Cardiac mapping

• US 9,730,602 B2
• Filed: 03/22/2015
• Issued: 08/15/2017
• Est. Priority Date: 06/13/2006
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Greenfield, Pavel, Amariglio, Leon
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US14/664,861
• Publication Number:
  US 20150196217A1
• Time in Patent Office: 877 Days
• Field of Search: None
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/343 Potential distribution indication
• CPC Class Codes: A61B 5/6852 Catheters

Abstract

A non-contact cardiac mapping method is disclosed that includes: (i) inserting a catheter into a heart cavity having an endocardium surface, the catheter including multiple, spatially distributed electrodes; (ii) measuring signals at the catheter electrodes in response to electrical activity in the heart cavity with the catheter spaced from the endocardium surface; and (iii) determining physiological information at multiple locations of the endocardium surface based on the measured signals and positions of the electrodes with respect to the endocardium surface. Related systems and computer programs are also disclosed.

Claims

1. A system comprising:

a catheter configured to be inserted into a heart cavity having an endocardium surface and to be moved to each of multiple different positions in the heart cavity, the catheter comprising electrodes configured to measure signals that are based on electrical activity in the heart cavity;

a sensor device configured to determine positions of the electrodes with respect to the endocardium surface, for each of the multiple different positions; and

a processing unit configured to determine physiological information at multiple locations of the endocardium surface based on the positions of the electrodes and the signals,

wherein the sensor device is configured to determine positions of the catheter with respect to the endocardium surface in a first coordinate system and to register a representation of the endocardium surface with the first coordinate system;

wherein the processing unit is configured to determine physiological information at multiple locations of the endocardium surface based on the positions of the electrodes and the signals by applying a transformation function to the signals, the transformation function relating signals from at least some of the multiple different positions to the physiological information at the multiple locations of the endocardium surface based at least in part on the positions of the catheter with respect to the endocardium surface; and

wherein the signals are measured during multiple electrical heart beat cycles and the physiological information is determined, at least in part, by combining information derived from the signals for different heart beat cycles.

2. The system of claim 1, comprising a display device configured to display at least a portion of the endocardium surface to include at least some of the physiological information determined at the multiple locations.

3. The system of claim 1, wherein the sensor device is configured to measure and use information about at least one of a position and orientation of the catheter within the heart cavity to determine the positions of the electrodes with respect to the endocardium surface.

4. The system of claim 3, wherein the information about at least one of a position and orientation of the catheter within the heart cavity includes information about the position of one or more of the electrodes within the heart cavity.

5. The system of claim 1, wherein the representation of the endocardium surface is obtained using an ultrasound-based imaging technique.

6. The system of claim 1, wherein the sensor device is configured to directly measure and use information about positions of each of the electrodes within the heart cavity.

7. The system of claim 1, wherein the processing unit is configured to determine the transformation function by calculating a forward transformation for relating the physiological information at the multiple different locations of the endocardium surface to the signals and inverting the forward transformation.

8. The system of claim 1, wherein the processing device is configured to determine electrical potential values at the multiple different locations at each of one or more different phases of the heart beat cycle, and comprising a display configured to display the electrical potential values at the multiple different locations at each of the one or more different phases of the heart beat cycle.

9. A method comprising:

inserting a catheter into a heart cavity having an endocardium surface, the catheter comprising multiple electrodes;

measuring signals, generated by electrical activity in the heart cavity, at the multiple electrodes; and

determining physiological information at multiple locations of the endocardium surface based on the signals and positions of the electrodes with respect to the endocardium surface,

wherein the signals are measured during multiple electrical heart beat cycles and the physiological information is determined, at least in part, by combining information derived from the signals for different heart beat cycles.

10. The method of claim 9, wherein the physiological information includes a maximum voltage amplitude for each of the different heart beat cycles at different endocardium surface locations.

11. The method of claim 10, wherein the combining information comprises averaging together the maximum voltage amplitudes for the different heart beat cycles.

12. The method of claim 9, wherein the physiological information includes electrical potential values at the multiple locations of the endocardium surface at each of one or more different phases of the heart beat cycle.

13. The method of claim 9 wherein the physiological information includes a frequency representation of electrical activity at the multiple locations of the endocardium surface during the heart beat cycle, wherein the frequency representation is computed based on electrical potential values at the multiple locations of the endocardium surface at different phases of the heart beat cycle.

14. The method of claim 9, wherein the physiological information includes an activation time for each of different locations of the endocardium surface.

15. The method of claim 9, wherein determining physiological information at the multiple locations of the endocardium surface comprises determining multiple estimates of the physiological information for each of at least some of the locations on the endocardium surface based on the signals corresponding to at least some of the different catheter positions.

16. A system comprising:

a catheter configured to be inserted into a heart cavity having an endocardium surface, the catheter comprising multiple electrodes configured to measure signals based on electrical activity in the heart cavity; and

a processing unit configured to determine physiological information at multiple locations of the endocardium surface based on the signals and positions of the electrodes with respect to the endocardium surface,

wherein the signals are measured during multiple electrical heart beat cycles and the processing unit is configured to, at least in part, combine information derived from the signals for different heart beat cycles.

17. The system of claim 16, wherein the information derived from the signals for different heart beat cycles comprises maximum voltage amplitudes for each of the different heart beat cycles at different ones of the endocardium surface locations.

18. The system of claim 17, wherein the processing unit is configured to average together the maximum voltage amplitudes for the different heart beat cycles.

19. The system of claim 16, wherein the physiological information includes at least one of:

electrical potential values at the multiple locations of the endocardium surface at each of one or more different phases of the heart beat cycle;

a frequency representation of electrical activity at the multiple locations of the endocardium surface during the heart beat cycle, wherein the frequency representation is computed based on electrical potential values at the multiple locations of the endocardium surface at different phases of the heart beat cycle; and

an activation time for each of different locations of the endocardium surface.