Grant: Project Grant

A major cause of sudden death is the development of a sustained very rapid heart rate associated with damage to cardiac muscle due to reduced blood supply. Several treatments have been developed to avoid this situation including the use of drugs to manage heart rate, implantable devices to reset the heart rate if an irregular rhythm is detected, and interventions where segments of cardiac muscle are destroyed through ablation to avoid conditions which can cause the rapid heart rate. The latter is potentially curative but suffers from low long-term success rates possibly due to poor ablation targeting or incomplete long-term tissue destruction. Magnetic resonance imaging (MRI) is proving effective in characterizing damage to the cardiac muscle which, when targeted with ablations, improves success in small patient studies. Pre-clinical studies also suggest MRI is effective in visualizing tissue destruction due to ablation. Our goal is to better understand how such information from MRI can be used to better understand reasons for treatment failures and to ultimately improve treatment strategies. To do so, we plan to integrate advances in MRI lesion visualization into ablation procedures in realistic animal models performed in ways similar to recent patient studies (facilitating rapid clinical translation of results). Specifically, we will directly characterize targeting accuracy, tissue destruction and subsequent healing with MRI and relate these results to procedure success. Results will inform further development of methods for MRI tissue characterization and more effective integration of MRI information into procedures for use in patient studies, yielding better outcomes.