System for analysis of complex rhythm disorders
Inventors
Narayan, Sanjiv • Rappel, Wouter-Jan
Assignees
Office of General Counsel of VA • University of California San Diego UCSD
Publication Number
US-9375156-B2
Publication Date
2016-06-28
Expiration Date
2029-10-09
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Abstract
A system to detect a cause of a complex rhythm disorder in a human heart includes a plurality of sensors disposed spatially in relation to the heart, where the signals generated by the sensors are associated with activations of the heart. A processor collects and analyzes the signals to identify 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 is a system and method for detecting and diagnosing the cause of complex heart rhythm disorders by using multiple sensors positioned spatially in relation to the heart to sense heart activation signals. A processor collects and analyzes the activation onset times from these sensors to generate an activation trail that reveals patterns indicative of the disorder's source, such as rotational (rotor) or radially emanating (focal beat) patterns. This enables direct identification and location of the causes of complex arrhythmias, which were previously unidentifiable with known methods.
The problem addressed arises from the difficulty in treating complex heart rhythm disorders like atrial fibrillation (AF), ventricular tachycardia (VT), and ventricular fibrillation (VF). Current treatment methods such as ablation are hindered by poor tools for identifying and locating the causes of these disorders, resulting in low success rates and long procedures with risks. Existing mapping systems and methods typically display data requiring practitioner interpretation without directly indicating causes or locations, which is especially problematic in complex rhythms where activation varies beat to beat.
The invention overcomes prior art limitations by directly identifying localized causes for complex rhythm disorders using spatially distributed sensor data to generate activation trails that reveal rotors, focal beats, or dispersed patterns. The system adapts sensor spacing for better resolution, uses algorithms including phase space and frequency domain methods, and can store and compare data in a database to improve diagnosis. Furthermore, the system can guide targeted treatment such as ablation, thereby improving efficacy while reducing tissue damage and procedure duration.
Claims Coverage
The patent includes multiple independent claims covering systems and methods to detect sources of complex rhythm disorders in heart and other biological organs, emphasizing sensor data acquisition and processing to generate activation trails indicative of disorder causes.
System for detecting complex heart rhythm disorder sources
A system comprising multiple sensors spatially disposed relative to the heart to sense activation signals, and a processor configured to collect activation times, generate activation trails based on sequential order of activation onset times, thereby indicating the source of the complex heart rhythm disorder and producing a clinical representation identifying the heart region associated with the source.
Activation trail patterns indicating sources
Activation trails generated by the processor comprise discernible repeating rotational patterns (rotors) or outwardly emanating patterns (focal beats), identifying the approximate core region related to the rhythm disorder sources.
Processing and visualization of activation trails
The processor performs analysis including filtering signal noise, employing methods such as direct phase assignment, Hilbert transform, and time-domain approaches to approximate activation trails, and visually depicts these trails on a display device for clinical interpretation.
Adaptive sensing and control system features
Sensor devices perform sensing concurrently or stepwise; electronic control systems and connection switching components enable independent switching between sensors to optimize sensing; signal processing components enhance signal clarity.
Identifying primary causes among multiple sources
The system includes determining whether a cause is a primary source of the complex rhythm disorder using criteria such as number and rate of activation repetitions, extent of tissue involved, whether the cause is localized or dispersed, and anatomical location.
System applicability to complex biological rhythm disorders
System architecture and methods apply not only to heart rhythm disorders but more generally to biological organs, detecting sources of complex biological rhythm disorders by sensing biological activation signals and generating activation trails for diagnosis.
Database integration for pattern comparison and augmentation
Storage of activation trail data associated with rhythm disorder sources in a database allows augmentation or modification of computed activation trails by comparing with stored similar patterns to improve detection and localization accuracy.
The independent claims broadly cover a comprehensive system and method of multi-location sensing, processing activation onset times to create activation trails that reveal rotors, focal beats, or dispersed patterns indicating causes of complex rhythm disorders, with features for adaptive sensing, signal processing, visualization, determination of primary sources, treatment integration, and database-supported pattern matching.
Stated Advantages
Direct identification and localization of causes for complex heart rhythm disorders, including atrial fibrillation and ventricular fibrillation, enabling targeted treatment.
Capability to detect sources with as little as one activation event, facilitating diagnosis of transient and moving sources.
Use of spatially distributed sensors with adjustable spacing allows wide field sensing and higher resolution focused sensing for improved source localization.
Visual and auditory display of activation trails aids practitioners in clearly locating and distinguishing rotors, focal beats, and dispersed sources.
Storage and use of a database of sources enhance diagnostic accuracy and assist in identifying causes in new patients or conditions with limited data.
Integration with treatment modalities like ablation enables efficient, minimally invasive therapy focused at the core regions of identified sources, reducing procedure duration and tissue damage.
Application beyond cardiac rhythm disorders to other biological rhythm disorders and potential non-medical uses.
Documented Applications
Detection, diagnosis, and treatment of complex heart rhythm disorders such as atrial fibrillation (AF), ventricular tachycardia (VT), ventricular fibrillation (VF), atrial flutter, and supraventricular tachycardia.
Use in minimally invasive catheter-based procedures and surgical approaches to locate and ablate sources sustaining heart rhythm disorders.
Offline or non-real-time review and planning of treatment for heart rhythm disorders using stored data and data from prior procedures.
Detection and localization of abnormal impulse generation or propagation sources in other biological organs including the brain (epilepsy and seizure), central and peripheral nervous systems, skeletal muscle, gastrointestinal, urogenital, and respiratory systems.
Potential applications outside medicine such as locating sources of seismic events or energy sources using methods analogous to radar or sonar.
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