Method and system for detection of biological rhythm disorders
Inventors
Narayan, Sanjiv • 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-8868169-B2
Publication Date
2014-10-21
Expiration Date
2031-04-06
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Abstract
System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.
Core Innovation
The invention provides systems, assemblies, and methods to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. This complex rhythm disorder can then be treated by application of energy to modify the source of the rhythm disorder.
The problem being solved is the difficulty in identifying and locating the cause of complex heart rhythm disorders, such as atrial fibrillation (AF), ventricular tachycardia (VT), and ventricular fibrillation (VF), which are challenging to treat due to the inability of existing tools and methods to detect and pinpoint the source of these irregularities accurately. Existing methods typically display data requiring interpretation but fail to directly identify and locate the cause, especially in complex arrhythmias where activation patterns vary from beat to beat. Consequently, treatment approaches like ablation are empiric, lengthy, and often only partially successful.
The invention overcomes prior art limitations by providing a method and system that identify and localize causes of complex biological rhythm disorders in individual patients, including electrical rotors and focal beats, using data from multiple sensors, by classifying cardiac signals into high and low confidence signals, determining activation onsets within acceptance windows, ordering activation onsets to create an activation trail, and thereby revealing the source of the disorder. This direct identification allows targeted ablation or other therapies, improving treatment efficacy and safety.
Claims Coverage
The patent includes multiple independent claims covering the system, assembly, and method for reconstructing cardiac information to identify and treat sources of complex rhythm disorders. The main inventive features focus on signal processing, classification, activation onset determination, ordering sequences to locate sources, and treatment application.
Classification of cardiac signals into high and low confidence
The system classifies cardiac information signals from multiple spatially related sensors into high and low confidence signals based on a confidence threshold linked to the percentage of beats with discernible activation onsets.
Determining activation onsets within acceptance time windows
Activation onsets associated with low confidence signals are determined within acceptance time windows defining earliest activation and latest termination for beats, incorporating physiological constraints such as action potential duration and conduction velocity.
Ordering activation onsets to indicate source location
Activation onsets from both high and low confidence signals are ordered using temporal, spatial, and phase information to create activation trails that reveal sources such as electrical rotors or focal beats indicative of the rhythm disorder's cause.
Use of time vectors for low confidence signal analysis
For low confidence signals, activation onsets are determined using time vectors computed between discernible activation onsets on spatially adjacent high confidence sensors, refined by properties like beat shape, polarity, and emanation pattern.
Signal filtering and noise rejection
The system removes baseline wander and noise via filtering, disregards signals with inadequate signal-to-noise ratio, and employs template matching and expert systems to identify high-confidence beats as templates for comparison.
Treatment integration
The system includes treatment means for modifying the indicated source of the complex rhythm disorder, which may include ablation energy, stimulation energy, drug therapy, cellular or gene therapy.
The independent claims cover a comprehensive system, assembly, and method that process multi-channel cardiac signals by classifying signal confidence, determining precise activation onsets including for challenging low-confidence signals, ordering these to identify and locate sources of complex rhythm disorders, and applying targeted treatments. This integrated approach represents an inventive advancement over prior art in diagnosing and treating complex cardiac arrhythmias.
Stated Advantages
Direct identification and localization of sources for complex heart rhythm disorders enables targeted treatment, reducing the need for extensive empirical ablation.
Adaptive spatial resolution through adjustable sensor configurations provides expansive coverage and high spatial resolution where needed.
Capability to analyze complex, fractionated signals including low confidence data improves accuracy of activation onset detection.
Integration of a database and expert system assists in diagnosis by comparing current patient data with stored physiological patterns.
Visual and auditory displays facilitate practitioner interpretation, enhancing treatment planning and execution.
Applicability to minimally invasive procedures supports safer and more effective therapy delivery.
Documented Applications
Diagnosis, identification, and treatment of complex heart rhythm disorders including atrial fibrillation, ventricular tachycardia, ventricular fibrillation, atrial flutter, and other related arrhythmias.
Minimally invasive and surgical procedures for localization and ablation of cardiac rhythm disorder sources.
Offline, non-real-time review and planning of electrophysiologic studies using stored patient or database signals.
Adaptive sensing and treatment in brain disorders such as epilepsy or seizure via electrical impulse detection and localization.
Detection and localization of abnormal impulses or tumors in skeletal muscle, gastrointestinal, genitourinary, respiratory systems, and nervous systems.
Non-medical applications such as locating sources of seismic events or energy sources in conjunction with radar or sonar methods.
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