Method for analysis of complex rhythm disorders
Inventors
Narayan, Sanjiv • Rappel, Wouter-Jan
Assignees
US Department of Veterans Affairs • Office of General Counsel of VA • University of California San Diego UCSD
Publication Number
US-8838223-B2
Publication Date
2014-09-16
Expiration Date
2029-10-09
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Abstract
A method of analyzing a complex rhythm disorder in a human heart includes accessing signals from a plurality of sensors disposed spatially in relation to the heart, where the signals are associated with activations of the heart, and identifying a region of the heart having an activation trail that is rotational or radially emanating, where the activation trail is indicative of the complex rhythm disorder and is based on activation times associated with the activations of the heart.
Core Innovation
The invention relates to methods, systems, and devices for identifying, locating, and treating complex biological rhythm disorders, particularly heart rhythm disorders such as atrial fibrillation (AF), ventricular fibrillation (VF), and ventricular tachycardia (VT). It provides a method to analyze signals from multiple sensors spatially disposed in relation to the heart, which capture activations of the heart, to identify regions exhibiting activation trails that are either rotational (rotors) or radially emanating (focal beats). This identification and localization enable targeted treatment, ideally by minimally invasive techniques.
The problem addressed by the invention is the difficulty in detecting and locating the causes of complex heart rhythm disorders using existing methods. Prior art systems often display electrical activity data but fail to directly identify and locate the causes, especially in complex disorders such as persistent AF, VF, or polymorphic VT. Existing treatments like ablation have limited success rates because tools to identify the precise location of the sources are lacking, leading to empirical and extensive treatment that can unnecessarily damage large areas of the heart.
This invention solves these problems by providing a system that processes activation time data from a spatial array of sensors, orders the activation onset times to create an activation trail, and discerns discernible signature patterns identifying localized sources sustaining the rhythm disorder. The method can detect electrical rotors that revolve around a core region or focal beats from which activation radiates radially. It also incorporates adaptive sensor spacing and signal processing techniques, including phase assignment and frequency domain methods, to accurately determine the location and nature of the rhythm disorder's cause. The invention further enables visualization of these sources to assist in targeted therapy, such as ablation, resulting in significantly improved treatment outcomes with minimized collateral damage.
Claims Coverage
The claims encompass multiple inventive features related to methods of analyzing complex heart rhythm disorders using spatially disposed sensors and interpreting activation patterns to identify and localize causes.
Analyzing activation trails to identify rhythm disorder regions
The method accesses signals from multiple spatially disposed sensors associated with heart activations and identifies regions exhibiting activation trails that are rotational or radially emanating, indicative of complex rhythm disorders.
Ordering activation times to form activation trails
Processing includes arranging activation onset times in sequences based on timing, shapes, sensor spatial relationships, or signal phase to create activation trails facilitating identification of localized sources.
Identifying core regions as rhythm disorder causes
The method identifies core regions around which activation trails revolve or from which they radially emanate, helping localize causes such as electrical rotors or focal beats.
Selecting regions for modification based on activation trails
The method includes selecting portions of core regions or adjacent areas for modification to eliminate, isolate, migrate, or otherwise modify the rhythm disorder source.
Visualization and comparison of activation trails
Generating and displaying representations of activation trails and core regions enables practitioner analysis and facilitates comparing current activation patterns with reference data.
Use of concurrent or stepwise sensing
Signals can be sensed concurrently across sensors or stepwise in time, aiding flexible data acquisition during analysis.
Coverage of complex rhythm disorders
The method applies to complex rhythm disorders including atrial fibrillation, ventricular fibrillation, and ventricular tachycardia.
Overall, the claims focus on a system and method that utilize spatially resolved sensing and processing of activation times to detect, localize, visualize, and enable treatment of core regions causing complex heart rhythm disorders through analysis of rotational or radially emanating activation trails.
Stated Advantages
Enables direct identification and precise localization of causes for complex heart rhythm disorders, improving diagnostic accuracy.
Facilitates targeted, minimally invasive treatment, reducing the extent of ablation and associated complications.
Improves treatment efficacy for difficult-to-treat arrhythmias such as persistent AF by focusing ablation on the actual sustaining sources.
Allows use of as little as one activation event to identify rhythm disorder causes, enhancing procedural efficiency.
Provides adaptive spatial resolution sensing to optimize field of view and resolution during analysis.
Includes visual and auditory representations of activation trails and core regions to aid practitioner interpretation.
Incorporates a database and expert system to assist in diagnosis and treatment planning by comparing new patient data to stored patterns.
Documented Applications
Detection, diagnosis, and treatment of complex heart rhythm disorders including atrial fibrillation, ventricular fibrillation, and ventricular tachycardia.
Application in minimally invasive and surgical techniques for ablation targeting identified core regions causing rhythm disorders.
Use in diagnosing and treating simple focal atrial and ventricular arrhythmias such as atrial tachycardias, premature atrial or ventricular complexes.
Potential application to detect and localize sources in other biological rhythms such as electrical impulse propagation abnormalities in the brain and central nervous system (e.g., epilepsy).
Extension to other systems including skeletal and smooth muscles disorders, gastrointestinal or urogenital systems, and locating tumors.
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