System and method for reconstructing cardiac signals associated with a complex rhythm disorder

Patent metadata

Field	Value
Publication number	US-9241667-B2
Application number	US-201514738626-A
Country	US
Kind code	B2
Filing date	Jun 12, 2015
Priority date	Apr 8, 2010
Publication date	Jan 26, 2016
Grant date	Jan 26, 2016

Abstract

System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.

First claim

The invention claimed is:

1. A system to reconstruct cardiac signals associated with a complex rhythm disorder, the system comprising at least one computing device that comprises:
a controller configured to receive the cardiac signals from a plurality of sensors associated spatially with a patient's heart; and
an analytic engine comprising:
a beat classification module configured to identify a plurality of discernible beats on high-confidence signals of sensors that are spatially adjacent to a sensor associated with a low-confidence signal, the discernible beats on the high-confidence signals corresponding to a non-discernible beat on the low-confidence signal; and
an activation onset module configured to:
compute a time vector between at least two activation onsets associated with the identified discernible beats on the high-confidence signals through the non-discernible beat on the low-confidence signal;
define a time interval associated with the non-discernible beat about a region of the low-confidence signal where the computed time vector crosses the non-discernible beat, the time interval indicating how early the non-discernible beat is able to activate based on a previous beat on the low-confidence signal that has a selected or determined activation onset and how late the non-discernible beat is able to terminate based on at least one predetermined property; and
assign the non-discernible beat an activation onset during the defined time interval that is closest to the computed time vector.

2. The system according to claim 1 , wherein the activation onset is assigned in association with a deflection or a quiescent period during the defined time interval.

3. The system according to claim 1 , wherein the activation onset module is further configured to:
determine a second time interval between discernible beats on the low-confidence signal occurring before the non-discernible beat, the second time extending from a first activation onset to a second activation onset of the respective discernible beats on the low-confidence signal;
advance the determined second time interval such that the first activation onset approximates the activation onset of a beat previous to the non-discernible beat;
reconcile the selected activation onset with the second activation onset to a reconciled activation onset; and
update the selected activation onset with the reconciled activation onset for the non-discernible beat.

4. The system according to claim 1 , wherein the beat classification module is further configured to classify high-confidence signals that include at least a predetermined percentage of discernible beats out of total beats, each discernible beat having an identifiable activation onset, and low-confidence signals that include a first number of discernible beats and a second number of non-discernible beats, each non-discernible beat having a plurality of deflections and quiescent periods associated with a possible activation onset, the first number of discernible beats being below the predetermined percentage.

5. The system according to claim 1 , wherein the complex rhythm disorder comprises no discernible period during which the cardiac signals are quiescent.

6. The system according to claim 1 , wherein the system further comprises:
at least one storage device configured to store the cardiac signals received from the patient's heart, the at least one storage device operatively coupled to the at least one computing device to provide the cardiac signals to the at least one computing device.

7. The system according to claim 1 , wherein the system further comprises a catheter comprising the plurality of sensors to receive the cardiac signals from the patient's heart and operatively coupled to the at least one computing device provide the cardiac signals to the at least one computing device.

8. The system according to claim 1 , wherein the at least one computing device comprises a computer-readable medium storing instructions, which when executed by a processing device, cause the processing device to perform operations of the analytic engine.

9. The system according to claim 1 , wherein the at least one computing device further comprises a representation tool configured to generate a clinical representation associated with the complex rhythm disorder using at least the activation onset assigned to the non-discernible beat.

10. An assembly to reconstruct cardiac signals associated with a complex rhythm disorder, the assembly comprising:
a catheter comprising a plurality of sensors spatially associated with a patient's heart to receive the cardiac signals; and
a computer-readable medium operatively coupled to the sensors, the computer-readable medium comprising instructions, which when executed by a computing device, cause the computing device to:
identify a plurality of discernible beats on high-confidence signals of sensors that are spatially adjacent to a sensor associated with a low-confidence signal, the discernible beats on the high-confidence signals corresponding to a non-discernible beat on the low-confidence signal;
compute a time vector between at least two activation onsets associated with the identified discernible beats on the high-confidence signals through the non-discernible beat on the low-confidence signal;
define a time interval associated with the non-discernible beat about a region of the low-confidence signal where the computed time vector crosses the non-discernible beat, the defined time interval indicating how early the non-discernible beat is able to activate based on a previous beat on the low-confidence signal that has a selected or determined activation onset and how late the non-discernible beat is able to terminate based on at least one predetermined property; and
assign the non-discernible beat an activation onset during the defined time interval that is closest to the computed time vector for the non-discernible beat.

11. The assembly according to claim 10 , wherein the activation onset is assigned in association with a deflection or a quiescent period during the defined time interval.

12. The assembly according to claim 10 , wherein the computer-readable medium further comprises instructions, which when executed by the computing device, cause the computing device to:
determine a second time interval between discernible beats on the low-confidence signal occurring before the non-discernible beat, the second time interval extending from a first activation onset to a second activation onset of the respective discernible beats on the low-confidence signal;
advance the second time interval such that the first activation onset approximates the activation onset of a beat previous to the non-discernible beat;
reconcile the selected activation onset with the second activation onset to a reconciled activation onset; and
update the selected activation onset with the reconciled activation onset for the non-discernible beat.

13. The assembly according to claim 10 , wherein the computer-readable medium further comprises instructions, which when executed by a computing device, cause the computing device to
classify high-confidence signals that include at least a predetermined percentage of discernible beats out of total beats, each discernible beat having an identifiable activation onset, and low-confidence signals that include a first number of discernible beats and a second number of non-discernible beats, each non-discernible beat having a plurality of deflections and quiescent periods associated with a possible activation onset, the first number of discernible beats being below the predetermined percentage.

Assignees

• Univ California
• Topera Inc
• Us Dept Of Veterans Affairs Office Of General Counsel

Inventors

• Narayan Sanjiv
• Sehra Ruchir

Classifications

• A61B5/7221

  Determining signal validity, reliability or quality (preventing, reducing or removing noise induced by motion artefacts A61B5/7207; noise originating from a therapeutic or surgical apparatus A61B5/7217) · CPC title

• A61B5/6852

  Catheters · CPC title

• A61B5/4857 Primary

  Indicating the phase of biorhythm · CPC title

• A61B5/726

  using Wavelet transforms · CPC title

• A61B5/0255

  Recording instruments specially adapted therefor · CPC title