Electroanatomical mapping

• US 9,498,146 B2
• Filed: 07/27/2015
• Issued: 11/22/2016
• Est. Priority Date: 01/13/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Rhythmia Medical, Inc. (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Stewart, Brian
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US14/809,858
• Publication Number:
  US 20160051160A1
• Time in Patent Office: 484 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 2560/0295 adapted for recording user messages or annotations
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0536 Impedance imaging, e.g. by tomography
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/343 Potential distribution indication
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/367 Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7242 using integration
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 5/7475 : User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61B 6/00 : Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment instruments measuring radiation intensity for application in the field of nuclear medicine, e.g. in vivo counting, G01T1/161; apparatus for taking X-ray photographs G03B42/02
• CPC Class Codes: G06T 19/00 : Manipulating 3D models or images for computer graphics
• CPC Class Codes: G06T 2219/004 : Annotating, labelling
• CPC Class Codes: G16H 10/60 : for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 : ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

This invention relates to the determination and/or representation of physiological information relating to a heart surface.

Claims

1. A method for providing an electroanatomical representation of a patient'"'"'s heart, the method comprising:

measuring signals at one or more electrodes over a time period including multiple heart beat cycles, at least some of the signals being in response to electrical activity in the patient'"'"'s heart cavity;

selecting portions of a first signal to process to determine a triggering event based on a second, different signal of the measured signals;

applying an algorithm to the selected portions of the first signal to determine the triggering event in the first signal;

synchronizing, by the computer, the signals measured at the one or more electrodes with one another according to a heartbeat cycle based on the triggering event; and

generating, by the computer, the electroanatomical representation of the patient'"'"'s heart based on the synchronized measured signals and positions of the catheter electrodes.

2. The method of claim 1, further comprising:

processing the second, different signal to determine an event corresponding in time to a potential undesired triggering event in the first signal; and

wherein selecting portions of the first signal to process to determine the triggering event comprises selecting a portion of the first signal that excludes the time period including the potential undesired triggering event.

3. The method of claim 1, wherein applying the algorithm to the selected portions of the first signal to determine the triggering event comprises:

processing the first signal using a sliding window integration to generate a reference signal; and

analyzing the reference signal to determine the triggering event.

4. The method of claim 1, wherein applying the algorithm to the selected portions of the first signal to determine the triggering event comprises:

processing the first signal to generate a representation of instantaneous energy; and

analyzing the representation of instantaneous energy to determine the triggering event.

5. The method of claim 1, wherein applying the algorithm to the selected portions of the first signal to determine the triggering event comprises:

applying an algorithm to generate a representation of the first signal having reduced jitter; and

analyzing the representation of the first signal having reduced jitter to determine the triggering event.

6. The method of claim 1, wherein applying the algorithm to the selected portions of the first signal to determine the triggering event comprises applying an algorithm to integrate the first signal over a window.

7. The method of claim 1, wherein selecting portions of the first signal comprises selecting portions of the first signal to process to determine the triggering event based on a surface electrocardiogram signal.

8. The method of claim 1, wherein selecting portions of the first signal comprises selecting portions of the first signal to exclude from processing.

9. The method of claim 1, wherein selecting portions of the first signal comprises selecting portions of the first signal to include in processing.

10. The method of claim 1, wherein the one or more electrodes comprise one or more electrodes on an intracardiac catheter.

11. A system for providing information about an electroanatomical representation of a patient'"'"'s heart, the system comprising:

one or more electrodes for measuring signals over a time period including multiple heart beat cycles, at least some of the signals being in response to electrical activity in the patient'"'"'s heart cavity; and

an electronic processor coupled to the one or more electrodes, wherein the electronic processor is configured to;

select portions of a first signal to process to determine a triggering event based on a second, different signal of the measured signals;

apply an algorithm to the first signal to determine the triggering event in the first signal;

synchronize the signals measured at the one or more electrodes with one another according to a heart beat cycle based on the triggering event; and

generate the electroanatomical representation of the patient'"'"'s heart based on the synchronized measured signals and positions of the catheter electrodes.

12. The system of claim 11, wherein the electronic processor is configured to:

process the second, different signal to determine an event corresponding in time to a potential undesired triggering event in the first signal; and

wherein to select portions of the first signal to process includes to select a portion of the first signal that excludes the time period including the potential undesired triggering event.

13. The system of claim 11, wherein to apply the algorithm to the first signal to determine the triggering event includes to:

process the first signal using a sliding window integration to generate a reference signal; and

analyze the reference signal to determine the triggering event.

14. The system of claim 11, wherein to apply the algorithm to the first signal to determine the triggering event includes to:

process the first signal to generate a representation of instantaneous energy; and

analyze the representation of instantaneous energy to determine the triggering event.

15. The system of claim 11, wherein to apply the algorithm to the first signal to determine the triggering event includes to:

apply an algorithm to generate a representation of the first signal having reduced jitter; and

analyze the representation of the first signal having reduced jitter to determine the triggering event.

16. The system of claim 11, wherein to apply the algorithm to the first signal to determine the triggering event includes to apply an algorithm to integrate the first signal over a window.

17. The system of claim 11, wherein to select portions of the first signal comprises to select portions of the first signal to process to determine the triggering event based on a surface electrocardiogram signal.

18. The system of claim 11, wherein to select portions of the first signal comprises to select portions of the first signal to exclude from processing.

19. The system of claim 11, wherein to select portions of the first signal comprises to select portions of the first signal to include in processing.

20. The system of claim 11, wherein the one or more electrodes comprise one or more electrodes on an intracardiac catheter.