System and method to identify sources associated with biological rhythm disorders
Inventors
Narayan, Sanjiv • Briggs, Carey Robert • Sehra, Ruchir
Assignees
United States, As Represented By Department Of Veteans Affairs • US Department of Veterans Affairs • Topera Inc • University of California San Diego UCSD
Publication Number
US-10098560-B2
Publication Date
2018-10-16
Expiration Date
2033-03-15
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Abstract
A system and method are provided to define a driver of a source associated with a cardiac rhythm disorder of a human heart. A plurality of cardiac signals associated with sensors arranged spatially in relation to an area of the heart are processed to determine a sequence of arcs of rotation in relation to the sensors over a time interval. Rotational directions of the arcs of rotation in the sequence are determined. The area of the heart is identified as controlling the source when the rotational directions of the arcs of rotation in the sequence continue in a same rotational direction in excess of a threshold.
Core Innovation
The invention provides a system and method to identify the driver of a source associated with a cardiac rhythm disorder of a human heart by processing a plurality of cardiac signals from sensors arranged spatially in relation to an area of the heart. This processing determines sequences of arcs of rotation over a time interval and identifies rotational directions. The area of the heart is identified as controlling the source when these rotational directions continue in the same rotational direction in excess of a threshold.
The problem being addressed is the difficulty in precisely identifying the core of a rotational source or the origin of a focal source that drives complex heart rhythm disorders. While prior methods could detect rotational or focal sources as areas involved in cardiac rhythm disorders, they could not define the inner mechanism or the driver within the source that controls activation in distant regions of the heart. Consequently, treatment targeting these sources has been challenged by the inability to distinguish persistent drivers from transient or passive activation patterns.
Claims Coverage
The patent contains one independent method claim and one independent system claim, collectively covering methods and systems for identifying areas of the heart associated with controlling a source of a cardiac rhythm disorder through analysis of rotational activation patterns.
Method to identify an area controlling a cardiac rhythm disorder source
Processing multiple cardiac signals from spatially arranged sensors over a time interval to determine sequences of activation and their rotational direction. Identification of a first local region as controlling a second distant region when the activation continues to rotate in the same direction with a substantial degree over the time interval, indicated via a rotational counter exceeding a threshold.
System to identify an area controlling a cardiac rhythm disorder source
A processing device and memory storing instructions to process cardiac signals from spatially arranged sensors to determine sequences of activation and rotational direction. The system identifies a first region as controlling a second region when rotation continues consistently over time, with the rotational counter surpassing a threshold.
The independent claims disclose methods and systems focused on calculating and assessing rotational sequences of cardiac activation signals from multiple sensors to identify persistent rotational drivers controlling cardiac rhythm disorders. Features include determining rotational directions via phase differences, calculating rotational counters, evaluating persistence over time intervals, and generating indicators overlaid on cardiac signal representations.
Stated Advantages
Ability to recognize rotational electrical patterns amidst indistinct sensed activation patterns to determine and treat the source of complex heart rhythm disorders.
Improved detection of persistent rotational or focal drivers that control activation in both local and distant heart regions, aiding precise identification of disorder sources.
Rapid execution allowing identification of sources during a sensing procedure to enable immediate targeted therapy such as cardiac tissue ablation.
Filtering out spurious or insignificant rotational or focal activations to improve treatment effectiveness for complex heart rhythm disorders.
Documented Applications
Identification and targeted treatment of cardiac rhythm disorders such as atrial fibrillation, ventricular fibrillation, polymorphic ventricular tachycardia, and other complex heart rhythm disorders.
Use in diagnosis and treatment planning when utilizing catheters with sensor arrays inserted into or placed near the heart for electrophysiological mapping.
Potential applicability to other biological rhythm disorders including neurological seizures, esophageal spasms, bladder instability, and irritable bowel syndrome by reconstructing biological activation information.
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