System and method to detect and treat arrhythmogenic regions in atrial fibrillation

Patent metadata

Field	Value
Publication number	US-11911178-B2
Application number	US-202117308756-A
Country	US
Kind code	B2
Filing date	May 5, 2021
Priority date	May 5, 2020
Publication date	Feb 27, 2024
Grant date	Feb 27, 2024

Abstract

A system for treating atrial fibrillation includes a memory configured to store a baseline measurement of an atrial fibrillation characteristic of a patient and a post administration measurement of the atrial fibrillation characteristic of the patient. The post administration measurement is obtained subsequent to administration of a reactive oxygens species (ROS) scavenger to the patient. The system also includes a processor operatively coupled to the memory and configured to determine a change between the baseline measurement and the post administration measurement of the atrial fibrillation characteristic. The processor is further configured to identify, based on the determined change, one or more hot spots of atrial fibrillation, where the one or more hot spots comprise target areas for treatment of the atrial fibrillation.

First claim

What is claimed is:

1. A system for treating atrial fibrillation comprising:
a memory configured to store a baseline measurement of an atrial fibrillation characteristic of a patient and a post administration measurement of the atrial fibrillation characteristic of the patient, wherein the post administration measurement is obtained subsequent to administration of a reactive oxygens species (ROS) scavenger to the patient;
a processor operatively coupled to the memory and configured to:
determine a change between the baseline measurement and the post administration measurement of the atrial fibrillation characteristic;
determine an activation pattern responsive to the determined change, wherein the activation pattern includes a number of rotational, focal, and wavelet activities that occur in the patient responsive to administration of the ROS scavenger; and
identify, based at least in part on the activation pattern, one or more hot spots of atrial fibrillation, wherein the one or more hot spots comprise target areas for treatment of the atrial fibrillation; and

a therapeutic device coupled to the processor, wherein the therapeutic device delivers a therapeutic substance to the one or more identified hot spots.

2. The system of claim 1 , further comprising an electrogram system operatively coupled to the processor, wherein the baseline measurement and the post administration measurement are received from the electrogram system.

3. The system of claim 1 , wherein the change between the baseline measurement and the post administration measurement comprises a percentage change.

4. The system of claim 1 , wherein the processor is further configured to determine changes between baseline measurements and post administration measurements for a plurality of additional atrial fibrillation characteristics.

5. The system of claim 4 , wherein the processor is configured to combine the changes between the atrial fibrillation characteristic and the plurality of additional atrial fibrillation characteristics to identify the one or more hotspots.

6. The system of claim 1 , wherein the atrial fibrillation characteristic comprises dominant frequency (DF), cycle length (CL), organization index ( 01 ), fractionation index (FI), recurrence morphology percentage (Rec %), Shannon's entropy (ShEn), conduction velocity, or voltage.

7. The system of claim 1 , wherein the processor is further configured to generate a visualization of a heart of the patient, wherein the visualization depicts the one or more hot spots.

8. The system of claim 1 , wherein the processor is configured to compare an amount of the change in the atrial fibrillation characteristic to a characteristic threshold.

9. The system of claim 8 , wherein the processor identifies the one or more hot spots as regions in which the amount of change in the atrial fibrillation characteristic exceeds the characteristic threshold.

10. The system of claim 1 , wherein the processor determines the change between the baseline measurement and the post administration measurement of the atrial fibrillation characteristic at a plurality of times subsequent to administration of the ROS scavenger to the patient.

11. The system of claim 1 , wherein the ROS scavenger comprises N-acetylcysteine.

12. The system of claim 1 , wherein the processor is further configured to determine changes between baseline measurements and post administration measurements for a plurality of additional atrial fibrillation characteristics, and wherein the processor is configured to identify an amount of overlap between the atrial fibrillation characteristic and the plurality of additional atrial fibrillation characteristics to identify the one or more hotspots.

13. The system of claim 1 , wherein the activation pattern also includes a frequency and stability of the rotational, focal, and wavelet activities that occur in the patient responsive to administration of the ROS scavenger.

14. The system of claim 1 , wherein the processor is configured to determine multivariate changes in the atrial fibrillation characteristic, and wherein the one or more hotspots are identified based at least in part on the multivariate changes.

15. A method of treating atrial fibrillation, the method comprising:
storing, in a memory of a computing system, a baseline measurement of an atrial fibrillation characteristic of a patient and a post administration measurement of the atrial fibrillation characteristic of the patient, wherein the post administration measurement is obtained subsequent to administration of a reactive oxygens species (ROS) scavenger to the patient;
determining, by a processor operatively coupled to the memory, a change between the baseline measurement and the post administration measurement of the atrial fibrillation characteristic;
determining, by the processor, an activation pattern responsive to the determined change, wherein the activation pattern includes a number of rotational, focal, and wavelet activities that occur in the patient responsive to administration of the ROS scavenger;
identifying, by the processor and based at least in part on the determined activation pattern, one or more hot spots of atrial fibrillation, wherein the one or more hot spots comprise target areas for treatment of the atrial fibrillation; and
delivering, by a therapeutic device coupled to the processor, a therapeutic substance to the one or more identified hot spots.

16. The method of claim 15 , further comprising:
determining, by the processor, changes between baseline measurements and post administration measurements for a plurality of additional atrial fibrillation characteristics; and
combining the changes between the atrial fibrillation characteristic and the plurality of additional atrial fibrillation characteristics to identify the one or more hotspots.

17. The method of claim 15 , further comprising generating, by the processor, a visualization of a heart of the patient, wherein the visualization depicts the one or more hot spots.

18. The method of claim 15 , further comprising comparing, by the processor, an amount of the change in the atrial fibrillation characteristic to a characteristic threshold, and wherein the processor identifies the one or more hot spots as regions in which the amount of change in the atrial fibrillation characteristic exceeds the characteristic threshold.

Assignees

• Univ Northwestern

Inventors

• Rottmann Markus
• Arora Rishi K
• Johnson David A
• Yoo Shin

Classifications

• A61B5/4848 Primary

  Monitoring or testing the effects of treatment, e.g. of medication · CPC title

• A61B5/339

  Displays specially adapted therefor · CPC title

• A61B5/361

  Detecting fibrillation · CPC title

• A61K31/198 Primary

  Alpha-amino acids, e.g. alanine or edetic acid [EDTA] (betaine A61K31/205; proline A61K31/401; tryptophan A61K31/405; histidine A61K31/4172; peptides not degraded to individual amino acids A61K38/00) · CPC title

• G16H50/20

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