Methods for detecting biological rhythm disorders
Inventors
Narayan, Sanjiv • Rappel, Wouter-Jan
Assignees
Office of General Counsel of VA • University of California San Diego UCSD
Publication Number
US-9380950-B2
Publication Date
2016-07-05
Expiration Date
2029-10-09
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Abstract
A method of detecting a cause of a heart rhythm disorder includes collecting data corresponding to activation onset time of each heart activation at multiple locations of the heart and generating an activation trail based on the sequential order of activation onset times. The activation trail is indicative of the cause of the heart rhythm disorder.
Core Innovation
The invention provides a method, system, and devices for identifying, locating, diagnosing, and treating biological rhythm disorders, particularly complex heart rhythm disorders such as atrial fibrillation (AF), ventricular tachycardia (VT), and ventricular fibrillation (VF). This includes collecting electrical activation signals from multiple locations within the heart using sensors, determining activation onset times, and generating an activation trail based on the sequential order of these activation onset times. The activation trail serves as a signature pattern indicating the source or cause of the rhythm disorder, such as an electrical rotor or focal beat. Once identified and located, targeted therapy including minimally invasive catheter ablation can be applied at the cause to treat or eliminate the disorder.
The problem being solved is that prior known methods and tools fail to directly identify and locate the cause or source of complex heart rhythm disorders, particularly AF and VF, which results in empiric, lengthy, and often unsuccessful ablation procedures affecting large portions of heart tissue. Existing methods often rely on surrogates or indirect measures that do not consistently correlate with the causes, and they require interpretation by the practitioner rather than providing direct diagnosis. This invention overcomes these limitations by providing processes to acquire detailed activation onset data over large regions of the heart, analyze and sequentially order these to reveal direct spatial-temporal activation patterns, and visualize causes such as rotors or focal sites to enhance diagnosis and targeted treatment.
Claims Coverage
The claims include two independent sets directed to methods for detecting sources of rhythm disorders in the heart and in biological organs, respectively, focusing on generating activation trails from sensed activation onset times and localizing causes, along with related system claims.
Method for detecting sources of complex heart rhythm disorders
Collecting activation onset times of heart signals sensed by multiple sensors at various locations; generating a sequentially ordered activation trail from these times to indicate the source; and producing a clinical representation identifying the heart region of the source.
Method for detecting sources of complex biological rhythm disorders in organs
Collecting activation onset times of biological signals from multiple sensors at multiple organ locations; generating an activation trail ordered sequentially in time to indicate the source; and generating a clinical representation to identify an associated region of the organ.
Activation trail characterization
The activation trail can represent rotational or outwardly emanating repeating patterns corresponding to rotors or focal activations.
Visual display and localization of core regions
Visually displaying the activation trail with depiction of activation onset times relative to sensor locations and determining approximate core regions about which activation revolves or from which it emanates, identifying rotors or focal activations as sources.
Augmentation of activation trail analysis using database comparison
Enhancing or modifying the activation trail derived from current data by comparing it with stored activation trail data in a database to improve source identification and localization.
Construction of physiological electrographs with inserted physiological patterns
Creating voltage-time tracings (electrographs) at each sensor location by inserting physiological signal patterns (such as recorded or simulated electrograms or action potentials) at activation onset times; where these patterns can be selected from prior patient recordings, different patients, or simulations, and adjusted for rate to better represent physiological activation.
The claims define methods and systems that acquire multi-location activation onset data, construct temporally ordered activation trails that reveal spatial patterns such as rotors or focal beats indicative of sources of biological or heart rhythm disorders, and provide visual and clinical representations for precise localization and targeted treatment, optionally enhanced by databases and physiological pattern insertion.
Stated Advantages
Identification and localization of the actual cause of complex heart rhythm disorders such as AF and VF, which was previously not possible.
Enables targeted, minimally invasive therapies such as catheter ablation to specific localized sources, potentially reducing procedure time and extent of tissue destruction.
Visual display of activation trails and sources markedly facilitates diagnosis and treatment decisions for practitioners.
The system adapts sensing resolution and coverage dynamically to optimize mapping of sources.
The invention allows for real-time or off-line analysis and may incorporate stored data to improve accuracy and guide therapy.
Documented Applications
Detection, diagnosis and treatment of complex heart rhythm disorders including atrial fibrillation, ventricular tachycardia, and ventricular fibrillation.
Treatment of simple heart rhythm disorders such as focal atrial tachycardia, supraventricular tachycardia, atrial flutter, premature atrial and ventricular complexes by simplifying source localization.
Minimally invasive or surgical ablation procedures guided by precise localization of rhythm disorder sources.
Diagnosis and treatment of electrical impulse disorders in other organs such as brain (including epilepsy and seizure foci), peripheral nervous system, skeletal muscle, gastrointestinal tract, bladder, and uterus.
Potential use in delivery of pharmacologic agents, gene or cell therapy targeted to localized sources.
Off-line review of stored electrograms or other biosignals for diagnosis or treatment planning.
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