System and method of identifying sources for biological rhythms
Inventors
Briggs, Carey Robert • Narayan, Sanjiv
Assignees
US Department of Veterans Affairs • Topera Inc • Office of General Counsel of VA • University of California San Diego UCSD
Publication Number
US-9392948-B2
Publication Date
2016-07-19
Expiration Date
2032-05-14
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Abstract
In a system and method of determining regularity associated with a rhythm disorder of a heart, a derivative of a first cardiac signal at a plurality of first time points is processed against a derivative of a second cardiac signal at a plurality of second time points to define a plurality of coordinate pairs of the first cardiac signal against the second cardiac signal. Thereafter, an index of regularity that exceeds a threshold is determined. The index of regularity indicates an approximate congruence of the plurality of coordinate pairs among the first cardiac signal and the second cardiac signal.
Core Innovation
The invention provides a system and method to identify the source or sources of biological rhythm disorders, particularly complex heart rhythm disorders such as atrial fibrillation, ventricular tachycardia, and ventricular fibrillation. It does so by processing a derivative of a first cardiac signal against a derivative of a second cardiac signal at multiple time points to define coordinate pairs, and computing an index of regularity indicating congruence between the signals. This approach does not rely on identifying specific activation onset times, which are difficult to determine in complex rhythms.
The problem addressed arises from the difficulty in diagnosing and treating complex heart rhythm disorders due to the inability of existing systems to identify sources of these disorders. Complex rhythms produce electrogram signals with multiple deflections and varying activation patterns, making it challenging or impossible to identify local activation onsets. Consequently, current ablation treatments for complex arrhythmias often fail because the tools cannot consistently locate the source. The invention solves this by using the regularity between signals rather than timing activation onsets to locate the source, facilitating improved and rapid targeted treatment.
The invention further improves upon prior art by providing a method that can rapidly process signals from multiple sensor locations to construct matrices and maps of regularity, enabling identification of regions with high indexes of regularity relative to adjacent regions. These identified regions indicate the source(s) of the rhythm disorder and can be targeted for treatment promptly, including ablation or other therapies, enhancing clinical outcomes for complex rhythm disorders.
Claims Coverage
The claims cover a set of inventive features focused on methods and systems for determining regularity associated with cardiac rhythm disorders and using this information to identify and treat sources of the disorder. There are three independent claims that cover methods of determining regularity, systems to perform this determination, and methods of treating cardiac rhythm disorders based on the regularity analysis.
Method for determining regularity between cardiac signals
Processing a derivative of a first cardiac signal against a derivative of a second cardiac signal at multiple time points to define coordinate pairs, and determining an index of regularity exceeding a threshold indicating congruence between the signals, independent of activation onset times.
Iterative selection and matrix construction of regularity indexes
Iteratively selecting pairs of cardiac signals from multiple cardiac signals, performing regularity processing for each pair, constructing a matrix of indexes of regularity, and determining one or more sources of rhythm disorder from the matrix by identifying regions with high indexes relative to adjacent regions.
Method and system for treatment of cardiac rhythm disorders using regularity analysis
Using the iterative selection of cardiac signal pairs, determining an index of regularity for each, constructing a matrix of indexes, identifying sources of the disorder from the matrix, and treating cardiac tissue at those sources using ablation, electrical or mechanical energy, drugs, cells, genes, or biological agents to suppress or eliminate the disorder.
Collectively, the inventive features establish a novel approach for analyzing derivatives of cardiac signals to quantify regularity, build matrices to map regions of high regularity as sources of rhythm disorder, and guide targeted treatment of those sources in complex cardiac arrhythmias.
Stated Advantages
Ability to identify the source of complex rhythm disorders from regularity in signals without relying on activation onset times, which are difficult to discern in complex signals.
Provides a rapid method and system that can be used in real-time with sensing devices such as catheters to immediately guide treatment of heart rhythm disorders.
Enables treatment of complex heart rhythm disorders that previously were difficult or impossible to accurately localize and treat.
Reduces the complexity and number of steps required to locate and treat sources of arrhythmias compared to prior methods and systems.
Documented Applications
Identifying sources of normal and disordered heart rhythms for diagnosis and treatment, including complex heart rhythm disorders such as atrial fibrillation, ventricular tachycardia, and ventricular fibrillation.
Applicability to other biological rhythms and biological rhythm disorders such as neurological seizures, esophageal spasms, bladder instability, and irritable bowel syndrome where biological signals can be recorded.
Use in invasive cardiac procedures involving catheters inserted into the heart for sensing cardiac electrical activity and delivering energy or agents to ablate or treat identified sources of rhythm disorders.
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