Comparative analysis of body surface potential distribution during cardiac pacing
First Claim
1. A method of locating a position of interest in the heart of a patient and in positioning a surgical instrument at this position, comprising the steps of:
- A. placing a plurality of electrodes on the surface of said patient in the area of the torso of the patient;
B. obtaining readouts from said electrodes during a pre-excitation phase or at the onset of an abnormal beat and forming therefrom a first body surface potential map (BSPM);
C. estimating said position of interest from said first BSPM;
D. placing said surgical instrument at said estimated position;
E. pacing the heart of said patient with an electrical signal applied through said surgical instrument;
F. obtaining readouts from said electrodes during said paced phase and forming a further BSPM therefrom;
G. determining from said further BSPM, when compared with the first BSPM, if the surgical instrument is in the correct position;
H. if the instrument is not in the correct position, moving the instrument in a direction as indicated by the comparison of the further BSPM with the first BSPM;
I. repeating steps E. to G. until the surgical instrument is at the position of interest.
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Accused Products
Abstract
Body surface potential map (BSPM) pace-mapping is a system and method that can be used in medicine to localize with precision the site of origin of abnormal cardiac electrical activity and to guide the positioning of a catheter over this site of origin, such as the site of ventricular preexcitation in patients with the Wolff-Parkinson-White syndrome or the focus of ectopic activity in patients with tachycardia. Body surface potential distributions are measured with a large number of electrodes, e.g. 24 to 128, distributed over the entire torso surface. The electrical signals are first amplified, converted into digital data and treated to remove electrical or muscle artifacts. Data recorded during abnormal activation (reference beat) are aligned with data recorded during cardiac pacing (paced beat) so as to maximize the average value of the correlation coefficient between the reference and the paced potential distributions during a preset time interval following the beginning of the QRS complex. Reference and paced maps showing color-coded isopotential contour lines are displayed side by side for the same time instant. Visual analysis of these maps according to previously published criteria determines the relative position of the pacing catheter with respect to the focus of abnormal activation, and gives information so as to guide the catheter toward the focus.
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Citations
21 Claims
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1. A method of locating a position of interest in the heart of a patient and in positioning a surgical instrument at this position, comprising the steps of:
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A. placing a plurality of electrodes on the surface of said patient in the area of the torso of the patient; B. obtaining readouts from said electrodes during a pre-excitation phase or at the onset of an abnormal beat and forming therefrom a first body surface potential map (BSPM); C. estimating said position of interest from said first BSPM; D. placing said surgical instrument at said estimated position; E. pacing the heart of said patient with an electrical signal applied through said surgical instrument; F. obtaining readouts from said electrodes during said paced phase and forming a further BSPM therefrom; G. determining from said further BSPM, when compared with the first BSPM, if the surgical instrument is in the correct position; H. if the instrument is not in the correct position, moving the instrument in a direction as indicated by the comparison of the further BSPM with the first BSPM; I. repeating steps E. to G. until the surgical instrument is at the position of interest. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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Specification