Apparatus and method for treating cardiac arrhythmias with no discrete target
First Claim
Patent Images
1. A method for treating cardiac arrhythmias, which comprises the steps of:
- (a) collecting local information concerning a patient'"'"'s heart so as to determine a local dimension value characteristic of conduction in the heart tissue;
(b) analyzing said information to determine lines or points of ablation, wherein the information is analyzed to optimize the line or points of ablation, wherein the continuous or discontinuous ablation lines interrupt each possible geometric shape having a radius ≧
a and a circumference or outer perimeter greater than or equal to the dimension value at a given location; and
(c) creating lines or points of ablation.
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Abstract
A method and apparatus for treating cardiac arrhythmias with no discrete focus. More particularly, one or more catheters are used to collect local information concerning a patient'"'"'s heart, the information is analyzed to determine where lines or points of ablation should be made, and then the lines or points of ablation are made.
934 Citations
87 Claims
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1. A method for treating cardiac arrhythmias, which comprises the steps of:
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(a) collecting local information concerning a patient'"'"'s heart so as to determine a local dimension value characteristic of conduction in the heart tissue; (b) analyzing said information to determine lines or points of ablation, wherein the information is analyzed to optimize the line or points of ablation, wherein the continuous or discontinuous ablation lines interrupt each possible geometric shape having a radius ≧
a and a circumference or outer perimeter greater than or equal to the dimension value at a given location; and(c) creating lines or points of ablation. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A method for determining lines or points of ablation to treat arrhythmias in the heart of a patient, which comprises the steps of:
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(a) creating an activation map of the heart of a patient; (b) creating a refractory period map of said heart; (c) creating a dimension map of said heart; and (d) analyzing the dimension map of step (c) to determine lines or points of ablation. - View Dependent Claims (20, 22, 23, 24, 25, 26, 27, 28, 29)
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21. A method for determining lines or points of ablation to treat arrhythmias in the heart of a patient, which comprises the steps of:
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(a) creating an activation map of at least a part of a chamber of the patient'"'"'s heart wherein a conduction velocity map is derived from the activation map; (b) creating an refractory period map of said chamber or part thereof; (c) creating a dimension map of said chamber or part thereof, wherein said dimension map is a mathemetical product of the conduction velocity map and the refractory period map; and (d) analyzing the dimension map of step (c) to determine lines or points of ablation.
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30. A method of determining lines or points of ablation to treat arrhythmias in the heart of a patient, which comprises the steps of:
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(a) positioning the distal tip of each of one or more catheters at a site within a chamber of a patient'"'"'s heart; (b) sensing location and local information at the site; (c) processing sensed information from step (b) to create one or more activation mapping data points; (d) repeating steps (a), (b), and (c) one or more times to create sufficient data points for an activation map; (e) calculating conduction velocity data points from the data received in step (d) to create a conduction velocity map; (f) determining the refractory period at each site; (g) repeating steps (a), (b), and (f) one or more times to create sufficient data points for a refractory period map; (h) multiplying the conduction velocity value of a data point from step (e) by the corresponding refractory period value to calculate the local dimension value; (i) repeating step (h) one or more times to create sufficient data points for a dimension map; (j) analyzing the dimension map from step (i) to determine lines or points of ablation. - View Dependent Claims (34, 35)
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31. A method for determining areas of ablation to treat arrhythmias in the heart of a patient, which comprises the steps of:
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(a) positioning the distal tip of each of one or more catheters at a site within a chamber of the patient'"'"'s heart; (b) sensing location information at each site; (c) sensing local information at each site; (d) sensing or determining the refractory period at each site; (e) processing sensed information from steps (b), (c), and (d) to create one or more data points; (f) repeating steps (a), (b), (c), (d), and (e) one or more times to create sufficient data points for an activation map and a refractory period map; (g) calculating conduction velocity data points from the data received in step (f) to create a conduction velocity map; (h) multiplying the conduction velocity value of a data point in step (g) by the corresponding refractory period value to calculate the local dimension value; (i) repeating step (h) one or more times to create sufficient data points for a dimension map; and (j) analyzing the activation map from step (f) and the dimension map from step (i) to determine lines or points of ablation. - View Dependent Claims (32)
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33. A method of creating a refractory period map of a patient'"'"'s heart, which comprises the steps of:
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(a) positioning the distal tip of each of one or more catheters at a site on the endocardium of a patient'"'"'s heart chamber; (b) sensing location information at each site; (c) determining the refractory period at each site; (d) processing sensed information from steps (b) and (c) to create one or more data points; (e) repeating steps (a) to (d) one or more times to create sufficient data points for a refractory period map; and (f) transmitting said data points from step (e) to a receiving means.
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36. A method of creating a dimension map of a patient'"'"'s heart which comprises:
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(a) deriving a conduction velocity map; (b) creating a refractory period map; (c) multiplying the conduction velocity value of a data point in step (a) by the corresponding refractory period value to calculate a local dimension value; and (d) repeating step (c) one or more times to create sufficient data points for a dimension map. - View Dependent Claims (37, 38)
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39. A method for determining lines or points of ablation to treat arrhythmias with no discrete target in the heart of a patient, which comprises the steps of:
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(a) creating an activation map, wherein a conduction velocity map is derived from the activation map, and refractory period map of at least a part of a chamber of a patient'"'"'s heart; (b) creating a dimension map of said chamber or a part thereof; and (c) calculating lines or points of ablation according to the criteria that any path with a radius of curvature larger than a, a being the minimum radius of curvature naturally occurring in the human heart, closing a loop at a particular location in the heart must be of a length equal to or greater than the local dimension number, D, wherein D is the mathematical product of the refractory period at any site on the refractory period map and the local conduction velocity at a corresponding site on the conduction velocity map, to cause the development of a reentrant conduction path, and that the electrical continuity must be preserved. - View Dependent Claims (40, 41)
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42. An apparatus for the treatment of cardiac arrhythmias which comprises:
- (a) means for collecting local information concerning a patient'"'"'s heart so as to determine a local dimension value characteristic of conduction in the heart tissue;
(b) means for analyzing said information to determine lines or points of ablation, wherein said means further comprises means for optimizing the lines or points of ablation, wherein the continuous or discontinuous ablation lines interrupt each possible geometric shape having a radius ≧
a and a circumference or outer perimeter greater than or equal to the dimension value at a given location; and(c) means for creating lines or points of ablation. - View Dependent Claims (43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 60)
- (a) means for collecting local information concerning a patient'"'"'s heart so as to determine a local dimension value characteristic of conduction in the heart tissue;
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59. An apparatus for the treatment of cardiac arrhythmias in a patient'"'"'s heart, wherein the cardiac arrhythmias have no focus, which comprises:
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(a) means assuring that the heart is in a regular sinus rhythm by cardioverting the patient; (b) a collector for collecting local information concerning a patient'"'"'s heart at a plurality of data points, wherein said information is updated after the acquisition of each data point; (c) an analyzer for analyzing said information to determine lines or points of ablation; and (d) means for creating lines or points of ablation. - View Dependent Claims (87)
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61. An apparatus for determining lines or points of ablation to treat arrhythmias in the heart of a patient, which comprises:
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(a) means for creating an activation map of the heart of a patient; (b) means for creating a refractory period map of said heart; (c) means for creating a dimension map of said heart; and (d) means for analyzing the dimension map to determine lines or points of ablation. - View Dependent Claims (62, 64, 65, 66, 67, 68, 69, 70)
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63. An apparatus for determining lines or points of ablation to treat arrhythmias in the heart of a patient, which comprises:
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(a) means for creating an activation map of at least a part of a chamber of the patient'"'"'s heart, wherein a conduction velocity map is derived from the activation map; (b) means for creating an refractory period map of said chamber or part thereof; (c) means for creating a dimension map of said chamber or part thereof; and (d) means for analyzing the dimension map to determine lines or points of ablation.
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71. An apparatus for determining lines or points of ablation to treat arrhythmias in the heart of a patient, which comprises:
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(a) means for positioning the distal tip of each of one or more catheters at a site within a chamber of a patient'"'"'s heart; (b) means for sensing location and local information at the site; (c) means for processing sensed information from step (b) to create one or more activation mapping data points; (d) means for repeating the positioning, sensing, and processing one or more times to create sufficient data points for an activation map; (e) means for calculating conduction velocity data points from the data received to create a conduction velocity map; (f) means for determining the refractory period at each site; (g) means for repeating the positioning, sensing, and refractory period determination one or more times to create sufficient data points for a refractory period map; (h) means for multiplying the conduction velocity value of a data point by the corresponding refractory period value to calculate the local dimension value; (i) means for repeating the calculation of the local dimension value one or more times to create sufficient data points for a dimension map; and (j) means for analyzing the dimension map to determine lines or points of ablation. - View Dependent Claims (75, 76)
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72. An apparatus for creating a refractory period map of a patient'"'"'s heart, which comprises:
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(a) means for positioning the distal tip of each of one or more catheters at a site on the endocardium of a patient'"'"'s heart chamber; (b) means for sensing location information at each site; (c) means for determining the refractory period at each site; (d) means for processing sensed information to create one or more data points; (e) means for repeating the positioning, sensing, refractory period determination, and processing one or more times to create sufficient data points for a refractory period map; and (f) means for transmitting said data points to a receiving means.
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73. An apparatus for determining areas of ablation to treat arrhythmias in the heart of a patient, which comprises:
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(a) means for positioning the distal tip of each of one or more catheters at a site within a chamber of the patient'"'"'s heart; (b) means for sensing location information at each site; (c) means for sensing local information at each site; (d) means for sensing or determining the refractory period at each site; (e) means for processing sensed information to create one or more data points; (f) means for repeating the positioning, sensing, and processing one or more times to create sufficient data points for an activation map and a refractory period map; (g) means for calculating conduction velocity data points from the data received to create a conduction velocity map; (h) means for multiplying the conduction velocity value of a data point by the corresponding refractory period value to calculate the local dimension value; (i) means for repeating the calculation of the local dimension value one or more times to create sufficient data points for a dimension map; and (j) means for analyzing the activation map and the dimension map to determine lines or points of ablation. - View Dependent Claims (74)
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77. An apparatus for creating a dimension map of a patient'"'"'s heart which comprises:
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(a) means for deriving a conduction velocity map; (b) means for creating a refractory period map; (c) means for multiplying the conduction velocity value of a data point on the conduction velocity map by the corresponding refractory period value to calculate a local dimension value; and (d) means for repeating said multiplication one or more times to create sufficient data points for a dimension map. - View Dependent Claims (78, 79)
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80. An apparatus for determining lines or points of ablation to treat arrhythmias with no discrete target in the heart of a patient, which comprises:
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(a) means for creating an activation map, wherein a conduction velocity map is derived from the activation map, and refractory period map of at least a part of a chamber of a patient'"'"'s heart; (b) means for creating a dimension map of said chamber or a part thereof; and (c) means for calculating lines or points of ablation according to the criteria that any path with a radius of curvature larger than a, a being the minimum radius of curvature naturally occurring in the human heart, closing a loop at a particular location in the heart must be of a length equal to or greater than the local dimension number, D, wherein D is the mathematical product of the refractory period at any site on the refractory period map and the local conduction velocity at a corresponding site on the conduction velocity map, to cause the development of a reentrant conduction path, and that the electrical continuity must be preserved. - View Dependent Claims (81, 82)
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83. A method for treating cardiac arrhythmias in a patient'"'"'s heart, wherein the cardiac arrhythmias have no focus, which comprises the steps of:
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(a) assuring that the heart is in a regular sinus rhythm by cardioverting the patient; (b) collecting local information concerning the patient'"'"'s heart, at a plurality of data points, wherein said information is updated after the acquisition of each data point; (c) analyzing said information to determine lines or points of ablation; and (d) creating lines or points of ablation. - View Dependent Claims (84, 85, 86)
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Specification