System and method for targeting heart rhythm disorders using shaped ablation
Inventors
Narayan, Sanjiv • Briggs, Carey Robert
Assignees
US Department of Veterans Affairs • Topera Inc • University of California San Diego UCSD
Publication Number
US-9655535-B2
Publication Date
2017-05-23
Expiration Date
2032-05-02
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Abstract
A system and method to target a biological rhythm disorder, such as a heart rhythm disorder include processing cardiac signals via a computing device to determine a shape in a region of tissue defined by a source associated with the biological rhythm disorder that migrates spatially on or within the shape, and identifying at least one portion of the tissue proximate to the shape to enable selective modification of the at least one portion of tissue in order to terminate or alter the heart rhythm disorder.
Core Innovation
The present invention discloses methods, systems and devices for diagnosing, identifying, locating and treating biological rhythm disorders, such as heart rhythm disorders, using shaped ablation. It involves processing cardiac signals via a computing device to determine a shape in a region of tissue defined by a source associated with the biological rhythm disorder that migrates spatially on or within the shape, and identifying at least one portion of the tissue proximate to the shape to enable selective modification of the at least one portion of tissue to terminate or alter the heart rhythm disorder.
The problem being solved, as described in the background section, is the difficulty in treating complex heart rhythm disorders, such as atrial fibrillation (AF), ventricular tachycardia (VT), and ventricular fibrillation (VF). Existing ablation therapies are often empiric, targeting point lesions or lines without a clear understanding of the actual source or shape of the rhythm disorder, resulting in low success rates and substantial damage to healthy tissue. Tools to precisely identify the size, shape, and location of the sources, especially when these sources migrate within a confined region of the heart, are lacking, and current methods and apparatus do not effectively locate or define these sources for tailored therapeutic interventions.
The invention addresses this problem by providing a novel method to identify and locate electrical rotors, focal beats, and other heart rhythm disorders, including complex rhythms, and to identify the size and shape of the region of heart tissue in which these sources migrate. This property of migration within a spatially constrained locus is distinct from static point sources or non-migrating reentrant circuits, offering a new understanding of the sources of such disorders. The invention further enables targeted ablation or selective modification of at least a portion of the identified shape or proximate tissue in order to terminate or alter the rhythm disorder, minimizing collateral damage to surrounding healthy tissue.
Claims Coverage
The patent includes multiple independent claims directed to methods and systems for targeting cardiac or biological rhythm disorders by determining shapes of migrating sources and selectively modifying tissue proximate to these shapes. The main inventive features focus on signal processing to identify migrating sources, defining shapes based on source migration, and selectively ablating or modifying tissue accordingly.
Determining shape of tissue defined by migrating source
Processing cardiac signals via a computing device to determine a shape in a region of tissue defined by migration of a source associated with a cardiac rhythm disorder.
Identification of tissue portions proximate to shape for selective modification
Identifying at least one portion of the tissue proximate to the shape to enable selective modification of the at least one portion in order to terminate or alter the cardiac rhythm disorder.
Selective modification of identified tissue
Modifying, including destroying, at least one portion of the tissue identified, using methods such as ablation, electrical therapy, mechanical therapy, drug therapy, gene therapy, and stem cell therapy to treat the rhythm disorder.
Shape determination based on tracking spatial migration over multiple activations
Determining the shape by identifying spatial points associated with the source at points in time, tracking migration of these points over multiple cardiac activations to define a path, and defining the shape around the path.
Refinement of shape based on anatomical and tissue properties
Refining the determined shape based on one or more of width, height, depth, and tissue type associated with the spatial migration of the source.
System configured for processing signals and selective tissue modification
A system comprising at least one processing device programmed to perform the above shape determination and identification of tissue portions, together with a modification module (e.g., catheter) configured to selectively modify the identified tissue portions to terminate or alter the rhythm disorder.
System with sensors adjustable to shape and tissue portions
A catheter system having a plurality of sensors arranged in a first spatial relationship with circuitry to receive data regarding the shape and identified tissue portions and adjust sensor positions to a second spatial relationship conforming to the shape and tissue portions to facilitate targeted therapy.
Networked method and system for remote processing and modification
Methods and systems in which signals are received and processed over a network by a processing device to determine shapes and tissue portions, and data is transmitted to another device to enable selective modification to terminate or alter the rhythm disorder.
The claims cover innovative methods and systems that identify spatially migrating sources of cardiac rhythm disorders, determine a defined shape based on the migration, identify tissue portions proximate to or within the shape, and perform targeted selective modification or ablation. The invention includes apparatus embodiments with adjustable sensors for shaped ablation, and networked implementations for remote analysis and therapy. These inventive features enable improved diagnosis and treatment of complex arrhythmias by directly targeting the dynamic source regions.
Stated Advantages
Enables precise identification and location of causes (sources) of heart rhythm disorders, including migrating sources within a spatially constrained region.
Allows tailoring ablation therapy to the size and shape of the source, minimizing damage to healthy tissue compared to existing empirical methods.
Improves the ability to terminate complex rhythm disorders such as atrial fibrillation rapidly with targeted ablation of a small fraction of tissue.
Supports adaptive sensing and analysis during real-time or offline procedures to optimize detection and treatment of rhythm sources.
Provides visual and auditory displays to aid practitioners in identifying the type and location of rhythm disorder sources.
Documented Applications
Minimally invasive and surgical methods for diagnosing, identifying, locating, and treating heart rhythm disorders including atrial fibrillation, ventricular tachycardia, ventricular fibrillation, atrial tachycardia, and atrial flutter.
Use in ablation therapy to selectively destroy or modify tissue at or near the migrating source regions to alter or terminate the cardiac rhythm disorder.
Application to other biological rhythm disorders in organs such as brain (e.g., epilepsy), nervous system, skeletal muscle, gastrointestinal, urogenital, and respiratory systems.
Use with implanted devices, catheter systems with adjustable sensors for sensing and delivery of energy or therapy to targeted regions.
Networked and non-real-time analysis for planning procedures, reviewing prior data, or remote diagnostics and therapy.
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