Intracardiac EGM signals for beat matching and acceptance

• US 10,271,758 B2
• Filed: 09/25/2016
• Issued: 04/30/2019
• Est. Priority Date: 09/26/2015
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Stewart, Brian, Harlev, Doron, Bennett, Nathan H.
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US15/275,438
• Publication Number:
  US 20170086701A1
• Time in Patent Office: 947 Days
• Field of Search: None
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• 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 5/333 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick

Abstract

A system for providing information about a patient'"'"'s heart, the system including one or more catheters that receive intracardiac signals from electrical activity of the heart over one or more heart beat cycles and an electronic processor coupled to the one or more catheters. The electronic processor to: receive the intracardiac signals from the one or more catheters; preprocess the intracardiac signals to provide preprocessed signals, wherein each of the intracardiac signals is preprocessed to provide a corresponding preprocessed signal; and compare the preprocessed signals to a set of signals to determine a degree of similarity between each of the preprocessed signals and the set of signals.

Claims

1. A system for providing information about a patient'"'"'s heart, the system comprising:

one or more catheters that receive intracardiac signals from electrical activity of the heart over one or more heart beat cycles;

an electronic processor coupled to the one or more catheters and configured to;

receive the intracardiac signals from the one or more catheters;

preprocess the intracardiac signals to provide preprocessed signals, wherein each of the intracardiac signals is preprocessed to provide a corresponding preprocessed signal;

compare the preprocessed signals to a set of signals to determine a degree of similarity between each of the preprocessed signals and the set of signals;

determine whether to accept one or more beats of the intracardiac signals into an existing cardiac map based on the degree of similarity;

receive an individual threshold value for each signal channel of signal channels for the set of signals;

provide a master threshold value;

determine a dynamic threshold value for each of the signal channels based on a combination of the individual threshold value for the signal channel and the master threshold value;

compare each of the preprocessed signals to the set of signals to obtain a comparison value for each of the signal channels; and

compare the comparison value for each of the signal channels to the dynamic threshold value for each of the signal channels to determine whether a beat of the intracardiac signals is to be accepted into an existing cardiac map; and

a display that displays a result of the comparison such that a user can switch between adding the beats of the intracardiac signals to a current cardiac map and adding the beats of the intracardiac signals to another cardiac map based on the comparison.

2. The system of claim 1, wherein to preprocess the intracardiac signals the electronic processor is to:

apply a transform function to the intracardiac signals to provide transformed signals, wherein each of the intracardiac signals is transformed to a corresponding transformed signal; and

apply a morphological close operation to each of the transformed signals to reduce noise in the preprocessed signals.

3. The system of claim 2, wherein the transform function is a Hilbert transform and the close operation is a non-boolean close operation.

4. The system of claim 1, wherein the electronic processor is to:

detect a beat of the heart;

define a window for samples of the intracardiac signals based on the beat; and

provide a matrix of the samples of the intracardiac signals in the window.

5. The system of claim 1, wherein the one or more catheters include one or more reference catheters situated at stable positions in the patient'"'"'s body and the set of signals includes a template of signals determined from the intracardiac signals received by the one or more reference catheters.

6. The system of claim 1, wherein the one or more catheters include one or more mapping catheters positioned in the patient'"'"'s heart and the set of signals includes a set of signals from the one or more mapping catheters and a previously detected beat of the heart.

7. The system of claim 1, wherein to compare the preprocessed signals the electronic processor is to:

receive individual threshold values for each of the intracardiac signals;

compare the preprocessed signals to the set of signals to obtain comparison values for the intracardiac signals; and

compare the comparison values to the individual threshold values to determine whether a beat of the intracardiac signals is to be accepted into an existing cardiac map.

8. The system of claim 1, wherein to compare the preprocessed signals the electronic processor is to:

receive individual threshold values for each of the intracardiac signals; and

compare each of the individual threshold values to a fixed value and if all of the individual threshold values are less than the fixed value, accept one or more beats of the intracardiac signals into an existing cardiac map.

9. The system of claim 1, wherein to compare the preprocessed signals the electronic processor is to:

compare the preprocessed signals to a set of signals from one or more mapping catheters and a previously detected beat of the heart to obtain previous beat comparison values; and

compare each of the previous beat comparison values to a corresponding threshold value to determine whether a beat of the intracardiac signals is to be accepted.

10. The system of claim 1, wherein the electronic processor is to determine whether to:

classify the intracardiac signals into the current cardiac map;

classify the intracardiac signals into another existing cardiac map;

or

make a new cardiac map based on the intracardiac signals.

11. A method for mapping a patient'"'"'s heart, comprising:

receiving intracardiac signals from electrical activity of the heart over one or more heart beat cycles at one or more catheters;

receiving the intracardiac signals at an electronic processor that is coupled to the one or more catheters;

preprocessing the intracardiac signals, by the electronic processor, to provide preprocessed signals, wherein each of the intracardiac signals is preprocessed to provide a corresponding preprocessed signal;

comparing the preprocessed signals, by the electronic processor, to a set of signals to determine a degree of similarity between each of the preprocessed signals and the set of signals;

determining whether to accept the intracardiac signals into an existing cardiac map based on the degree of similarity,

wherein preprocessing the intracardiac signals includes transforming each of the intracardiac signals via a transform function, and applying a close operation to reduce noise in the preprocessed signals, and comparing the preprocessed signals comprises;

receiving individual threshold values for each signal channel of signal channels for the set of signals;

setting a master threshold value;

providing dynamic threshold values based on the individual threshold values and the master threshold value;

comparing the preprocessed signals to the set of signals to obtain comparison values for the preprocessed signals; and

comparing the comparison values to the dynamic threshold values to determine whether a beat of the intracardiac signals is to be accepted into an existing cardiac map; and

displaying a result of the comparison such that a user can switch between adding the beats of the intracardiac signals to a current cardiac map and adding the beats of the intracardiac signals to another cardiac map based on the comparison.

12. The method of claim 11, wherein comparing the preprocessed signals comprises:

receiving individual threshold values for each of the intracardiac signals;

comparing the preprocessed signals to the set of signals to obtain comparison values; and

comparing the comparison values to the individual threshold values to determine whether a beat of the intracardiac signals is to be accepted into an existing cardiac map.

13. The method of claim 11, wherein comparing the preprocessed signals comprises:

receiving individual threshold values for each of the intracardiac signals; and

comparing each of the individual threshold values to a fixed value and if all of the individual threshold values are less than the fixed value, accept one or more beats of the intracardiac signals into an existing cardiac map.

14. The method of claim 11, wherein comparing the preprocessed signals comprises:

comparing the preprocessed signals to a set of signals from one or more mapping catheters and a previously detected beat of the heart to obtain previous beat comparison values; and

comparing each of the previous beat comparison values to a corresponding threshold value to determine whether a beat of the intracardiac signals is to be accepted.