Beat alignment and selection for cardiac mapping

• US 10,335,051 B2
• Filed: 04/06/2015
• Issued: 07/02/2019
• Est. Priority Date: 01/13/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Rhythmia Medical, Inc. (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Eldar, Rotem
• Primary Examiner(s): Koharski, Christopher
• Assistant Examiner(s): Bays, Pamela M.
• Application Number:
  US14/679,832
• Publication Number:
  US 20150282729A1
• Time in Patent Office: 1,548 Days
• Field of Search: 600509
• 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 5/35 by template matching
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• 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

Abstract

A method including measuring cardiac beats in signals at one or more electrodes on a catheter in response to electrical activity in the heart cavity and collecting a plurality of additional data signals related to the cardiac beats, computing criteria that is used to characterize beat morphology of a cardiac beat in the plurality of additional data signals, the criteria based on a comparison of the plurality of additional data signals and a beat template, selecting a subset of less than all of the cardiac beats in the signals measured by the one or more electrodes by determining, based on the criteria, whether to select the cardiac beat and include beat data for the cardiac beat, and determining physiological information based on the selected subset of less than all of the cardiac beats in the signals measured by the one or more electrodes.

Claims

1. A method of determining and displaying physiological information related to a heart surface, comprising:

for each of multiple, different catheter positions in a heart cavity, concurrently measuring cardiac beats in signals at one or more electrodes on a catheter in response to electrical activity in the heart cavity and collecting a plurality of additional data signals related to the cardiac beats;

computing criteria that is used to characterize beat morphology of a cardiac beat in the plurality of additional data signals, wherein the criteria are based on a comparison of the plurality of additional data signals and a beat template;

selecting a subset of less than all of the cardiac beats in the signals measured by the one or more electrodes by determining, based on the criteria, whether to select the cardiac beat and include beat data for the cardiac beat in the subset of less than all of the cardiac beats in the signals;

selecting cardiac beats from the subset of less than all of the cardiac beats in the signals by at least one of;

comparing beat duration information for the cardiac beat with an expected beat duration and excluding the beat data for the cardiac beat if the beat duration is below a beat duration threshold, and

selecting the beat data for the cardiac beat based on a location of the cardiac beat in a beat train of the cardiac beats;

determining the physiological information at multiple locations of an endocardium surface by processing the cardiac beats selected from the subset of less than all of the cardiac beats in the signals measured by the one or more electrodes;

displaying at least a portion of the determined physiological information on a display to aid physicians in determining a source of arrhythmias and in guiding therapeutic treatment; and

guiding therapeutic treatment based on the determined physiological information.

2. The method of claim 1, comprising synchronizing the signals measured at the different catheter positions with one another based on the plurality of additional data signals.

3. The method of claim 1, wherein processing the cardiac beats selected from the subset of less than all of the cardiac beats in the signals measured by the one or more electrodes comprises processing the cardiac beats selected from the subset of less than all of the cardiac beats in the signals measured by the one or more electrodes as though they were obtained at one time.

4. The method of claim 1, wherein computing criteria comprises comparing one or more of the plurality of additional data signals for the cardiac beat with one or more templates representing an exemplary cardiac beat of interest.

5. The method of claim 4, wherein the computed criteria comprises a value representing a similarity between the one or more of the plurality of additional data signals for the cardiac beat and the one or more templates.

6. The method of claim 5, wherein selecting the subset of less than all of the cardiac beats in the signals comprises comparing the value with a threshold value and including the beat data for the cardiac beat in the subset of less than all of the cardiac beats in the signals if the value is greater than the threshold value.

7. The method of claim 1, wherein computing criteria and selecting the subset of less than all of the cardiac beats in the signals comprises:

collecting one or more of the plurality of additional data signals from a plurality of channels;

comparing each of the one or more of the plurality of additional data signals from the plurality of channels to associated templates to generate comparison results; and

determining whether to include the beat data for the cardiac beat in the subset of less than all of the cardiac beats in the signals based on the comparison results.

8. The method of claim 1, wherein computing criteria and selecting the subset of less than all of the cardiac beats in the signals comprises:

comparing beat duration information for the cardiac beat with an expected beat duration; and

excluding the beat data for the cardiac beat from the subset of less than all of the cardiac beats in the signals if the beat duration is below a threshold.

9. The method of claim 1, wherein computing criteria and selecting the subset of less than all of the cardiac beats in the signals comprises:

comparing an energy for the cardiac beat with an expected energy; and

excluding the beat data for the cardiac beat from the subset of less than all of the cardiac beats in the signals if the energy is above a threshold.

10. The method of claim 1, wherein selecting the subset of less than all of the cardiac beats in the signals comprises selecting the beat data for the cardiac beat in the subset of less than all of the cardiac beats in the signals based on a location of the heart beat in a beat train of a morphology of interest.

11. A system for determining and displaying physiological information related to a heart surface, the system comprising:

one or more electrodes configured to concurrently measure, for each of multiple, different catheter positions in a heart cavity, cardiac beats in signals in response to electrical activity in the heart cavity having the heart surface;

one or more additional devices configured to measure a plurality of additional data signals related to the cardiac beats; and

a processing unit configured to;

define a template set comprising the plurality of additional data signals collected during an exemplary beat of interest;

determine criteria that is used to characterize beat morphology of a cardiac beat in the plurality of additional data signals, wherein the criteria are based on a comparison of the plurality of additional data signals and the template set;

select a subset of less than all of the cardiac beats in the signals measured by the one or more electrodes by determining, based on the criteria, whether to select the cardiac beat and include beat data for the cardiac beat in the subset of less than all of the cardiac beats in the signals;

select cardiac beats from the subset of less than all of the cardiac beats in the signals by at least one of;

comparing beat duration information for the cardiac beat with an expected beat duration and excluding the beat data for the cardiac beat if the beat duration is below a beat duration threshold, and

selecting the beat data for the cardiac beat based on a location of the cardiac beat in a beat train of the cardiac beats;

determine the physiological information at multiple locations of an endocardium surface by processing the cardiac beats selected from the subset of less than all of the cardiac beats in the signals measured by the one or more electrodes;

display at least a portion of the determined physiological information on a display to aid physicians in determining a source of arrhythmias and in guiding therapeutic treatment and

guide therapeutic treatment based on the determined physiological information.

12. The system of claim 11, wherein the processing unit is configured to provide at least one of a correlation of each of the plurality of additional data signals to the template set and alignment of the signals measured at the different positions relative to a phase in an electrical cycle of the heart.