Electroanatomical mapping

• US 9,888,862 B2
• Filed: 10/31/2016
• Issued: 02/13/2018
• Est. Priority Date: 01/13/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Stewart, Brian
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US15/338,523
• Publication Number:
  US 20170042436A1
• Time in Patent Office: 470 Days
• Field of Search: None
• 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 information about a patient'"'"'s heart, the method comprising:

measuring signals using 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;

generating, by a computer, annotation information for the measured signals by applying one or more operators to a specified measured signal and one or more spatially and/or temporally neighboring measured signals; and

generating, by the computer, an electroanatomical representation of the patient'"'"'s heart that includes at least some of the annotation information.

2. The method of claim 1, wherein generating the annotation information comprises applying one or more operators to the measured signals to identify at least one of regions of the heart having double deflections, regions of the heart having multiple deflections, regions of the heart having fractionation, regions of the heart having double activation, and regions of the heart having no activation.

3. The method of claim 1, further comprising:

receiving, from an operator, a change to the annotation information for a specified measured signal; and

modifying, by the computer, annotation information for one or more additional measured signals based on the change.

4. The method of claim 3, wherein modifying the annotation information for one or more additional measured signals comprises automatically adjusting annotation information for one or more additional measured signals in proximity to the specified measured signal.

5. The method of claim 4, wherein the measured signals in spatial proximity to the specified measured signal comprise signals at positions with a set distance to the specified measured signal.

6. The method of claim 5, 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 the signals measured at the one or more electrodes comprise electrograms.

8. The method of claim 7, further comprising:

receiving, from an operator, a change to the annotation information for a specified electrogram; and

automatically, by the computer, adjusting the annotation information for other electrograms based on the operator change to the annotation information for the specified electrogram.

9. The method of claim 1, wherein spatially neighboring electrograms comprise electrograms within a predefined distance.

10. The method of claim 1, wherein generating the annotation information comprises:

for electrograms including multiple deflections, selecting a deflection of the multiple deflections based on timing information for the multiple deflections and timing information for deflections in spatially neighboring electrograms; and

using the selected deflection to determine the annotation information.

11. The method of claim 1, wherein generating the annotation information comprises generating annotation information for a specific location of the endocardium based on the signals measured at an electrode location corresponding to the specific location and signals measured at one or more additional electrodes at locations in spatial proximity to the electrode location corresponding to the specific location.

12. The method of claim 11, wherein one or more additional electrodes at locations in spatial proximity to the specific location comprise one or more additional electrodes with a predefined distance of the specific location.

13. The method of claim 1, wherein generating the annotation information comprises generating annotation information for a specific location of the endocardium based on the signals measured at an electrode location corresponding to the specific beat and signals measured at one or more previous beats at the same electrode.

14. The method of claim 1, wherein generating the annotation information comprises using spatial information about the positions at which the signals were measured to determine local timing information.

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

16. The method of claim 1, further comprising using the electroanatomical representation of a patient'"'"'s heart to guide treatment of the heart activity.

17. The method of claim 1, further comprising selecting a subset of less than all of the signals and generating an electroanatomical representation of the patient'"'"'s heart based on the selected subset of less than all of the signals.

18. A system for providing information about a patient'"'"'s heart, the system comprising:

one or more electrodes for measuring signals at multiple positions in the heart cavity, 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;

generate annotation information for the measured signals by applying one or more operators to a specified measured signal and spatially and/or temporally neighborhood measured signals; and

generate an electroanatomical representation of the patient'"'"'s heart that includes at least some of the annotation information.

19. The system of claim 18, further comprising selecting a subset of less than all of the signals and generating an electroanatomical representation of the patient'"'"'s heart based on the selected subset of less than all of the signals.

20. A system for providing information about a patient'"'"'s heart, the system comprising:

one or more electrodes for measuring signals at multiple positions in the heart cavity, 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 a subset of less than all of the signals;

generate annotation information for the measured signals by applying one or more operators to a specified measured signal and spatially and/or temporally neighborhood measured signals; and

generate, based on the selected subset of less than all of the signals, an electroanatomical representation of the patient'"'"'s heart that includes at least some of the annotation information.