Determination of site of origin for a natural electrical pulse in a living body

• US 8,588,894 B2
• Filed: 09/25/2008
• Issued: 11/19/2013
• Est. Priority Date: 09/28/2007
• Status: Active Grant

• Current Assignee: University of Maryland Baltimore County (University of Maryland)
• Original Assignee: University of Maryland Baltimore County (University of Maryland)
• Inventors: Saba, Magdi M., Shorofsky, Stephen R.
• Primary Examiner(s): MALAMUD, DEBORAH LESLIE
• Application Number:
  US12/680,454
• Publication Number:
  US 20100262203A1
• Time in Patent Office: 1,881 Days
• Field of Search: 600508-510, 600/512, 600515-518, 607 1- 2, 607 4- 5, 607/9, 607/11, 607/17, 607/25, 607/26, 607/115, 607/119, 607/125, 128/920
• US Class Current: 600/512
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia

Abstract

Techniques include determining a first vector of temporal changes in electrical data measured at multiple electrical sensors positioned at corresponding locations on a surface of a living body due to a natural electrical pulse. A different vector of temporal changes in electrical data measured at the same electrical sensors is determined due to each stimulated signal of multiple stimulated signals within the living body. Stimulated position data is received, which indicates a different corresponding position within the living body where each of the stimulated signals originates. The site of origin of the natural electrical pulse is determined based on the first vector and the multiple different vectors and the stimulated position data. Among other applications, these techniques allow the rapid, automatic determination of the site of origin of ventricular tachycardia arrhythmia (VT).

Claims

1. A method for determining a site of origin of a natural electrical pulse in a living body comprising:

determining a first vector of temporal changes in electrical data measured at a plurality of electrical sensors positioned at a corresponding plurality of locations on an external surface of a living body due to a natural electrical pulse, wherein each vector comprises a plurality of properties of the temporal changes at each electrical sensor;

determining a different vector of temporal changes in electrical data measured at the plurality of electrical sensors positioned at the corresponding plurality of locations on the external surface of the living body due to each stimulated signal of a plurality of stimulated signals within the living body, wherein each vector comprises a plurality of properties of the temporal changes at each electrical sensor;

receiving stimulated position data that indicates a different corresponding position within the living body where each of the plurality of stimulated signals originates; and

determining the site of origin of the natural electrical pulse based on the first vector and the plurality of different vectors and the stimulated position data.

2. A method as recited in claim 1, wherein the natural electrical pulse is a ventricular tachycardia arrhythmia.

3. A method as recited in claim 1, wherein the electrical data measured at the plurality of electrical sensors positioned at the corresponding plurality of locations on a surface of the living body comprises electrocardiograph (ECG) lead data for a plurality of ECG leads positioned at three or more of twelve standard ECG positions.

4. A method as recited in claim 1, wherein:

said step of determining the first vector of temporal changes further comprising determining a change in voltage at each lead of at least three leads of an ECG system during a first time interval after onset of an electrical depolarization of heart ventricles known as a QRS portion of a heartbeat; and

said step of determining the different vector of temporal gradients further comprising determining a change in voltage at each lead of the at least three leads of the ECG system during the first time interval after stimulation by a catheter positioned inside a heart ventricle of interest.

5. A method as recited in claim 1, further comprising, after said step of determining the site of origin of the natural electrical pulse, applying treatment to the site of origin.

6. A method as recited in claim 1, further comprising, before said step of determining the site of origin of the natural pulse, receiving data that indicates a three-dimensional electro-anatomic map of a ventricle of interest.

7. A method as recited in claim 1, said step of determining the different vector of temporal changes further comprising, for each stimulation signal of the plurality of stimulation signals:

positioning a electrophysiological catheter at a different corresponding position in the living body; and

discharging a stimulation signal with a spike in voltage of a particular amplitude repeated at a particular rate.

8. A method as recited in claim 7, wherein

the different corresponding position in the living body is a different particular position on a wall of a ventricle of a heart;

and

the particular rate is a repeat rate of a ventricular tachycardia arrhythmia.

9. A method as recited in claim 1, said step of determining the site of origin of the natural electrical pulse further comprising determining a single vector transform that best converts every different vector to the different corresponding position within the body.

10. A method as recited in claim 1, said step of determining the site of origin of the natural electrical pulse further comprising determining a linear combination of the different vectors to produce the first vector.

11. A method as recited in claim 10, said step of determining the site of origin of the natural electrical pulse further comprising applying the linear combination to the corresponding positions to determine the site of origin.

12. A non-transitory computer-readable medium carrying one or more sequences of instructions for determining site of origin or a natural electrical pulse inside a living body, wherein execution of the one or more sequences of instructions by one or more processors causes the one or more processors to perform the steps of:

determining a first vector of temporal changes in electrical data measured at a plurality of electrical sensors positioned at a corresponding plurality of locations on an external surface of a living body due to a natural electrical pulse, wherein each vector comprises a plurality of properties of the temporal changes at each electrical sensor;

determining a different vector of temporal changes in electrical data measured at the plurality of electrical sensors positioned at the corresponding plurality of locations on the external surface of the living body due to each stimulated signal of a plurality of stimulated signals within the living body, wherein each vector comprises a plurality of properties of the temporal changes at each electrical sensor;

receiving stimulated position data that indicates a different corresponding position within the living body where each of the plurality of stimulated signals originates; and

determining the site of origin of the natural electrical pulse based on the first vector and the plurality of different vectors and the stimulated position data.

13. A system for determining a site of origin of a natural electrical pulse in a living body comprising:

means for determining a first vector of temporal changes in electrical data measured at a plurality of electrical sensors positioned at a corresponding plurality of locations on an external surface of a living body due to a natural electrical pulse, wherein each vector comprises a plurality of properties of the temporal changes at each electrical sensor;

means for determining a different vector of temporal changes in electrical data measured at the plurality of electrical sensors positioned at the corresponding plurality of locations on the external surface of the living body due to each stimulated signal of a plurality of stimulated signals within the living body, wherein each vector comprises a plurality of properties of the temporal changes at each electrical sensor;

means for receiving stimulated position data that indicates a different corresponding position within the living body where each of the plurality of stimulated signals originates; and

means for determining the site of origin of the natural electrical pulse based on the first vector and the plurality of different vectors and the stimulated position data.