System and method of identifying sources associated with biological rhythm disorders

• US 10,434,319 B2
• Filed: 05/02/2017
• Issued: 10/08/2019
• Est. Priority Date: 10/09/2009
• Status: Active Grant

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Narayan, Sanjiv M., Briggs, Carey Robert, Sehra, Ruchir
• Primary Examiner(s): Levicky, William J
• Application Number:
  US15/585,091
• Publication Number:
  US 20170232263A1
• Time in Patent Office: 889 Days
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/3712 Auto-capture, i.e. automatic adjustment of the stimulation threshold
• CPC Class Codes: A61N 1/378 Electrical supply

Abstract

An example system and method associated with identifying and treating a source of a heart rhythm disorder are disclosed. In accordance therewith, a spatial element associated with a region of the heart is selected. Progressive rotational activations or progressive focal activations are determined in relation to the selected spatial element over a period of time. The selecting and determining are repeated over multiple periods of time. A source parameter of rotation activations or focal activations is determined, wherein the source parameter indicates consistency of successive rotational activations or focal activations in relation to a portion of the region of the heart. The determining of a source parameter is repeated for multiple regions of the heart. Thereafter, representation of the source parameter is displayed for each of the multiple regions of the heart to identify a shape representing the source of the heart rhythm disorder.

Claims

1. A method associated with identifying a source of a heart rhythm disorder, the method comprising a computing device:

selecting a spatial element associated with a region of the heart;

determining progressive rotational activations or progressive focal activations in relation to the selected spatial element over a period of time;

repeating the selecting and determining over multiple periods of time;

determining an index of rotational activations or focal activations, wherein the index indicates consistency of successive rotational activations or focal activations in relation to a portion of the region of the heart;

repeating the determining of an index for multiple regions of the heart; and

displaying a representation of the index for each of the multiple regions of the heart to identify a shape representing the source of the heart rhythm disorder.

2. The method of claim 1, wherein the index is associated with a frequency of successive rotational activations in the region of the heart.

3. The method of claim 1, wherein the index is associated with a frequency of progressive angular displacement in the region of the heart.

4. The method of claim 1, wherein the index is a regularity with which the rotational activations or focal activations are present.

5. The method of claim 4, wherein the regularity is one of periodicity, repetitiveness, and/or frequency of occurrence of rotational or focal activations.

6. The method of claim 1, wherein displaying the representation of the index comprises displaying a representation of an arithmetic mean of the index of the region over time.

7. The method of claim 1, wherein displaying the representation of the index comprises displaying a representation of a geometric mean of the index of the region over time.

8. The method of claim 1, wherein displaying the representation of the index comprises displaying a representation of a weighted average of the index of the region over time.

9. The method of claim 1, further comprising displaying the representation of the index on at least one of an isolated display, a three-dimensional abstract representation, a three-dimensional representation of the cardiac tissue or a polar representation.

10. A system associated with identifying a source of a heart rhythm disorder, the system comprising:

a processor; and

a memory storing instructions that, when executed by the processor, cause the processor to perform operations comprising;

selecting a spatial element associated with a region of the heart;

determining progressive rotational activations or progressive focal activations in relation to the selected spatial element over a period of time;

repeating the selecting and determining over multiple periods of time;

determining an index of rotational activations or focal activations, wherein the index indicates consistency of successive rotational activations or focal activations in relation to a portion of the region of the heart;

repeating the determining of an index for multiple regions of the heart; and

displaying a representation of the index for each of the multiple regions of the heart to identify a shape representing the source of the heart rhythm disorder.

11. The system of claim 10, wherein the index is associated with a frequency of successive rotational activations in the region of the heart.

12. The system of claim 10, wherein the index is associated with a frequency of progressive angular displacement in the region of the heart.

13. The system of claim 10, wherein the index is a regularity with which the rotational activations or focal activations are present.

14. The system of claim 13, wherein the regularity is one of periodicity, repetitiveness, and/or frequency of occurrence of rotational or focal activations.

15. The system of claim 10, wherein displaying the representation of the index comprises displaying a representation of an arithmetic mean of the index of the region over time.

16. The system of claim 10, wherein displaying the representation of the index comprises displaying a representation of a geometric mean of the index of the region over time.

17. The system of claim 10, wherein displaying the representation of the index comprises displaying a representation of a weighted average of the index of the region over time.

18. The system of claim 10, wherein the representation of the index is displayed on at least one of an isolated display, a three-dimensional abstract representation, a three-dimensional representation of the cardiac tissue or a polar representation.

19. A non-transitory storage medium storing instructions that, when executed by a processor, cause the processor to perform operations associated with identifying a source of a heart rhythm disorder, the operations comprising:

selecting a spatial element associated with a region of the heart;

determining progressive rotational activations or progressive focal activations in relation to the selected spatial element over a period of time;

repeating the selecting and determining over multiple periods of time;

determining an index of rotational activations or focal activations, wherein the index indicates consistency of successive rotational activations or focal activations in relation to a portion of the region of the heart;

repeating the determining of an index for multiple regions of the heart; and

displaying a representation of the index for each of the multiple regions of the heart to identify a shape representing the source of the heart rhythm disorder.

20. The storage medium of claim 19, wherein the index is associated with a frequency of successive rotational activations in the region of the heart.

21. The storage medium of claim 19, wherein the index is associated with a frequency of progressive angular displacement in the region of the heart.

22. The storage medium of claim 19, wherein the index is a regularity with which the rotational activations or focal activations are present.

23. The storage medium of claim 22, wherein the regularity is one of periodicity, repetitiveness, and/or frequency of occurrence of rotational or focal activations.

24. The storage medium of claim 19, wherein displaying the representation of the index comprises displaying a representation of an arithmetic mean of the index of the region over time.

25. The storage medium of claim 19, wherein displaying the representation of the index comprises displaying a representation of a geometric mean of the index of the region over time.

26. The storage medium of claim 19, wherein displaying the representation of the index comprises displaying a representation of a weighted average of the index of the region over time.

27. The storage medium of claim 19, wherein the representation of the index is displayed on at least one of an isolated display, a three-dimensional abstract representation, a three-dimensional representation of the cardiac tissue or a polar representation.

28. A method of identifying and treating a source of a heart rhythm disorder, the method comprising a computing device:

selecting a spatial element associated with a region of the heart;

determining progressive rotational activations or progressive focal activations in relation to the selected spatial element over a period of time;

repeating the selecting and determining over multiple periods of time;

determining an index of rotational activations or focal activations, wherein the index indicates consistency of successive rotational activations or focal activations in relation to a portion of the region of the heart;

repeating the determining of an index for multiple regions of the heart;

displaying a representation of the index for each of the multiple regions of the heart to identify a shape representing the source of the heart rhythm disorder; and

selectively modifying a region of the heart associated with the shape in order to terminate or alter the heart rhythm disorder.