Method and system for detection of biological rhythm disorders
Inventors
Narayan, Sanjiv M. • Sehra, Ruchir
Assignees
US Department of Veterans Affairs • Topera Inc • Office of General Counsel of VA • University of California San Diego UCSD
Publication Number
US-10856760-B2
Publication Date
2020-12-08
Expiration Date
2031-04-06
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Abstract
A system for processing cardiac activation information associated with a complex rhythm disorder identifies a location of the heart rhythm disorder by determining activations within cardiac signals obtained at neighboring locations of the heart and arranging the activations to identify an activation trail. The activation trail may define a rotational pattern or radially emanating pattern corresponding to an approximate core of the heart rhythm disorder.
Core Innovation
The invention provides a system, assembly, and method for processing cardiac activation information associated with complex heart rhythm disorders to identify and locate the source of the disorder in a patient's heart. This involves receiving cardiac signals from multiple sensors at neighboring locations, classifying these signals into high and low confidence categories, determining activation onsets within these signals, ordering the activations to create an activation trail, and identifying a core region that defines the cause of the rhythm disorder, such as an electrical rotor or a focal beat with radially emanating activation.
The problem addressed is the difficulty in accurately identifying and locating the causes of complex heart rhythm disorders such as atrial fibrillation (AF), ventricular tachycardia (VT), and ventricular fibrillation (VF), particularly because existing tools and methods do not directly identify or locate the sources of these disorders. Prior art methods only display data requiring expert interpretation without pinpointing localized causes, resulting in suboptimal treatments, long procedures, and lower success rates. This is especially challenging for disorders with beat-to-beat varying activation patterns and multiple deflections in cardiac signals, for which known methods either fail or are inadequate.
The invention advances the art by providing a method to detect, diagnose, and treat complex heart rhythm disorders by accurately identifying localized sources including rotors and focal beats, even when these sources are transient or functional. It processes signals with a combination of classification, pattern recognition, vector analysis, and phase analysis techniques to reconstruct activation trails. The invention includes adaptive spatial and temporal sensing using specialized catheters, filters noisy and complex signals, and applies algorithms to create visual or auditory representations of activation patterns, thereby directly locating the underlying cause of the disorder for targeted therapy such as ablation.
Claims Coverage
The patent includes multiple independent claims covering systems for processing cardiac activation information and identifying sources of complex heart rhythm disorders based on analysis of high and low confidence cardiac signals.
System for processing cardiac activation signals to identify rhythm disorder location
A computing device obtains cardiac signals from sensors located at multiple sites in the heart, determines whether beats in these signals are discernible or non-discernible, infers activations for non-discernible beats based on neighboring high-confidence signals, and identifies a physical source location within the heart based on ordered activation onsets.
Activation classification and confidence thresholding
The system classifies cardiac signals into high-confidence and low-confidence categories based on criteria including signal quality and percentage of discernible beats, establishing a confidence threshold to separate them.
Use of vectors and acceptance windows for activation onset determination
For low-confidence signals with non-discernible beats, the system computes time vectors between activation onsets of neighboring high-confidence channels, defines acceptance time windows considering physiological properties such as action potential duration (APD) and conduction velocity (CV), and selects activation onsets that best conform to these constraints.
Generation of activation trails and core identification via phase and frequency analysis
The system processes ordered activations through phase analysis, Hilbert transform, time domain analysis, or dominant frequency analysis to generate activation trails manifesting as rotational or radially emanating patterns, thereby identifying approximate core regions representing rotors or focal sources.
Reconciliation and refinement of activation onset detection
The system iteratively revises activation onsets for class-B (low-confidence) beats using data from adjacent class-A (high-confidence) beats and reconciles differences to improve accuracy across all channels.
The claims collectively cover a novel system and method that classify cardiac activation signals by confidence, reconstruct activation onsets through vector and physiological constraints, order these to form activation trails via various domain analyses, and thereby identify and locate sources of complex heart rhythm disorders within the heart for diagnosis and targeted treatment.
Stated Advantages
Enables direct identification and precise localization of the cause of complex heart rhythm disorders such as AF and VF, which was not possible with prior methods.
Facilitates minimally invasive and targeted treatment, such as ablation, by providing accurate visualization of rotors or focal sources.
Improves diagnostic clarity with adaptive spatial sensing and classification of signals into high- and low-confidence categories, making analysis of complex, noisy signals more reliable.
Allows for treatment efficiency by localizing causes rapidly, reducing procedural time and extent of ablation compared to empirical methods.
Supports both real-time and off-line analysis, and includes a database for probability mapping and expert system assistance to improve diagnosis and therapy planning.
Documented Applications
Minimally invasive detection, diagnosis, and treatment of complex heart rhythm disorders such as atrial fibrillation, ventricular tachycardia, ventricular fibrillation, and other biological rhythm disorders in the heart.
Surgical therapy for heart rhythm disorders, including direct exposure approaches and robotically assisted ablation.
Localization and treatment of electrical impulse disorders in other organs such as the brain (e.g., epilepsy or seizure focus detection), nervous system tumors, skeletal and smooth muscle disorders including gastrointestinal and genitourinary systems.
Use of catheter assemblies for wide-area cardiac signal sensing with adaptive spatial resolution and integrated therapy delivery including ablation, pacing, pharmacological delivery, and gene or cellular therapy.
Data analysis of stored cardiac signals for offline review, prediction, and classification of heart rhythm sources to plan future treatment procedures.
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