Real-time morphology analysis for lesion assessment

• US 9,743,854 B2
• Filed: 12/18/2015
• Issued: 08/29/2017
• Est. Priority Date: 12/18/2014
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Inventors: Stewart, Brian, Magen, Adam, Bennett, Nathan H., Weisman, Michal, Hultz, Paul
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US14/975,197
• Publication Number:
  US 20160174865A1
• Time in Patent Office: 620 Days
• Field of Search: None
• 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 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• 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 5/6852 Catheters

Abstract

Electrodes are used to measure an electrical signal (e.g., an electrogram). One or more filters are applied to the electrical signal to generate one or more filtered signals. Features of the filtered signals are evaluated to assess a sharpness corresponding to the electrical signal. Based on the sharpness, various characteristics of a morphology of the electrogram may be evaluated over a time period.

Claims

1. A system comprising:

a catheter including;

a flexible catheter body having a distal portion; and

at least one electrode disposed on the distal portion, the at least one electrode configured to measure an electrical signal based on a cardiac activation signal; and

a mapping processor configured to;

acquire the electrical signal from the at least one electrode;

provide an electrogram based on the electrical signal;

determine a sharpness feature associated with the electrogram and, based on the determined sharpness feature, determine a characteristic of a morphology of the electrogram, wherein the characteristic of the morphology of the electrogram is related to the sharpness.

2. The system of claim 1, wherein the catheter comprises an ablation catheter including a tissue ablation electrode configured to apply ablation energy to tissue, the system further comprising a radiofrequency (RF) generator operatively coupled to the tissue ablation electrode, wherein the RF generator is configured to generate the ablation energy and convey the generated ablation energy to the tissue ablation electrode, and wherein the mapping processor is configured to determine the sharpness before an ablation, during an ablation, and/or after an ablation.

3. The system of claim 1, further comprising a display device, wherein the mapping processor comprises:

a filter configured to filter the electrical signal to generate a filtered signal;

a feature detector configured to determine an amplitude of the filtered signal; and

an output component configured to provide an output to the display device, wherein the output comprises the determined amplitude of the filtered signal.

4. The system of claim 3, wherein the amplitude comprises at least one of an absolute amplitude, a root-mean-squared (RMS) measurement, a peak-to-peak measurement, a maximum of a peak-to-peak measurement over a window, a percentile range measurement, a beat-gated measurement, and a free-running measurement.

5. The system of claim 3, wherein the filter is more responsive to high-frequency and/or quickly-varying components of the electrical signal than to low-frequency and/or slowly-varying components of the electrical signal.

6. The system of claim 3, wherein the filtered signal comprises an approximate derivative of the electrical signal.

7. The system of claim 3, wherein the filter includes a nonlinear processing element configured to attenuate one or more components of the electrical signal based on a polarity of a deflection of the electrical signal.

8. The system of claim 7, wherein the filter comprises a half-wave rectifier.

9. The system of claim 3, wherein the display device is configured to indicate a relative change in the amplitude of the filtered signal during a period of time.

10. The system of claim 3, wherein the display device is configured to display a waveform representing at least one of the filtered signal, an envelope of the filtered signal, an amplitude of the filtered signal, and a power of the filtered signal.

11. The system of claim 10, wherein the output component is configured to determine a combined signal comprising a combination of the filtered signal with an additional filtered signal, the waveform representing at least one of the combined signal, an envelope of the combined signal, an amplitude of the combined signal, and a power of the combined signal.

12. The system of claim 1, further comprising a display device, the mapping processor comprising:

a first filter configured to filter the electrical signal across a first time scale to generate a first filtered signal, wherein the first filter comprises a first frequency response;

a second filter configured to filter the electrical signal across a second time scale to generate a second filtered signal, wherein the second filter comprises a second frequency response, wherein at least a portion of the frequency response of the second filter is lower than a corresponding portion of the frequency response of the first filter;

a feature detector configured to determine a feature corresponding to sharpness by analyzing the first and second filtered signals; and

an output component configured to provide an output to the display device, wherein the output comprises the determined feature, wherein the display device is configured to depict a change in the determined feature over time.

13. The system of claim 12, wherein at least one of the first and second filters is configured to determine at least one of a time difference of the electrical signal, an approximate derivative of the electrical signal, a slope estimate across a time window, and a wavelet decomposition of the electrical signal.

14. The system of claim 12, wherein at least one of the first and second filters is more responsive to high-frequency and/or quickly-varying components of the electrical signal than to low-frequency and/or slowly-varying components of the electrical signal.

15. The system of claim 12, wherein the feature detector is configured to assess the sharpness of the electrical signal by comparing one or more levels of the first filtered signal with one or more levels of the second filtered signal to determine an amplitude-invariant measure of sharpness.

16. The system of claim 1, wherein the mapping processor is further configured to determine an overall morphology change of the electrogram based on a pre-ablation deflection template.

17. The system of claim 16, wherein the change in morphology is determined using at least one of a matched filter, a correlation, and a convolution with the pre-ablation deflection template or a signal derived therefrom.

18. A method for evaluating a condition of myocardial tissue, the method comprising:

positioning a catheter adjacent to myocardial tissue within a patient'"'"'s body, the catheter comprising;

a flexible catheter body having a distal portion; and

at least one electrode disposed on the distal portion, the at least one electrode configured to measure an electrical signal based on a cardiac activation signal;

receiving the electrical signal;

providing an electrogram based on the electrical signal;

determining a sharpness feature of the electrogram;

determining, based on the determined sharpness feature of the electrogram, a characteristic of a morphology of the electrogram, the characteristic of the morphology of the electrogram relating to the sharpness of the electrogram; and

displaying an indication of at least one of the sharpness and the characteristic of the morphology, wherein the indication comprises at least one of a map, a light indicator, and a waveform.

19. The method of claim 18, further comprising:

filtering the electrical signal across a first time scale, using a first filter, to generate a first filtered signal, wherein the first filter comprises a first frequency response;

filtering the electrical signal across a second time scale, using a second filter, to generate a second filtered signal, wherein the second filter comprises a second frequency response, wherein at least a portion of the frequency response of the second filter is lower than a corresponding portion of the frequency response of the first filter;

determining a feature corresponding to sharpness by analyzing the first and second filtered signals; and

providing an output to a display device, wherein the output comprises the determined feature, wherein the display device is configured to depict a change in the determined feature over time.

20. A system comprising:

an ablation catheter including;

a flexible catheter body having a distal portion;

a tissue ablation electrode disposed on the distal portion of the flexible catheter body, wherein the tissue ablation electrode is configured to apply ablation energy to tissue;

at least one electrode disposed on the distal portion, the at least one electrode configured to measure an electrical signal based on a cardiac activation signal; and

a radiofrequency (RF) generator operatively coupled to the tissue ablation electrode and configured to generate the ablation energy to be conveyed to the tissue ablation electrode; and

a mapping processor configured to;

acquire the electrical signal from the at least one electrode;

provide an electrogram based on the electrical signal;

determine a sharpness feature associated with the electrogram and, based on the determined sharpness feature, determine a characteristic of a morphology of the electrogram, the characteristic relating to the sharpness.