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Esophagus electrode probe and method for cardiological treatment and diagnosis

Abstract

This innovative esophageal catheter has advanced sensors and electrodes that enable comprehensive tissue parameters to be recorded during catheter ablation. Additional sensor technology on the remote side of the heart not only enables reference measurements that allow comprehensive monitoring and thus increase patient safety; hemodynamic monitoring and pain reduction in transesophageal electrostimulation are also possible.

Background

Along with atrial and ventricular tachycardia, atrial fibrillation is the most common persistent cardiac arrhythmia, which now affects almost 1.8 million Germans. Cardioversion can be treated with medication; however, catheter ablation has become the established method of choice, not least due to the considerable side effects of medication. The ablation of tachyarrhythmias is considered a comparatively gentle interventional electrophysiological procedure and was performed more than 80,000 times in Germany in 2016, with an upward trend.

Problem

Esophageal catheters are used to monitor this procedure and to perform further non-invasive diagnostics (e.g. TEE, EPS). The proximity of the left atrium to the esophagus carries the risk of perforations from the left atrium to the esophagus during ablations. To avoid complications, the parameters of the surrounding tissue should be constantly monitored. However, conventional methods use probes whose sensors only measure the temperature in the esophagus on the heart side.

Solution

The invention of the Offenburg University of Applied Sciences relates to a procedure and the associated esophageal electrode probe, which is equally suitable for the diagnosis and therapy of cardiac arrhythmias and consequential interventions, as well as for the preparation of neurological findings. This catheter has additional electrodes for bioimpedance measurements and neurostimulation on the side remote from the heart, which allows for more precise monitoring of tissue condition and pain reduction in transesophageal electrostimulation. Tissue changes can now be monitored via the electrodes on the heart side and continuously compared with the parameters on the opposite side. This results in a considerably more precise assessment of the situation, which effectively reduces the risk for the patient. Furthermore, transesophageal hemodynamic monitoring is also quite easy to implement with this catheter.

Heart rhythm model with conduction of excitation, heart catheter positions and esophageal catheter (left) and detail of the catheter model with sensors on both sides (right).
Heart rhythm model with conduction of excitation, heart catheter positions and esophageal catheter (left) and detail of the catheter model with sensors on both sides (right).

Advantages

  • Bioimpedance measurement and neurostimulation on the side remote from the heart
  • More reliable monitoring of an ablation through comparative measurements
  • Transesophageal hemodynamic monitoring
  • Pain reduction in transesophageal electrostimulation by neurostimulation

Application

During ablation, the heart muscle tissue is selectively heated (HF, laser) or cooled (cryo) by means of a catheter, which results in the formation of scar tissue. The structured insertion of scars can limit the function of nerve tracts and myocardial tissue (e.g. PVI or substrate modification), which consequently prevents the negative influence on the heart rhythm.
The new catheter not only makes ablation safer, it also enables extended diagnoses and helps to avoid pain by enhanced neurostimulation.

Exposé
Contact
Anne Böse, M.Sc.
TLB GmbH
Ettlinger Straße 25
76137 Karlsruhe | Germany
Phone +49 721-79004-0
boese(at)tlb.de | www.tlb.de
Development Status
Concept / TRL2
Patent Situation
DE 102017010318 B3 granted
PCT WO 2019/091991 A1 pending
Reference ID
17/027TLB
Service
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