Integrated analysis of electrophysiological data

Patent metadata

Field	Value
Publication number	US-9820666-B2
Application number	US-201514614219-A
Country	US
Kind code	B2
Filing date	Feb 4, 2015
Priority date	Feb 4, 2014
Publication date	Nov 21, 2017
Grant date	Nov 21, 2017

Abstract

A method can include analyzing non-invasive electrical data for a region of interest (ROI) of a patient's anatomical structure to identify one or more zones within the ROI that contain at least one mechanism of distinct arrhythmogenic electrical activity. The method also includes analyzing invasive electrical data for a plurality of signals of interest at different spatial sites within each of the identified zones to determine intracardiac signal characteristics for the plurality of sites within each respective zone. The method also includes generating an output that integrates the at least one mechanism of distinct arrhythmogenic electrical activity for the one or more zones with intracardiac signal characteristics for the plurality of sites within each respective zone.

First claim

What is claimed is:

1. A method comprising:
receiving, by a system comprising a processor, non-invasive electrical data from a plurality of electrodes on an external surface of a patient's body, wherein the plurality of electrodes define a region of interest (ROI) of the patient's anatomical structure;
analyzing, by the system, the non-invasive electrical data to identify one or more zones within the ROI that contain at least one mechanism of distinct arrhythmogenic electrical activity;
analyzing, by the system, invasive electrical data for a plurality of signals of interest at different spatial sites within each of the identified zones to determine intracardiac signal characteristics for the plurality of sites within each respective zone;
determining, by the system, a number of mechanisms of distinct arrhythmogenic electrical activity that occur within each respective zone during at least one time interval based on the intracardiac signal characteristics for the plurality of sites within each respective zone, wherein the number of mechanisms of distinct arrhythmogenic electrical activity within each respective zone comprises at least one of a number of rotors that occur within the at least one time interval or a number of foci that occur within the at least one time interval, and a number of fast bursting cycle lengths that occur within the at least one time interval;
generating, by the system, an output map that integrates the at least one mechanism of distinct arrhythmogenic electrical activity for the one or more zones and the intracardiac signal characteristics for the plurality of sites within each respective zone; and
displaying, by a display device of the system, a hybrid graphical map comprising the output map superimposed on a model of the cardiac surface.

2. The method of claim 1 , wherein the one or more zones are a plurality of zones, the method further comprises:
determining, by the system, a zonal priority among the plurality of zones based on a relative number of the mechanisms of distinct arrhythmogenic electrical activity that occur within in each respective zone during the at least one time interval.

3. The method of claim 2 , the method further comprising evaluating, by the system, a plurality of different intracardiac signal characteristics determined for the plurality of sites within each zone to determine a local priority among the plurality of sites within each respective zone.

4. The method of claim 3 , wherein the plurality of different intracardiac signal characteristics comprises at least two of a cycle length, cycle length variation, percentage of continuous activation and fractionation determined for at least one measurement interval.

5. The method of claim 4 , the method further comprising assigning, by the system, different priority weighting to at least two of the different intracardiac signal characteristics for the plurality of sites within a given zone according to the mechanisms of distinct arrhythmogenic electrical activity identified for the given zone to provide weighted signal characteristics for the at least two different intracardiac signal characteristics, and
wherein the local weighting for the plurality of sites within the given zone is determined based on the weighted signal characteristics for the given zone.

6. The method of claim 3 , the method further comprising:
applying treatment to a selected site of the plurality of sites within a given zone in an order according to the local priority among the plurality of sites within the given zone.

7. The method of claim 6 , the method further comprising repeating, by the system, each of the analyzing non-invasive electrical data, analyzing invasive electrical data and determining the priority based on other sets of non-invasive electrical data and invasive electrical data representing electrical activity following the applying of the treatment.

8. The method of claim 6 , the method further comprising determining, by the system, improvement at the selected site based on comparing at least one of the intracardiac signal characteristics determined at approximately the selected site prior to applying the treatment with respect to the same at least one of the intracardiac signal characteristics determined at approximately the selected site following the applying the treatment to the selected site.

9. The method of claim 6 , the method further comprising determining, by the system, improvement at the selected site residing in the given zone based on comparing the mechanisms of distinct arrhythmogenic electrical activity for the given zone identified prior to applying the treatment with respect to mechanisms of distinct arrhythmogenic electrical activity for the given zone identified following the applying the treatment to the selected site.

10. The method of claim 6 , the method further comprising determining, by the system, improvement at the selected site residing in the given zone based on comparing an indication of synchrony across atria or regions of interest near to the given zone identified prior to applying the treatment with respect to synchrony across the atria or the regions of interest near to the given zone identified following the applying the treatment to the selected site.

11. The method of claim 1 , wherein the one or more zones are a plurality of zones,
the method further comprising determining, by the system, a zonal priority among the plurality of zones based on a comparison of an average of each of the intracardiac signal characteristics determined for the plurality of sites within each respective zone.

12. The method of claim 11 , the method further comprising evaluating, by the system, a plurality of different intracardiac signal characteristics determined for the plurality of sites within each zone to determine a local priority among the plurality of sites within each respective zone, wherein the plurality of different intracardiac signal characteristics comprises at least two of a cycle length, cycle length variation, percentage of continuous activation and fractionation determined for at least one measurement interval.

13. The method of claim 12 , the method further comprising:
applying therapy to the plurality of sites within a given zone in an order according to the local priority among the plurality of sites within the given zone; and
repeating, by the system, each of the analyzing non-invasive electrical data, analyzing invasive electrical data and determining the priority following the applying of the therapy.

14. The method of claim 1 , wherein the ROI comprises a three-dimensional cardiac envelope corresponding to an entire surface of the heart.

15. The method of claim 1 , further comprising determining a spatial location for each of the plurality of sites according to placement of one or more sensors during each time interval when intracardiac electrical measurements are obtained.

16. The method of claim 1 , the method further comprising reconstructing electrograms on a cardiac envelope based on non-invasively acquired electrical activity via body surface sensors to provide the non-invasive electroanatomic data for the cardiac envelope.

17. The method of claim 1 , the method further comprising:
assigning, by the system, different weighting to at least two different intracardiac signal characteristics determined for signals of interest during at least one time interval within a given zone according to the mechanisms of distinct arrhythmogenic electrical activity identified for the given zone to provide differently weighted signal characteristics, and
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Assignees

• Cardioinsight Technologies Inc

Inventors

• Bokan Ryan
• Ramanathan Charulatha
• Jia Ping
• Strom Maria
• Zeng Qingguo

Classifications

• G16H50/20

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

• A61B5/066

  Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging · CPC title

• A61B5/06

  Devices, other than using radiation, for detecting or locating foreign bodies {; Determining position of diagnostic devices within or on the body of the patient} · CPC title

• A61B5/0036 Primary

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

• A61B5/0245

  by using sensing means generating electric signals, {i.e. ECG signals} · CPC title