System and method of identifying sources for biological rhythms

• US 10,058,262 B2
• Filed: 06/27/2016
• Issued: 08/28/2018
• Est. Priority Date: 12/09/2011
• Status: Active Grant

• Current Assignee: US Department of Veterans Affairs (Government of the United States of America), Regents of the University of California (University of California)
• Original Assignee: Topera, Inc (Abbott Laboratories Incorporated), US Department of Veterans Affairs (Government of the United States of America), Regents of the University of California (University of California)
• Inventors: Briggs, Carey Robert, Narayan, Sanjiv M.
• Primary Examiner(s): Wu, Eugene T
• Application Number:
  US15/194,357
• Publication Number:
  US 20160324434A1
• Time in Patent Office: 792 Days
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 5/7425 Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 8/02 Measuring pulse or heart rate

Abstract

In a system and method of determining regularity associated with a rhythm disorder of a heart, a derivative of a first cardiac signal at a plurality of first time points is processed against a derivative of a second cardiac signal at a plurality of second time points to define a plurality of coordinate pairs of the first cardiac signal against the second cardiac signal. Thereafter, an index of regularity that exceeds a threshold is determined. The index of regularity indicates an approximate congruence of the plurality of coordinate pairs among the first cardiac signal and the second cardiac signal.

Claims

1. A method of determining regularity associated with a source of a cardiac rhythm disorder, the method comprising:

processing by a computing device one of a zero order, a first order, and a higher order derivative of a first cardiac signal associated with a first location at a plurality of first time points against one of a zero order, a first order, and a higher order derivative of a second cardiac signal associated with a second location at a plurality of second time points to define a plurality of coordinate pairs of the first cardiac signal against the second cardiac signal;

determining by the computing device an index of regularity that exceeds a threshold, the index of regularity being associated with periodic repeating activity, the index of regularity indicating an approximate congruence of the plurality of coordinate pairs among the first cardiac signal and the second cardiac signal;

iteratively selecting pairs of cardiac signals from the plurality of defined coordinate pairs of cardiac signals;

performing the processing and determining for each pair of the iteratively selected pairs of cardiac signals;

constructing a matrix of indexes of regularity for the iteratively selected pairs of cardiac signals; and

determining one or more sources of the rhythm disorder using the matrix of indexes of regularity.

2. The method of claim 1, wherein determining the one or more sources comprises:

identifying from the matrix one or more regions of the heart associated with higher indexes of regularity as compared to indexes of regularity at adjacent regions of the heart.

3. The method of claim 1, wherein the first cardiac signal and the second cardiac signal are from different regions of the heart.

4. The method of claim 1, wherein the plurality of first time points is contemporaneous with the plurality of second time points.

5. The method of claim 1, wherein the method further comprises:

plotting the plurality of coordinate pairs; and

connecting the plurality of coordinate pairs to generate a plurality of loops.

6. The method of claim 5, wherein the index of regularity indicates the approximate congruence among the plurality of loops.

7. The method of claim 1, wherein the method further comprises:

performing a frequency analysis using a selected parameter associated with the plurality of coordinate pairs to generate a frequency spectrum; and

determining at least one peak in the frequency spectrum.

8. The method of claim 7, further comprising:

calculating a sum of the area of the at least one peak in the frequency spectrum;

calculating a result from dividing the sum of the area of the at least one peak by a total area of the frequency spectrum within a predefined frequency range; and

determining whether the result exceeds the threshold.

9. The method of claim 7, wherein the at least one peak includes a fundamental frequency.

10. The method of claim 9, wherein the at least one peak further includes one or more harmonics of the fundamental frequency.

11. The method of claim 7, wherein the at least one peak includes one or more harmonics of a fundamental frequency.

12. The method of claim 7, wherein the selected parameter is one of amplitude, angle, vector, area and derivative.

13. The method of claim 7, wherein the frequency analysis is a Fourier analysis.

14. The method of claim 1, wherein the one of a zero order, a first order, and a higher order derivative of the first cardiac signal and the one of a zero order, a first order, and a higher order derivative of the second cardiac signal are one of a first order derivative and a higher order derivative.

15. The method of claim 1, wherein the one of a zero order, a first order, and a higher order derivative of the first cardiac signal and the one of a zero order, a first order, and a higher order derivative of the second cardiac signal are a zero order derivative.

16. The method of claim 1, wherein one of the first order and the higher order derivative of the first cardiac signal and one of the first order and the higher order derivative of the second cardiac signal are in one of time and space.

17. The method of claim 1, wherein the index of regularity is determined in one of a time domain, frequency domain and spatial domain.

18. The method of claim 1, wherein the approximate congruence indicates recurrence of at least a portion of the plurality of coordinate pairs within a defined confidence interval.

19. The method of claim 1, wherein the method further comprises iteratively selecting the first cardiac signal and the second cardiac signal from a plurality of cardiac signals.

20. The method of claim 1, wherein the first cardiac signal and the second cardiac signal represent a first voltage time series and a second voltage time series, respectively.

21. The method of claim 1, wherein the plurality of first time points and the plurality of second time points are associated with at least one beat of the rhythm disorder.

22. A system to determine regularity associated with a source of a cardiac rhythm disorder, the system comprising at least one computing device configured to:

process one of a zero order, a first order, and a higher order derivative of a first cardiac signal associated with a first location at a plurality of first time points against s-one of a zero order, a first order, and a higher order derivative of a second cardiac signal associated with a second location at a plurality of second time points to define a plurality of coordinate pairs of the first cardiac signal against the second cardiac signal;

determine an index of regularity that exceeds a threshold, the index of regularity being associated with periodic repeating activity, the index of regularity indicating an approximate congruence of the plurality of coordinate pairs among the first cardiac signal and the second cardiac signal;

iteratively select pairs of cardiac signals from the plurality of defined coordinate pairs of cardiac signals;

perform the processing and determining for each pair of the iteratively selected pairs of cardiac signals;

construct a matrix of indexes of regularity for the iteratively selected pairs of cardiac signals; and

determine one or more sources of the cardiac rhythm disorder using the matrix of indexes of regularity.

23. The system of claim 22, wherein the at least one computing device is further configured to:

identify from the matrix one or more regions of the heart associated with higher indexes of regularity as compared to indexes of regularity at adjacent regions of the heart.

24. The system of claim 22, wherein the at least one computing device is further configured to iteratively select the first cardiac signal and the second cardiac signal from a plurality of cardiac signals.

25. The system of claim 24, further comprising a catheter that includes a plurality of sensors configured to detect the plurality of cardiac signals.

26. The system of claim 22, further comprising a display device configured to display the index of regularity.

27. The system of claim 22, further comprising a computer storage medium comprising instructions, which when executed by the at least one computing device, cause the at least one computing device to process and determine.