Systems and methods for deriving and displaying the propagation velocities of electrical events in the heart

• US 5,487,391 A
• Filed: 01/28/1994
• Issued: 01/30/1996
• Est. Priority Date: 01/28/1994
• Status: Expired due to Term

• Current Assignee: EP Technology (Boston Scientific Corporation)
• Original Assignee: EP Technology (Boston Scientific Corporation)
• Inventors: Panescu, Dorin
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Parker, Marianne
• Application Number:
  US08/188,242
• Time in Patent Office: 732 Days
• Field of Search: 128/695, 128/696, 128/702, 128/642, 128/699, 607/115, 607/116, 607/119, 607/122
• US Class Current: 600/512
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems

Abstract

Systems and methods examine heart tissue morphology by locating electrodes in contact with a region of heart tissue to sense the timing of a local depolarization events. From this, the systems and methods derive the propagation velocities of the depolarization events and create an output that displays the derived propagation velocities in spatial relation to sensing electrode. The systems and methods can arrange the derived propagation velocities into groups of equal propagation velocities and generate in three dimensions an output of the groups of equal propagation velocities in spatial relation to the location of the sensing electrodes. The iso-conduction display more rapidly identifies the regions of slow conduction which are candidate ablation sites, than an iso-chronal or iso-delay display.

Claims

1. A system for examining heart tissue comprising

at least two electrodes,

means for locating the electrodes in contact with a heart tissue region,

means for sensing with the electrodes timing of a local depolarization event in the heart tissue region, and

means for deriving a propagation vector velocity of the depolarization event.

2. A system according to claim 1

wherein the locating means places the electrodes in contact with endocardial tissue.

3. A system according to claim 1

and further including means for creating an output of the derived propagation vector velocity.

4. A system for examining heart tissue comprising

multiple electrodes,

means for locating the multiple electrodes in contact with a heart tissue region,

means for sensing with the multiple electrodes timing of local depolarization events in the heart tissue region, and

means for deriving propagation vector velocities of the depolarization events.

5. A system according to claim 4

wherein the locating means locates all the electrodes in contact with endocardial tissue.

6. A system according to claim 4

and further including means for creating an output of the derived propagation vector velocities.

7. A system for examining heart tissue comprising

at least two electrodes,

means for locating the electrodes in contact with a heart tissue region,

means for sensing with the electrodes timing of a local depolarization event in the heart tissue region,

means for deriving a propagation vector velocity of the depolarization event, and

means for generating an output comprising the derived propagation vector velocity in spatial relation to the electrodes.

8. A system according to claim 7

wherein the locating means locates the electrode in contact with endocardial tissue.

10. A system according to claim 8

wherein the locating means locates all the electrodes in contact with endocardial tissue.

9. A system for examining heart tissue comprising

multiple electrodes,

means for locating the multiple electrodes in contact with a heart tissue region,

means for sensing with the multiple electrodes timing of local depolarization events in the heart tissue region, and

means for deriving propagation vector velocities of the depolarization events,

means for arranging the derived propagation vector velocities into groups of equal propagation vector velocities, and

means for generating an output of the groups of equal propagation vector velocities in spatial relation to the multiple electrodes.

11. A system for examining heart tissue comprising

a three dimensional structure,

an array of spaced apart electrodes carried by the three dimensional structure for contacting endocardial tissue in a heart tissue region,

means for sensing with the array of spaced apart electrodes timing of a local depolarization event in the heart tissue region,

means for deriving propagation velocities of the depolarization event, and

means for generating an output showing in three dimensions the derived propagation velocities in spatial relation to the array of spaced apart electrodes.

13. A system according to claim 11 or 12

wherein the means for sensing senses timing of local depolarization events without substantially altering the position of the three-dimensional structure.

14. A system according to claim 11 or 12

wherein the output is in printed form.

15. A system according to claim 11 or 12

wherein the output is displayed on a graphics display monitor.

12. A system for examining heart tissue comprising

a three dimensional structure,

an array of spaced apart electrodes carried by the three dimensional structure for contacting endocardial tissue in a heart tissue region,

means for sensing with the array of spaced apart electrodes timing of a local depolarization event in the heart tissue region,

means for deriving propagation velocities of the depolarization event,

means for arranging the derived propagation velocities into groups of equal propagation velocities,

means for generating an output showing in three dimensions the groups of equal propagation velocities in spatial relation to the array of spaced apart electrodes.

16. A system for examining heart tissue comprising

a three dimensional structure having a shape,

an array of spaced apart electrodes carried by the three dimensional structure for contacting endocardial tissue in a heart tissue region,

means for sensing with the array of spaced apart electrodes timing of a local depolarization event in the heart tissue region,

means for deriving propagation velocities of the depolarization event, and

means for creating in three dimensions an output displaying groups of equal propagation velocities in spatial relation to the array of spaced apart electrodes on the three dimensional structure comprising

first means for computing location of the array of spaced apart electrodes on the three dimensional structure in a three dimensional coordinate system,

second means for generating a three dimensional pattern of intersecting horizontal and vertical lines forming a three dimensional mesh that conforms to the shape of the three dimensional structure, the intersection between the horizontal and vertical lines comprising nodes, the nodes that represent locations of the electrodes comprising knots,

third means for assigning values to the nodes that reflect the timing of the local depolarization event by assigning to each knot a value relating to the timing of the local depolarization event determined at the associated electrode and by interpolating between the knots to assign interpolated values relating to the timing of the local depolarization event to the remaining nodes, and means for computing a spatial gradient relating to the timing of the local depolarization event for each node of the mesh, the spatial gradient having a magnitude at each node, and

fourth means for computing at each node a propagation velocity as the inverse of the magnitude of the spatial gradient at each node, and

fifth means for creating an output display by assigning a first indicium to the node or nodes where the computed propagation velocity is largest among the computed propagation velocities, a second indicium to the node or nodes where the computed propagation velocity is smallest among the computed propagation velocities, and intermediate indicia between the first and second indicium to the node or nodes for the computed propagation velocities between the largest and smallest propagation velocities.

17. A system according to claim 16

wherein the means for sensing senses timing of local depolarization events without substantially altering the position of the three dimensional structure.

18. A system according to claim 16

wherein the output is in printed form.

19. A system according to claim 16

wherein the output is displayed on a graphics display monitor.

20. A system according to claim 16

wherein the indicia comprise contrasting colors.

21. A system for examining heart tissue comprising

a three dimensional structure having a shape,

an array of spaced apart sensor means each at a location on the three dimensional structure for contacting a heart tissue region and for sensing a selected physiologic parameter in the heart tissue region in terms of a sensed magnitude,

means for outputting in three dimensions the sensed magnitudes in groups arranged according to equal sensed magnitudes in spatial relation to the location of the sensor means on the three dimensional structure comprising

first means for computing the location of the sensor means on the three dimensional structure in a three dimensional coordinate system,

second means for generating a pattern of intersecting horizontal and vertical lines forming a three dimensional mesh that conforms to the shape of the three dimensional structure, the intersection between the horizontal and vertical lines comprising nodes, the nodes that represent the location of the sensor means on the three dimensional structure comprising knots,

third means for assigning values to the nodes that reflect the sensed magnitudes by assigning to each knot the sensed magnitude sensed by the associated sensor means and by interpolating between the knots to assign interpolated magnitudes to the remaining nodes, and

fourth means for creating an output display by assigning a first indicium to the node or nodes where the sensed or interpolated magnitude is largest among the sensed and interpolated magnitudes, a second indicium to the node or nodes where the sensed or interpolated magnitude is smallest among the sensed and interpolated magnitudes, and intermediate indicia between the first and second indicia to the node or nodes having intermediate sensed or interpolated magnitudes between the largest and smallest sensed and interpolated magnitudes.

22. A system according to claim 21

wherein the output is in printed form.

23. A system according to claim 21

wherein the output is displayed on a graphics display monitor.

24. A system according to claim 21

wherein the indicia comprise contrasting colors.

25. A method for examining heart tissue comprising the steps sensing timing of a local depolarization event in heart tissue, and deriving a propagation vector velocity of the depolarization event.

26. A method according to claim 25

and further including the step of creating an output of the derived propagation vector velocity.

27. A method for examining heart tissue comprising the steps of

sensing with multiple electrodes timing of local depolarization events in a heart tissue region, and

deriving propagation vector velocities of the depolarization events.

28. A method according to claim 27

and further including the step of creating an output of the derived propagation vector velocities.

29. A method for examining heart tissue comprising the steps of

sensing with multiple electrodes timing of local depolarization events in a region of heart tissue,

deriving propagation vector velocities of the depolarization events,

arranging the derived propagation vector velocities into groups of equal propagation vector velocities, and

generating an output of the groups of equal propagation vector velocities in spatial relation to the multiple electrodes.

30. A method for examining heart tissue comprising

locating a three dimensional basket structure having a shape and carrying an array of spaced apart electrodes in contact with endocardial tissue in a heart tissue region,

sensing with the array of spaced apart electrodes timing of a local depolarization event in the heart tissue region,

deriving propagation velocities of the depolarization event, and

creating an output displaying in three dimensions groups of equal propagation velocities in spatial relation to the array of spaced apart electrodes on the three dimensional basket structure by

locating the array of spaced apart electrodes on the three dimensional basket structure in a three dimensional coordinate system,

generating a three dimensional pattern of intersecting horizontal and vertical lines forming a three dimensional mesh that conforms to the shape of the three dimension basket structure, the intersection between the horizontal and vertical lines comprising nodes, the nodes that represent the array of spaced apart electrodes comprising knots,

assigning values to the nodes that reflect timing of the local depolarization event by assigning to each knot a value relating to the timing of the local depolarization event determined at the associated electrode and by interpolating between the knots to assign interpolated values relating to the timing of the local depolarization event to the remaining nodes,

computing a spatial gradient relating to the timing of the local depolarization event for each node of the mesh, the spatial gradient having a magnitude at each node,

computing a propagation velocity at each node as the inverse of the magnitudes of the spatial gradient at each node, and

creating an output display by assigning a first indicium to the node or nodes where the computed propagation velocity is largest among the computed propagation velocities, a second indicium to the node or nodes where the computed propagation velocity is smallest among the computed propagation velocities, and intermediate indicia between the first and second indicia to the node or nodes where the computed propagation velocities between the largest and smallest propagation velocities.

31. A method according to claim 30

wherein the indicia comprise contrasting colors.

32. A method for examining heart tissue comprising the steps of

providing a three dimensional structure having a shape and carrying an array of spaced apart sensor, each sensor being carried at a location on the three dimensional structure,

locating the array of spaced apart sensors in contact with a heart tissue region for sensing a selected physiologic parameter in the heart tissue region in terms of sensed magnitudes, and

outputting in three dimensions the sensed magnitudes in groups arranged according to equal sensed magnitudes in spatial relation to the location of the sensors on the three dimensional structure by

computing the location of the sensors on the three dimensional structure in a three dimensional coordinate system,

generating a pattern of intersecting horizontal and vertical lines forming a three dimensional mesh that conforms to the shape of the three dimensional structure, the intersection between the horizontal and vertical lines comprising nodes, the nodes that represent the location of the sensors on the three dimensional structure comprising knots,

assigning values to the nodes that reflect the sensed magnitudes by assigning to each knot the sensed magnitude sensed at the associated sensor and by interpolating between the knots to assign interpolated magnitudes to the remaining nodes, and

creating an output display by assigning a first indicium to the node or nodes where the sensed or interpolated magnitude is largest among the sensed and interpolated magnitudes, a second indicium to the node or nodes where the sensed or interpolated magnitude is smallest among the sensed and interpolated magnitudes, and intermediate indicia between the first and second colors to the node or nodes sensed or interpolated magnitudes between the largest and smallest sensed and interpolated magnitudes.