Method and system to automatically assign map points to anatomical segments and determine mechanical activation time

• US 10,285,647 B2
• Filed: 05/05/2014
• Issued: 05/14/2019
• Est. Priority Date: 05/05/2014
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Razavi, Hoda, Nabutovsky, Yelena
• Primary Examiner(s): Clow, Lori A.
• Application Number:
  US14/270,191
• Publication Number:
  US 20150317448A1
• Time in Patent Office: 1,835 Days
• Field of Search: None
• CPC Class Codes: A61B 2576/023 for the heart
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/0265 using electromagnetic means, e.g. electromagnetic flowmeter
• CPC Class Codes: A61B 5/027 using catheters
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1102 Ballistocardiography
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/283 Invasive
• 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 5/6852 Catheters
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61B 5/7485 Automatic selection of region of interest
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/487 involving fluoroscopy
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: G16H 20/40 : relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 : for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 30/40 : for processing medical images, e.g. editing
• CPC Class Codes: G16H 50/50 : for simulation or modelling of medical disorders

Abstract

A method and system are provided for assigning map points to anatomical segments of a heart. The method and system utilize an intravascular mapping tool configured to be inserted into at least one of the endocardial or epicardial space. The mapping tool is maneuvered to select locations proximate to surfaces of the heart, while collecting map points at the select locations to form a ROI data set. The method and system store the ROI data set in a data storage and defines apical, basal and circumferential landmarks within the ROI data set. The method and system automatically calculate circumferential and longitudinal segment boundaries, associated with wall segments of the heart, based on the apical, basal and circumferential landmarks. The method and system automatically assign segment identifiers (IDs) to the map points based on locations of the map points relative to the circumferential and longitudinal boundaries, the segment IDs associated with wall segments of the heart.

Claims

1. A method for determining mechanical activation times (MATs) associated with map points of a heart, the method comprising:

utilizing one or more processors to perform the following operations;

obtaining a region of interest (ROI) data set comprising a plurality of point specific (PS) motion data representative of wall motion at select map points,

selecting a current map point from the select map points and a corresponding collection of PS motion data for the current map point, the collection of PS motion data comprising a set of directional motion components indicative of wall motion along at least first and second directions at the current map point;

analyzing a component preference characteristic (CPC) of the set of directional motion components for the current map point, wherein the CPC is at least one of i) a time characteristic that is to be identified from the collection of PS motion data, ii) a location characteristic indicating a wall segment in which the current map point is located, and/or iii) a quality characteristic indicating a clarity of a characteristic of interest in motion waveforms;

identifying the wall motion as predominately along the first or second directions based on the CPC of the set of directional motion components for the current map point;

designating, by a mapping tool, a first directional motion component from the set of directional motion components based on identifying that wall motion is predominately along the first direction, wherein the designating comprises selecting between the first directional motion component and a second directional motion component; and

determining a MAT for the current map point of the heart based on the first designated directional motion component.

2. The method of claim 1, wherein the CPC represents the time characteristic that is to be identified from the collection of PS motion data, the method selecting between the first and second directional motion component based on the time characteristic representing one of an onset and an end for one of a contraction action and an extension action of a region of interest.

3. The method of claim 2, wherein the determining operation determines the MAT based on an earlier occurrence of a contraction onset exhibited in one of radial or longitudinal component motion waveforms that correspond to the first and second directional motion component, respectively.

4. The method of claim 2, wherein the determining operation determines the MAT based on a later occurrence of a contraction end event exhibited in one of radial or longitudinal component motion waveforms that correspond to the first and second directional motion component, respectively.

5. The method of claim 1, wherein the set of directional motion components includes radial, circumferential and longitudinal component motion waveforms, the designating operation selecting at least two of the radial, circumferential and longitudinal component motion waveforms as the first directional motion component and a third directional motion component to be used during the determining operation to determine the MAT.

6. The method of claim 1, wherein the CPC represents the location characteristic indicating the wall segment in which the current map point is located, the analyzing comprising identifying the wall motion as predominately along the first or second directions based on the location characteristic representing an apical, middle, basal, anteroseptal, anterior, lateral, septal, inferior, or posterior wall segment, the first directional motion component designated to be associated with the wall segment in which the current map point is located as indicated by the CPC.

7. The method of claim 1, wherein the analyzing operation includes identifying the current map point in a wall segment for which wall motion is predominately in a radial direction or predominately in a longitudinal direction;

wherein the designating operation selects a longitudinal component motion waveform and the determining operation uses the longitudinal component motion waveform associated with the current map point to identify the MAT, when the wall motion is predominately in the longitudinal direction,

wherein the designating operation selects a longitudinal component motion waveform and the determining operation uses the radial component motion waveform associated with the current map point to identify the MAT, when the wall motion is predominately in the radial direction.

8. The method of claim 1, wherein the CPC represents the quality characteristic indicating the clarity of the characteristic of interest in motion waveforms associated with the set of directional motion components.

9. The method of claim 1, wherein the analyzing operation comprises analyzing one or more characteristics of interest of motion waveforms for the set of directional motion components to identify the wall motion as predominately along the first or second directions, the characteristics of interest including at least one of angle of a select waveform segment, a presence of notches in a vicinity of onset and/or end systole, a number of peaks/valleys, or a number of changes in slope in the motion waveforms.

10. The method of claim 1, further comprising assigning a clarity score to each of the set of directional motion components, the CPC based on the clarity scores, the clarity scores indicating a distinctiveness of a characteristic of interest in the set of directional motion components, the analyzing operation utilizing the clarity scores to identify the wall motion as predominately along the first or second directions.

11. The method of claim 1, further comprising generating motion component waveforms for at least a portion of the select map points based on the collection of PS motion data, the motion component waveforms indicative of wall motion at the corresponding select map points along the at least corresponding first and second directions.

12. The method of claim 11, wherein the analyzing comprises analyzing a CPC of the motion component waveforms associated with the current map point, and designating a first motion component waveform from the motion component waveforms based on the analysis of the CPC.

13. A system for determining mechanical activation times (MATs) associated with map points of a heart, the system comprising an intravascular mapping tool comprising:

a data storage configured to store a region of interest (ROI) data set comprising a plurality of point specific (PS) motion data representative of motion at select map points proximate to the heart, a collection of the PS motion data comprising a set of directional motion components indicative of motion along at least corresponding first and second directions at a current map point from the select map points; and

a processor configured to;

select the current map point from the select map points;

analyze a component preference characteristic (CPC) of the set of directional motion components for the current map point, wherein the CPC is at least one of i) a time characteristic that is to be identified from the collection of PS motion data, ii) a location characteristic indicating a wall segment in which the current map point is located, and/or iii) a quality characteristic indicating a clarity of a characteristic of interest in motion waveforms;

identify the wall motion as predominately along the first or second directions based on the CPC of the set of directional motion components for the current map point;

designate a first directional motion component from the set of directional motion components based on identifying that wall motion is predominately along the first direction, wherein the designate operation comprises selecting between the first directional motion component and a second directional motion component; and

determine a MAT for the current map point of the heart based on the first designated directional motion component.

14. The system of claim 13, wherein the CPC represents the time characteristic that is to be identified from the collection of PS motion data, and wherein the processor is configured to select between the first and second directional motion components based on the time characteristic representing one of an onset and an end for one of a contraction action and an extension action of a region of interest.

15. The system of claim 14, wherein the processor is configured to determine the MAT based on an earlier occurrence of a contraction onset exhibited in one of radial or longitudinal component motion waveforms that correspond to the first and second directional motion component, respectively.

16. The system of claim 14, wherein the processor is configured to determine the MAT based on a later occurrence of a contraction end event exhibited in one of radial or longitudinal component motion waveforms that correspond to the first and second directional motion component, respectively.

17. The system of claim 13, wherein the set of directional motion components include radial, circumferential and longitudinal component motion waveforms, the processor configured to select at least two of the radial, circumferential and longitudinal component motion waveforms as the first directional motion component and a third directional motion component to be used during the determining operation to determine the MAT.

18. The system of claim 13, wherein the CPC represents the location characteristic indicating the wall segment in which the current map point is located, the processor configured to identify the wall motion as predominately along the first or second directions based on the location characteristic representing an apical, middle, basal, anteroseptal, anterior, lateral, septal, inferior, or posterior wall segment, and wherein the processor is further configured to designate the first directional motion component associated with the wall segment in which the current map point is located as indicated by the CPC.

19. The system of claim 13, wherein the processor is configured to:

identify the current map point as in a wall segment for which wall motion is predominately in a radial direction or predominately in a longitudinal direction;

select a longitudinal component motion waveform associated with the current map point to identify the MAT, when the wall motion is predominately in the longitudinal direction, and

select a radial component motion waveform associated with the current map point to identify the MAT, when the wall motion is predominately in the radial direction.

20. The system of claim 13, wherein the CPC represents the quality characteristic indicating the clarity of the characteristic of interest in motion waveforms associated with the set of directional motion components.

21. The system of claim 13, wherein the processor is configured to analyze one or more characteristics of interest of motion waveforms for the set of directional motion components to identify the wall motion as predominately along the first or second directions, the characteristics of interest including at least one of angle of a select waveform segment, a presence of notches in a vicinity of onset and/or end systole, a number of peaks/valleys, or a number of changes in slope in motion waveforms.

22. The system of claim 13, wherein the processor is configured to assign a clarity score to each of the set of directional motion components, the CPC based on the clarity scores, the clarity scores indicating a distinctiveness of a characteristic of interest in the set of directional motion components, the processor configured to utilize the clarity scores to identify the wall motion as predominately along the first or second direction.

23. The system of claim 13, wherein the processor is configured to generate motion component waveforms for at least a portion of the select map points based on the collection of PS motion data, the motion component waveforms indicative of motion at the corresponding select map points along the at least corresponding first and second directions.

24. The system of claim 23, wherein the processor is configured to analyze the CPC of the motion component waveforms associated with the current map point, and designate a first motion component waveform from the motion component waveforms based on the analysis of the CPC.