Identifying ambiguous cardiac signals for electrophysiologic mapping

• US 9,782,094 B2
• Filed: 07/31/2015
• Issued: 10/10/2017
• Est. Priority Date: 07/31/2015
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Du, Juan, Ghosh, Subham, Gillberg, Jeffrey M
• Primary Examiner(s): Heller, Tammie K
• Application Number:
  US14/815,478
• Publication Number:
  US 20170027463A1
• Time in Patent Office: 802 Days
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/346 Analysis of electrocardiograms
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/6823 Trunk, e.g., chest, back, abdomen, hip
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61N 1/36507 controlled by gradient or slope of the heart potential

Abstract

A system and associated method is disclosed for determining whether a signal is ambiguous. The system comprises a plurality of electrodes configured to be located proximate tissue of a patient. A display apparatus comprises a graphical user interface configured to present information to a user. A computing apparatus is coupled to the electrode apparatus. The computing apparatus is configured to calculate a first derivative of a signal acquired from the electrodes, determine a first minimum from the first derivative, determine a second minimum from the second derivative and a second index within a window, calculate a ratio of the first and second derivatives, calculate a difference between a first and second index. In response to determining the ratio and the difference between the first and second index, the display apparatus displays whether the signal is ambiguous.

Claims

1. A system for use in monitoring cardiac signals comprising:

an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient;

a display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to present information for use in assisting a user;

computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to determine whether a signal acquired from the electrode apparatus is ambiguous, the computing apparatus configured to;

calculate a first derivative of the signal;

identify a first minimum value of the first derivative and a first time index associated therewith;

identify a second minimum value of the first derivative and a second time index associated therewith, within a time window that also includes the first minimum value;

calculate a ratio of the identified first and second minimum values of the first derivative;

calculate a difference between the first and second time indexes;

identify whether the signal is ambiguous or non-ambiguous based on the ratio and the difference between the first and second time indexes; and

display on the display apparatus an indication of the signal as ambiguous or non-ambiguous.

2. A system according to claim 1, wherein the computing apparatus is further configured to compare the difference between the first and second indexes to a first preselected number and, in response to determining that the difference between the first and second time indexes is greater than or equal to the first preselected number, to display on the display apparatus an indication that the signal is potentially ambiguous.

3. A system according to claim 2, wherein the computing apparatus is configured to compare the ratio to a second preselected number and, in response to determining that the ratio is less than or equal to the second preselected number, to display on the display apparatus an indication that the signal is confirmed as being ambiguous.

4. A system according to claim 2, wherein the computing apparatus is configured to compare the ratio to a third preselected number and, in response to determining that the ratio is greater than the third preselected number, to display on the display apparatus an indication that the signal is confirmed as being non-ambiguous.

5. A system according to claim 1, wherein the computing apparatus is further configured to compare the difference between the first and second time indexes to a fourth preselected number and, in response to determining the difference is less than the fourth preselected number, to display on the display apparatus an indication that the signal is non-ambiguous.

6. A system according to claim 1, wherein the computing apparatus is configured to compare the ratio to a fifth preselected number and, in response to determining that the ratio is greater than the fifth preselected number, to display on the display apparatus an indication that the signal is non-ambiguous.

7. The system of claim 1, wherein the electrode apparatus is configured to be located around the patient'"'"'s torso.

8. The system of claim 1, wherein the computing apparatus is configured to determine whether the signal is ambiguous during an ablation procedure.

9. The system of claim 1, wherein the signal is acquired from a patient diagnosed with atrial fibrillation.

10. The system of claim 1, wherein the system is configured to locate optimal electrode placement for cardiac therapy.

11. A method for a multichannel mapping system comprising a processor connected to an electrode apparatus and a display apparatus, the electrode apparatus configured to be located proximate tissue of a patient, the method comprising:

acquiring a signal by the processor from the electrode apparatus;

calculating a first derivative of the signal;

determining minimum and maximum values of the first derivative;

identifying first and second of the minimum values of the first derivative and their respective first and second time indexes within a time window;

calculating a ratio of the identified first and second minimum values of the first derivative;

calculating a difference between the first and second time indexes;

identifying whether the signal is ambiguous or non-ambiguous based on the ratio and the difference between the first and second time indexes; and

displaying on the display apparatus an indication of the signal as ambiguous or non-ambiguous.

12. A method according to claim 11, further comprising comparing the difference between the first and second time indexes to a first preselected number and, in response to determining that the difference between the first and second time indexes is greater than or equal to the first preselected number, displaying on the display apparatus an indication that the signal is potentially ambiguous.

13. A method according to claim 12, further comprising comparing the ratio to a second preselected number and, in response to determining that the ratio is less than or equal to the second preselected number, displaying on the display apparatus an indication that the signal is confirmed as being ambiguous.

14. A method according to claim 12, further comprising comparing the ratio to a third preselected number and, in response to determining that the ratio is greater than the third preselected number, displaying on the display apparatus an indication that the signal is confirmed as being non-ambiguous.

15. A method according to claim 11, further comprising comparing the difference between the first and second time indexes to a fourth preselected number and, in response to determining that the difference between the first and second time indexes is less than the fourth preselected number, displaying on the display apparatus an indicator that the signal is non-ambiguous.

16. A method according to claim 11, further comprising comparing the ratio to a fifth preselected number and, in response to determining that the ratio is greater than or equal to the fifth preselected number, displaying on the display apparatus an indicator that the signal is non-ambiguous.

17. The method of claim 11, wherein the electrode apparatus is configured to be located around the patient'"'"'s torso.

18. The method of claim 11, wherein identifying whether the signal is ambiguous occurs during ablation of human tissue.

19. The method of claim 11, wherein the patient from whom the signal is acquired has been diagnosed with atrial fibrillation.

20. The method of claim 11, wherein identifying whether the signal is ambiguous is used to locate optimal electrode placement for cardiac therapy.