof-of-concept experiments, we show a 37 C temperature rise in the lesion location and demonstrate the possibility of lesion imaging.

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Clinical application and technical challenges for intracardiac ultrasound imaging - catheter based ICE imaging with EP mapping

Cited by 8 publications

References 10 publications

Multifunctional catheters combining intracardiac ultrasound imaging and electrophysiology sensing

Multifunctional catheters combining intracardiac ultrasound imaging and electrophysiology sensing

A family of intracardiac ultrasound imaging devices designed for guidance of electrophysiology ablation procedures

Feasibility of noncontact intracardiac ultrasound ablation and imaging catheter for treatment of atrial fibrillation

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