Analyzing and mapping ECG signals and determining ablation points to eliminate Brugada syndrome

Patent metadata

Field	Value
Publication number	US-11819281-B2
Application number	US-202117146218-A
Country	US
Kind code	B2
Filing date	Jan 11, 2021
Priority date	Jan 25, 2017
Publication date	Nov 21, 2023
Grant date	Nov 21, 2023

Abstract

A system and method for Brugada syndrome epicardial ablation comprising preparing an endocardial duration map; preparing a baseline epicardial duration map comprising at least one or more areas of delimination; and when some of the areas of delimination are greater than 200 ms, performing epicardial ablation of the areas of delimination greater than 200 ms. The method may further comprise preparing an updated epicardial duration map after performing epicardial ablation, and determining whether or not a BrS pattern appears in the updated epicardial duration map; and when the BrS pattern appears, performing epicardial ablation. The method may further comprise preparing an updated epicardial duration map after performing epicardial ablation, and determining whether or not an abnormal EGM exists in the updated epicardial duration map; and when the abnormal EGM exists, performing epicardial ablation. The method may further comprise preparing an updated epicardial map comprising maintaining anatomical volume data and adding electroanatomical data.

First claim

What is claimed is:

1. A computer implemented method for determining target ablation areas of a heart, comprising:
acquiring, over time, electrical signals for a plurality of areas of the heart and generating an epicardial potential duration map for display by;
defining a window of interest of the acquired electrical signals including a plurality of heart beats and a heart beat cycle length;
calculating, for each acquired electrical signal, a plurality of prior heart beats based on the heart beat cycle length and a first reference point in time of one of the plurality of prior heart beats;
calculating a second reference point in time of a second of the plurality of prior heart beats according to an amount of time from the first reference point in time equal to the heart beat cycle length; the second of the plurality of prior heart beats is calculated based on the heart beat cycle length and the second reference point in time;
calculating a respective sub window of interest for each of the plurality of prior heart beats;
calculating a potential duration for each respective sub window of interest of each of the plurality of prior heart beats by:
calculating a plurality of consecutive peaks in each respective sub window of interest based upon at least a peak amplitude threshold and a time threshold for an amount of time between the plurality of consecutive peaks;
determining a start potential duration and an end potential duration for each respective sub window of interest based upon the calculated plurality of consecutive peaks; and
determining a potential duration value for each respective sub window of interest as the difference between the start potential duration and the end potential duration,

wherein, when a potential duration value of an electrical signal is greater than or equal to a potential duration threshold, the area of the heart corresponding to the electrical signal is targeted for ablation.

2. The method according to claim 1 , further comprising:
performing epicardial ablation on the areas of the heart targeted for ablation;
after performing the epicardial ablation, preparing an updated epicardial potential duration map and determining whether the updated epicardial potential duration map includes a displayed abnormality; and
when the updated epicardial potential duration map includes the abnormality, performing another epicardial ablation on an area of the heart corresponding to the displayed abnormality.

3. The method according to claim 1 , wherein the potential duration threshold is 200 ms.

4. The method according to claim 1 , further comprising
determining the start potential duration and the end potential duration by identifying the start potential duration as the start of the slope before a first consecutive peak and identifying the end potential duration as a second consecutive peak having a distance greater than or equal to 120 ms from the first consecutive peak.

5. The method according to claim 1 , further comprising:
performing epicardial ablation on the area of the heart targeted for ablation; and
after performing the epicardial ablation, preparing an updated epicardial potential duration map,
wherein an epicardial potential duration map, and the updated epicardial potential duration map include displayed concentric areas having a plurality of different cut-off intervals.

6. A system for determining target ablation areas in a heart, comprising:
a catheter for acquiring electrical signals for a plurality of areas of the heart;
one or more processors configured to:
generate an epicardial potential ablation map for display by:
defining a window of interest of the acquired electrical signals including a plurality of heart beats and a heart beat cycle length;
calculating, for each acquired electrical signal, a plurality of prior heart beats based on the heart beat cycle length and a first reference point in time of one of the plurality of prior heart beats;
calculating a second reference point in time of a second of the plurality of prior heart beats according to an amount of time from the first reference point in time equal to the heart beat cycle length; the second of the plurality of prior heart beats is calculated based on the heart beat cycle length and the second reference point in time;
calculating a respective sub window of interest for each of the plurality of prior heart beats;
calculating a potential duration for each respective sub window of interest of each of the plurality of prior heart beats by:
calculating a plurality of consecutive peaks in each respective sub window of interest based upon at least a peak amplitude threshold and a time threshold for an amount of time between the plurality of consecutive peaks;

determining a start potential duration and an end potential duration for each respective sub window of interest based upon the calculated plurality of consecutive peaks; and
determining a potential duration value for each respective sub window of interest as the difference between the start potential duration and the end potential duration,

wherein, when a potential duration value of an electrical signal is greater than or equal to a potential duration threshold, the area of the heart corresponding to the electrical signal is targeted for ablation; and

a display device for displaying an epicardial potential duration map.

7. The system according to claim 6 , the one or more processors are further configured to:
control the catheter to perform epicardial ablation on the areas of the heart targeted for ablation;
after performing the epicardial ablation, prepare an updated epicardial potential duration map and determine whether the updated epicardial potential duration map includes a displayed abnormality; and
when the updated epicardial potential duration map includes the displayed abnormality, perform another epicardial ablation on an area of the heart corresponding to the displayed abnormality.

8. The system according to claim 6 , wherein the potential duration threshold is 200 ms.

9. The system according to claim 6 , the one or more processors are further configured to determine the start potential duration and the end potential duration by identifying the start potential duration as the start of the slope before a first consecutive peak and identifying the end potential duration as a second consecutive peak having a distance greater than or equal to 120 ms from the first consecutive peak.

10. The system according to claim 6 , wherein the one or more processors are further configured to:
control the catheter to perform epicardial ablation on the area of the heart targeted for ablation; and
after performing the epicardial ablation, prepare an updated epicardial potential duration map,
wherein at least one of the epicardial potential duration map, and the updated epicardial potential duration map include displayed concentric areas having a plurality of different cut-off intervals.

11. A non-transitory computer readable storage medium comprising instructions for causing a computer to execute a method of determining target ablation areas of a heart, the instructions comprising:
acquiring, over time, electrical signals for a plurality of areas of the heart; and
generating an epicardial potential duration map for display by:
defining a window of interest of the acquired electrical signals including a plurality of heart beats and a heart beat cycle length;
calculating, for each acquired electrical signal, a plurality of prior heart beats based on the heart beat cycle length and a first reference point in time of one of the plurality of prior heart beats;
calculating a second reference point in time of a

Assignees

• Biosense Webster Israel Ltd
• Pappone Carlo

Inventors

• Pappone Carlo
• Turgeman Aharon
• Pozzi Paolo Roberto
• Natalizia Andrea

Classifications

• A61B5/367

  Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping · CPC title

• A61B5/339

  Displays specially adapted therefor · CPC title

• A61B5/283

  Invasive · CPC title

• A61B34/10 Primary

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

• A61B5/0036 Primary

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