Mapping of complex fractionated atrial electrogram

Patent metadata

Field	Value
Publication number	US-9629567-B2
Application number	US-62037007-A
Country	US
Kind code	B2
Filing date	Jan 5, 2007
Priority date	Jan 12, 2006
Publication date	Apr 25, 2017
Grant date	Apr 25, 2017

Abstract

Software and apparatus are provided to automatically detect and map areas of complex fractionated electrograms within cardiac chambers. Electrogram signal are analyzed to count the number of complexes whose amplitude and peak-to-peak intervals meet certain criteria. Functional maps indicating average complex interval, shortest complex interval, and confidence levels are produced for display.

First claim

The invention claimed is:

1. A method for mapping abnormal electrical activity in a heart of a living subject, comprising the steps of:
providing a catheter comprising an electrode distally disposed thereon;
inserting said catheter into said heart;
using said catheter and obtaining electrical signal data from respective locations of said heart using said electrode;
providing a subsystem comprising:
(i) a peak detector module configured to identify voltage peaks having amplitudes within a predefined voltage range from said electrical signal data provided by said electrode of said catheter,
(ii) a peak quantitation module configured to identify peak-to-peak intervals between said identified voltage peaks that occur within a predefined time range from said electrical signal data provided by said electrode of said catheter, and
wherein said subsystem is configured to automatically analyze said signal data to identify complex fractionated electrograms therein using said identified peak-to-peak intervals between said identified voltage peaks that occur within a predefined time range; and

displaying on a display information derived from said signal data indicative of a spatial distribution of said complex fractionated electrograms in said heart.

2. The method according to claim 1 , wherein said step of obtaining electrical signal data comprises the steps of:
wherein the catheter further comprises a position sensor distally disposed thereon;
contacting a surface of said heart using the catheter; and
measuring electrical signals at said respective locations via said electrode and obtaining location information from said position sensor from at least one point on said surface.

3. The method according to claim 2 , wherein said step of measuring electrical signals is performed using a unipolar electrode.

4. The method according to claim 2 , wherein step of measuring electrical signals is performed using a bipolar electrodes.

5. The method according to claim 2 , wherein said surface is an endocardial surface.

6. The method according to claim 1 , wherein said respective locations are at an atrium of said heart.

7. The method according to claim 1 , wherein said respective locations are at a ventricle of said heart.

8. The method according to claim 1 , wherein at least a portion of said respective locations are on an endocardial surface of said heart.

9. The method according to claim 1 , wherein at least a portion of said respective locations are on an epicardial surface of said heart.

10. The method according to claim 1 , wherein obtaining electrical signal data from said respective locations of said heart comprises the steps of:
disposing multiple electrodes on an external surface of said subject;
detecting electrical signals from said heart using said multiple electrodes; and
applying said electrical signals to a pre-established impedance matrix to identify said respective locations.

11. The method according to claim 1 , wherein displaying information comprises constructing a functional map of said heart that is coded according to average durations of said complex fractionated electrograms.

12. The method according to claim 1 , wherein displaying information comprises constructing a functional map of said heart that is coded according to shortest complex durations of said complex fractionated electrograms.

13. The method according to claim 1 , wherein displaying information comprises constructing a functional map of said heart that is coded according to numbers of said complex fractionated electrograms detected in said respective locations.

14. The method according to claim 1 , further comprising the steps of ablating cardiac tissue associated with said complex fractionated electrograms.

15. A computer software product for use with an apparatus comprising a catheter having an electrode distally disposed thereon configured to obtain electrical signal data from respective locations of said heart using said electrode and a subsystem, wherein the apparatus is configured to map electrical activity in a heart of a living subject, and wherein the subsystem includes a tangible computer-readable medium in which;
computer program instructions are stored, which instructions, when read by a computer, cause the computer to:
store electrical signal data from respective locations of said heart;
automatically analyze said signal data to identify complex fractionated electrograms therein using (i) a peak detector module configured to identify voltage peaks having amplitudes within a predefined voltage range from said electrical signal data provided by said electrode of said catheter, and (ii) a peak quantitation module configured to identify peak-to-peak intervals between said identified voltage peaks that occur within a predefined time range from said electrical signal data provided by said electrode of said catheter, and; and
output information to a display that is indicative of a spatial distribution of said complex fractionated electrograms in said heart.

16. The computer software product according to claim 15 , wherein said computer is further instructed to construct a functional map of said heart that is coded according to average durations of said complex fractionated electrograms.

17. The computer software product according to claim 15 , wherein said computer is further instructed to construct a functional map of said heart that is coded according to shortest complex durations of said complex fractionated electrograms.

18. The computer software product according to claim 15 , wherein said computer is further instructed to construct a functional map of said heart that is coded according to numbers of said complex fractionated electrograms detected in said respective locations.

19. An apparatus for mapping electrical activity in a heart of a living subject, comprising:
a catheter comprising an electrode distally disposed thereon configured to obtain electrical signal data from respective locations of said heart using said electrode;
a subsystem comprising:
(i) a peak detector module configured to identify voltage peaks having amplitudes within a predefined voltage range from said electrical signal data provided by said electrode of said catheter,
(ii) a peak quantitation module configured to identify peak-to-peak intervals between said identified voltage peaks that occur within a predefined time range from said electrical signal data provided by said electrode of said catheter, and
(iii) a processor configured to to automatically analyze said signal data using said identified peak-to-peak intervals between said identified voltage peaks that occur within a predefined time range to identify complex fractionated electrograms therein and to construct a

functional map of said heart that is indicative of a spatial distribution of said complex fractionated electrograms in said heart; and
a display linked to said processor for displaying said functional map.

20. The apparatus according to claim 19 , wherein said functional map is coded by said processor according to average durations of said complex fractionated electrograms.

21. The apparatus according to claim 19 , wherein said functional map is coded by said processor according to shortest complex durations of said complex fractionated electrograms.

22. The apparatus according to claim 19 , wherein said functional map of said heart coded by said processor according to numbers of said complex fractionated electrograms detect

Assignees

• Porath Joshua
• Abbo Aharon
• Turgeman Aharon
• Nademanee Koonlawee
• Biosense Webster Inc

Inventors

• Porath Joshua
• Abbo Aharon
• Turgeman Aharon
• Nademanee Koonlawee

Classifications

• A61B5/0452

  Human Necessities · mapped topic

• A61B2018/00839

  Bioelectrical parameters, e.g. ECG, EEG · CPC title

• A61B18/1492

  having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence) · CPC title

• A61B5/0422 Primary

  Human Necessities · mapped topic

• A61B5/05 Primary

  Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves (measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24) · CPC title