ELECTROANATOMICAL MAPPING

• US 20150112178A1
• Filed: 12/31/2014
• Published: 04/23/2015
• Est. Priority Date: 01/13/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Rhythmia Medical, Inc. (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Stewart, Brian
• Granted Patent: US 9,289,148 B2
• Time in Patent Office: Days
• US Class Current: 600/374
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 2560/0295 adapted for recording user messages or annotations
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0536 Impedance imaging, e.g. by tomography
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/343 Potential distribution indication
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/367 Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7242 using integration
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 5/7475 : User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61B 6/00 : Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment instruments measuring radiation intensity for application in the field of nuclear medicine, e.g. in vivo counting, G01T1/161; apparatus for taking X-ray photographs G03B42/02
• CPC Class Codes: G06T 19/00 : Manipulating 3D models or images for computer graphics
• CPC Class Codes: G06T 2219/004 : Annotating, labelling
• CPC Class Codes: G16H 10/60 : for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 : ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

This invention relates to the determination and/or representation of physiological information relating to a heart surface.

Claims

1. A method for providing information about a patient'"'"'s heart, the method comprising:

measuring signals from one or more electrodes at multiple positions in the heart cavity in response to electrical activity in the patient'"'"'s heart cavity over multiple heart beat cycles;

generating, by a computer, annotation information for the measured signals by applying one or more operators to the measured signals;

receiving, from an operator, a change to the annotation information for a specified measured signal;

modifying, by the computer, annotation information for one or more neighboring additional measured signals based on the change to generate modified annotation information; and

generating, by the computer, an electroanatomical representation of the patient'"'"'s heart that includes at least some of the annotation information and at least some of the modified annotation information.

2. The method of claim 1, wherein generating the annotation information comprises:

identifying a time annotation for at least one electrogram.

3. The method of claim 1, wherein:

receiving, from the operator, the change to the annotation information includes receiving, from the operator, a change to an activation time for a specified measured signal; and

wherein modifying the annotation information includes automatically adjusting activation times for one or more neighboring additional measured signals based on the operator change.

4. The method of claim 1, wherein generating the annotation information comprises:

identifying at least one region of the heart having fractionation.

5. The method of claim 1, wherein generating the annotation information comprises:

identifying at least one of a region of the heart having double deflections, a region of the heart having multiple deflections, a region of the heart having fractionation, a region of the heart having double activation, and a region of the heart having no activation.

6. The method of claim 1, wherein generating the annotation information comprises:

identifying at least one of a region of the heart having early deflections, a region of the heart having late deflections, and a region of the heart having far field effects with no activation.

7. The method of claim 1, wherein modifying the annotation information for one or more additional measured signals comprises automatically adjusting annotation information for one or more neighboring additional measured signals in at least one of spatial proximity and temporal proximity to the specified measured signal.

8. A method for providing information about a patient'"'"'s heart, the method comprising:

measuring signals from one or more electrodes at multiple positions in the heart cavity in response to electrical activity in the patient'"'"'s heart cavity over multiple heart beat cycles;

generating, by a computer, annotation information for the measured signals by applying one or more operators to the measured signals to identify at least one of a region of the heart having early deflections and a region of the heart having late deflections;

receiving, from an operator, a change to the annotation information for a specified measured signal;

modifying, by the computer, annotation information for one or more neighboring additional measured signals based on the change to generate modified annotation information; and

generating, by the computer, an electroanatomical representation of the patient'"'"'s heart that includes at least some of the annotation information.

9. The method of claim 8, wherein:

generating the annotation information comprises applying an algorithm to the measured signals to detect an early deflection; and

generating the electroanatomical representation comprises identifying a region of early deflections.

10. The method of claim 8, wherein:

generating the annotation information comprises applying an algorithm to the measured signals to detect a late deflection; and

generating the electroanatomical representation comprises identifying a region of late deflections.

11. The method of claim 8, wherein modifying the annotation information for one or more neighboring additional measured signals comprises automatically adjusting annotation information for one or more neighboring additional measured signals in spatial proximity to the specified measured signal.

12. The method of claim 8, wherein generating the annotation information comprises generating annotation information based on a specified electrogram and spatially or temporally neighboring electrograms.

13. The method of claim 8, wherein generating the annotation information comprises generating annotation information for a specific location of the endocardium based on the signals measured at an electrode location corresponding to the specific location and signals measured at one or more additional electrodes at locations in spatial proximity to the electrode location corresponding to the specific location.

14. The method of claim 8, wherein generating the annotation information comprises generating annotation information for a specific location of the endocardium based on the signals measured at an electrode location corresponding to the specific beat and signals measured at one or more previous beats at the same electrode.

15. A system for providing information about a patient'"'"'s heart, the system comprising:

one or more electrodes for measuring signals at multiple positions in the heart cavity in response to electrical activity in the patient'"'"'s heart cavity over multiple heart beat cycles; and

an electronic processor coupled to the one or more electrodes, wherein the electronic processor is configured to;

generate annotation information for the measured signals by applying one or more operators to the measured signals to identify a time annotation for at least one electrogram;

receive, from an operator, a change to the automatically generated annotation information for a specified measured signal;

modify annotation information for one or more neighboring additional measured signals based on the change to generate modified annotation information; and

generate an electroanatomical representation of the patient'"'"'s heart that includes at least some of the annotation information.

16. The system of claim 15, wherein the electronic processor is configured to:

receive, from the operator, a change to an activation time for the specified measured signal; and

automatically adjust activation times for one or more neighboring additional measured signals based on the operator change to the activation time.

17. The system of claim 15, wherein the electronic processor is configured to generate the annotation information to identify at least one of a region of the heart having double deflections, a region of the heart having multiple deflections, a region of the heart having fractionation, a region of the heart having double activation, a region of the heart having no activation, a region of the heart having early deflections, a region of the heart having late deflections, and a region of the heart having far field effects with no activation.

18. The system of claim 15, wherein the electronic processor is configured to adjust the annotation information for one or more neighboring additional measured signals by automatically adjusting annotation information for one or more neighboring additional measured signals in spatial proximity to the specified measured signal.

19. The system of claim 15, wherein the electronic processor is configured to generate the annotation information by generating annotation information for a specific location of the endocardium based on the signals measured at an electrode location corresponding to the specific location and signals measured at one or more additional electrodes at locations in spatial proximity to the electrode location corresponding to the specific location.

20. The system of claim 15, wherein the electronic processor is configured to generate the annotation information by generating annotation information for a specific location of the endocardium based on the signals measured at an electrode location corresponding to the specific beat and signals measured at one or more previous beats at the same electrode.