High density atrial fibrillation cycle length (AFCL) detection and mapping system

• US 8,903,478 B2
• Filed: 11/01/2012
• Issued: 12/02/2014
• Est. Priority Date: 05/17/2004
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: MacAdam, David P., Mashimo, Minoru, Fanier, Sylvain
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US13/666,652
• Publication Number:
  US 20130303879A1
• Time in Patent Office: 761 Days
• Field of Search: None
• US Class Current: 600/515
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 2018/00351 Heart
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• 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 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/7257 using Fourier transforms

Abstract

Systems and methods to assist in locating the focus of an atrial fibrillation include the association of atrial fibrillation cycle length values and statistics relating thereto with temporal locations on an electrogram of a given electrode, and/or the coordination of electrode locations with respective the spectral analyses of electrogram signals and further parameters and statistics relating thereto. Ablation therapy can proceed under guidance of such information.

Claims

1. A method for annotating an electrocardiogram with an atrial fibrillation cycle length (AFCL) value that is displayable on a display of an electrophysiology system, comprising the steps of:

(a) providing an electrocardiogram signal within the electrophysiology system;

(b) accepting input to the electrophysiology system to define a time segment of interest within the electrocardiogram signal;

(c) locating successive activation signals within the time segment of interest on each electrocardiogram signal;

(d) determining one or more average AFCL values using the located successive activation signals and an AFCL statistic from the one or more average AFCL values;

(e) associating on the display of the electrophysiology system at least one of the determined average AFCL values and the AFCL statistic together with the electrocardiogram signal;

(f) depicting a rendering of a portion of at least one heart chamber; and

(g) including the AFCL statistic in the rendering.

2. The method of claim 1, wherein the locating step comprises applying the electrocardiogram signal within the time segment of interest to an input of an FIR filter and outputting a stream of signals from the FIR filter which includes the located successive activation signals.

3. The method of claim 1, including the additional step of automatically marking the located successive activation signals on the display in association with the electrocardiogram signal.

4. The method of claim 3, wherein the average AFCL values include at least a first set of values which correspond to the absolute value of the time interval between each successive activation signal that has been located.

5. The method of claim 4, wherein the first set of AFCL values is displayed on the display of the electrophysiology system proximate to the located successive activation signals.

6. The method of claim 1, wherein the rendering is a model of the at least one heart chamber.

7. The method of claim 1, wherein the rendering is a captured image of the at least one heart chamber.

8. The method of claim 7, wherein the captured image is captured by a technique selected from the group consisting of:

fluoroscopy, magnetic resonance imaging, computer tomography, ultrasound imaging, and ultrasound echoing.

9. The method of claim 1, wherein the rendering is depicted in a window separate from the electrocardiogram signal.

10. The method of claim 9, wherein the window is presented on a second display independent of the display of the electrophysiology system.

11. The method of claim 1, wherein the electrocardiogram signal is provided from a first electrode of a multi-electrode catheter and wherein there are plural electrocardiogram signals associated with respective plural additional electrodes on the multi-electrode catheter, each of said plural electrocardiogram signals having at least one AFCL statistic associated therewith over a time segment of interest that overlaps with the time segment of interest for the electrocardiogram signal from the first electrode.

12. The method of claim 11, wherein the step of including the AFCL statistic in the rendering comprises coordinating a position of one or more of the electrodes of the multi-electrode catheter with a respective AFCL statistic.

13. The method of claim 12, including the additional steps, after an ablation procedure has been initiated, of determining one or more additional AFCL values and statistics within the at least one heart chamber and depicting said additional AFCL statistics in a second rendering of the at least one heart chamber.

14. The method of claim 1, wherein the step of providing the electrocardiogram signal includes obtaining signals from an intracardiac lead and displaying the signals on the display.

15. The method of claim 1, wherein the time segment is defined based on an input provided by a user.

16. A method for annotating an electrocardiogram with an atrial fibrillation cycle length (AFCL) value that is displayable on a display of an electrophysiology system, comprising the steps of:

(a) providing an electrocardiogram signal within the electrophysiology system;

(b) accepting input to the electrophysiology system to define a time segment of interest within the electrocardiogram signal;

(c) locating successive activation signals within the time segment of interest on each electrocardiogram signal;

(d) determining one or more average AFCL values using the located successive activation signals and determining an AFCL statistic from the one or more average AFCL values;

(e) associating on the display of the electrophysiology system at least one of the determined average AFCL values together with the electrocardiogram signal; and

(f) depicting a rendering of a portion of at least one heart chamber, and including the AFCL statistic in the rendering.

17. The method of claim 16, wherein the locating step comprises applying the electrocardiogram signal within the time segment of interest to an input of an FIR filter and outputting a stream of signals from the FIR filter which includes the located successive activation signals.

18. The method of claim 16, including the additional step of automatically marking the located successive activation signals on the display in association with the electrocardiogram signal.

19. The method of claim 18, wherein the average AFCL values include at least a first set of values which correspond to the absolute value of the time interval between each successive activation signal that has been located.

20. The method of claim 19, wherein the first set of AFCL values is displayed on the display of the electrophysiology system proximate to the located successive activation signals.

21. The method of claim 16, wherein the rendering is a model of the at least one heart chamber.

22. The method of claim 21, wherein the rendering is a captured image of the at least one heart chamber.

23. The method of claim 22, wherein the captured image is captured by a technique selected from the group consisting of:

fluoroscopy, magnetic resonance imaging, computer tomography, ultrasound imaging, and ultrasound echoing.

24. The method of claim 16, wherein the rendering is depicted in a window separate from the electrocardiogram signal.

25. The method of claim 24, wherein the window is presented on a second display independent of the display of the electrophysiology system.

26. The method of claim 16, wherein the electrocardiogram signal is provided from a first electrode of a multi-electrode catheter and wherein there are plural electrocardiogram signals associated with respective plural additional electrodes on the multi-electrode catheter, each of said plural electrocardiogram signals having at least one AFCL statistic associated therewith over a time segment of interest that overlaps with the time segment of interest for the electrocardiogram signal from the first electrode.

27. The method of claim 26, wherein the step of including the AFCL statistic in the rendering comprises coordinating a position of one or more of the electrodes of the multi-electrode catheter with a respective AFCL statistic.

28. The method of claim 27, including the additional steps, after an ablation procedure has been initiated, of determining one or more additional AFCL values and statistics within the at least one heart chamber and depicting said additional AFCL statistics in a second rendering of the at least one heart chamber.

29. The method of claim 16, wherein the step of providing the electrocardiogram signal includes obtaining signals from an intracardiac lead and displaying the signals on the display.

30. The method of claim 16, wherein the time segment is defined based on an input provided by a user.