Identification of fractionated signals

• US 10,314,542 B2
• Filed: 01/12/2017
• Issued: 06/11/2019
• Est. Priority Date: 01/14/2016
• Status: Active Grant

• Current Assignee: Biosense Webster Israel Ltd. (Johnson & Johnson)
• Original Assignee: Biosense Webster Israel Ltd. (Johnson & Johnson)
• Inventors: Bar-Tal, Meir, Houben, Richard P. M., Ben Zrihem, Yaniv, Goldberg, Stanislav, Urman, Roy
• Primary Examiner(s): Bockelman, Mark
• Application Number:
  US15/404,244
• Publication Number:
  US 20170202516A1
• Time in Patent Office: 880 Days
• 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 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• 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 5/6852 Catheters

Abstract

A system and method of determining regions of interest for heart ablation using fractionation. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals, each ECG signal detected via one of the sensors and indicating electrical activity of a heart, determining, for each of the ECG signals, activation times (LATs) each indicating a time of activation of a corresponding ECG signal, generating, based on the determined LATs of each of the ECG signals, one or more driver maps and one or more perpetuator maps, each representing the electrical activity of the heart, deriving parameters from the driver and perpetuator maps, using at least fractionation, processing and combining the derived parameters into driver evidence and perpetuator evidence, and determining the regions of interest for heart ablation in accordance with the fractionation used to derive the driver evidence and the perpetuator evidence.

Claims

1. A computer implemented method of determining regions of interest for cardiac ablation using fractionation which improves performance of a processing system, the method comprising:

detecting, via a plurality of sensors, electro-cardiogram (ECG) signals, each ECG signal detected via one of the plurality of sensors and indicating electrical activity of a heart;

determining, for each of the plurality of ECG signals, one or more local activation times (LATs) each indicating a time of activation of a corresponding ECG signal;

generating, based on the determined one or more LATs of each of the plurality of ECG signals, one or more driver maps and one or more perpetuator maps, each representing the electrical activity of the heart;

deriving parameters, comprising fractionated ECG signal potentials, from the perpetuator maps by;

comparing an ECG signal potential within a fractionation window to a plurality of stored signal potential templates;

selecting one of the stored signal potential templates according to a level of resemblance to the ECG signal within the fractionation window; and

displaying a mapping, using the derived parameters, which indicates driver evidence and perpetuator evidence of areas of fractionation,

wherein the regions of interest for cardiac ablation are determined in accordance with the areas of fractionation.

2. The method of claim 1, further comprising:

deriving the parameters by;

filtering the LATs and removing non-fractionated LATs comprising non-fractionated single potentials, short double potentials and long double potentials.

3. The method of claim 1, further comprising displaying, on a display device, the regions of interest.

4. A computer implemented method of determining regions of interest for cardiac ablation using fractionation which improves performance of a processing system, the method comprising:

detecting, via a plurality of sensors, electro-cardiogram (ECG) signals, each ECG signal detected via one of the plurality of sensors and indicating electrical activity of a heart;

determining, for each of the plurality of ECG signals, one or more local activation times (LATs) each indicating a time of activation of a corresponding ECG signal;

generating, based on the determined one or more LATs of each of the plurality of ECG signals, one or more driver maps and one or more perpetuator maps, each representing the electrical activity of the heart;

deriving parameters, comprising fractionated ECG signal potentials, from the perpetuator maps by;

determining peaks and valleys of an ECG signal within windows of fractionation;

calculating a number of fractionation slopes of the ECG signal between the peaks and valleys of the ECG ECG signal;

comparing the number of fractionation slopes to a predetermined threshold;

determining an ECG signal to be a fractionated signal if the number of fractionation slopes is greater than a predetermined threshold; and

displaying a fractionation map of the ECG signal,

wherein the regions of interest for cardiac ablation are determined from the fractionation map.

5. The method of claim 4, further comprising:

calculating incidence using the detected peak valleys;

calculating incidence fractionation far field for single potential slopes using the incidence.

6. The method of claim 4, further comprising:

converting slopes between the peaks and valleys into potentials using a time gate comprising temporal grouping of primary and secondary slopes;

grouping the potentials into groups of consecutive slopes within a predetermined interval; and

analyzing the potentials as slope types in accordance with the groupings.

7. The method of claim 6, wherein each group comprises one of a single slope group, a short double slope group, a long double slope group and a two slope group.

8. A system of determining regions of interest for cardiac ablation using fractionation which improves processing performance, the system comprising:

a plurality of sensors, each configured to detect one of a plurality of electro-cardiogram (ECG) signals over time, each ECG signal indicating electrical activity of a heart;

a processing device comprising one or more processor configured to;

determine, for each of the plurality of ECG signals, one or more local activation times (LATs) each indicating a time of activation of a corresponding ECG signal;

generate, based on the determined one or more LATs of each of the plurality of ECG signals, one or more driver maps and one or more perpetuator maps, each representing the electrical activity of the heart;

derive parameters, comprising fractionated ECG signal potentials, from the perpetuator maps by;

comparing an ECG signal potential within a fractionation window to a plurality of stored signal potential templates; and

selecting one of the stored signal potential templates according to a level of resemblance to the ECG signal within the fractionation window; and

a display device configured to display a mapping, using the derived parameters, which indicates driver evidence and perpetuator evidence of areas of fractionation,

wherein the regions of interest for cardiac ablation are determined in accordance with the areas of fractionation.

9. The system of claim 8, wherein the processing device is further configured to:

deriving the parameters by;

filtering the LATs and removing non-fractionated LATs comprising non-fractionated single potentials, short double potentials and long double potentials.

10. The system of claim 8, wherein the display device is configured to display the regions of interest.

11. A system of determining regions of interest for cardiac ablation using fractionation which improves processing performance, the system comprising:

a plurality of sensors, each configured to detect one of a plurality of electro-cardiogram (ECG) signals over time, each ECG signal indicating electrical activity of a heart;

a processing device configured to;

detect, via a plurality of sensors, electro-cardiogram (ECG) signals, each ECG signal detected via one of the plurality of sensors and indicating electrical activity of a heart;

determine, for each of the plurality of ECG signals, one or more local activation times (LATs) each indicating a time of activation of a corresponding ECG signal;

generate, based on the determined one or more LATs of each of the plurality of ECG signals, one or more driver maps and one or more perpetuator maps, each representing the electrical activity of the heart;

derive parameters, comprising fractionated ECG signal potentials, from the perpetuator maps by;

determining peaks and valleys of an ECG signal within windows of fractionation;

calculating a number of fractionation slopes of the ECG signal between the peaks and valleys of the ECG ECG signal;

comparing the number of fractionation slopes to a predetermined threshold;

determining an ECG signal to be a fractionated signal if the number of fractionation slopes is greater than a predetermined threshold; and

displaying a fractionation map of the ECG signal,

wherein the regions of interest for cardiac ablation are determined from the fractionation map.

12. The system of claim 11, wherein the processing device is further configured to:

calculate incidence using the detected peak valleys;

calculate incidence fractionation far field for single potential slopes using the incidence.

13. The system of claim 11, wherein the processing device is further configured to:

convert slopes between the peaks and valleys into potentials using a time gate comprising temporal grouping of primary and secondary slopes;

group the potentials into groups of consecutive slopes within a predetermined interval; and

analyze the potentials as slope types in accordance with the groupings.

14. The system of claim 13, wherein each group comprises one of a single slope group, a short double slope group, a long double slope group and a two slope group.