Integrated analysis of electrophysiological data

Patent metadata

Field	Value
Publication number	US-10076260-B2
Application number	US-201715711642-A
Country	US
Kind code	B2
Filing date	Sep 21, 2017
Priority date	Feb 4, 2014
Publication date	Sep 18, 2018
Grant date	Sep 18, 2018

Abstract

A method can include analyzing non-invasive electrical data for a region of interest (ROI) of a patient's anatomical structure to identify one or more zones within the ROI that contain at least one mechanism of distinct arrhythmogenic electrical activity. The method also includes analyzing invasive electrical data for a plurality of signals of interest at different spatial sites within each of the identified zones to determine intracardiac signal characteristics for the plurality of sites within each respective zone. The method also includes generating an output that integrates the at least one mechanism of distinct arrhythmogenic electrical activity for the one or more zones with intracardiac signal characteristics for the plurality of sites within each respective zone.

First claim

What is claimed is:

1. A method, comprising:
receiving, by a system comprising a processor, non-invasive electrical data from a plurality of electrodes on an external surface of a patient's body, wherein the plurality of electrodes define a region of interest (ROI) of the patient's anatomical structure;
analyzing, by the system, the non-invasive electrical data for the ROI to identify one or more zones within the ROI that contain at least one mechanism of distinct arrhythmogenic electrical activity;
analyzing, by the system, invasive electrical data for a plurality of signals of interest at different spatial sites within each of the identified one or more zones to determine intracardiac signal characteristics for the different spatial sites within each of the identified one or more zones;
generating, by the system, output data that integrates the at least one mechanism of distinct arrhythmogenic electrical activity for the one or more zones with the intracardiac signal characteristics for the plurality of sites within each respective zone;
determining, by the system, a baseline indication of synchrony across at least one of the respective zones based on the output data;
determining, by the system, a post-treatment indication of synchrony across the at least one of the respective zones after applying a treatment to at least one of the plurality of sites based on the output data that is recalculated after application of the treatment;
comparing, by the system, the baseline indication of synchrony with the post-treatment indication of synchrony and providing a comparison output indicating changes between the baseline indication of synchrony and the post-treatment indication of synchrony; and
displaying, by a display device of the system, a visualization based on the comparison output.

2. The method of claim 1 , wherein analyzing non-invasive electrical information further comprises determining a number of mechanisms of distinct arrhythmogenic electrical activity that occur within each respective zone during at least one time interval.

3. The method of claim 2 , wherein the number of mechanisms of distinct arrhythmogenic electrical activity within each respective zone comprises at least one of a number of rotors that occur within the at least one time interval or a number of foci that occur within the at least one time interval, and a number of fast bursting cycle length that occur within the at least one time interval.

4. The method of claim 2 , wherein the one or more zones are a plurality of zones, the method further comprises: determining a zonal priority among the plurality of zones based on a relative number of the mechanisms of distinct arrhythmogenic electrical activity that occur within in each respective zone during the at least one time interval.

5. The method of claim 4 , further comprising evaluating a plurality of different intracardiac signal characteristics determined for the plurality of sites within each zone to determine a local priority among the plurality of sites within each respective zone.

6. The method of claim 5 , wherein the plurality of different intracardiac signal characteristics comprises at least two of a cycle length, cycle length variation, percentage of continuous activation and fractionation determined for at least one measurement interval.

7. The method of claim 6 , further comprising assigning different priority weighting to at least two of the different intracardiac signal characteristics for the plurality of sites within a given zone according to the mechanisms of distinct arrhythmogenic electrical activity identified for the given zone to provide weighted signal characteristics for the at least two different intracardiac signal characteristics, and
wherein the local weighting for the plurality of sites within the given zone is determined based on the weighted signal characteristics for the given zone.

8. The method of claim 7 , wherein the mechanisms of distinct arrhythmogenic electrical activity within the given zone comprise at least one of rotors that occur within the at least one time interval, foci that occur within the at least one time interval or a cycle length determined for the at least one time interval to be below a predetermined threshold,
wherein in response to determining that the only mechanisms of distinct arrhythmogenic electrical activity in the given zone include one or more rotors, the method comprising assigning a greater priority weighting to the percentage of continuous activation relative to other intracardiac signal characteristics determined for the at least one measurement interval and for the given zone, and
wherein in response to determining that the only mechanisms of distinct arrhythmogenic electrical activity in the given zone include one or more foci, the method comprising assigning an increased priority weighting to at least one of cycle length or the cycle length variation relative to the other intracardiac signal characteristics determined for the at least one measurement interval and for the given zone.

9. The method of claim 7 , wherein the mechanisms of distinct arrhythmogenic electrical activity within each respective zone comprise at least two of rotors that occur within the at least one time interval, foci that occur within the at least one time interval or cycle length determined for the at least one time interval to be below a predetermined threshold, and
wherein each of the intracardiac signal characteristics determined for the given zone are weighted proportionally to the number of each type of the mechanisms of distinct arrhythmogenic electrical activity identified within the given zone.

10. The method of claim 1 , further comprising generating a hybrid graphical map of the ROI of the patient's anatomical structure, the hybrid map integrating the non-invasive electroanatomic data and the intracardiac signal characteristics determined for at least a portion of the plurality of sites.

11. A system, comprising:
an arrangement of sensors configured to measure electrical data from an external body surface;
a device configured to measure electrical activity directly from a cardiac surface;
memory configured to store non-invasive electroanatomic data representing cardiac electrical activity reconstructed on a cardiac envelope based on the electrical data from the arrangement of sensors, intracardiac electrical data based on the electrical activity measured by the device invasively measured electrical data for a plurality of sites, and machine readable instructions;
a processor configured to execute the machine readable instructions the instructions comprising:
providing zone data identifying one or more zones within a region of interest of the cardiac envelope that contain at least one mechanism of distinct arrhythmogenic electrical activity based on the non-invasively sensed electrical data;
determining intracardiac signal characteristic data representing intracardiac signal characteristics based on the intracardiac electrical data for a plurality of sites within each respective zone; and
providing output data that integrates the zone data and the intracardiac signal characteristic data; and
determining (i) a baseline indication of synchrony across one of the zones based on the output data measured prior to delivery of a treatment and (ii) another indication of synchrony across the one of the zones based on the output data obtained during or after delivery of a treatment to one or more sites within the one of the zones; and
comparing the baseline indication of synchrony with the other indication of synchrony; and
providing a comparison output indicating changes between the baseline indication of synchrony a

Assignees

• Cardioinsight Technologies Inc

Inventors

• Bokan Ryan
• Ramanathan Charulatha
• Jia Ping
• Strom Maria
• Zeng Qingguo

Classifications

• G16H50/20

  for computer-aided diagnosis, e.g. based on medical expert systems · CPC title

• A61B5/066

  Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging · CPC title

• A61B5/06

  Devices, other than using radiation, for detecting or locating foreign bodies {; Determining position of diagnostic devices within or on the body of the patient} · CPC title

• A61B5/0036 Primary

  including treatment, e.g., using an implantable medical device, ablating, ventilating · CPC title

• A61B5/0245

  by using sensing means generating electric signals, {i.e. ECG signals} · CPC title