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

Abstract

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.

Fig 1

HockeyStick catheter with extra electrodes to enable electrofield 3D localization and image overlay. The phased array (PA) catheter is 9Fr.

Fig 2

HockeyStick in RV (r-l invert of LV and RV post ions in diagram) capable of imaging the entire LV in a 60 kg pig.

Fig 3

An example of a NavX overlay image plane (left), and image of LA and pulmonary veins with side looking HockeyStick catheter.

Fig 4

Early prototype tip assemblies of the piezoceramic MicroLinear forward looking ICE catheter showing good match between lab and model.

Fig 5

Forward looking catheter imaging ablation of the right atrium near the ostium of the coronary sinus.

Fig 6

MicroLinear forward looking catheter, imaging ablation (“crater”) and altered strain rate mechanics in ablated region.

Fig 7

Forward looking cMUT based MicroLinear array fabrication.

Fig 8

Imaging of the atrium and atrial appendage of a Langendorff heart preparation with the forward looking cMUT based array mounted on a breadboard beneath a water tank and diagram of catheter configuration for cMUT MicroLinear array.

Fig 9

Design elements, fabrication and connections for the cMUT ring array catheter device.

Fig 10

Bench imaging of springs and stents in water using the cMUT ring array device.

Fig 11

Prototype imaging with a 4D intracardiac imaging catheter, of a curved catheter placed through the left atrial appendage into the LV (seen in short axis view) in an open-chest pig experiment.