System for automatic medical ablation control

• US 9,277,956 B2
• Filed: 08/13/2012
• Issued: 03/08/2016
• Est. Priority Date: 11/09/2011
• Status: Active Grant

• Current Assignee: PixArt Imaging Incorporated
• Original Assignee: Siemens Medical Solutions USA Incorporated (Siemens AG)
• Inventors: Zhang, Hongxuan
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US13/572,862
• Publication Number:
  US 20130116681A1
• Time in Patent Office: 1,303 Days
• Field of Search: 606/27, 606/34, 606/41, 607 4- 5
• US Class Current: 1/1
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/0075 Phase
• CPC Class Codes: A61B 2018/00761 Duration
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/283 Invasive
• 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 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence

Abstract

A system provides heart ablation unit control. The system includes an input processor for acquiring electrophysiological signal data from multiple tissue locations of a heart and data indicating tissue thickness at the multiple tissue locations. A signal processor processes the acquired electrophysiological signal data to identify location of particular tissue sites of the multiple tissue locations exhibiting electrical abnormality in the acquired electrophysiological signal data and determines an area of abnormal tissue associated with individual sites of the particular sites. An ablation controller automatically determines ablation pulse characteristics for use in ablating cardiac tissue at an individual site of the particular tissue sites in response to the acquired data indicating the thickness of tissue and determined area of abnormality of the individual site.

Claims

1. A system for heart ablation unit control, comprising:

an input processor for acquiring electrophysiological signal data from a plurality of tissue locations of a heart and data indicating tissue thickness at said plurality of tissue locations;

a signal processor for processing the acquired electrophysiological signal data to,

identify location of particular tissue sites of said plurality of tissue locations exhibiting electrical abnormality in said acquired electrophysiological signal data and

determine an area of abnormal tissue associated with individual sites of said particular sites;

an ablation controller for automatically determining ablation pulse characteristics for use in ablating cardiac tissue at an individual site of said particular tissue sites in response to the acquired data indicating the thickness of tissue and determined area of abnormality of the individual site; and

a severity processor for processing the acquired electrophysiological signal data to determine a degree of severity of abnormality at each of said particular tissue sites and prioritizing order in which said particular tissue sites are ablated in response to the determined degree of severity, wherein said severity processor processes the acquired electrophysiological signal data to determine said degree of severity of abnormality by determining a measure of distortion in a P wave in said electrophysiological signal data in response to at least one of, (a) change in peak amplitude of said P wave, (b) change in dominant frequency of said P wave, (c) change in energy of said P wave and (d) change in time duration between successive peaks of said P wave.

2. The system according to claim 1, including

a display processor for generating data representing a display image showing a representation of said plurality of tissue locations and indicating said particular tissue sites and area of abnormal tissue associated with said individual sites of said particular sites.

3. The system according to claim 2, wherein

said representation of said plurality of tissue locations comprises a two dimensional (2D) or three dimensional (3D) representation of a patient heart.

4. The system according to claim 1, wherein

said input processor acquires data indicating a measured dominant rotor frequency at said individual site and said ablation controller determines an ablation pulse characteristic comprising pulse frequency in response to the rotor frequency.

5. The system according to claim 1, wherein

said input processor acquires data indicating a measured dominant rotor frequency at said individual site and said ablation controller determines an ablation pulse characteristic comprising an ablation pulse frequency in response to the rotor frequency by selection of said pulse frequency from predetermined information associating ablation pulse frequency with rotor frequency for a patient having similar patient demographic characteristics as said patient.

6. The system according to claim 5, wherein

said demographic characteristics comprise at least one of, age, weight, gender, body mass index and height.

7. The system according to claim 1, wherein

said ablation controller determines an ablation pulse characteristic comprising pulse width in response to at least one, (a) of said thickness of tissue and (b) said determined area of abnormality by selection of said pulse width from predetermined information associating ablation pulse width with thickness of tissue and area of tissue for a patient having similar patient demographic characteristics as said patient.

8. The system according to claim 7, wherein

said ablation controller determines an ablation pulse characteristic comprising pulse electrical energy in response to at least one, (a) of said thickness of tissue and (b) said determined area of abnormality by selection of said pulse electrical energy from predetermined information associating ablation pulse electrical energy with tissue thickness and abnormality area for a patient having similar patient demographic characteristics as said patient.

9. The system according to claim 1 including

a display processor for generating data representing a display image showing a representation of said plurality of tissue locations and indicating said particular tissue sites and area of abnormal tissue associated with said individual sites of said particular sites and the priority of order of ablation of said particular tissue sites.

10. The system according to claim 9, wherein

said display processor automatically updates said display image to show an updated area of abnormal tissue associated with said individual sites in response to performing ablation at said individual site.

11. The system according to claim 9, wherein

said ablation controller automatically re-determines and updates said ablation pulse characteristics in response to performing ablation at said individual site.

12. The system according to claim 1, including

a display processor for generating data representing a display image showing a representation of said plurality of tissue locations and indicating said particular tissue sites and area of abnormal tissue associated with said individual sites of said particular sites and the priority of order of ablation of said particular tissue sites and

said display processor updates said display image to show an updated area of abnormal tissue associated with said individual sites in response to performing ablation at said individual site.

13. The system according to claim 1, wherein

said ablation controller determines an ablation pulse characteristic comprising pulse type by selecting pulse type from, (a) a uniphase type and (a) biphase type in response to a determined rotor signal type.

14. The system according to claim 1, wherein

said ablation controller determines an ablation characteristics comprising interval between ablation episodes and ablation duration in response to at least one, (a) of said thickness of tissue and (b) said determined area of abnormality by selection of said pulse width from predetermined information associating ablation pulse width with thickness of tissue and area of tissue for a patient having similar patient demographic characteristics as said patient.

15. The system according to claim 1, wherein

said ablation controller synchronizes ablation pulse delivery with a heart cycle synchronization signal.

16. The system according to claim 1, wherein

said ablation controller compares areas of abnormality after ablation of said individual site with areas of abnormality prior to ablation of said individual site and indicates differences.

17. A method for heart ablation unit control, comprising the activities of:

acquiring electrophysiological signal data from a plurality of tissue locations of a heart and data indicating tissue thickness at said plurality of tissue locations;

processing the acquired electrophysiological signal data to,

identify location of particular tissue sites of said plurality of tissue locations exhibiting electrical abnormality in said acquired electrophysiological signal data and

determine an area of abnormal tissue associated with individual sites of said particular sites;

acquiring data indicating a measured dominant rotor frequency at said individual site;

automatically determining ablation pulse characteristics comprising pulse frequency in response to the rotor frequency for use in ablating cardiac tissue at an individual site of said particular tissue sites in response to the acquired data indicating the thickness of tissue and determined area of abnormality of the individual site.

18. The method according to claim 17, including the activity of

generating data representing a display image showing a representation of said plurality of tissue locations and indicating said particular tissue sites and area of abnormal tissue associated with said individual sites of said particular sites.

19. The method according to claim 18, wherein

said representation of said plurality of tissue locations comprises a two dimensional (2D) or three dimensional (3D) representation of a patient heart.

20. The system according to claim 17, including the activity of

processing the acquired electrophysiological signal data to determine a degree of severity of abnormality at each of said particular tissue sites and prioritizing order in which said particular tissue sites are ablated in response to the determined degree of severity.

21. A system for heart ablation unit control, comprising:

an input processor for acquiring electrophysiological signal data from a plurality of tissue locations of a heart and data indicating tissue thickness at said plurality of tissue locations;

a signal processor for processing the acquired electrophysiological signal data to,

identify location of particular tissue sites of said plurality of tissue locations exhibiting electrical abnormality in said acquired electrophysiological signal data and

determine an area of abnormal tissue associated with individual sites of said particular sites, wherein said input processor acquires data indicating a measured dominant rotor frequency at said individual site; and

an ablation controller for automatically determining ablation pulse characteristics comprising pulse frequency in response to the rotor frequency for use in ablating cardiac tissue at an individual site of said particular tissue sites in response to the acquired data indicating the thickness of tissue and determined area of abnormality of the individual site.

22. The system according to claim 21, wherein

said input processor acquires said data indicating a measured dominant rotor frequency at said individual site and said ablation controller determines said ablation pulse characteristic comprising said ablation pulse frequency in response to the rotor frequency by selection of said pulse frequency from predetermined information associating ablation pulse frequency with rotor frequency for a patient having similar patient demographic characteristics as said patient.

23. The system according to claim 22, wherein

said demographic characteristics comprise at least one of, age, weight, gender, body mass index and height.