System and method for reconstructing cardiac signals associated with a complex rhythm disorder
Inventors
Narayan, Sanjiv • Sehra, Ruchir
Assignees
US Department of Veterans Affairs • Topera Inc • University of California San Diego UCSD
Publication Number
US-9549684-B2
Publication Date
2017-01-24
Expiration Date
2031-04-06
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Abstract
Reconstruction of cardiac information representing a complex rhythm disorder is facilitated by assigning activation onsets to non-discernible beats in low confidence signals based upon time associations relative to activation onsets in adjacent high confidence signals.
Core Innovation
The invention provides systems, assemblies, and methods to reconstruct cardiac information representing complex rhythm disorders associated with a patient's heart to indicate the source of the heart rhythm disorder. It facilitates assigning activation onset times to beats in low-confidence signals that are non-discernible by utilizing time associations relative to activation onset times in spatially adjacent high-confidence signals. This reconstruction enables detection, diagnosis, and targeted treatment of complex heart rhythm disorders such as atrial fibrillation, ventricular tachycardia, and ventricular fibrillation through minimally invasive or surgical methods.
The background identifies the critical problem of treating complex heart rhythm disorders due to the inability of existing methods and tools to accurately identify and locate the causes of these disorders. Current therapies like ablation often achieve suboptimal success because of poor identification of the disorder’s source, especially in complex arrhythmias like persistent atrial fibrillation. Prior art systems display data that require interpretation but do not directly indicate the cause or source, leaving treatment imprecise and difficult. Additionally, signals from complex arrhythmias are often noisy and contain multiple deflections, complicating analysis and activation onset identification, which impedes effective diagnosis and targeted therapy.
Claims Coverage
The patent includes multiple independent claims covering systems, assemblies, and methods for reconstructing cardiac signals with activation onset assignment in complex rhythm disorders using spatial and temporal associations between high- and low-confidence signals.
Activation onset assignment for non-discernible beats based on adjacent high-confidence signals
The system identifies discernible beats on high-confidence signals adjacent to low-confidence signals and computes time associations to assign activation onset times to non-discernible beats in low-confidence signals using defined time intervals and physiological constraints.
Use of time vectors and acceptance windows for activation onset determination
Activation onset is assigned during a defined time interval closest to a computed time vector between discernible activation onsets, incorporating factors such as deflections, quiescent periods, and predetermined physiological properties.
Classification of signals into high- and low-confidence based on proportion of discernible beats
Signals are classified into high-confidence ones containing a predetermined percentage of discernible beats with identifiable activation onsets, and low-confidence ones with non-discernible beats exhibiting multiple deflections and quiescent periods.
Reconciliation and updating of activation onsets through iterative time interval adjustment
The system determines time intervals between discernible beats on low-confidence signals, advances these intervals to approximate previous beats, and reconciles assigned activation onsets with these intervals to update onset times for accuracy.
The claims cover a comprehensive approach to reconstruct cardiac signals with particular focus on assigning activation onsets to low-confidence signal beats by leveraging spatial-temporal relationships with adjacent high-confidence signals, employing signal classification, time vector computation, and iterative correction, enabling accurate source localization in complex rhythm disorders.
Stated Advantages
Improves identification and localization of causes for complex heart rhythm disorders.
Enables accurate assignment of activation onsets in noisy or low-confidence signals using spatial and temporal associations.
Facilitates targeted and efficient treatment by providing visual and/or audio representations of rhythm disorder sources.
Reduces the extent of tissue ablation needed by precisely locating source sites, potentially improving clinical outcomes and reducing complications.
Capable of analyzing single activation events (beats) and addressing sources that may be fixed or transient/migratory.
Documented Applications
Identification and localization of sources for complex heart rhythm disorders such as atrial fibrillation, ventricular tachycardia, polymorphic ventricular tachycardia, and ventricular fibrillation.
Minimally invasive or surgical ablation therapy targeting localized electrical rotors or focal beats identified as sources of rhythm disorders.
Use in diagnosis and treatment of simpler rhythm disorders including focal atrial tachycardias, multifocal atrial tachycardias, inappropriate sinus tachycardia, premature atrial complexes, and premature ventricular complexes.
Potential application to locating abnormal electrical impulse generation or propagation in the brain and nervous system, such as epilepsy or seizures, and abnormal activity in smooth muscles of gastrointestinal and genitourinary systems.
Creation of expert systems or probability distribution maps to assist physicians in diagnosing and planning treatment of rhythm disorders.
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