Medical devices for mapping cardiac tissue

Patent metadata

Field	Value
Publication number	US-9408544-B2
Application number	US-201514706517-A
Country	US
Kind code	B2
Filing date	May 7, 2015
Priority date	May 9, 2014
Publication date	Aug 9, 2016
Grant date	Aug 9, 2016

Abstract

Medical devices and methods for making and using medical devices are disclosed. An example method may include a method of identifying an activation time in a cardiac electrical signal. The method may include sensing a cardiac electrical signal, generating an approximation signal based at least in part on one or more parameters of the cardiac electrical signal, identifying a fiducial point on the approximation signal and determining, based at least in part on a timing of the fiducial point in the approximation signal, an activation time in the cardiac electrical signal.

First claim

What is claimed is:

1. A system for mapping the electrical activity of the heart, the system comprising:
a processor, the processor configured to:
sense a plurality of signals with a plurality of electrodes positioned within the heart;
generate, based at least in part on the sensed plurality of signals, an alternate signal for each one of the plurality of signals, wherein each alternate signal corresponds to one of the plurality of signals, and wherein generating the alternate signal for each one of the plurality of signals includes determining a dominant frequency for the plurality of signals;
determine a fiducial point on each alternate signal; and
determine, based at least in part on each determined fiducial point, an activation time in each corresponding one of the plurality of signals.

2. The system of claim 1 , wherein determining, based at least in part on each determined fiducial point, an activation time in each corresponding one of the plurality of signals comprises determining a timing associated with each fiducial point as the activation time for each corresponding one of the plurality of signals.

3. The system of claim 2 , wherein determining, based at least in part on each determined fiducial point, an activation time in each corresponding one of the plurality of signals comprises:
identifying, based at least in part on a timing associated with each fiducial point, a window in each corresponding one of the plurality of signals; and
for each of the plurality of signals, determining an activation time within the identified window.

4. The system of claim 3 , wherein determining an activation time within the identified window comprises determining the timing of the maximum negative derivative in the identified window as the activation time for each of the plurality of signals.

5. The system of claim 4 , wherein determining an activation time within the identified window comprises determining the timing of a zero-crossing in the identified window as the activation time for each of the plurality of signals.

6. The system of claim 5 , wherein if no zero-crossing occurs within an identified window, determining the timing associated with the fiducial point as the activation time for the corresponding one of the plurality of signals.

7. The system of claim 6 , wherein a width of the window is user defined.

8. The system of claim 1 , wherein generating, based at least in part on the sensed plurality of signals, an alternate signal for each one of the plurality of signals comprises:
determining a phase for each of the plurality of signals at the dominant frequency; and
generating an alternate signal corresponding to one of the plurality of signals for each of the plurality of signals, wherein each generated alternate signal has the same phase as the corresponding one of the plurality of signals.

9. The system of claim 1 , wherein determining a dominant frequency for the plurality of signals comprises:
processing each of the plurality of signals using a Fourier Transform; generating a composite signal based on the processed plurality of signals; and
determining the frequency with the greatest power in the composite signal.

10. The system of claim 9 , wherein generating a composite signal based on the processed plurality of signals comprises:
determining the median value of all of the plurality of signals at each frequency; determining the mean value of all of the plurality of signals at each frequency; or
determining the mode value of all of the plurality of signals at each frequency.

11. The system of claim 10 , wherein each alternate signal is a sinusoid.

12. The system of claim 11 , wherein the activation time is displayed on a display.

13. The system of claim 12 , wherein an activation time is displayed on a static activation map, a dynamic map, or both.

14. The system of claim 13 , wherein displaying an activation map further includes displaying one or more phase values of one or more alternate signals.

15. The system of claim 1 , wherein determining, based at least in part on each determined fiducial point, an activation time in each corresponding one of the plurality of signals further comprises utilizing a probability function to determine the activation time.

16. A method of mapping electrical activity of a heart, the method comprising:
sensing a plurality of signals with a plurality of electrodes positioned within the heart;
generating, based at least in part on the sensed plurality of signals, an alternate signal for each one of the plurality of signals, wherein each alternate signal corresponds to one of the plurality of signals and generating the alternate signal for each one of the plurality of signals by determining a dominant frequency for the plurality of signals;
determining a fiducial point on each alternate signal; and
determining, based at least in part on each determined fiducial point, an activation time in each corresponding one of the plurality of signals.

17. A method for mapping the electrical activity of the heart during a cardiac cycle, the method comprising:
sensing a plurality of signals with a plurality of electrodes positioned within the heart, wherein the plurality of signals includes a first signal corresponding to a first electrode location;
converting the first signal to an activation signal, wherein converting includes one or more of filtering, rejecting, isolating, setting positive values to zero, smoothing and inverting;
determining a cycle length of the first signal from the activation signal;
estimating a first activation time for the first signal, wherein the first activation time is determined by using an iterative statistical algorithm, and wherein the iterative statistical method utilizes the activation signal and cycle length; and
estimating a second activation time for the first signal, wherein estimating the second activation time utilizes the estimated first activation time and the cycle length.

18. The method of claim 17 , wherein estimating a first activation time for the first signal, wherein the first activation time is determined by using an iterative statistical algorithm, and wherein the iterative statistical method utilizes the activation signal and cycle length further comprises:
selecting a first initialization probability distribution for a first beat in the cardiac cycle; generating a first modified probability distribution, wherein generating includes modifying the first initialization probability distribution with a first low-pass filter;
generating a first modified signal by multiplying the first modified probability distribution with the activation signal; and
selecting a first activation time from the first modified signal.

19. The method of claim 18 , wherein estimating a second activation time for the first signal, wherein estimating the second activation time utilizes the estimated first activation time and the cycle length further comprises:
time-shifting the first modified signal by the cycle length;
selecting a second initialization probability distribution for the second beat in the cardiac cycle, wherein the second initialization probability distribution corresponds to the first modified signal;
generating a second modified probability distribution, wherein generating includes modifying the second initialization probability distribution with a second low-pass filter;
generating a second modified signal by multiplying the second modified probability distribution with the activation signal; and
selecting a second activation tim

Assignees

• Boston Scient Scimed Inc

Inventors

• Laughner Jacob I
• Hultz Paul
• Shome Shibaji
• Thakur Pramodsingh Hirasingh
• Meyer Scott A

Classifications

• A61B5/339

  Displays specially adapted therefor · CPC title

• A61B5/367 Primary

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

• A61B5/044

  Human Necessities · mapped topic

• A61B5/046

  Human Necessities · mapped topic

• A61B5/6858 Primary

  with a distal basket, e.g. expandable basket · CPC title