Method for analysis of complex rhythm disorders
Inventors
Narayan, Sanjiv • Rappel, Wouter-Jan
Assignees
US Department of Veterans Affairs • University of California San Diego UCSD
Publication Number
US-9439573-B2
Publication Date
2016-09-13
Expiration Date
2029-10-09
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Abstract
A method of analyzing a complex rhythm disorder in a human heart includes accessing signals from a plurality of sensors disposed spatially in relation to the heart, where the signals are associated with activations of the heart, and identifying 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 provides methods, systems and devices for analyzing and treating complex rhythm disorders of the human heart by accessing signals from multiple spatially distributed sensors associated with heart activations. It identifies regions in the heart where activation trails show rotational or radially emanating patterns, which are indicative of localized causes of complex heart rhythm disorders such as atrial fibrillation (AF), ventricular fibrillation (VF) and ventricular tachycardia (VT). This identification is based on activation onset times of signals from the heart.
The problem addressed is the difficulty in diagnosing and locating the causes of complex heart rhythm disorders, which hinders effective treatment such as targeted ablation. Existing methods and tools lack the ability to directly identify and pinpoint sources of complex rhythms like AF and VF. This causes prolonged procedures, suboptimal success rates, and unnecessary damage to cardiac tissue during empirical ablation therapy. Prior art either detects electrical potentials without localizing causes or relies on surrogates like spectral dominant frequency or signal organization, which have proven inadequate for complex rhythms in humans.
The invention advances the art by directly producing an ordered activation trail from sensed signals representing activation onset times, enabling the visualization and identification of localized sources such as electrical rotors (with rotational activation) and focal beats (with radially emanating activation). It includes adaptive sensing techniques with adjustable sensor devices to cover wide or focused heart regions at different spatial resolutions and computer-implemented analytical methods including direct phase mapping, Hilbert transform, time-domain, and frequency domain analyses to define the activation pattern and core region causing the disorder. Once identified, these causal regions can be targeted for therapy such as ablation, pacing, or pharmacological intervention to effectively ameliorate or eliminate the disorder.
Claims Coverage
The claims include multiple independent claims defining methods for analyzing sources of complex rhythm disorders in the human heart by spatially sensing activations and identifying activation trails indicative of the source. The methods utilize various analytical techniques and produce clinical representations for locating the source, with further claims detailing treatment selection.
Method of analyzing activation trails indicative of a complex rhythm disorder
Accessing spatially disposed sensor signals associated with heart activations, identifying regions with activation trails that are rotational or radially emanating, and generating clinical representations of such regions indicating sources of complex rhythm disorders.
Use of direct phase method for activation trail identification
Analyzing activation signals via a direct phase method to identify activation trails revolving around or emanating from a core region indicative of the source, including generating clinical representations and selecting portions of the core region for modification or elimination of the source.
Use of Hilbert transform for activation trail analysis
Employing Hilbert transform techniques on activation signals to identify activation trails and core regions that indicate sources of complex rhythm disorders, including generating clinical representations and selecting core or adjacent portions for therapy.
Use of time-domain methods for activation trail detection
Applying time-domain analytical methods to activation signals to identify activation trails revolving around or radially emanating from core regions, and enabling clinical representation and selective treatment targeting these regions.
Combination of phase, Hilbert transform and time-domain methods
Creating activation trails using one or more methods—direct phase, Hilbert transform, time-domain—and identifying core regions indicative of the source, with associated clinical representation and therapeutic selection.
Accessing various types of activation-related signals
Collecting data representative of heart activations during complex rhythm disorders including electrical, acoustic, electromagnetic, magnetic, microwave signals or combinations thereof for analysis to detect activation patterns corresponding to sources.
The claims converge on inventive features enabling the detection, localization, and representation of activation trails in the heart that revolve around or radiate from core regions identified as sources of complex rhythm disorders. The methods cover multiple signal types and analytical approaches with provisions for selecting portions of the core or adjacent regions for therapeutic modification.
Stated Advantages
Allows direct identification and precise localization of causes of complex heart rhythm disorders such as atrial fibrillation, ventricular fibrillation, and ventricular tachycardia.
Improves treatment efficacy by enabling targeted therapy at the identified sources, potentially reducing procedure time and collateral tissue damage.
Provides adaptable sensing configurations with adjustable spatial resolution for effective coverage of large or focused heart regions.
Supports use of multiple analytical methods including phase mapping, Hilbert transform, and time-domain analysis for robust identification of arrhythmia sources.
Facilitates real-time and offline analysis modes, enhancing diagnostic flexibility and post-procedure review.
Enables creation of a database of identified source patterns to assist in diagnosis and therapy planning in current and future patients.
Documented Applications
Diagnosis and targeted treatment of complex heart rhythm disorders including atrial fibrillation, ventricular fibrillation, ventricular tachycardia, polymorphic ventricular tachycardia, torsades de pointes, and various focal and reentrant arrhythmias.
Minimally invasive or surgical interventions including catheter-based ablation, pacing, pharmaceutical delivery, gene or cellular therapy guided by identified activation sources.
Use in electrophysiologic studies to identify sources during procedures or in offline review of recorded cardiac signals.
Potential application to other biological rhythm disorders outside the heart, including electrical disorders of the brain (e.g., epilepsy), peripheral nervous system, skeletal muscle, gastrointestinal tract, bladder, and uterus.
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