System and method for assessing atrial electrical stability

• US 8,265,752 B2
• Filed: 04/28/2009
• Issued: 09/11/2012
• Est. Priority Date: 04/28/2008
• Status: Expired due to Fees

• Current Assignee: The General Hospital Corporation (Mass General Brigham, Inc.)
• Original Assignee: The General Hospital Corporation (Mass General Brigham, Inc.)
• Inventors: Armoundas, Antonis A.
• Primary Examiner(s): Layno, Carl H.
• Assistant Examiner(s): MORALES, JON ERIC C
• Application Number:
  US12/431,558
• Publication Number:
  US 20100042172A1
• Time in Patent Office: 1,232 Days
• Field of Search: 607/23, 607/17, 600/500, 600/509
• US Class Current: 607/17
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate

Abstract

A method for identifying a susceptibility of a subject to atrial-rhythm disturbances includes a) placing a plurality of sensors on the subject to measure a physiologic signal of the subject, and b) recording the physiologic signal from the sensor. The physiologic signal includes an atrial electrical activity of the subject. The method includes c) determining a beat-to-beat variability in the atrial electrical activity of the subject. The beat-to-beat variability includes alternans of electrocardiographic waveforms of a predetermined number of a sequence of heart beats. The method includes d) determining a susceptibility to atrial-rhythm disturbances of the subject using the beat-to-beat variability in the atrial electrical activity determined in step c), and e) generating a report of the susceptibility to atrial-rhythm disturbances of the subject.

Claims

1. A method for identifying a susceptibility of a subject to atrial-rhythm disturbances, comprising the steps of:

a) placing a plurality of sensors on the subject to measure a physiologic signal of the subject;

b) recording the physiologic signal from the sensor, the physiologic signal including an atrial electrical activity of the subject;

c) determining a beat-to-beat variability in the atrial electrical activity of the subject, the beat-to-beat variability including alternans of electrocardiographic waveforms of a predetermined number of a sequence of heart beats;

d) determining a susceptibility to atrial-rhythm disturbances of the subject using the beat-to-beat variability in the atrial electrical activity determined in step c); and

e) generating a report of the susceptibility to atrial-rhythm disturbances of the subject.

2. The method of claim 1, further comprising f) using the report of the susceptibility to determine a therapy plan including at least one of a delivery of a chemical substance and a delivery of electrical energy to the subject.

3. The method of claim 2, wherein the delivery of electrical energy includes delivering electrical energy during an absolute refractory period on alternate beats within the sequence of heart beats.

4. The method of claim 1, wherein step c) includes performing a Fast Fourier Transform to estimate alternans of the electrocardiographic waveforms.

5. The method of claim 1, wherein step c) includes identifying beat-to-beat variability created by at least one of atrial depolarization and repolarization alternans.

6. The method of claim 1, wherein step a) includes arranging the plurality of sensors in a bipolar configuration.

7. The method of claim 1, wherein step a) includes arranging the plurality of sensors in a unipolar configuration.

8. The method of claim 1, wherein step e) includes displaying the susceptibility to atrial-rhythm disturbances of the subject showing a first output showing raw electrocardiogram (ECG) signals of the subject and a second output showing the susceptibility to atrial-rhythm disturbances of the subject.

9. A method for identifying a susceptibility of a subject to atrial-rhythm disturbances, comprising the steps of:

a) placing a sensor on the subject to measure a physiologic signal of the subject;

b) recording the physiologic signal from the sensor, the physiologic signal including an electrical activity of a heart of the subject;

c) determining a beat-to-beat variability in the atrial electrical activity of the subject during a sequence of heart beats;

d) determining a susceptibility to atrial-rhythm disturbances of the subject using the beat-to-beat variability in the atrial electrical activity; and

e) generating a report of the susceptibility to atrial-rhythm disturbances of the subject.

10. The method of claim 9, further comprising f) determining a therapy location for a delivery of one of a chemical substance and an electrical energy to the subject to compensate for the susceptibility to atrial-rhythm disturbances of the subject.

11. The method of claim 10, wherein the delivery of electrical energy includes delivering electrical energy during an absolute refractory period on alternate beats in the sequence of heart beats.

12. The method of claim 9, wherein step c)includes performing a Fast Fourier Transform to estimate alternans of the electrocardiographic waveforms.

13. The method of claim 9, wherein the beat-to-beat variability is created by atrial depolarization or repolarization alternans.

14. The method of claim 9, wherein step e) includes displaying the susceptibility to atrial-rhythm disturbances of the subject via a user interface.

15. The method of claim 14, wherein displaying the susceptibility to atrial- rhythm disturbances of the subject via the user interface includes displaying a first output showing raw electrocardiogram (ECG) signals of the subject and a second output showing the susceptibility to atrial-rhythm disturbances of the subject.

16. A system for identifying susceptibility to atrial-rhythm disturbances, comprising:

a plurality of sensors configured to measure a physiologic signal of a subject;

a computer for recording the physiologic signal from the sensor, the physiologic signal including an atrial electrical activity of the subject, the computer being configured to;

determine a beat-to-beat variability in the atrial electrical activity of the subject, the beat-to-beat variability including alternans of electrocardiographic waveforms of a predetermined number of a sequence of heart beats, and

use the beat-to-beat variability in the atrial electrical activity to determine a susceptibility to atrial-rhythm disturbances of the subject; and

a user interface for displaying the susceptibility to atrial-rhythm disturbances of the subject.

17. The system of claim 16, including a treatment device configured to deliver at least one of a chemical substance and electrical energy to the subject to compensate for the susceptibility to atrial-rhythm disturbances of the subject.

18. The system of claim 17, wherein the treatment device is configured to deliver electrical energy during an absolute refractory period on alternate beats in the sequence of heart beats.

19. The system of claim 16, wherein the plurality of sensors are configured to be arranged in a bipolar configuration.

20. The system of claim 16, wherein the plurality of sensors are configured to be arranged in a unipolar configuration.

21. The system of claim 16, wherein the user interface includes a first display configured to display raw electrocardiogram (ECG) signals of the subject and a second display configured to display the susceptibility to atrial-rhythm disturbances of the subject.