Congestive Heart Failure

Focused Ultrasound Therapy

arly Stage squareFocused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with congestive heart failure (CHF). This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) enabling CHF to be treated without surgery.

One early, preclinical project is looking at the period after an infarction and uses focused ultrasound to shrink the size of the infarcted region. The goal is to achieve the right amount of tissue reduction to offset the post-myocardial tissue expansion that is typically seen. A recent publication showed a decrease in tissue strain in the affected region. Additional research will likely be needed prior to clinical trials.

The primary options for treatment of CHF include medication but may also include invasive surgery.

For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost.

Advantages:

  • Focused ultrasound is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
  • Focused ultrasound can reach the desired target without damaging surrounding tissue.
  • It can be repeated, if necessary.

Clinical Trials

At the present time, there are no clinical trials recruiting patients for focused ultrasound CHF treatments.

Regulatory Approval and Reimbursement 

Focused ultrasound treatment for CHF is not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

Miller DL, Lu X, Dou C, Zhu YI, Fuller R, Fields K, Fabiilli ML, Owens GE, Gordon D, Kripfgans OD. Ultrasonic Cavitation-Enabled Treatment for Therapy of Hypertrophic Cardiomyopathy: Proof of Principle. Ultrasound Med Biol. 2018 Jul;44(7):1439-1450. doi: 10.1016/j.ultrasmedbio.2018.03.010. Epub 2018 Apr 19. PMID:29681423

Douglas L. Miller, Xiaofang Lu, Chunyan Dou, Yiying I. Zhu, Mario L. Fabiilli, Gabe E. Owens, Oliver D. Kripfgans. Multiple ultrasound cavitation-enabled treatments for myocardial reduction. Journal of Therapeutic Ultrasound. 2017 5:29.

Laughner JI, Sulkin MS, Wu Z, Deng CX, Efimov IR. Three potential mechanisms for failure of high intensity focused ultrasound ablation in cardiac tissue. Circ Arrhythm Electrophysiol. 2012 Apr;5(2):409-16. doi: 10.1161/CIRCEP.111.967216.

Otsuka R, Fujikura K, Abe Y, Okajima K, Pulerwitz T, Engel DJ, Muratore R, Ketterling JA, Kalisz A, Sciacca R, Marboe C, Yi G, Wang J, Homma S. Extracardiac ablation of the left ventricular septum in beating canine hearts using high-intensity focused ultrasound. J Am Soc Echocardiogr. 2007 Dec;20(12):1400-6.

Yin X, Epstein LM, Hynynen K. Noninvasive transesophageal cardiac thermal ablation using a 2-D focused, ultrasound phased array: a simulation study. IEEE Trans Ultrason Ferroelectr Freq Control. 2006 Jun;53(6):1138-49.

Click here for additional references from PubMed.