4D Acoustoelectric Cardiac Imaging for Fast and Accurate Mapping of Arrhythmias

Abstract
Despite global success of interventional cardiac surgery for treatment of arrhythmias, electroanatomical
mapping (EAM) of the heart has significant drawbacks. The procedure is slow and prone to registration
errors, largely ineffective for treating transient arrhythmias, such as ventricular tachycardia, and exhibits
relatively poor spatial resolution. With only a 50% success rate for first-time interventions, these
limitations contribute to multiple erroneous ablations, repeat procedures, and increased complications for
the patient. This Phase 1 SBIR proposes to develop and validate 4D Acoustoelectric Cardiac Imaging
(ACI) technology for mapping electrical current in the in vivo pig heart. ACI is a patented technology that
offers real-time capability and superior spatial resolution (andlt;2 mm) for rapid localization of arrhythmias
during ablation therapy. Our preliminary studies suggest that ACI would offer the following benefits over
conventional EAM: 1) 4D real-time imaging of current densities in the heart; 2) high spatial resolution
determined by the US focus (0.2 - 2 mm); 3) accurate localization of both sustained and transient
arrhythmias; 4) fusion of current densities (ACI) with cardiac anatomy and motion (pulse echo US). The
primary goal of the Phase 1 SBIR is to demonstrate and validate ACI for in vivo mapping of the
electrocardiogram and cardiac activation wave in the live pig. The project partners ElectroSonix LLC with
The University of Arizona to enhance the ACI platform and assess performance for in vivo mapping of
electrical current in a wild type pig model. Our ultimate vision is to develop a mobile or even portable
platform based on proprietary ACI technology (i.e., hardware, signal processing, data analysis and
integration) for fast, real-time mapping of arrhythmias that is far superior to state-of-the-art electrical
cardiac mapping techniques. A successful demonstration in the pig heart (Phase 1) would lead to an
expanded Phase 2 project directly comparing ACI with a commercial EAM system (e.g., GE CARTO) for
image-guided ablation during treatment of arrhythmias. The overarching goal is to improve the success
rate of resynchronization therapy and reduce chances of complication by limiting the number of
unnecessary ablations and repeat procedures. This would effectively reduce the chances for medical
errors and improve the quality of life in patients who receive treatment. The value from this SBIR will be
the first step towards commercializing a fully integrated ACI medical device realization.Project Narrative
ElectroSonix LLC will partner with the University of Arizona to develop and validate acoustoelectric cardiac
imaging (ACI), a potentially revolutionary technology for high resolution and accurate electrical mapping of
abnormal heart rhythms during ablation therapy. This technique has several advantages over current-state-
of-the-art imaging methods and could lead to higher success rates, fewer medical errors and complications,
and improved quality of life for patients who undergo corrective therapy for arrhythmias.