System and method of identifying sources for biological rhythms
Inventors
Narayan, Sanjiv • Briggs, Carey Robert
Assignees
US Department of Veterans Affairs • Topera Inc • University of California San Diego UCSD
Publication Number
US-9724009-B2
Publication Date
2017-08-08
Expiration Date
2032-07-27
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Abstract
A system and method of locating a source of a heart rhythm disorder are provided in which a first pair of cardiac signals is processed to define a first coefficient associated with variability of the first pair of signals at a first region of the heart. A second pair of cardiac signals is processed to define a second coefficient associated with variability of the second pair of signals at a second region of the heart. Thereafter, the first coefficient of variability is compared to the second coefficient of variability to determine a direction towards the source of the rhythm disorder.
Core Innovation
The invention provides a system and method of locating a source of a heart rhythm disorder by processing pairs of cardiac signals from different regions of the heart to define coefficients of variability. These coefficients reflect the variability in the signals at distinct regions, and by comparing them, the system determines a direction towards the source of the rhythm disorder based on changes in variability. The method uniquely determines variability independently of activation onsets within the signals, which is particularly useful for complex rhythm disorders where activation onsets are difficult or impossible to identify.
The problem addressed by the invention is the difficulty in diagnosing and treating complex heart rhythm disorders, such as atrial fibrillation (AF), ventricular tachycardia (VT), and ventricular fibrillation (VF). Traditional treatments are challenged by the inability to accurately identify the earliest activation sites due to irregular and complex signal patterns from beat to beat. Existing methods that rely on identifying activation onset times or regularity indices have been inadequate for locating the sources of these disorders, limiting the effectiveness of treatments such as ablation.
The invention eliminates the need to assign activation onset times to cardiac signals and instead uses variability analysis between pairs of signals to identify the source of the rhythm disorder. This approach enables rapid determination of the source location even in complex rhythm disorders where signals display variable and intricate activation patterns. The system includes a catheter with multiple sensors to detect cardiac signals, a signal processing device, and a computing device that analyzes signal variability to generate maps of regularity and variability that guide treatment by locating and ablation of the source tissue.
Claims Coverage
The claims include two independent claims directed to a method and a system for locating the source of a heart rhythm disorder using coefficients of variability derived from cardiac signal pairs.
Variability-based localization of rhythm disorder source independent of activation onset timing
Processing a first pair and a second pair of cardiac signals to define respective coefficients of variability at different heart regions, and comparing these coefficients to determine the direction towards the source of the rhythm disorder, with variability determined independently of activation onset times within the signals.
Definition of coefficients of variability based on coordinate pairs of cardiac signals
Processing cardiac signals at one or more time points against corresponding signals at one or more second time points to define coefficients of variability based on coordinate pairs of signals in each pair, enabling assessment of signal variability without relying on activation onset identification.
Construction and analysis of a matrix of coefficients of variability to identify sources
Iteratively selecting multiple cardiac signal pairs from a plurality of signals, processing each pair to compute coefficients of variability, constructing a matrix of these coefficients for all pairs, and determining one or more sources of the rhythm disorder by identifying regions with higher variability coefficients surrounded by areas of lower variability.
The claims cover methods and systems that process pairs of cardiac signals to calculate coefficients of variability independent of activation onset times, compare these coefficients to locate the source of a rhythm disorder, and utilize matrices of such coefficients to identify sources for treatment.
Stated Advantages
Ability to identify the source of complex rhythm disorders from variability in signals independent of activation onset times.
Capability to rapidly determine the source location during sensing, enabling immediate treatment such as ablation.
Reduction in complexity and procedural steps compared to prior methods, improving efficacy of diagnosis and treatment for complex heart rhythm disorders.
Documented Applications
Identification and treatment of sources of heart rhythm disorders including complex arrhythmias such as atrial fibrillation, ventricular fibrillation, ventricular tachycardia, atrial tachycardia, supraventricular tachycardia, and atrial flutter.
Diagnosis and treatment guidance for biological rhythm disorders beyond cardiac rhythm, including neurological seizures, esophageal spasms, bladder instability, irritable bowel syndrome, and other biological rhythm-related disorders where biological signals can be recorded.
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