High Density Atrial Fibrillatrion Cycle Length (AFCL) Detection and Mapping System

• US 20090204113A1
• Filed: 04/05/2009
• Published: 08/13/2009
• Est. Priority Date: 05/17/2004
• Status: Abandoned Application

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: C.R. Bard, Inc. (Becton, Dickinson & Co)
• Inventors: Collins, Tim, He, Ding S., Fanier, Sylvain, MacAdam, David P., Dubois, Remi, Mashimo, Minoru
• Application Number:
  US12/418,601
• Publication Number:
  US 20090204113A1
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 2018/00351 Heart
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/7257 using Fourier transforms

Abstract

Systems and methods to assist in locating the focus of an atrial fibrillation include the association of atrial fibrillation cycle length values and statistics relating thereto with temporal locations on an electrogram of a given electrode, and/or the coordination of electrode locations with respective the spectral analyses of electrogram signals and further parameters and statistics relating thereto. Ablation therapy can proceed under guidance of such information.

Claims

1-26. -26. (canceled)

27. An ablation and mapping procedure, comprising the steps of:

percutaneously advancing a catheter into at least one heart chamber, the catheter having multiple electrodes supported along a distal portion thereof;

associating in a memory of a machine one or more locations of the electrodes within the at least one heart chamber;

capturing electrocardiogram signals associated with at least one electrode of the catheter at one or more of the locations for at least a prescribed time period;

for at least a portion of the captured electrocardiogram signals over at least the prescribed time period, transforming the electrogram signals into a frequency domain representation;

coordinating the frequency domain representation with respective locations of the multiple electrodes to define a set of data points;

outputting a depiction of a heart on a display; and

outputting the data points in the depiction of the heart.

28. A system for performing diagnostics on electrocardiogram data along a distal portion thereof captured by a catheter that supports plural electrodes, comprising:

a monitor operative to display electrophysiology data;

an input configured to accept a time-domain representation of one or more electrocardiogram (EGM) signals obtained by the electrodes at respective different locations within the heart;

a processor connected to receive the signals from the input over a time interval;

software executable by the processor and configured to (i) transform the time-domain EGM signals into a frequency domain representation over at least a portion of the time interval, (ii) identify said respective different locations of each electrode within the heart, (iii) cause a depiction of a heart to be displayed on the monitor, and (iv) include information related to the frequency domain representation in the depiction of the heart in association with said respective different locations of the electrodes at which each EGM signal was obtained.

29. The system of claim 28, wherein the information related to the frequency domain representation is a FFT of at least one of the one or more EGMs.

30. The system of claim 29, wherein the software is further configured to arrange the FFT for display on the monitor as a plot of frequency versus magnitude.

31. The system of claim 28, wherein the software applies a Welch algorithm to the EGMs to obtain the information related to the frequency domain representation.

32. The system of claim 28, further comprising an interface suitable for providing parameters used by the software in transforming the time-domain EGM signals.

33. The system of claim 32, wherein the interface includes controls selectable by a user to invoke pre-transformation processing of the time-domain EGM signals.

34. The system of claim 33, wherein one of the controls of the interface comprises a digital filter adapted to filter the EGM data prior to FFT computation.

35. The system of claim 33, wherein one of the controls of the interface comprises a non-linear function that operates upon the time-domain EGM signals.

36. The system of claim 28, wherein the information related to the frequency domain representation is a numeric frequency value representative of a dominant frequency in the frequency domain representation.

37. The system of claim 28, wherein the information related to the frequency domain representation comprises both a FFT of at least one of the one or more EGMs and a numeric frequency value representative of a dominant frequency in the frequency domain representation.

38. The system of claim 28, wherein the at least a portion of the time interval is no less than about 4 seconds.

39. The system of claim 28, wherein the at least a portion of the time interval is between about 4 seconds and 10 seconds.

40. The system of claim 28, wherein the software is further configured to identify said respective different locations and to simultaneously display on the monitor the information related to the frequency domain representation in association with plural ones of said identified locations.

41. The system of claim 40, wherein the information related to the frequency domain representation is a FFT of at least one of the one or more EGMs.

42. The system of claim 40, wherein the information related to the frequency domain representation is a numeric frequency value representative of a dominant frequency in the frequency domain representation.

43. The system of claim 40, wherein the information related to the frequency domain representation comprises both a FFT of at least one of the one or more EGMs and a numeric frequency value representative of a dominant frequency in the frequency domain representation.

44. The system of claim 40, wherein the software is further configured to arrange the FFT for display on the monitor as a plot of frequency versus magnitude.

45. The system of claim 40, wherein the software applies a Welch algorithm to the EGMs to obtain the information related to the frequency domain representation.

46. The system of claim 40, further comprising an interface suitable for providing parameters used by the software in transforming the time-domain EGM signals.

47. The system of claim 46, wherein the interface includes controls selectable by a user to invoke pre-transformation processing of the time-domain EGM signals.

48. The system of claim 47, wherein one of the controls of the interface comprises a digital filter adapted to filter the EGM data prior to FFT computation.

49. The system of claim 47, wherein one of the controls of the interface comprises a non-linear function that operates upon the time-domain EGM signals.

50. The system of claim 40, wherein the at least a portion of the time interval is no less than about 4 seconds.

51. The system of claim 40, wherein the at least a portion of the time interval is between about 4 seconds and about 10 seconds.

52. The system of claim 28, wherein the software is further configured to include visual representations of each electrode in the depiction of the heart in association with the respective different identified locations.

53. The system of claim 28, wherein the software is further configured to include a visual representation of the catheter in the depiction of the heart in association with a location of the catheter when the time-domain representation of one or more ECM signals is obtained.

54. The system of claim 28, wherein the information related to the frequency domain representation includes one or more indicators that are representative of the frequency domain transformation.

55. The system of claim 52, wherein the indicators comprise colors such that each color represents a different value in the frequency domain representation.

56. The system of claim 52, wherein the indicators comprise isochronal bands each representing a different value in the frequency domain representation.

57. A system for performing diagnostics on electrocardiogram data along a distal portion thereof captured by a catheter that supports plural electrodes, comprising:

a monitor operative to display electrophysiology data;

an input configured to accept a time-domain representation of one or more electrocardiogram (EGM) signals obtained by the electrodes at respective different locations within the heart;

a processor connected to receive the signals from the input over a time interval;

software executable by the processor and configured to (i) transform at least one time-domain EGM signal into a frequency domain representation over at least a portion of the time interval, (ii) identify said respective different locations of each electrode within the heart, (iii) cause a depiction of a heart to be displayed on the monitor, and (iv) cause information related to the frequency domain representation to be displayed on the monitor in association with the location of each electrode at which the EGM signal was obtained.

58. The system of claim 57, wherein the software is further configured to include visual representations of each electrode in the depiction of the heart in association with the respective different identified locations.

59. The system of claim 57, wherein the software is further configured to include a visual representation of the catheter in the depiction of the heart in association with a location of the catheter when the time-domain representation of one or more ECM signals is obtained.

60. The system of claim 57, wherein the information related to the frequency domain representation includes one or more indicators that are representative of the frequency domain transformation.

61. The system of claim 58, wherein the indicators comprise colors such that each color represents a different value in the frequency domain representation.

62. The system of claim 58, wherein the indicators comprise isochronal bands each representing a different value in the frequency domain representation.