Ehud Schmidt, PhD, Director of Engineering Physics in the Department of Radiology, Brigham and Women’s Hospital, and Associate Professor at Harvard Medical School receives a Pilot award to develop MRI-compatible voltage device tracking for multimodality electrophysiology. The interventions consist of; (A) diagnostic electro-anatomic mapping (EAM), mapping the location, size and geometry of electrical voltages on cardiac-chamber walls, detecting arrhythmia-conduction pathways, (B) pathway ablation using radio-frequency/cryogenic energy, and (C) post-ablative validation of arrhythmia termination. MRI is used at all stages of intervention. It is used (A) pre-operatively to assess anatomy and scar causing AF or VT, (B) intra-operatively to monitor ablation necrosis and edema, and (C) post-operatively to validate ablation success. However, EAM and ablation are still performed primarily in conventional EP labs, so multiple patient transfers to and from MRI are required (Multi-modality intervention). For efficient Multi-modality procedures, patient transfer and incorporation of multi-modality information must be easy.
Voltage Device tracking (VDT) is used in >90% of EP sites, since VDT catheters collect both location and voltage data using electrodes placed on catheter shafts. Schmidt’s team has shown that VDT can be performed both inside and outside the MRI scanner without registration, using MRI-compatible VDT catheters that stay inside the patient, forming the only tracking method that allows efficient multi-modality intervention. This project develops a means for VDT tracking during MRI imaging, overcoming gradient-induced-voltage noise. This enabling technology will allow accurate and fast incorporation of MRI data from all EP-procedure stages performed inside MRI.
Gabriel Gruionu, PhD, Director of the Trauma Innovation Program/MGH, Instructor in Surgery, Harvard Medical School receives a Pilot award to develop a rapid perfusion catheter. Peripheral intravenous (PIV) catheter placement is difficult in critically ill patients throughout the hospital. Patients with hypotension require rapid infusion of fluid and blood products using a large diameter IV catheter (14G), but unfortunately their veins are constricted and only a smaller diameter catheter (22G) can be introduced easily. This limitation results in delayed delivery of fluids, longer recovery and poor patient outcomes. To address this, the Gruionu team is developing a rapid and non-traumatic catheter with diameter increase using the current needle insertion technique. Preliminary animal and clinical experiments using FDA approved IV catheters reveal the approach is feasible but the existing devices do not fit in terms of diameter, length, and connectivity between components. The purpose of this study is to prove technical feasibility of a functional prototype. RPC is applicable to all PIV procedures – a market of 200 million devices in the USA alone.
Karin Hoffmeister, MD, Associate Biologist, Brigham and Women’s Hospital, Associate Professor of Pediatrics, Harvard Medical School receives a DRIVE award to develop novel approaches for platelet storage and The current FDA restricted shelf life (< 5 days) of room temperature stored platelets seriously limits platelet availability, drives donor recruitment efforts and leads to significant wastage of this critical resource and of health care dollars. In 2011, a total number of 2,169,000 platelet units were transfused in the United States1, of which 321,070 apheresis platelets [12.8%] valued at nearly $172 million [$535.17 each] expired. In patients with hypoproliferative thrombocytopenia, who use about 80% of stored platelet components and receive chronic platelet transfusion predominantly for prophylaxis, post-transfusion increments, survival time, and durable hemostatic efficacy are important; however, platelet transfusion alone does not prevent bleeding. Solutions to increase platelet shelf life and at the same time to prevent platelets from deteriorating during storage will not only improve the provision of platelets to patients, but will increase safety and efficacy of platelet transfusions.