System and method for targeting heart rhythm disorders using shaped ablation

• US 10,485,438 B2
• Filed: 05/11/2017
• Issued: 11/26/2019
• 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: Regents of the University of California (University of California)
• Inventors: Narayan, Sanjiv M., Briggs, Carey Robert
• Primary Examiner(s): Bockelman, Mark
• Application Number:
  US15/593,135
• Publication Number:
  US 20170245774A1
• Time in Patent Office: 929 Days
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/4029 for evaluating the peripheral nervous systems A61B5/24 takes precedence
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61M 5/00 Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests vaccination appliances for veterinary use A61D1/025 ; tube connectors, tube couplings, valves or branch units specially adapted for medical use A61M39/00; containers specially adapted for medical or pharmaceutical purposes A61J1/00; combinations of vial and syringe for mixing or transferring their contents A61J1/20; holders for containers for collecting, storing or administering blood or medical fluids A61J1/16
• CPC Class Codes: A61N 1/0565 Electrode heads

Abstract

A system and method to target a biological rhythm disorder include processing cardiac signals via a computing device to determine a shape in a region of tissue defined by a source associated with the biological rhythm disorder that migrates spatially on or within the shape, and identifying at least one portion of the tissue proximate to the shape to enable selective modification of the at least one portion of tissue in order to terminate or alter the biological rhythm disorder.

Claims

1. A method of targeting a biological rhythm disorder, the method comprising:

obtaining biological signals from a patient via a plurality of biological signal sensors,

processing the biological signals via a computing device to determine a shape in a region of tissue defined by migration of a source associated with the biological rhythm disorder;

identifying via the computing device at least one portion of the tissue proximate to the shape, the at least one portion being associated with terminating or altering the biological rhythm disorder; and

generating a clinical representation of the at least one portion to guide treatment of the biological rhythm disorder.

2. The method of claim 1, wherein the source causes the biological rhythm disorder.

3. The method of claim 1, wherein a portion identified is at least one of within the shape and on the shape.

4. The method of claim 1, wherein a portion identified is outside the shape.

5. The method of claim 1, wherein a first portion of the tissue identified is at least one of within the shape and on the shape, and a second portion of the tissue identified is outside the shape.

6. The method of claim 1, wherein migration of the source includes one of:

an impulse generator that migrates within or on the shape;

a fixed impulse generator that generates multiple excitation waves within or on the shape; and

at least one reentrant impulse generator that generates multiple excitation waves within or on the shape.

7. The method of claim 1, wherein determination of the shape includes:

identifying at least one spatial point in relation to the region at a point in time, the at least one spatial point associated with the source;

tracking migration of the at least one spatial point over multiple points in time associated with one or more activations in the biological signals to define a plurality of spatial points;

connecting the plurality of spatial points to form at least one path; and

defining the shape around the at least one path.

8. The method of claim 1, further comprising refining the shape based on one or more of width, height, depth, and tissue type associated with the spatial migration of the source.

9. The method of claim 1, wherein the region is associated with one or more of an organ, nerves that supply regions of the organ, regions of a brain that control the nerves, blood vessels that supply regions of the organ, and tissues adjacent to the organ.

10. The method of claim 1, further comprising modifying the at least one portion of the tissue in order to terminate or alter the biological rhythm disorder.

11. A system to target a biological rhythm disorder, the system comprising:

a plurality of biological signal sensors capable of placement in or on a patient to obtain biological signals from the patient, and

a computing device configured to;

process the biological signals to determine a shape in a region of tissue defined by migration of a source associated with the biological rhythm disorder;

identify at least one portion of the tissue proximate to the shape, the at least one portion being associated with terminating or altering the biological rhythm disorder; and

generate a clinical representation of the at least one portion to guide treatment of the biological rhythm disorder.

12. The system of claim 11, wherein the source causes the biological rhythm disorder.

13. The system of claim 11, wherein a portion identified is at least one of within the shape and on the shape.

14. The system of claim 11, wherein a portion identified is outside the shape.

15. The system of claim 11, wherein a first portion of the tissue identified is at least one of within the shape and on the shape, and a second portion of the tissue identified is outside the shape.

16. The system of claim 11, wherein migration includes one of:

an impulse generator that migrates within or on the shape;

a fixed impulse generator that generates multiple excitation waves within or on the shape; and

at least one reentrant impulse generator that generates multiple excitation waves within or on the shape.

17. The system of claim 11, wherein to determine the shape the computing device is configured to:

identify at least one spatial point in relation to the region at a point in time, the at least one spatial point associated with the source;

track migration of the at least one spatial point over multiple points in time associated with one or more activations in the biological signals to define a plurality of spatial points;

connect the plurality of spatial points to form at least one path; and

define the shape around the at least one path.

18. The system of claim 11, wherein the computing device is further configured to refine the shape based on one or more of width, height, depth, and tissue type associated with the spatial migration of the source.

19. The system of claim 11, wherein the region is associated with in one or more of an organ, nerves that supply regions of the organ, regions of a brain that control the nerves, blood vessels that supply regions of the organ, and tissues adjacent to the organ.

20. The system of claim 11, further comprising a catheter configured to modify the at least one portion of tissue in order to terminate or alter the biological rhythm disorder.

21. The system of claim 20, wherein the catheter comprises:

a plurality of sensors in a first spatial relationship; and

a circuit configured to;

receive data from the computing device that indicates at least one of the shape and the at least one portion proximate to the shape; and

adjust the first spatial relationship of the plurality of sensors to a second spatial relationship of the plurality of sensors based on the data to approximate at least one of the shape and the at least one portion proximate to the shape.

22. The system of claim 11, wherein the computing device comprises a computer readable medium comprising instructions that, when executed by the at least one computing device, cause the at least one computing device to determine the shape and identify the at least one portion proximate to the shape.