Mapping of atrial fibrillation

Patent metadata

Field	Value
Publication number	US-10674929-B2
Application number	US-201816169834-A
Country	US
Kind code	B2
Filing date	Oct 24, 2018
Priority date	Mar 31, 2016
Publication date	Jun 9, 2020
Grant date	Jun 9, 2020

Abstract

Electroanatomic mapping is carried out by inserting a multi-electrode probe into a heart of a living subject, recording electrograms from the electrodes concurrently at respective locations in the heart, delimiting respective activation time intervals in the electrograms, generating a map of electrical propagation waves from the activation time intervals, maximizing coherence of the waves by adjusting local activation times within the activation time intervals of the electrograms, and reporting the adjusted local activation times.

First claim

What is claimed is:

1. A method, comprising the acts of:
inserting a probe into a heart of a living subject, the probe having a plurality of electrodes;
recording electrograms from the electrodes concurrently at respective locations in the heart;
delimiting respective activation time intervals in the electrograms, the activation time intervals associated with a peak and a valley of a slope;
generating an activation map of electrical propagation waves from the activation time intervals, including segmenting the electrograms into a series of frames at respective times, wherein the frames are respective assignments of readings of the electrodes to a matrix of values;
assigning local activation times for the electrodes from the matrix of values;
modeling at least a portion of the heart as a mesh with vertices, wherein a portion of the vertices correspond to respective locations of the electrodes;
determining conduction velocities of the electrical propagation waves between the vertices from the frames based on assigned location activation times;
computing coherence of the waves in accordance with the conduction velocities; and
maximizing the coherence of the wave by adjusting the local activation times within the activation time intervals of the electrograms; and
ablating tissue of the heart to modify the electrical propagation waves.

2. The method of claim 1 , wherein the activation time intervals comprise:
first intervals delimited by the peak and the valley representing a start and end of a slope; and
second intervals including windows about the first intervals, wherein the adjusting local activation times is performed within the second intervals.

3. The method of claim 1 , wherein the frames are filled with local activation times that most logically relate to each other based on the conduction velocities of the electrical propagation waves.

4. The method of claim 1 , wherein the frame are filled in accordance with:
a source list comprising electrode numbers and associated local activation times to be checked against neighboring local activations for block or conduction; and
a source frame having an input including a frame structure, a distance matrix and local activation time obtained from a source electrode and an output including a frame number for the source electrode,
wherein assignment of the frame number is based on vacancy of frames at the local activation times of the source electrode.

5. The method of claim 1 , wherein local activation times are assigned within boundaries of a given time window.

6. The method of claim 1 , wherein local activation times are assigned from alternative slopes.

7. The method of claim 1 , wherein frame segmentation includes modeling an atrium as a 3-D triangular mesh.

8. The method of claim 1 , wherein the modeling includes representing activation times at the vertices of the mesh as fuzzy vertex membership functions (μu) that may vary between 0 and 1.

9. The method of claim 1 , wherein the modeling includes interpolating activation times of vertices of the mesh that do not correspond to the respective locations of the electrodes.

10. The method of claim 1 , wherein determining conducting velocities include region growing.

11. A system, comprising:
a probe having a plurality of electrodes and adapted for insertion into a heart of a living subject; and
a processor configured to receive electrical signals from the electrodes and to perform the acts of:
recording electrograms from the electrodes concurrently at respective locations in the heart;
delimiting respective activation time intervals in the electrograms, the activation time intervals associated with a peak and a valley of a slope;
generating an activation map of electrical propagation waves from the activation time intervals, including segmenting the electrograms into a series of frames at respective times, wherein the frames are respective assignments of readings of the electrodes to a matrix of values;
assigning local activation times for the electrodes from the matrix of values;
modeling at least a portion of the heart as a mesh with vertices, wherein a portion of the vertices correspond to respective locations of the electrodes;
determining conduction velocities of the electrical propagation waves between the vertices from the frames based on assigned location activation times;
computing coherence of the waves in accordance with the conduction velocities; and
maximizing the coherence of the wave by adjusting the local activation times within the activation time intervals of the electrograms; and

an ablation power generator connected to the probe for ablating tissue in the heart to modify the electrical propagation waves.

12. The system of claim 11 , wherein the activation time intervals comprise:
first intervals delimited by the peak and the valley representing a start and end of a slope; and
second intervals including windows about the first intervals, wherein the adjusting local activation times is performed within the second intervals.

13. The system of claim 11 , wherein the frames are filled with local activation times that most logically relate to each other based on the conduction velocities of the electrical propagation waves.

14. The system of claim 11 , wherein the frame are filled in accordance with:
a source list comprising electrode numbers and associated local activation times to be checked against neighboring local activations for block or conduction; and
a source frame having an input including a frame structure, a distance matrix and local activation time obtained from a source electrode and an output including a frame number for the source electrode,
wherein assignment of the frame number is based on vacancy of frames at the local activation times of the source electrode.

15. The system of claim 11 , wherein local activation times are assigned within boundaries of a given time window.

16. The system of claim 11 , wherein local activation times are assigned from alternative slopes.

17. The system of claim 11 , wherein frame segmentation includes modeling an atrium as a 3-D triangular mesh.

18. The system of claim 11 , wherein the modeling includes representing activation times at the vertices of the mesh as fuzzy vertex membership functions (μu) that may vary between 0 and 1.

19. The system of claim 11 , wherein the modeling includes interpolating activation times of vertices of the mesh that do not correspond to the respective locations of the electrodes.

20. The system of claim 11 , wherein determining conducting velocities include region growing.

Assignees

• Biosense Webster Israel Ltd

Inventors

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

Classifications

• A61B2018/00636

  Sensing and controlling the application of energy · CPC title

• A61B5/0044

  for the heart · CPC title

• A61B2018/00351

  Heart · CPC title

• A61B5/4836

  Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence) · CPC title

• A61B5/743

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