System and Method for Targeting Heart Rhythm Disorders Using Shaped Ablation

• US 20130006131A1
• Filed: 05/02/2012
• Published: 01/03/2013
• 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), United States Department of Veterans Affairs Office of General Counsel, Regents of the University of California (University of California)
• Original Assignee: Topera, Inc (Abbott Laboratories), Regents of the University of California (University of California)
• Inventors: Narayan, Sanjiv, Briggs, Carey Robert
• Granted Patent: US 9,282,910 B2
• Time in Patent Office: Days
• US Class Current: 600/508
• 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

Provided is a system and method to target a biological rhythm disorder, such as a heart rhythm disorder. The system and method 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 heart rhythm disorder.

Claims

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

processing cardiac signals via a computing device to determine a shape in a region of tissue defined by a source associated with the cardiac 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 in order to terminate or alter the heart rhythm disorder.

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

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

4. The method of claim 1, wherein a portion of the tissue 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 the source that migrates spatially includes one of:

an impulse generator that migrates within or 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 shape.

7. The method of claim 1, wherein shape is determined by:

identifying at least one spatial point in the region of tissue 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 cardiac activations 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 heart rhythm disorder comprises one or more of atrial fibrillation, ventricular fibrillation, atrial tachycardia, atrial flutter, ventricular tachycardia, ventricular flutter, or other electrical disturbance within the heart.

10. The method of claim 1, wherein the region of tissue lies in one or more of the heart, nerves that supply regions of the heart, regions of the brain that control the nerves, blood vessels that supply regions of the heart, and tissues adjacent to the heart.

11. The method of claim 1, further comprising modifying the at least one portion of the tissue.

12. The method of claim 11, wherein modifying comprises destroying the at least one portion of the tissue.

13. The method of claim 11, wherein modifying the at least one portion comprises delivery of one or more of ablation, electrical therapy, mechanical therapy, drug therapy, gene therapy, and stem cell therapy.

14. The method of claim 1, further comprising selectively modifying one or more portions of a plurality of portions of the tissue identified.

15. The method of claim 14, wherein modifying comprises destroying the one or more portions.

16. A system to target a heart rhythm disorder, the system comprising:

at least one computing device configured to;

process cardiac signals to determine a shape in a region of tissue defined by a source associated with the heart rhythm disorder that migrates spatially on or within the shape; and

identify at least one portion of the tissue proximate to the shape to enable selective modification of the at least one portion in order to terminate or alter the heart rhythm disorder.

17. The system of claim 16, wherein the source causes the heart rhythm disorder.

18. The system of claim 16, wherein a portion of the tissue identified is at least one of within the shape and on the shape.

19. The method of claim 16, wherein a portion of the tissue identified is outside the shape.

20. The method of claim 16, 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.

21. The system of claim 16, wherein the source that migrates spatially includes one of:

an impulse generator that migrates within or 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 shape.

22. The system of claim 16, wherein to determine the shape the at least one computing device is configured to:

identify at least one spatial point in the region of tissue 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 cardiac activations 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.

23. The system of claim 16, wherein the at least one 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.

24. The system of claim 16, wherein the heart rhythm disorder comprises one or more of atrial fibrillation, ventricular fibrillation, atrial tachycardia, atrial flutter, ventricular tachycardia, ventricular flutter, or other electrical disturbance within the heart.

25. The system of claim 16, wherein the region of tissue lies in one or more of the heart, nerves that supply regions of the heart, regions of the brain that control the nerves, blood vessels that supply regions of the heart, and tissues adjacent to the heart.

26. The system of claim 16, further comprising a catheter configured to modify the at least one portion of the tissue.

27. The system of claim 26, wherein modification comprises destruction of the at least one portion of the tissue.

28. The system of claim 26, wherein modification of the at least one portion comprises the device delivering one or more of ablation, electrical therapy, mechanical therapy, drug therapy, gene therapy, and stem cell therapy.

29. The system of claim 16, further comprising a catheter configured to selectively modify one or more portions of a plurality of portions of the tissue identified.

30. The system of claim 16, wherein the catheter comprises:

a plurality of sensors in a first spatial relationship; and

a circuit configured to;

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

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

31. A non-transitory computer readable medium comprising instructions that, when executed by a computing device, cause the computing device to:

process cardiac signals to determine a shape in a region of tissue defined by a source associated with a heart rhythm disorder that migrates spatially on or within the shape; and

identify at least one portion of the tissue proximate to the shape to enable selective modification of the at least one portion in order to terminate or alter the heart rhythm disorder.

32. The medium of claim 31, wherein the source causes the heart rhythm disorder.

33. The medium of claim 31, wherein a portion of the tissue identified is at least one of within the shape and on the shape.

34. The medium of claim 31, wherein a portion of the tissue identified is outside the shape.

35. The medium of claim 31, 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.

36. The medium of claim 31, wherein the source that migrates spatially includes one of:

an impulse generator that migrates within or 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 shape.

37. The medium of claim 31, wherein instructions to determine shape cause the computing device to:

identify at least one spatial point in the region of tissue 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 cardiac activations 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.

38. The medium of claim 31, further comprising instructions that, when executed by a computing device, cause the computing device to refine the shape based on one or more of width, height, depth, and tissue type associated with the spatial migration of the source.

39. The medium of claim 31, wherein the heart rhythm disorder comprises one or more of atrial fibrillation, ventricular fibrillation, atrial tachycardia, atrial flutter, ventricular tachycardia, ventricular flutter, or other electrical disturbance within the heart.

40. The medium of claim 31, wherein the region of tissue lies in one or more of the heart, nerves that supply regions of the heart, regions of the brain that control the nerves, blood vessels that supply regions of the heart, and tissues adjacent to the heart.

41. The medium of claim 31, further comprising instructions that, when executed by the computing device, cause the computing device to output data that indicates at least one of the shape and the at least one portion of the tissue proximate to the shape to enable modification of the at least one portion of the tissue.

42. The medium of claim 41, wherein modification comprises destruction of the at least one portion of the tissue.

43. The medium of claim 41, wherein modification of the at least one portion comprises delivery of one or more of ablation, electrical therapy, mechanical therapy, drug therapy, gene therapy, and stem cell therapy.

44. The medium of claim 31, further comprising instructions that, when executed by the computing device, cause the computing device to output data to enable selective modification of one or more portions of a plurality of portions of the tissue identified.

45. The medium of claim 44, wherein modification comprises destruction of the one or more portions.

46. A method of targeting a heart rhythm disorder, the method comprising:

receiving signals in a computing device over a network, the signals associated with a biological rhythm disorder of an organ;

processing the signals in the 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 within the shape;

identifying at least one portion of the tissue proximate to the shape for selective modification of the at least one portion; and

transmitting data from the computing device to a second computing device over the network, the data indicating at least one of the shape and the at least one portion proximate to the shape to enable selective modification of the at least one portion to terminate or alter the biological rhythm disorder.

47. A system to target a heart rhythm disorder, the system comprising:

a computing device configured to;

receive signals from a second computing device over a network, the signals associated with a biological rhythm disorder of an organ;

process the signals to determine a shape in a region of tissue defined by a source associated with the biological rhythm disorder that migrates spatially on within the shape;

identify at least one portion of the tissue proximate to the shape for selective modification of the at least one portion; and

transmit data to the second computing device over the network, the data indicating at least one of the shape and the at least one portion proximate to the shape to enable selective modification of the at least one portion to terminate or alter the biological rhythm disorder.