Physiological mapping for arrhythmia

Patent metadata

Field	Value
Publication number	US-10194982-B2
Application number	US-201615226448-A
Country	US
Kind code	B2
Filing date	Aug 2, 2016
Priority date	Sep 21, 2012
Publication date	Feb 5, 2019
Grant date	Feb 5, 2019

Abstract

A non-transitory computer-readable medium can have instructions executable by a processor. The instructions can include an electrogram reconstruction method to generate reconstructed electrogram signals for each of a multitude of points residing on or near a predetermined cardiac envelope based on geometry data and non-invasively measured body surface electrical signals. The instructions can include a phase calculator to compute phase signals for the multitude of points based on the reconstructed electrogram signals and a visualization engine to generate an output based on the computed phase signals.

First claim

What is claimed is:

1. A non-transitory computer-readable medium having instructions executable by a processor, the instructions comprising:
an electrogram reconstruction method to generate reconstructed electrogram signals for each of a multitude of points residing on or near a predetermined cardiac envelope based on non-invasively measured body surface electrical signals;
a post-inverse solution processing method to filter the reconstructed electrogram signals and provide corresponding filtered reconstructed electrogram signals, wherein the post-inverse solution processing method further comprises:
a bandpass filter applied to the reconstructed electrogram signals to pass one or more predetermined frequency bands; and
a baseline removal function programmed to remove baseline wander from the bandpass-filtered signal;

a phase calculator to compute phase signals for the multitude of points based on the filtered reconstructed electrogram signals; and
a visualization engine to generate an output based on the computed phase signals, wherein the output comprises at least one spatially and temporally consistent map to characterize one or more mechanisms of an arrhythmia for multiple chambers of a patient's heart over multiple time intervals.

2. The medium of claim 1 , wherein the instructions further comprise a preprocessing method programmed to process the non-invasively measured body surface electrical signals prior to the electrogram reconstruction method to remove signal features determined not to contribute to a predefined arrhythmia and to provide corresponding processed electrical signals, the electrogram reconstruction method generating the reconstructed electrogram signals from the corresponding processed electrical signals.

3. The medium of claim 2 , wherein the preprocessing method is further programmed to remove signal features from the non-invasively measured body surface electrical signals that are due to ventricular electrical activity to provide the corresponding processed electrical signals to have an increased specificity for an atrial type of arrhythmia.

4. The medium of claim 3 , wherein the preprocessing method further is further programmed to at least one of implement cancellation of QRS-waves or cancellation of T-waves from the non-invasively measured body surface electrical signals to remove the signal features from the non-invasively measured body surface electrical signals.

5. The medium of claim 2 , wherein the instructions further comprise a graphical user interface programmed to specify a predetermined type arrhythmia for evaluation in response to a user input, the preprocessing method being programmed to selectively control the preprocessing depending in response to the user input.

6. The medium of claim 5 , wherein if the user input selects evaluation of an atrial type of arrhythmia, the preprocessing method being programmed to remove signal features relating to ventricular electrical activity from the non-invasively measured body surface electrical signals.

7. The medium of claim 1 , wherein the instructions further comprise a phase singularity computation programmed to determine a location of at least one phase singularity on the cardiac envelope based on the computed phase signals, the location of the at least one phase singularity being identified in the output.

8. The medium of claim 1 , wherein the instructions further comprise a focal source calculator programmed to determine a location of at least one focal source on the cardiac envelope based on an estimated integral of the computed phase signals, the at least one focal source being identified in the output.

9. The medium of claim 1 , wherein the output comprises at least one of a phase map, an integral phase gradient map, a rotor road map, a cycle length map to present spatially and temporally consistent information for multiple chambers of a patient's heart based on the computed phase signals.

10. The medium of claim 1 , wherein the instructions further comprise a rotor identification function programmed to identify a location of a rotor core as a target for ablation based on the computed phase signals.

11. The medium of claim 1 , wherein the electrogram reconstruction method generates the reconstructed electrogram signals for each of the multitude of points based on geometry data and the non-invasively measured body surface electrical signals, the geometry data including at least one of actual geometry data acquired for a given patient and a generic anatomical model.

12. The medium of claim 1 , wherein the wherein the instructions further comprise a cycle length computation function programmed to compute an indication of cycle length based on the computed phase signals.

13. The medium of claim 1 , wherein the reconstructed electrogram signals are spatially and temporally consistent across the entire cardiac envelope.

14. A method comprising:
converting, by a system comprising a processor, processed data, corresponding to non-invasively recorded electrical data obtained from a patient for at least one time interval, to corresponding reconstructed electrical signals on a predetermined cardiac envelope;
filtering the reconstructed electrical signals to provide corresponding filtered reconstructed electrical signals, wherein filtering the reconstructed electrical signals further comprises:
bandpass filtering the reconstructed electrical signals to pass one or more predetermined frequency bands; and
removing baseline wander from the bandpass-filtered signal;

computing, by the system, phase data based on the corresponding filtered reconstructed electrical signals; and
generating, by the system, an output based on the computed phase data, wherein the output comprises at least one spatially and temporally consistent map to characterize one or more mechanisms of an arrhythmia for multiple chambers of a patient's heart over multiple time intervals.

15. The method of claim 14 , wherein the reconstructed electrical signals are spatially and temporally consistent across the entire cardiac envelope.

16. The method of claim 14 , further comprising determining, by the system, a location of at least one phase singularity in a three-dimensional mesh on the cardiac envelope based on the computed phase data, the location of the at least one phase singularity being identified in the output.

17. The method of claim 14 , wherein the reconstructed electrical signals are further based on at least one of actual geometry data acquired for a given patient and a generic anatomical model.

18. The method of claim 14 , wherein a wavefront is determined based on the computed phase data.

19. The method of claim 14 , wherein the method further comprises:
processing the non-invasively recorded electrical data prior to the converting to remove signal features determined not to contribute to a predefined arrhythmia and to provide corresponding processed electrical signals, the corresponding reconstructed electrical signals being generated from the corresponding processed electrical signals.

20. A system comprising:
non-transitory memory to store machine readable instructions and data; and
one or more processors to access the memory and execute the instructions, the instructions comprising:
a reconstruction method to generate reconstructed electrical signals for each of a multitude of points residing on or near a predetermined cardiac envelope based on non-invasively measured body surface electrical signals;
a post-inverse solution processing method to filter t

Assignees

• Cardioinsight Technologies Inc

Inventors

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

Classifications

• A61B5/0036

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

• A61B2018/00869

  Phase · CPC title

• A61B2018/00839

  Bioelectrical parameters, e.g. ECG, EEG · CPC title

• A61B2017/00053

  Mapping · CPC title

• A61B2017/00044

  Sensing electrocardiography, i.e. ECG · CPC title