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Peri-procedural transmural electrophysiological imaging of scar-related ventricular tachycardia

Award Number: R01HL145590
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/08/2019
PERIOD OF PERFORMANCE END DATE: 01/31/2026

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Peri-procedural transmural electrophysiological imaging of scar-related ventricular tachycardia - Project Summary Ventricular tachycardia (VT) is an important cause of mortality and morbidity in patients with heart diseases. The majority of life-threatening VT episodes are caused by an electrical short circuit , formed by a narrow channel of surviving tissue inside myocardial scar. An important treatment for scar-related VT is to target and destroy these culprit slow-conducting channels. Effective ablation requires the ability to delineate the morphology of the circuit in order to identify the slow-conducting channels. Unfortunately, with conventional catheter mapping, up to 90% of the VT circuits are too short-lived to be mapped. For the 10% “mappable” VTs, their data are available only during ablation and limited to one ventricular surface. This inadequacy of functional VT data largely limits our current knowledge about scar-related VT and ablation strategies, and reduces the ability of clinicians to identify ablation targets and assess ablation outcome. The goal of this proposal is to develop a novel technique to provide pre- and post-ablation functional VT data – integrated with LGE-MRI scar data in 3D – to improve VT ablation with pre-procedural identification of ablation targets and post-procedural mechanistic elucidation of ablation failure. It builds on the rapidly increasing clinical interest in electrocardiographic imaging (ECGi), an emerging technique that obtains cardiac electrical activity through inverse reconstructions from body-surface ECGs. Its specific objectives include: 1) To develop and validate a peri-procedural ECGi for mapping scar-related VT circuits. 2) To integrate LGE-MRI scar into ECGi for improved electroanatomical investigations of VT circuits. 3) To perform clinical evaluation of pre-ablation and post-ablation MRI-ECGi of scar-related VT. These investigations will be carried out on a prospective cohort of 40 patients with VT due to previous infarction. This research builds on our previously established technical foundation for transmural ECGi and promising preliminary data generated under the support of our exploratory NIH grant. It is further supported by previous technical and clinical advances in each of the subcontractors' lab, including camera-based torso modeling (Siemens), intramural mapping and ablation (NSHA), and LGE-MRI scar imaging in VT (UPenn). The outcome of this research will generate new knowledge about the electroanatomical mechanism of scar-related VT and the mechanism behind ablation failure. It will enable pre- and post-procedural mapping of 3D functional circuits of all inducible VTs, improving the ability of clinicians to identify ablation targets and assess ablation outcome. Finally, it will timely deliver the next generation of ECGi techniques to further our general technical capability for safer and more efficient cardiac electrophysiological studies in a broader variety of heart diseases.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2023	ROCHESTER INSTITUTE OF TECHNOLOGY	1 LOMB MEMORIAL DR	ROCHESTER	NY	14623	MONROE	USA	Cardiovascular Diseases Research	000	5	12/10/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	ROCHESTER INSTITUTE OF TECHNOLOGY	1 LOMB MEMORIAL DR	ROCHESTER	NY	14623	MONROE	USA	Cardiovascular Diseases Research	000	5	6/21/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $505,846 )
2023	2023	ROCHESTER INSTITUTE OF TECHNOLOGY (INC)	1 LOMB MEMORIAL DR	ROCHESTER	NY	14623	MONROE	USA	Cardiovascular Diseases Research	000	5	1/24/2023	NON-COMPETING CONTINUATION	$505,846
														Subtotal = $505,846

Issue Date FY: 2022 ( Subtotal = $660,954 )
2022	2022	ROCHESTER INSTITUTE OF TECHNOLOGY (INC)	1 LOMB MEMORIAL DR	ROCHESTER	NY	14623	MONROE	USA	Cardiovascular Diseases Research	001	4	6/29/2022	NON-COMPETING CONTINUATION	$66,095
2022	2022	ROCHESTER INSTITUTE OF TECHNOLOGY (INC)	1 LOMB MEMORIAL DR	ROCHESTER	NY	14623	MONROE	USA	Cardiovascular Diseases Research	000	4	1/31/2022	NON-COMPETING CONTINUATION	$594,859
														Subtotal = $660,954

Issue Date FY: 2021 ( Subtotal = $627,240 )
2021	2021	ROCHESTER INSTITUTE OF TECHNOLOGY (INC)	1 LOMB MEMORIAL DR	ROCHESTER	NY	14623	MONROE	USA	Cardiovascular Diseases Research	000	3	2/27/2021	NON-COMPETING CONTINUATION	$627,240
														Subtotal = $627,240

Issue Date FY: 2020 ( Subtotal = $642,839 )
2020	2020	ROCHESTER INSTITUTE OF TECHNOLOGY (INC)	1 LOMB MEMORIAL DR	ROCHESTER	NY	14623	MONROE	USA	Cardiovascular Diseases Research	000	2	1/20/2020	NON-COMPETING CONTINUATION	$642,839
														Subtotal = $642,839

Issue Date FY: 2019 ( Subtotal = $717,253 )
2019	2019	ROCHESTER INSTITUTE OF TECHNOLOGY (INC)	1 LOMB MEMORIAL DR	ROCHESTER	NY	14623	MONROE	USA	Cardiovascular Diseases Research	000	1	2/8/2019	NEW	$717,253
														Subtotal = $717,253

Grand Total All Awards = $3,154,132

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Peri-procedural transmural electrophysiological imaging of scar-related ventricular tachycardia

Award Number: R01HL145590

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/08/2019

PERIOD OF PERFORMANCE END DATE: 01/31/2026

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