System and method of identifying sources for biological rhythms

• US 9,724,009 B2
• Filed: 10/06/2014
• Issued: 08/08/2017
• Est. Priority Date: 12/09/2011
• 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), National Aeronautics and Space Administration (Government of the United States of America), Regents of the University of California (University of California)
• Inventors: Narayan, Sanjiv, Briggs, Carey Robert
• Primary Examiner(s): Kahelin, Michael
• Assistant Examiner(s): PHAM, MINH DUC GIA
• Application Number:
  US14/507,790
• Publication Number:
  US 20150038861A1
• Time in Patent Office: 1,037 Days
• Field of Search: 600508
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• 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 5/339 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 5/35 by template matching
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 5/7425 Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 8/02 Measuring pulse or heart rate

Abstract

A system and method of locating a source of a heart rhythm disorder are provided in which a first pair of cardiac signals is processed to define a first coefficient associated with variability of the first pair of signals at a first region of the heart. A second pair of cardiac signals is processed to define a second coefficient associated with variability of the second pair of signals at a second region of the heart. Thereafter, the first coefficient of variability is compared to the second coefficient of variability to determine a direction towards the source of the rhythm disorder.

Claims

1. A method of locating a source of a rhythm disorder of a heart, the method comprising:

processing a first pair of cardiac signals to define a first coefficient associated with variability among the first pair of signals at a first region of the heart;

processing a second pair of cardiac signals to define a second coefficient associated with variability among the second pair of signals at a second region of the heart; and

comparing the first coefficient of variability to the second coefficient of variability to determine a direction towards the source of the rhythm disorder;

wherein variability is determined independent of activation onsets within the signals.

2. The method of claim 1, wherein processing the first pair of cardiac signals comprises processing a first cardiac signal at one or more first time points against a second cardiac signal at one or more second time points to define the first coefficient of variability based on one or more coordinate pairs of the first cardiac signal against the second cardiac signal.

3. The method of claim 1, wherein processing the second pair of cardiac signals comprises processing a third cardiac signal at one or more third time points against a fourth cardiac signal at one or more fourth time points to define the second coefficient of variability based on one or more coordinate pairs of the third cardiac signal against the fourth cardiac signal.

4. The method of claim 1, wherein the first cardiac signal and the third cardiac signal comprise a common signal.

5. The method of claim 1, wherein the first and second regions are the same region of the heart.

6. The method of claim 1, wherein the first and second regions are different regions of the heart.

7. The method of claim 1, wherein at least one of the first coefficient of variability and the second coefficient of variability is determined from at least one of a variability in signal timing and a variability in signal amplitude among at least one of the first pair of cardiac signals and the second pair of cardiac signals.

8. The method of claim 1, wherein at least one of the first coefficient of variability and the second coefficient of variability is determined from variability in signal shape among at least one of the first pair of cardiac signals and the second pair of cardiac signals.

9. The method of claim 1, wherein at least one of the first coefficient of variability and the second coefficient of variability is determined by one or more methods selected from a group consisting of standard deviation analysis, frequency analysis, entropy analysis, cross-correlation analysis, randomness analysis, Monte Carlo simulation methods, quantification of chaos, other complex statistical analyses, and combinations thereof.

10. The method of claim 1, wherein the variability is in one or more of amplitude, voltage, motion, direction, impedance, conductance, and another dimension other than time.

11. The method of claim 1, wherein the variability is in time.

12. The method of claim 1, wherein the method further comprises:

iteratively selecting the first pair of cardiac signals and the second pair of cardiac signals from a plurality of cardiac signals, each iteratively selected pair differing in at least one cardiac signal;

processing the first iteratively selected signal and the second iteratively selected signal from each pair for each iteration to define the first coefficient of variability and the second coefficient of variability, respectively;

constructing a matrix of coefficients associated with variability for the iteratively selected pairs of cardiac signals; and

determining one or more sources of the rhythm disorder using the matrix of coefficients.

13. The method of claim 12, wherein determining the one or more sources comprises identifying from the matrix one or more regions of the heart associated with higher coefficients of variability surrounded by regions of lower coefficients of variability.

14. The method of claim 1, wherein the source of the rhythm disorder is located in a direction from lower coefficients of variability towards higher coefficients of variability.

15. A system to locate a source of a rhythm disorder of a heart, the system comprising at least one computing device configured to:

process a first pair of cardiac signals to define a first coefficient associated with variability among the first pair of signals at a first region of the heart;

process a second pair of cardiac signals to define a second coefficient associated with variability among the second pair of signals at a second region of the heart; and

compare the first coefficient of variability to the second coefficient of variability to determine a direction towards the source of the rhythm disorder;

wherein variability is determined independent of activation onsets within the signals.

16. The system of claim 15, wherein the at least one computing device is configured to processes a first cardiac signal at one or more first time points against a second cardiac signal at one or more second time points to define the first coefficient of variability based on one or more coordinate pairs of the first cardiac signal against the second cardiac signal.

17. The system of claim 15, wherein the at least one computing device is configured to processes a third cardiac signal at one or more third time points against a fourth cardiac signal at one or more fourth time points to define the second coefficient of variability based on one or more coordinate pairs of the third cardiac signal against the fourth cardiac signal.

18. The system of claim 15, wherein the first cardiac signal and the third cardiac signal comprise a common signal.

19. The system of claim 15, wherein the first and second regions are the same region of the heart.

20. The system of claim 15, wherein the first and second regions are different regions of the heart.

21. The system of claim 15, wherein at least one of the first coefficient of variability and the second coefficient of variability is determined from at least one of variability in signal timing and variability in signal amplitude among at least one of the first pair of cardiac signals and the second pair of cardiac signals.

22. The system of claim 15, wherein at least one of the first coefficient of variability and the second coefficient of variability is determined from variability in signal shape among at least one of the first pair of cardiac signals and the second pair of cardiac signals.

23. The system of claim 15, wherein at least one of the first coefficient of variability and the second coefficient of variability is determined by one or more methods selected from a group consisting of standard deviation analysis, frequency analysis, entropy analysis, cross-correlation analysis, randomness analysis, Monte Carlo simulation methods, quantification of chaos, other complex statistical analyses, and combinations thereof.

24. The system of claim 15, wherein the variability is in one or more of amplitude, voltage, motion, direction, impedance, conductance, and another dimension other than time.

25. The system of claim 15, wherein the variability is in time.

26. The system of claim 15, wherein the at least one computing device is configured to:

iteratively select the first pair of cardiac signals and the second pair of cardiac signals from a plurality of cardiac signals, each iteratively selected pair differing in at least one cardiac signal;

process the first iteratively selected signal and the second iteratively selected signal from each pair for each iteration to define the first coefficient of variability and the second coefficient of variability, respectively;

construct a matrix of coefficients associated with variability for the iteratively selected pairs of cardiac signals; and

determine one or more sources of the rhythm disorder using the matrix of coefficients.

27. The system of claim 15, wherein the at least one computing device is further configured to identify from the matrix one or more regions of the heart associated with higher coefficients of variability surrounded by regions of lower coefficients of variability to determine one or more sources of the rhythm disorder.

28. The system of claim 15, wherein the source of the rhythm disorder is located in a direction from lower coefficients of variability towards higher coefficients of variability.