System and method for reconstructing cardiac activation information

• US 10,149,622 B2
• Filed: 08/23/2016
• Issued: 12/11/2018
• Est. Priority Date: 05/02/2011
• Status: Active Grant

• Current Assignee: Topera, Inc (Abbott Laboratories), 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), The United States of America As Represented By The Secretary of Agriculture, Regents of the University of California (University of California)
• Inventors: Narayan, Sanjiv, Briggs, Carey Robert
• Primary Examiner(s): Voorhees, Catherine
• Assistant Examiner(s): Dinga, Roland
• Application Number:
  US15/244,792
• Publication Number:
  US 20160360983A1
• Time in Patent Office: 840 Days
• Field of Search: 600515
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2562/046 in a matrix array
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/0255 Recording instruments specially adapted therefor
• 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 5/33 specially adapted for cooperation with other devices
• 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 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/367 Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7217 : of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
• 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 5/7278 : Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• CPC Class Codes: A61B 5/7282 : Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/743 : Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots

Abstract

In a system and method of reconstructing cardiac activation information, pairs of cardiac signals obtained from a patient are accessed. The pairs have a first cardiac signal that is common among the pairs and second cardiac signals that are different among the pairs. The first cardiac signal and the second cardiac signals are processed to identify points of change in the first cardiac signal at which a derivative of the first cardiac signal diverges with respect to derivatives of the second cardiac signals. An activation onset time is assigned at a point in the first cardiac signal based on correspondence of the points of change to define a cardiac activation indicating a beat.

Claims

1. A system to generate an output map of successive cardiac signals comprising:

at least one computing device configured to;

determine values for each of a plurality of points associated with cardiac signal data for a given spatial region of tissue, the values corresponding to electrical information for each respective point of the plurality of points within a plurality of time intervals;

process the values for each of the plurality of points within a first time interval of the plurality of time intervals to generate a first map;

process the values for each of the plurality of points within one or more successive time intervals of the plurality of time intervals to generate one or more successive maps;

compare the processed values within the first time interval and the one or more successive time intervals relative to reference signals in a database to identify activation onsets within the plurality of time intervals; and

generate an output map of successive cardiac signals for the given spatial region of tissue based on the compared processed values, the output map comprising a clinical representation of activation patterns within the given spatial region of tissue.

2. The system of claim 1, wherein the output map identifies a source of a cardiac rhythm disorder.

3. The system of claim 2, wherein the source is rotational.

4. The system of claim 2, wherein the source is a rotor.

5. A method for generating an output map of successive cardiac signals to indicate a source of a complex cardiac rhythm disorder, comprising:

determining values for each of a plurality of points associated with cardiac signal data for a given spatial region of tissue, the values associated with electrical information for each respective point of the plurality of points within a plurality of time intervals;

processing the values for each of the plurality of points within a first time interval to generate a first map;

processing the values for each respective point of the plurality of points one or more successive time intervals to generate one or more successive maps;

comparing the first map and the one or more successive maps relative to reference signals in a database to identify activation onsets; and

generating an output map of successive cardiac signals for the given spatial region of tissue based on the compared maps, the output map comprising a clinical representation indicative of the source of the complex rhythm disorder in the given spatial region of tissue.

6. The method of claim 5, further comprising treating cardiac tissue at the source in order to suppress or eliminate the cardiac rhythm disorder.

7. The method of claim 6, wherein treating the cardiac tissue is by ablation.

8. The method of claim 7, wherein the ablation includes but is not limited to radiofrequency energy, freezing energy, or other forms energy in the electromagnetic spectrum.

9. A non-transitory computer readable medium comprising instructions that, when executed by a computing device, cause the computing device to:

determine values for each of a plurality of points associated with cardiac signal data for a given spatial region of tissue, the values corresponding to electrical information for each respective point of the plurality of points within a plurality of time intervals;

process the values for each of the plurality of points within a first time interval of the plurality of time intervals to generate a first map;

process the values for each of the plurality of points within one or more successive time intervals of the plurality of time intervals to generate one or more successive maps;

compare the first map and the one or more successive maps relative to reference signals in a database to identify activation onsets; and

generate an output map of successive cardiac signals for the given spatial region of tissue based on the compared maps, the output map comprising a clinical representation of activation patterns within the given spatial region of tissue.

10. The computer readable medium of claim 9, wherein the output map identifies a source of a cardiac rhythm disorder.

11. The computer readable medium of claim 10, wherein the source is rotational.

12. The computer readable medium of claim 11, wherein the source is a rotor.