Magnetic Resonance Guided Therapy of Cardiac Arhythmia ( MaRGiTA)
Lead Research Organisation:
King's College London
Department Name: Imaging & Biomedical Engineering
Abstract
This project will develop novel devices and imaging technology for minimal-invasive treatment of cardiac arrhythmias, a major healthcare problem affecting 5.3% of the UK population. Currently diagnosis and treatment of cardiac arrhythmia is performed under X-ray guidance. This imaging modality offers no 3D information and no soft tissue contrast, the procedure takes several hours, resulting in significant radiation exposure to patient and medical staff. This project will develop the first Magnetic Resonance (MR) guided arrhythmia therapy procedure using a novel catheter device. The new procedure will avoid radiation dose completely. Furthermore, non-invasive MR-techniques will also be developed as a biomarker of the arrhythmia treatment. The project will be performed in three phases.Phase 1. Prototyping: In the first phase catheter prototypes and MR-tracking techniques will be developed. In parallel, MR-techniques to image and quantify ablation lesions will be developed and tested with lesions made by standard ablation catheters under X-ray and subsequent evaluation under MR in our X-MR facilities. Phase 2. Preclinical Test: During the second phase catheter prototypes and MR ablation lesion imaging will be optimized and tested in a preclinical model.Phase 3. Clinical Feasibility. During the third phase clinical catheter prototypes will be developed and after obtaining regulatory approval, these will be tested in a limited number of patients.
Publications
Knowles BR
(2010)
3-D visualization of acute RF ablation lesions using MRI for the simultaneous determination of the patterns of necrosis and edema.
in IEEE transactions on bio-medical engineering
Schirra CO
(2010)
Accelerated 3D catheter visualization from triplanar MR projection images.
in Magnetic resonance in medicine
Arujuna A
(2012)
Acute pulmonary vein isolation is achieved by a combination of reversible and irreversible atrial injury after catheter ablation: evidence from magnetic resonance imaging.
in Circulation. Arrhythmia and electrophysiology
Kolbitsch C
(2014)
Cardiac functional assessment without electrocardiogram using physiological self-navigation.
in Magnetic resonance in medicine
Harrison JL
(2014)
Cardiac magnetic resonance and electroanatomical mapping of acute and chronic atrial ablation injury: a histological validation study.
in European heart journal
Karim R
(2013)
Evaluation of current algorithms for segmentation of scar tissue from late gadolinium enhancement cardiovascular magnetic resonance of the left atrium: an open-access grand challenge.
in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
Weiss S
(2011)
In vivo evaluation and proof of radiofrequency safety of a novel diagnostic MR-electrophysiology catheter.
in Magnetic resonance in medicine
Polygerinos P
(2011)
MRI-Compatible Intensity-Modulated Force Sensor for Cardiac Catheterization Procedures
in IEEE Transactions on Biomedical Engineering
Kolbitsch C
(2012)
Prospective high-resolution respiratory-resolved whole-heart MRI for image-guided cardiovascular interventions.
in Magnetic resonance in medicine
Sohns C
(2014)
Quantitative magnetic resonance imaging analysis of the relationship between contact force and left atrial scar formation after catheter ablation of atrial fibrillation.
in Journal of cardiovascular electrophysiology
Ataollahi A
(2016)
Three-Degree-of-Freedom MR-Compatible Multisegment Cardiac Catheter Steering Mechanism.
in IEEE transactions on bio-medical engineering
Schirra CO
(2009)
Toward true 3D visualization of active catheters using compressed sensing.
in Magnetic resonance in medicine
Description | A novel catheter device has been developed that allows the tretament of cardiac arhythmia using magnetic resonance imaging (MRI) for guidance, which is an imaging technique that does not employ any ionizing radiation to the patient and staff. Furthermore new MRI acquisitions have been investigated. |
Exploitation Route | The findings have been used in first-in-man study to treat patients wit atrial flutter. This study has been supported by industrial partner, Philips Healthcare, who has developed a platform (iSuite) for MR-guided interventions. This platform can be used by others. |
Sectors | Healthcare |
URL | http://www.kcl.ac.uk/lsm/research/divisions/imaging/departments/biomedengineering/research/ciqmri.aspx |
Description | The newly developed device and themagnetic resonance imaging technqiues have been used in a first in man study;, i.e. diagnosis and treatment of a patinet with atrial flutter. The device has been commercialized by Imricor. The image-guided platform has been devloped by Philips Healthcare. The results of the first-in-man study has been published on conferences and JACC-Clinical EP. THis has stimulated Siemens Healthcare to develop a similar image-gidance platform. |
First Year Of Impact | 2016 |
Sector | Healthcare |
Impact Types | Societal,Economic |
Description | MR-GAST-VT |
Amount | £1,800,000 (GBP) |
Funding ID | 106944/Z/15/Z |
Organisation | Wellcome Trust |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 10/2015 |
End | 09/2019 |
Description | Medical Engineering Centre |
Amount | £1,000,000 (GBP) |
Organisation | Wellcome Trust |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 10/2013 |
End | 09/2018 |
Title | CONTINUUM MANIPULATOR |
Description | Embodiments of the present invention provide a continuum manipulator that can be used, for example, as a steerable catheter tip. The manipulator of the embodiments comprises a plurality of segments arranged in a stack, which is then able to bend in a range of directions away from the long axis of the stack. In one embodiment the segments include a helical portion which winds in the direction of the long axis of the stack, and can thus bend away from the long axis in any direction. In another embodiment the segments include a backbone portion with cantilevered rings extending from the backbone portion, separated by bending gaps which allow the segment to bend in a range of directions away from the backbone portion so that the bending gap between the rings closes. In some embodiments a carbon fibre rod is included as a backbone for the stack, to minimise hysteresis and improve repeatability of bending. In addition, in embodiments of the invention tendon control channels are provided formed within the segments, through which tendon control wires extend to apply compression and/or bending forces to the stack Having the control channels formed internally to the stack strengthens the stack and makes the stacked structure conform to the channel(s). In particular unwanted twisting of the tip of the stack can be prevented and torquability can be improved. |
IP Reference | WO2013017875 |
Protection | Patent granted |
Year Protection Granted | 2013 |
Licensed | No |
Impact | Commercialsation grant funded by teh commercialsation instute KCL |
Title | MR-Compatible Catheter |
Description | A MR-compatible catheter has been tested in a investigator led clinical study, which registered at MHRA. |
Type | Therapeutic Intervention - Medical Devices |
Current Stage Of Development | Early clinical assessment |
Year Development Stage Completed | 2013 |
Development Status | Under active development/distribution |
Impact | New product New intervention |
Title | Platform for MR-guided interventions |
Description | The platform for image-guided interventions (iSuite) has been devloped by Philips Healthcare and is currently tested for electrophysiology applications. |
Type | Diagnostic Tool - Imaging |
Current Stage Of Development | Early clinical assessment |
Year Development Stage Completed | 2014 |
Development Status | Under active development/distribution |
Impact | The platform can also be used for other applications, e.g. MR-guided biopsy or MR-guided RF-ablation of tumors |
URL | http://www.medscape.com/viewarticle/829753_8 |