Systems and methods for analyzing cardiac biopotential morphologies by cross-correlation

• US 5,792,064 A
• Filed: 10/21/1997
• Issued: 08/11/1998
• Est. Priority Date: 02/17/1995
• Status: Expired due to Term

• Current Assignee: David K. Swanson, Dorin Panescu, James G. Whayne, Michael D. Lesh
• Original Assignee: David K. Swanson, Dorin Panescu, James G. Whayne, Michael D. Lesh
• Inventors: Panescu, Dorin, Swanson, David K., Whayne, James G., Lesh, Michael D.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US08/949,287
• Time in Patent Office: 294 Days
• Field of Search: 607/122, 607/9, 600/373, 600/375, 600/509, 600/510, 600/515, 600/518, 382/209
• US Class Current: 600/510
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence

Abstract

An analog or digital processing element and associated method analyses electrograms or electrocardiograms to locate sites potentially appropriate for ablation. The element and method compares a first number of electrogram or electrocardiogram samples recorded over time during a cardiac event of known diagnosis with a second number of paced electrogram or electrocardiogram samples recorded over time. The comparison cross-correlates the first number of electrogram samples with the second number of paced electrogram samples. The element and method generate an output based upon the cross-correlation. The element and method compare the output to a predetermined value to determine whether a pacing site for the paced electrogram or electrocardiogram samples is near to a potential ablation site.

Claims

1. A processing element for analyzing electrograms comprising

first means for inputting a first number of electrogram samples recorded during a cardiac event of known diagnosis, the first number of electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation,

second means for inputting a second number of paced electrogram samples, the second number of paced electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

third means for cross-correlating the first number of electrogram samples with the second number of paced electrogram samples and generating an output based upon the cross-correlation, whereby the output comprises a diagnostic indicator.

3. An element according to claim 1 or 2

wherein the output comprises a numerical cross-correlation function.

4. An element according to claim 1 or 2

wherein the paced samples are triggered from a known pacing site,

and further including fourth means for comparing the output to a predetermined value to determine whether the pacing site is a potential ablation site.

5. An element according to claim 4

wherein the fourth means provides a potential site identification output when the output exceeds the predetermined value.

2. An element for analyzing electrocardiograms comprising

first means for inputting a first number of electrocardiogram samples recorded during a cardiac event of known diagnosis using multiple body surface electrodes, the first number of electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation,

second means for inputting a second number of paced electrocardiogram samples recorded using the multiple body surface electrodes, the second number of paced electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

third means for cross-correlating the first number of electrocardiogram samples with the second number of paced electrocardiogram samples using a cross correlation function and generating an output based upon the cross-correlation function, whereby the output comprises a diagnostic indicator.

6. A system for analyzing electrograms comprising

electrode means electrically coupled to myocardial tissue,

a processing element coupled to the electrode means comprising

first means for conditioning the electrode means to record a first number of electrogram samples during a cardiac event of known diagnosis, the first number of electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation.

second means for conditioning the electrode means to pace the heart and to record with the electrode means a second number of paced electrogram samples, the second number of paced electrogram samples comprising a slot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

third means for cross-correlating the first number of electrogram samples with the second number of paced electrogram samples and generating an output based upon the cross-correlation whereby the output comprises a diagnostic indicator.

7. A system according to claim 6

wherein the output comprises a numerical cross-correlation function.

8. A system according to claim 6

and further including fourth means for comparing the output to a predetermined value to determine whether the electrode means is near a potential ablation site.

9. An element according to claim 8

wherein the fourth means provides a potential site identification output when the output exceeds the predetermined value.

10. A system for analyzing electrograms comprising

an array comprising multiple electrodes,

an element adapted to support the multiple electrode array within a heart chamber in electrical communication with a region of endocardial tissue, and

a processing element coupled to the electrode array comprising

first means for conditioning the electrode array to record at each electrode on the array a first number of electrogram samples during a cardiac event of known diagnosis, the first number of electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation,

second means for conditioning at least one of the multiple electrodes on the array to emit a pacing signal and to record at each electrode a second number of paced electrogram samples, the second number of paced electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

third means for cross-correlating the first number of electrogram samples with the second number of paced electrogram samples and generating for each electrode on the array an output based upon the cross-correlation, whereby the output comprises a diagnostic indicator.

11. A system according to claim 10

wherein the output for each electrode comprises a numerical cross-correlation function.

12. A system according to claim 10

and further including fourth means for comparing the output to a predetermined value to determine whether the at least one of the multiple electrodes emitting the pacing signal is near a potential ablation site.

13. A system according to claim 12

wherein the fourth means provides a potential site identification output when the output exceeds the predetermined value.

14. A system according to claim 10

wherein the second means sequentially conditions different ones of the multiple electrodes on the array to emit a pacing signal and to record at each electrode on the array the second number of paced electrogram samples for each different one of the pacing signal-emitting electrodes, and

wherein the third means individually cross-correlates, for each different one of the pacing signal-emitting electrodes, the first number of electrogram samples with the second number of paced electrogram samples and generates an output for each electrode on the array.

15. A system according to claim 14

wherein the output for each electrode comprises a numerical cross-correlation function.

16. A system according to claim 14 and further including fourth means for comparing each output to a predetermined value to determine whether the pacing signal-emitting electrode is near a potential ablation site.

17. A system according to claim 16

wherein the fourth means provides a potential site identification output when the output exceeds the predetermined value.

18. A system for analyzing electrocardiograms comprising

multiple body surface electrodes,

an element supporting the multiple electrodes in association with a body surface in electrical communication with myocardial tissue, and

a processing element coupled to the multiple electrodes comprising

first means for conditioning the electrode means to record a first number of electrocardiogram samples during a cardiac event of known diagnosis, the first number of electrocardiogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation,

second means for conditioning the multiple electrodes to pace the heart and to record with the electrodes a second number of paced electrocardiogram samples, the second number of paced electrocardiogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

third means for cross-correlating the first number of electrocardiogram samples with the second number of paced electrocardiogram samples and generating an output based upon the cross-correlation whereby the output comprises a diagnostic indicator.

19. A system according to claim 18

wherein the output for each electrode comprises a numerical cross-correlation function.

20. A system according to claim 18

and further including fourth means for comparing the output to a predetermined value to determine whether the electrode means pacing the heart is near a potential ablation site.

21. A system according to claim 20

wherein the fourth means provides a potential site identification output when the output exceeds the predetermined value.

22. A system according to claim 18

wherein the second means sequentially conditions different ones of the multiple electrodes to emit a pacing signal and to record at each electrode the second number of paced electrocardiogram samples for each different one of the pacing signal-emitting electrodes, and

wherein the third means individually cross-correlates, for each different one of the pacing signal-emitting electrodes, the first number of electrocardiogram samples and the second number of paced electrocardiogram samples recorded by each electrode and generates an output associated with each electrode.

23. A system according to claim 22

wherein the output for each electrode comprises a numerical cross-correlation function.

24. A system according to claim 22

and further including fourth means for comparing each output to a predetermined value to determine whether the electrode means pacing the heart is near a potential ablation site.

25. A system according to claim 24

wherein the fourth means provides a potential site identification output when the output exceeds the predetermined value.

26. A method for analyzing electrograms comprising the steps of

inputting a first number of electrogram samples recorded during a cardiac event of known diagnosis, the first number of electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation.

inputting a second number of paced electrogram samples, the second number of paced electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

cross-correlating the first number of electrogram samples with the second number of paced electrogram samples and generating an output based upon the cross-correlation, whereby the output comprises a diagnostic indicator.

27. A method according to claim 26

and further including the step of comparing the output to a predetermined value to determine whether a pacing site for the paced electrogram samples is near to a potential ablation site.

28. A method according to claim 27

wherein the step of comparing the output to a predetermined value provides a potential site identification output when the output exceeds the predetermined value.

38. A method according to claim 26 or 29 or 32 or 35

wherein the output comprises a numerical cross-correlation function.

29. A method for analyzing electrograms comprising the steps of

conditioning an array of multiple electrodes supported within a heart chamber in electrical communication with a region of endocardial tissue to record at each electrode on the array a first number of electrogram samples during a cardiac event of known diagnosis, the first number of electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation.

conditioning at least one of the multiple electrodes on the array to emit a pacing signal and to record at each electrode a second number of paced electrogram samples, the second number of paced electrogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

cross-correlating the first number of electrogram samples with the second number of paced electrogram samples and generating for each electrode on the array an output based upon the cross-correlation, whereby the output comprises a diagnostic indicator.

30. A method according to claim 29

and further including the step of comparing the output to a predetermined value to determine whether a pacing site for the paced electrocardiogram samples is near to a potential ablation site.

31. A method according to claim 30

wherein the step of comparing the output to a predetermined value provides a potential site identification output when the output exceeds the predetermined value.

32. A method for analyzing electrocardiograms comprising the steps of

inputting a first number of electrocardiogram samples recorded during a cardiac event of known diagnosis using multiple body surface electrodes in electrical communication with myocardial tissue, the first number of electrocardiogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation,

inputting a second number of paced electrocardiogram samples recorded using the multiple body surface electrodes, the second number of paced electrocardiogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

cross-correlating the first number of electrocardiogram samples with the second number of paced electrocardiogram samples and generating an output based upon the cross-correlation, whereby the output comprises a diagnostic indicator.

33. A method according to claim 32

and further including the step of comparing the output to a predetermined value to determine whether a pacing site for the paced electrocardiogram samples is near to a potential ablation site.

34. A method according to claim 33

wherein the step of comparing the output to a predetermined value provides a potential site identification output when the output exceeds the predetermined value.

35. A method for analyzing electrocardiograms in myocardial tissue comprising the steps of

conditioning multiple body surface electrodes in association with a body surface in electrical communication with myocardial tissue to record a first number of electrocardiogram samples during a cardiac event of known diagnosis, the first number of electrocardiogram samples comprising a slot of biopotentials over time and not a spacial distribution of endocardial surface activation,

conditioning electrode means to pace the heart and to record with the multiple body surface electrodes a second number of paced electrocardiogram samples, the second number of paced electrocardiogram samples comprising a plot of biopotentials over time and not a spacial distribution of endocardial surface activation, and

cross-correlating the first number of electrocardiogram samples with the second number of paced electrocardiogram samples and generating an output based upon the cross-correlation, whereby the output comprises a diagnostic indicator.

36. A method according to claim 35

and further including the step of comparing the output to a predetermined value to determine whether a pacing site for the paced electrocardiogram samples is near to a potential ablation site.

37. A method according to claim 36

wherein the step of comparing the output to a predetermined value provides a potential site identification output when the output exceeds the predetermined value.