Endomyocardial monophasic action potential for early detection of myocardium pathology
First Claim
1. An apparatus for three-dimensional interior mapping of endomyocardial monophasic action potential (MAP) of endomycardial tissue comprising:
- a catheter with a distal and proximal end;
a wire basket disposed on said distal end of said catheter;
a plurality of electrodes forming an array of separated electrodes carried by said wire basket, said wire basket self-expandable by reason of resiliency of said wire basket to a size and stiffness sufficient to cause said electrodes to make intimate contact with said endomycardial tissue with point contact pressure at each electrode; and
a flexible cable disposed in said catheter electrically coupling said plurality of electrodes to said proximal end of said catheter.
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Abstract
A catheter-delivered electrode array is used to three dimensionally map the endomyocardial monophasic action potential (MAP). The catheter is used in a method for endomyocardial MAP mapping and for establishing diagnostic criteria for the cardiac myocyte injury. During allograft rejection, conduction impairment occurs within the atrial myocardium. Abnormalities of the terminal force of the P wave in Lead V1 (ptfV1) and dispersion of corrected atrial repolarization (Ta-TcD) represent interatrial conduction defects that accompanies the rejection process. Three dimensional endomyocardium monophasic action potential mappings are used to directly monitor the pathophysiological changes in cardiac myocytes. Changes in amplitude, duration and morphology of the action potential were recorded and used to detect the early rejection of the transplant organ with high sensitivity and specificity. Using this MAP-mapping system, the area of myocardium injury induced by a coronary artery occlusion or by ablation can be pin pointed.
101 Citations
10 Claims
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1. An apparatus for three-dimensional interior mapping of endomyocardial monophasic action potential (MAP) of endomycardial tissue comprising:
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a catheter with a distal and proximal end;
a wire basket disposed on said distal end of said catheter;
a plurality of electrodes forming an array of separated electrodes carried by said wire basket, said wire basket self-expandable by reason of resiliency of said wire basket to a size and stiffness sufficient to cause said electrodes to make intimate contact with said endomycardial tissue with point contact pressure at each electrode; and
a flexible cable disposed in said catheter electrically coupling said plurality of electrodes to said proximal end of said catheter. - View Dependent Claims (2)
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3. A method of determining the myocardium injury/electrical-pathophysiology of cardiac myocytes comprising:
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providing a catheter having with a distal and proximal end, and a wire basket disposed on said distal end of said catheter with a plurality of at least 64Ag/AgCl plated electrodes carried by said basket, having a flexible cable disposed in said catheter electrically coupling said plurality of electrodes to said proximal end of said catheter, and a sheath temporarily disposed over said basket to retain said basket in a collapsed configuration;
disposing said catheter in a heart chamber to be mapped, telescopically removing said sheath from said basket to allow said basket to self-expand in said heart chamber, said basket being self-expandable by reason of resiliency of said basket to a size and stiffness sufficient to cause said electrodes to make intimate contact with said endomycardial tissue; and
recording and electrophysiologically analyzing a data signal from each of said plurality of electrodes to generate a three-dimensional endomyocardium mapping of endomyocardial monophasic action potential from said plurality of electrodes.- View Dependent Claims (4, 5, 6, 7, 8, 9, 10)
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Specification