UCLA researchers in the Department of Cardiology have developed a novel system and method for manipulating cardiac tissue to homogenize scar tissue and treat arrhythmias.
Following cardiac injury, an area of scar tissue can emerge. While the scar itself may not have any electrical activity, there are often myocardial cells interspersed, creating a heterogeneous area of scar tissue called the border zone (BZ). BZ areas have slow conductance, electrical instability, low voltage, and often late potentials.
These BZs can be a source for ventricular tachycardia, at which point the area needs to be ablated to restore normal rhythm, creating a more homogeneous scar. Radiofrequency ablation is the established therapy for cardiac ablation, but cryoablation, high-intensity focused ultrasound, laser, microwave, and chemical ablation have all been studied as well.
The invention described here uses collagenase to promote cardiac ablation by focal digestion. Scar tissue contains high levels of various collagen subtypes, allowing for a more targeted ablation that does minimal damage to surrounding normal tissue. Collagenase, with or without another therapeutic agent, is introduced to an area of cardiac tissue using a specialized, site-specific device. The efficacy of modifying that area is measured using cardiac imaging techniques and electroanatomical mapping.
This procedure could be used to treat any type of arrhythmia caused by regions of abnormal cardiac tissue. Examples include:
Researchers are currently developing a prototype. They have developed an appropriate animal model for ventricular tachycardia in order to test the efficacy. The initial data shows that the method works and can reach electrophysiological endpoints in a model relevant to human arrhythmias.
|United States Of America||Published Application||20150320845||11/12/2015||2011-131|
Cardiac ablation, arrhythmia, ventricular tachycardia, collagenase, late potential, radiofrequency ablation, myocardium, border zone, bioenzymatic ablation