System and method for reconstructing cardiac activation information
Inventors
Narayan, Sanjiv • Briggs, Carey Robert
Assignees
US Department of Veterans Affairs • Topera Inc • Office of General Counsel of VA • University of California San Diego UCSD
Publication Number
US-9055877-B2
Publication Date
2015-06-16
Expiration Date
2031-08-24
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Abstract
An example system and method of processing cardiac activation information are disclosed. The method includes accessing a first cardiac signal and a second cardiac signal obtained from a patient. The first cardiac signal and the second cardiac signal are processed to identify a point of change in the first cardiac signal at which a derivative of the first cardiac signal diverges with respect to a derivative of the second cardiac signal. An activation onset time is assigned in the first cardiac signal at the point of change to define a cardiac activation.
Core Innovation
The invention provides a system and method for reconstructing cardiac activation information, specifically activation onset times, from cardiac signals obtained from a patient. The method involves accessing first and second cardiac signals, processing these signals to identify points of change where the derivative of the first signal diverges relative to the derivative of the second signal, and assigning activation onset times at the points of change to define cardiac activations. This process enables determination of activation onsets amidst complex and variable cardiac signals, especially in complex heart rhythm disorders.
The problem addressed by the invention stems from the difficulty in diagnosing and treating complex heart rhythm disorders such as atrial fibrillation, ventricular fibrillation, and polymorphic ventricular tachycardia. In these disorders, activation onset patterns vary beat-to-beat and lack identifiable earliest or latest points, rendering known systems and methods ineffective in locating the sources of arrhythmias. Signals obtained from sensors exhibit complex and irregular deflections, making it challenging to distinguish local from far-field activations or noise. Prior art failed to provide a reliable means for reconstructing activation information to facilitate targeted treatment.
The present invention overcomes these challenges by providing a system that iteratively processes pairs of cardiac signals obtained from an array of sensors positioned in or near the heart. It identifies significant points of divergence between derivatives of signal pairs, assigns activation onset times, and reconstructs cardiac activation patterns accordingly. This reconstructed information aids in identifying the sources of rhythm disorders and guiding targeted treatments such as ablation. The system can rapidly perform these computations while sensors are deployed, enabling immediate therapeutic intervention.
Claims Coverage
The patent includes two independent claims covering a method and a system for processing cardiac activation information focusing on identifying points of change between paired cardiac signals to assign activation onset times.
Processing paired cardiac signals to identify activation onset times
Accessing a first and second cardiac signal from a patient and processing them to identify points of change in the first cardiac signal where its derivative diverges relative to the derivative of the second signal, then assigning activation onset times at these points to define cardiac activations.
Forming and using a composite cardiac signal for point of change determination
Forming a composite cardiac signal from the first and second signals, calculating ratio values at multiple points representing differences among derivatives of the signals, and selecting the point having the largest ratio as the point of change.
Iteratively processing multiple pairs of cardiac signals to reconstruct cardiac activation patterns
Accessing pairs of cardiac signals from a plurality, performing processing and assigning activation onset times for each pair, and reconstructing activation patterns from these onsets to indicate sources of rhythm disorders, with optional display for treatment facilitation.
System comprising at least one computing device configured to process cardiac signals for activation onset identification
A system including computing device(s) configured to access and process pairs of cardiac signals by identifying derivative divergence points and assigning activation onset times, with provisions for forming composite signals, iteratively accessing multiple pairs, and reconstructing and displaying activation patterns.
The independent claims cover a method and system that focus on analyzing paired cardiac signals through derivative divergence to assign activation onset times, using composite signals and iterative processing to reconstruct activation patterns that help identify sources of cardiac rhythm disorders, facilitating targeted treatment.
Stated Advantages
Ability to reconstruct cardiac activation information in complex heart rhythm disorders where prior methods failed.
Capability to rapidly perform computation while sensors are deployed, facilitating immediate treatment such as ablation.
Provision of a relatively simple method with fewer steps compared to prior art for accurately identifying activation onset times.
The system enables identification of sources of heart rhythm disorders to enable targeted, meaningful, and potentially curative therapy.
Documented Applications
Diagnosis and treatment of complex heart rhythm disorders including atrial fibrillation, ventricular fibrillation, and polymorphic ventricular tachycardia.
Construction of cardiac activation maps to locate sources of arrhythmias for ablation or other therapies such as gene therapy, stem cell therapy, pacing stimulation, and drug therapy.
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