Detecting conduction timing

Patent metadata

Field	Value
Publication number	US-10575749-B2
Application number	US-201715498662-A
Country	US
Kind code	B2
Filing date	Apr 27, 2017
Priority date	May 3, 2016
Publication date	Mar 3, 2020
Grant date	Mar 3, 2020

Abstract

An example method includes analyzing morphology and/or amplitude of each of a plurality of electrophysiological signals across a surface of a patient's body to identify candidate segments of each signal satisfying predetermined conduction pattern criteria. The method also includes determining a conduction timing parameter for each candidate segment in each of the electrophysiological signals.

First claim

What is claimed is:

1. A method, comprising:
analyzing, by one or more processors, a morphology and an amplitude of each of a plurality of electrophysiological signals captured by a plurality of sensors distributed across a surface of a patient's body to identify candidate segments of each signal satisfying predetermined conduction pattern criteria;
determining, by the one or more processors, a conduction timing parameter for each candidate segment in each of the electrophysiological signals; and
causing, by the one or more processors, a graphical map to be outputted on a display that includes a visualization of or derived based on the conduction timing parameters determined for the plurality of electrophysiological signals.

2. The method of claim 1 , wherein analyzing the morphology and the amplitude further comprises determining a set of potential segments in each of the electrophysiological signals satisfying downward slope criteria.

3. The method of claim 2 , wherein determining the set of potential segments further comprises:
selecting at least a portion of the candidate segments from the set of potential segments based on the amplitude and duration thereof satisfying amplitude and duration criteria; and
designating a portion from the set of potential segments for further evaluation.

4. The method of claim 3 , wherein the further evaluation comprises:
selecting, as one of the candidate segments, each segment in the set of potential segments that is spatially and temporally consistent with neighboring candidates that have been selected and aggregating the candidate segments for each of the plurality of electrophysiological signals; and
removing each respective segment from further consideration in determining the conduction timing parameter that is not spatially and/or temporally consistent with neighboring candidates that have been selected.

5. The method of claim 1 , further comprising:
acquiring electrical signals by a non-invasive arrangement of the plurality of sensors distributed on an outer body surface of the patient; and
computing reconstructed electrical signals on a cardiac envelope with respect to an anatomical surface of the patient's heart based on the acquired electrical signals and geometry data describing spatial locations of the plurality of sensors with respect to patient geometry that includes the anatomical surface of the patient's heart.

6. The method of claim 1 , wherein the method further comprises:
computing an indication of arrhythmogenic activity based on the conduction timing parameter;
generating the graphical map to visualize the indication of arrhythmogenic activity with respect to the heart; and
outputting the graphical map to a display device.

7. The method of claim 6 , wherein the indication of arrhythmogenic activity comprises a number of focal points, a number of rotational activities and/or a trajectory of at least one rotational activity, the indication of arrhythmogenic activity being displayed in the graphical map spatially with respect to the heart.

8. The method of claim 6 , further comprising storing data to document user review of each indication of arrhythmogenic activity displayed in the graphical map in response to a corresponding user input interacting with the displayed indication of arrhythmogenic activity.

9. The method of claim 6 , further comprising:
removing a given indication of arrhythmogenic activity displayed in the graphical map in response to a user input instruction to reject the given indication of arrhythmogenic activity; and
storing, in memory, data documenting the user input instruction.

10. The method of claim 1 , wherein the conduction timing parameter is an activation time computed for each of a plurality of points on the surface over at least one time interval.

11. The method of claim 10 , the method further comprising:
selecting one of a plurality of different activation time calculating functions based on at least one of noise, amplitude and morphology of the signals, the selected one of the activation time calculating functions performing the analyzing to identify the candidate segments; and
using the selected activation time calculating function to compute the conduction timing parameter as an activation time for the electrophysiological signals.

12. A system comprising:
memory to store machine readable instructions and data, the data comprising electrical data representing electrophysiological signals distributed across a body surface;
at least one processor to access the memory and execute the instructions, the instructions comprising:
a conduction pattern estimator that analyzes at least a morphology that includes a downward slope of each of a plurality of electrophysiological signals across a surface of a patient's body, to identify candidate segments of each of the plurality of electrophysiological signals that satisfy predetermined conduction pattern criteria;
a conduction pattern parameter identifier that determines a conduction timing parameter for each of the identified candidate segments in the electrophysiological signals; and
an output engine that provides output data to drive a display with a graphical map that includes a visualization of or derived based on the conduction timing parameters determined for the electrophysiological signals.

13. The system of claim 12 , wherein the conduction pattern estimator is further programmed to:
determine a set of potential segments in each of the electrophysiological signals satisfying downward slope criteria;
select at least a portion of the candidate segments from the set of potential segments based on an amplitude and duration thereof satisfying amplitude and duration criteria; and
designate another portion from the set of potential segments as questionable candidate segments for further evaluation.

14. The system of claim 13 , wherein the conduction pattern estimator is further programmed to:
select, as one of the candidate segments, each segment in the set of potential segments that is spatially and temporally consistent with neighboring candidates that have been selected and aggregating the candidate segments for each of the plurality of electrophysiological signals; and
removing each respective segment from further consideration in determining the conduction timing parameter that is not spatially and/or temporally consistent with neighboring candidates that have been selected.

15. The system of claim 12 , wherein the conduction timing parameter is an activation time parameter, the further comprises locating an activation time on the downward slope of each of the candidate segments.

16. The system of claim 15 , further comprising a dynamic activation time estimator that selects one of a plurality of different activation time calculating functions based on at least one of a noise, an amplitude and the morphology of the electrophysiological signals, the selected one of the activation time calculating functions analyzing the signal segments to identify the candidate segments; and
the conduction pattern estimator including a signal segment analyzer that employs the selected activation time calculating function to determine the activation time for each of the electrophysiological signals.

17. The system of claim 12 , further comprising an arrhythmogenic activity calculator that computes an indication of arrhythmogenic activity based on the conduction timing parameter determined for the electrophysiological signals, wherein the output engine generates the graphical map to visualize the indication of arrhythmogenic

Assignees

• Cardioinsight Technologies Inc

Inventors

• Lou Qing
• Stone Meredith E
• Zeng Qingguo
• Adair Jeffrey B
• Edel Connor S
• Jia Ping
• Ponziani Kevin R
• George Brian P
• Bokan Ryan M
• Sabo Matthew J
• Turovskiy Vladimir A
• Patel Ketal C
• Ramanathan Charulatha

Classifications

• A61B5/7278

  Artificial waveform generation or derivation, e.g. synthesizing signals from measured signals · CPC title

• A61B5/7485

  Automatic selection of region of interest · CPC title

• G16H50/20

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

• A61B5/743 Primary

  Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots · CPC title

• A61B5/7275

  Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor · CPC title