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2014 Abstracts

3D Mapping of Cardiac Nerves for Improved Cardiac Ablation Procedures in the Treatment of Cardiac Arrhythmia

Adam Jorgensen, Brigham Young University

Life Sciences

Arrhythmia is a serious heart defect that effects 14 million people in the United States. It is characterized by irregular rhythm in the electrical impulses of the heart. Arrhythmia can cause sudden cardiac arrest and stroke. Recent developments in cardiac ablation have helped in the treatment of arrhythmia. Cardiac ablation works by scarring tissue in the heart, thus preventing abnormal electrical signals to travel through the myocardium. The three-dimensional map created in this project will improve the accuracy of cardiac ablation by offering a more dynamic view of the human heart and associated nerve branches. By properly articulating the intricate nerve branching of the heart, surgeons will be able to better target the nerves themselves when scarring heart tissue, thus allowing a less invasive procedure.

We have acquired n=2 cadaveric hearts free of pathology. We have used the BYU MRI Research Facility to acquire preliminary data of the cadaveric hearts. The data acquired will be used as the scaffold for three-dimensional reconstruction of the heart, allowing the nerves to be traced in three-dimensional space within the pre-acquired parameters. Once we acquire the scaffold data, we will obtain the intricate data of nerve branching in the heart. To do so we will use Sihler’s stain, a whole mount nerve staining technique that renders soft tissue translucent while staining the nerves. To date, Sihler’s stain is the best tool for demonstrating precise intramuscular branching and distribution patterns. Using this technique we will render the myocardium of the cadaveric hearts translucent and the nerves deep blue, thus allowing us to acquire 3D images of the nerves via 3D Photography. Once we acquire this data, we will use 3D Slicer to consolidate the data acquired by MRI and that of the 3D images to render a complete model of the human heart’s nerve branches.