Double bipolar configuration for atrial fibrillation annotation

Patent metadata

Field	Value
Publication number	US-10238309-B2
Application number	US-201615380340-A
Country	US
Kind code	B2
Filing date	Dec 15, 2016
Priority date	Jan 29, 2014
Publication date	Mar 26, 2019
Grant date	Mar 26, 2019

Abstract

Catheterization of the heart is carried out by inserting a probe having electrodes into a heart of a living subject, recording a bipolar electrogram and a unipolar electrogram from one of the electrodes at a location in the heart, and defining a window of interest wherein a rate of change in a potential of the bipolar electrogram exceeds a predetermined value. An annotation is established in the unipolar electrogram, wherein the annotation denotes a maximum rate of change in a potential of the unipolar electrogram within the window of interest. A quality value is assigned to the annotation, and a 3-dimensional map is generated of a portion of the heart that includes the annotation and the quality value thereof.

First claim

The invention claimed is:

1. A method of removing an interfering signal from a unipolar fibrillation signal, the method comprising:
receiving a first unipolar electrogram and a second unipolar electrogram;
generating a mean QRS template;
subtracting the mean QRS template from the first unipolar electrogram to obtain a first resulting unipolar electrogram;
subtracting the mean QRS template from the second unipolar electrogram to obtain a second resulting unipolar electrogram; and
generating a bipolar electrogram by subtracting the first resulting unipolar electrogram from the resulting second unipolar electrogram.

2. The method of claim 1 , wherein the generating a mean QRS template step further comprises:
identifying plurality of occurrences of QRS episodes in the unipolar electrograms;
identifying a mean of the plurality of QRS episodes; and
generating the mean QRS template from the mean of the plurality of QRS episodes.

3. The method of claim 1 , wherein the generating a mean QRS template step further comprises generating a mean QRS template from a predefined ventricle signal.

4. The method of claim 1 , wherein the generating a mean QRS template step further comprises estimating a ventricular far field signal from a fibrillation signal at times where the signal is only ventricular.

5. The method of claim 1 , further comprising:
identifying a plurality of occurrences of QRS episodes for each of the unipolar electrograms from one or more of a body ECG signal, a ventricular intra-cardiac signal, or a coronary sinus signal.

6. The method of claim 1 , wherein each subtracting step comprises:
identifying times for each occurrence of a plurality of QRS episodes in each of the unipolar electrograms;
subtracting the mean QRS template from the first or second unipolar electrogram at the time identified for each occurrence of a plurality of QRS episodes of the first or second unipolar electrogram.

Assignees

• Biosense Webster Israel Ltd

Inventors

• Bar-Tal Meir
• Houben Richard P M
• Ben Zriham Yaniv
• Pressman Assaf
• Urman Roy
• Auerbach Shmuel

Classifications

• A61B5/7235

  Details of waveform analysis (detecting specific parameters of the electrocardiograph cycle A61B5/349) · CPC title

• A61B2018/00267

  having a basket shaped structure · CPC title

• A61B2034/2051

  Electromagnetic tracking systems · CPC title

• A61B2018/0016

  Energy applicators arranged in a two- or three dimensional array · CPC title

• A61B34/20

  Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis · CPC title