Systems and methods for leveraging IEGM couples to determine ablation sites

• US 10,638,930 B2
• Filed: 12/21/2017
• Issued: 05/05/2020
• Est. Priority Date: 12/21/2017
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Casset, Cyrille, Mangual-Soto, Jan, Richer, Louis-Philippe, Jiang, Chunlan, Markovitz, Craig
• Primary Examiner(s): Voorhees, Catherine M
• Assistant Examiner(s): Dinga, Roland
• Application Number:
  US15/851,352
• Publication Number:
  US 20190192002A1
• Time in Patent Office: 866 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 2017/00053 Mapping
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/15087 short range, e.g. between console and disposable using implanted devices A61B5/150877
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61B 5/6882 Anchoring means
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

The present disclosure provides systems and methods for determining a proposed ablation site in a cardiac chamber. A system includes an implanted device configured to record a plurality of intracardiac electrogram (IEGM) couples, and a mapping and ablation system communicatively coupled to the implanted device. The mapping and ablation system is configured to receive the recorded plurality of IEGM couples from the implanted device, calculate a parameter for each of the plurality of IEGM couples, determine, based on the calculated parameters, an area of origin for each IEGM couple, and determine an intersection between the determined areas of origin, wherein the intersection represents the proposed ablation site in the cardiac chamber.

Claims

1. A system for determining a proposed ablation site in a cardiac chamber, the system comprising:

an implanted device configured to record a plurality of intracardiac electrogram (IEGM) couples; and

a mapping and ablation system communicatively coupled to the implanted device, the mapping and ablation system including a controller configured to;

receive the recorded plurality of IEGM couples from the implanted device;

calculate a parameter for each of the plurality of IEGM couples;

determine, based on the calculated parameters, an area of origin for each IEGM couple; and

determine an intersection between the determined areas of origin, wherein the intersection represents the proposed ablation site in the cardiac chamber.

2. The system of claim 1, wherein each IEGM couple includes a near-field IEGM and a far-field IEGM.

3. The system of claim 1, wherein the implanted device is an implantable cardioverter defibrillator.

4. The system of claim 1, wherein the mapping and ablation system is communicatively coupled to the implanted device using a wireless communication scheme.

5. The system of claim 1, wherein the mapping and ablation system is further configured to:

generate a map of the cardiac chamber including the proposed ablation site; and

display the generated map.

6. The system of claim 5, wherein the generated map includes scar data.

7. The system of claim 1, wherein the implanted device is further configured to define, based on user input, the plurality of IEGM couples to be recorded.

8. The system of claim 1, wherein the parameter includes at least one of i) a time from a far field initial signal to a near field main deflection or ii) a time from the far field initial signal to an end of the signal.

9. The system of claim 1, wherein the area of origin for at least one of the IEGM couples is determined based on a ratio between time measures for signals from the corresponding IEGM couples.

10. A mapping and ablation system for determining a proposed ablation site in a cardiac chamber, the mapping and ablation system comprising:

a memory device; and

a processor communicatively coupled to the memory device, the processor configured to;

receive a plurality of intracardiac electrogram (IEGM) couples recorded by an implanted device;

calculate a parameter for each of the plurality of IEGM couples;

determine, based on the calculated parameters, an area of origin for each IEGM couple; and

determine an intersection between the determined areas of origin, wherein the intersection represents the proposed ablation site in the cardiac chamber.

11. The mapping and ablation system of claim 10, wherein each IEGM couple includes a near-field IEGM and a far-field IEGM.

12. The mapping and ablation system of claim 10, wherein the implanted device is an implantable cardioverter defibrillator.

13. The mapping and ablation system of claim 10, wherein the mapping and ablation system is communicatively coupled to the implanted device using a wireless communication scheme.

14. The mapping and ablation system of claim 10, wherein the mapping and ablation system is further configured to:

generate a map of the cardiac chamber including the proposed ablation site; and

display the generated map.

15. The mapping and ablation system of claim 14, wherein the generated map includes scar data.

16. The mapping and ablation system of claim 10, wherein the parameter includes at least one of i) a time from a far field initial signal to a near field main deflection or ii) a time from the far field initial signal to an end of the signal.

17. The mapping and ablation system of claim 10, wherein the area of origin for at least one of the IEGM couples is determined based on a ratio between time measures for signals from the corresponding IEGM couples.

18. A method for determining a proposed ablation site in a cardiac chamber, the method comprising:

receiving, at a mapping and ablation system, a plurality of intracardiac electrogram (IEGM) couples recorded by an implanted device;

calculating, using the mapping and ablation system, a parameter for each of the plurality of IEGM couples;

determining, using the mapping and ablation system, based on the calculated parameters, an area of origin for each IEGM couple; and

determining, using the mapping and ablation system, an intersection between the determined areas of origin, wherein the intersection represents the proposed ablation site in the cardiac chamber.

19. The method of claim 18, wherein each IEGM couple includes a near-field IEGM and a far-field IEGM.

20. The method of claim 18, wherein the mapping and ablation system receives the plurality of intracardiac electrogram (IEGM) couples from the implanted device using a wireless communication scheme.

21. The method of claim 18, further comprising:

generating a map of the cardiac chamber including the proposed ablation site; and

displaying the generated map.

22. The method of claim 21, wherein generating a map comprises generating a map including scar data.

23. The method of claim 18, wherein the parameter includes at least one of i) a time from a far field initial signal to a near field main deflection or ii) a time from the far field initial signal to an end of the signal.

24. The method of claim 18, wherein the area of origin for at least one of the IEGM couples is determined based on a ratio between time measures for signals from the corresponding IEGM couples.