Analysis and detection for arrhythmia drivers

Patent metadata

Field	Value
Publication number	US-10117594-B2
Application number	US-201615240636-A
Country	US
Kind code	B2
Filing date	Aug 18, 2016
Priority date	May 8, 2013
Publication date	Nov 6, 2018
Grant date	Nov 6, 2018

Abstract

Systems and methods are provided to detect and analyze arrhythmia drivers. In one example, a system can include a wave front analyzer programmed to compute wave front lines extending over a surface for each of the plurality of time samples based on phase information computed from electrical data at nodes distributed across the surface. A trajectory detector can be programmed to compute wave break points for each of the wave front lines and to determine a trajectory of at least one rotor core across the surface. A stability detector can be programmed to identify at least one stable rotor portion corresponding to subtrajectories of the determined trajectory.

First claim

What is claimed is:

1. One or more non-transitory computer-readable media having instructions executable by a processor to perform a method of analyzing cardiac electrophysiological signals on a cardiac envelope, the method comprising:
determining wave break points for each identified cardiac wave front line at a given time sample of a plurality of time samples of the cardiac electrophysiological signals;
for each other of the plurality of time samples:
evaluating a spatial distance for a given wave break point relative to each active trajectory in a previous time sample to identify a closest active trajectory;
appending the given wave break point to update the closest active trajectory based on the evaluating; and
repeating the evaluating and the appending for each wave break point over the plurality of time samples to generate a set of at least one rotor trajectory;

computing a stability value for each of the least one rotor trajectory based on at least one of a temporal, angular and spatial characteristic for each respective rotor trajectory;
identifying at least one stable subtrajectory of each of the least one rotor trajectory based on the stability value relative to a stability threshold value, wherein the stability threshold value is one of a temporal stability threshold value indicative of a minimum subtrajectory lasting time, an angular stability threshold value indicative of a minimum angular characteristic that is determined for a respective rotor subtrajectory based on rotation angles along the respective rotor subtrajectory, or a spatial stability threshold value indicative of a maximum subtrajectory component distance from a centroid of a respective subtrajectory;
generating and displaying on a display a graphical map that includes a visualization of the at least one stable subtrajectory on a graphical representation of the cardiac envelope.

2. The one or more media of claim 1 , wherein the angular characteristic comprises at least one of a rotation rate for a rotor corresponding to the least one rotor trajectory, an angular acceleration for the rotor, a number of rotations for the rotor, a rotation cycle length for the rotor, and a direction of rotation for the rotor for a plurality of time samples.

3. The one or more media of claim 1 , the method further comprising beginning a new trajectory with the given wave break point if the evaluating indicates that the closest active trajectory for a current time sample is greater than a predetermined distance or if the closest active trajectory already has been updated for the current time sample.

4. The one or more media of claim 1 , wherein the at least one stable subtrajectory comprise at least two stable subtrajectories, the method further comprising computing an indication of connectivity between the at least two stable subtrajectories based on a number of at least one wave front line linking the at least two stable subtrajectories.

5. The one or more media of claim 4 , wherein the method further comprises determining that at least two of the stable subtrajectories are stably connected based on the indication of connectivity exceeding a time-based threshold.

6. The one or more media of claim 1 , wherein the method further comprises computing an index representing a sustainability of at least one arrhythmia driver residing within at least one spatial region on a geometric surface, wherein the index comprises a value to quantify the sustainability of the at least one arrhythmia driver.

7. The one or more media of claim 6 , wherein the index is computed based on an average number of rotations by one or more rotors residing within a spatial region on the geometric surface.

8. The one or more media of claim 1 , wherein the method further comprises controlling at least one therapy delivery parameter based on stored arrhythmia driver data corresponding to the set of at least one rotor trajectory.

9. The one or more media of claim 1 , wherein the wave front lines are generated by:
computing phase values for a plurality of nodes distributed across a geometric surface based on data representing electrical activity for the plurality of nodes over time;
evaluating the computed phase values for each of the nodes at a given time to identify each pair of adjacent nodes having phase values that encompass a predetermined phase threshold; and
determining at least one location on the geometric surface, corresponding to a wave front at the given time, based on the evaluating; and
wherein determining the wave break points for a current time sample is computed for each non-spatially looping wave front line generated for the current time sample.

10. The one or more media of claim 1 , the method further comprising displaying the graphical map in substantially real time as electrical signals on which the cardiac electrophysiological signals are based are measured from a body surface.

11. A system for analyzing cardiac electrophysiological signals on a cardiac envelope, the system comprising:
memory to store machine readable instructions and data, the data comprising cardiac electrical data representing cardiac electrical activity for a plurality of nodes distributed across a geometric surface representative of the cardiac envelope over a plurality of time samples of the cardiac electrophysiological signals;
at least one processor to access the memory and execute the instructions, the instructions comprising:
an arrhythmia driver analyzer comprising:
a trajectory detector programmed to compute wave break points for each of a wave front lines computed based on phase information derived from the cardiac electrical data from the plurality of nodes distributed across the geometric surface for each of the plurality of time samples and to determine a rotor trajectory for at least one rotor core across the geometric surface based on applying temporal and/or spatial constraints to the wave break points through a sequence of the plurality of time samples, the determined rotor trajectory being stored as arrhythmia driver data in the memory; and
a stability detector programmed to identify at least one stable rotor portion corresponding to subtrajectories of the determined rotor trajectory based on a stability value relative to a stability threshold value, the stability value being computed based on at least one of a temporal, angular and spatial characteristic of the determined rotor trajectory, the stability threshold value being one of a temporal stability threshold value indicative of a minimum subtrajectory lasting time, an angular stability threshold value indicative of a minimum angular characteristic that is determined for a respective rotor subtrajectory based on rotation angles along the respective rotor subtrajectory, or a spatial stability threshold value indicative of a maximum subtrajectory component distance from a centroid of a respective subtrajectory, each identified stable rotor portion being stored as the arrhythmia driver data in the memory; and

a map generator to generate a graphical map based on the arrhythmia driver data that includes a graphical representation of at least one of the determined rotor trajectory and the identified stable rotor portions with respect to a graphical representation of the surface; and

at least one display to display the graphical map.

12. The system of claim 11 , wherein the instructions further comprise a wave front analyzer programmed to compute the wave front lines extending over a surface for each of the plurality of time samples based on the phase information computed from the electrical data at nodes distributed across the geometrical surface for each of the plurality of time samples

Assignees

• Cardioinsight Technologies Inc

Inventors

• Zeng Qingguo
• Jia Ping
• Bokan Ryan
• George Brian P
• Ramanathan Charulatha
• Vasudevan Venkatesh
• Strom Maria

Classifications

• A61N7/00 Primary

  Ultrasound therapy (lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 {; using ultrasound for introducing media into the body A61M37/0092}) · CPC title

• A61N1/056

  Transvascular endocardial electrode systems · CPC title

• A61B34/10

  Computer-aided planning, simulation or modelling of surgical operations · CPC title

• A61N1/3622

  comprising two or more electrodes co-operating with different heart regions · CPC title

• A61B2018/0212

  using an instrument inserted into a body lumen, e.g. catheter · CPC title