System and method for reconstructing cardiac signals associated with a complex rhythm disorder

• US 9,241,667 B2
• Filed: 06/12/2015
• Issued: 01/26/2016
• Est. Priority Date: 04/08/2010
• Status: Active Grant

• Current Assignee: Topera, Inc (Abbott Laboratories), US Department of Veterans Affairs (Government of the United States of America), Regents of the University of California (University of California)
• Original Assignee: Topera, Inc (Abbott Laboratories), The United States of America As Represented By The Secretary of Agriculture, Regents of the University of California (University of California)
• Inventors: Narayan, Sanjiv, Sehra, Ruchir
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): CAREY, MICHAEL JAMES
• Application Number:
  US14/738,626
• Publication Number:
  US 20150289807A1
• Time in Patent Office: 228 Days
• Field of Search: 600/515, 600/513, 600/523
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0255 Recording instruments specially adapted therefor
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/4857 Indicating the phase of biorhythm clocks or watches with indicators for biological cycles G04B19/264
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61B 5/726 using Wavelet transforms
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence

Abstract

System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient'"'"'s heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.

Claims

1. A system to reconstruct cardiac signals associated with a complex rhythm disorder, the system comprising at least one computing device that comprises:

a controller configured to receive the cardiac signals from a plurality of sensors associated spatially with a patient'"'"'s heart; and

an analytic engine comprising;

a beat classification module configured to identify a plurality of discernible beats on high-confidence signals of sensors that are spatially adjacent to a sensor associated with a low-confidence signal, the discernible beats on the high-confidence signals corresponding to a non-discernible beat on the low-confidence signal; and

an activation onset module configured to;

compute a time vector between at least two activation onsets associated with the identified discernible beats on the high-confidence signals through the non-discernible beat on the low-confidence signal;

define a time interval associated with the non-discernible beat about a region of the low-confidence signal where the computed time vector crosses the non-discernible beat, the time interval indicating how early the non-discernible beat is able to activate based on a previous beat on the low-confidence signal that has a selected or determined activation onset and how late the non-discernible beat is able to terminate based on at least one predetermined property; and

assign the non-discernible beat an activation onset during the defined time interval that is closest to the computed time vector.

2. The system according to claim 1, wherein the activation onset is assigned in association with a deflection or a quiescent period during the defined time interval.

3. The system according to claim 1, wherein the activation onset module is further configured to:

determine a second time interval between discernible beats on the low-confidence signal occurring before the non-discernible beat, the second time extending from a first activation onset to a second activation onset of the respective discernible beats on the low-confidence signal;

advance the determined second time interval such that the first activation onset approximates the activation onset of a beat previous to the non-discernible beat;

reconcile the selected activation onset with the second activation onset to a reconciled activation onset; and

update the selected activation onset with the reconciled activation onset for the non-discernible beat.

4. The system according to claim 1, wherein the beat classification module is further configured to classify high-confidence signals that include at least a predetermined percentage of discernible beats out of total beats, each discernible beat having an identifiable activation onset, and low-confidence signals that include a first number of discernible beats and a second number of non-discernible beats, each non-discernible beat having a plurality of deflections and quiescent periods associated with a possible activation onset, the first number of discernible beats being below the predetermined percentage.

5. The system according to claim 1, wherein the complex rhythm disorder comprises no discernible period during which the cardiac signals are quiescent.

6. The system according to claim 1, wherein the system further comprises:

at least one storage device configured to store the cardiac signals received from the patient'"'"'s heart, the at least one storage device operatively coupled to the at least one computing device to provide the cardiac signals to the at least one computing device.

7. The system according to claim 1, wherein the system further comprises a catheter comprising the plurality of sensors to receive the cardiac signals from the patient'"'"'s heart and operatively coupled to the at least one computing device provide the cardiac signals to the at least one computing device.

8. The system according to claim 1, wherein the at least one computing device comprises a computer-readable medium storing instructions, which when executed by a processing device, cause the processing device to perform operations of the analytic engine.

9. The system according to claim 1, wherein the at least one computing device further comprises a representation tool configured to generate a clinical representation associated with the complex rhythm disorder using at least the activation onset assigned to the non-discernible beat.

10. An assembly to reconstruct cardiac signals associated with a complex rhythm disorder, the assembly comprising:

a catheter comprising a plurality of sensors spatially associated with a patient'"'"'s heart to receive the cardiac signals; and

a computer-readable medium operatively coupled to the sensors, the computer-readable medium comprising instructions, which when executed by a computing device, cause the computing device to;

identify a plurality of discernible beats on high-confidence signals of sensors that are spatially adjacent to a sensor associated with a low-confidence signal, the discernible beats on the high-confidence signals corresponding to a non-discernible beat on the low-confidence signal;

compute a time vector between at least two activation onsets associated with the identified discernible beats on the high-confidence signals through the non-discernible beat on the low-confidence signal;

define a time interval associated with the non-discernible beat about a region of the low-confidence signal where the computed time vector crosses the non-discernible beat, the defined time interval indicating how early the non-discernible beat is able to activate based on a previous beat on the low-confidence signal that has a selected or determined activation onset and how late the non-discernible beat is able to terminate based on at least one predetermined property; and

assign the non-discernible beat an activation onset during the defined time interval that is closest to the computed time vector for the non-discernible beat.

11. The assembly according to claim 10, wherein the activation onset is assigned in association with a deflection or a quiescent period during the defined time interval.

12. The assembly according to claim 10, wherein the computer-readable medium further comprises instructions, which when executed by the computing device, cause the computing device to:

determine a second time interval between discernible beats on the low-confidence signal occurring before the non-discernible beat, the second time interval extending from a first activation onset to a second activation onset of the respective discernible beats on the low-confidence signal;

advance the second time interval such that the first activation onset approximates the activation onset of a beat previous to the non-discernible beat;

reconcile the selected activation onset with the second activation onset to a reconciled activation onset; and

update the selected activation onset with the reconciled activation onset for the non-discernible beat.

13. The assembly according to claim 10, wherein the computer-readable medium further comprises instructions, which when executed by a computing device, cause the computing device to

classify high-confidence signals that include at least a predetermined percentage of discernible beats out of total beats, each discernible beat having an identifiable activation onset, and low-confidence signals that include a first number of discernible beats and a second number of non-discernible beats, each non-discernible beat having a plurality of deflections and quiescent periods associated with a possible activation onset, the first number of discernible beats being below the predetermined percentage.

14. The assembly according to claim 10, wherein the complex rhythm disorder comprises no discernible period during which the cardiac signals are quiescent.

15. The assembly according to claim 10, wherein the assembly further comprises at least one storage device configured to store the cardiac signals received from the catheter, the at least one storage device accessible to the computer-readable medium to provide the cardiac signals to the computing device.

16. The assembly according to claim 10, wherein the computer-readable medium further comprises instructions, which when executed by a computing device, cause the computing device to generate a clinical representation associated with the complex rhythm disorder using at least the activation onset assigned to the non-discernible beat.

17. A method of reconstructing cardiac signals associated with a complex rhythm disorder received from a plurality of sensors associated spatially with a patient'"'"'s heart, the method comprising:

identifying, using a beat classification module of a computing device, a plurality of discernible beats on high-confidence signals of sensors that are spatially adjacent to a sensor associated with a low-confidence signal, the discernible beats on the high-confidence signals corresponding to a non-discernible beat on the low-confidence signal;

computing, using an activation onset module of the computing device, a time vector between at least two activation onsets associated with the identified discernible beats on the high-confidence signals through the non-discernible beat on the low-confidence signal;

defining, using the activation onset module, a time interval associated with the non-discernible beat about a region of the low-confidence signal where the computed time vector crosses the non-discernible beat, the time interval indicating how early the non-discernible beat is able to activate based on a previous beat on the low-confidence signal that has a selected or determined activation onset and how late the non-discernible beat is able to terminate based on at least one predetermined property; and

assigning, using the activation onset module, the non-discernible beat an activation onset during the defined time interval that is closest to the computed time vector.

18. The method according to claim 17, wherein the activation onset is assigned in association with a deflection or a quiescent period during the defined time interval.

19. The method according to claim 17, wherein the method further comprises:

determining, using the activation onset module, a second time interval between discernible beats on the low-confidence signal occurring before the non-discernible beat, the second time interval extending from a first activation onset to a second activation onset of the respective discernible beats on the low-confidence signal;

advancing, using the activation onset module, the second time interval such that the first activation onset approximates the activation onset of a beat previous to the non-discernible beat;

reconciling, using the activation onset module, the selected activation onset with the second activation onset to a reconciled activation onset; and

updating, using the activation onset module, the selected activation onset with the reconciled activation onset for the non-discernible beat.

20. The method according to claim 17, wherein the method further comprises classifying, using the beat classification module, high-confidence signals that include at least a predetermined percentage of discernible beats out of total beats, each discernible beat having an identifiable activation onset, and low-confidence signals that include a first number of discernible beats and a second number of non-discernible beats, each non-discernible beat having a plurality of deflections and quiescent periods associated with a possible activation onset, the first number of discernible beats being below the predetermined percentage.

21. The method according to claim 17, wherein the method further comprises generating, using a representation tool of the computing device, a clinical representation associated with the complex rhythm disorder using at least the activation onset assigned to the non-discernible beat.