System 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-9955879-B2
Publication Date
2018-05-01
Expiration Date
2029-10-09
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Abstract
A system to generate a representation of a rhythm disorder includes a plurality of sensors disposed at multiple locations spatially in relation to the heart, wherein cardiac information signals are sensed. A processor receives and analyzes the activation onsets of the cardiac information signals to determine an arrangement of activation onsets. A representation that indicates the clinical source of the rhythm disorder is generated based on the arrangement of the activation onsets.
Core Innovation
The invention discloses a system and method for identifying, locating, and treating heart rhythm disorders by sensing biological activation signals at multiple locations and analyzing the activation onsets of these signals to create a sequential arrangement called an activation trail. This activation trail provides a representation that indicates the clinical source of the rhythm disorder, such as a rotational pattern around a core region (rotor) or a radially emanating pattern (focal beat). It enables the identification and location of localized causes, facilitating targeted therapy, including minimally invasive ablation or other treatments.
The problem being solved is the difficulty in identifying and locating causes of complex heart rhythm disorders such as atrial fibrillation (AF), ventricular tachycardia (VT), and ventricular fibrillation (VF). Prior methods and tools either do not accurately identify and locate the sources or rely on surrogates without direct localization, limiting ablation success and causing excessive or ineffective tissue damage. Existing sensing tools lack sufficient field of view or resolution, and animal model findings do not translate well to human cases. The invention addresses these challenges by providing a process and system for collecting, analyzing, and visually representing cardiac activation data to directly identify and localize causes of rhythm disorders.
Claims Coverage
The claims include one independent claim directed to a system for generating a representation of a clinical source of a complex heart rhythm disorder and describe multiple inventive features related to sensing, data processing, and visualization.
System for sensing and analyzing cardiac activation signals at multiple locations
A plurality of sensors disposed at multiple spatial locations in relation to the heart sense cardiac information signals, and a processor receives data comprising activation onset times at each location.
Sequential arrangement and activation trail generation
The processor determines a sequential arrangement of activation onsets, ordering activation times to create an activation trail indicative of the rhythm disorder cause, which can comprise rotational or radially emanating repeating patterns around a core region.
Visual and auditory representation of the activation trail
The sensory representation generated can be visually depicted on a display device, showing activation onsets spatially relative to sensors, or presented as auditory signals, facilitating identification of the location and type of the rhythm disorder cause.
Analytical methods for core region identification
The processor can analyze cardiac signals using methods like direct phase assignment, Hilbert transform, wavelet transform, and phase-delay analysis to determine approximate core regions representing rotors or focal activations.
Adaptive sensing and data processing
The system supports sensing cardiac signals concurrently or stepwise, includes electronic switching components for sensor selection, and filters signal noise to optimize clarity.
Integration of a treatment component
An ablation component integrated with the sensor system can modify or destroy tissue regions responsible for the cause of the complex heart rhythm disorder.
Database storing and augmenting source data
The system can store data including activation trails, source characteristics, and patient information in a database for comparison and augmentation of current patient analyses.
Determination of primary cause criteria
Criteria such as number and rate of activation trail repetitions, volume of tissue activated, localization, and location within the heart are used to determine if a localized source is a primary cause of the disorder.
The claims cover a comprehensive system and method for sensing, analyzing, visually and auditorily representing, and treating complex heart rhythm disorders by identifying specific localized sources such as rotors and focal beats through sophisticated data processing, integrated treatment delivery, and database-supported analysis.
Stated Advantages
Enables direct identification and precise localization of sources for complex heart rhythm disorders, improving targeted treatment effectiveness.
Facilitates treatment using minimally invasive methods by accurately locating arrhythmia causes.
Provides visual and auditory representations of activation trails, aiding practitioners in understanding and targeting rhythm disorder causes.
Allows adaptive sensing with adjustable spatial resolution and sensor configurations to optimize data acquisition.
Supports integration with treatment devices such as ablation catheters for simultaneous diagnosis and therapy.
Includes database storage and comparison for enhancing diagnosis accuracy and predicting source locations based on patient characteristics.
Documented Applications
Detection, diagnosis, and treatment of complex heart rhythm disorders including atrial fibrillation (AF), ventricular tachycardia (VT), ventricular fibrillation (VF), atrial tachycardia (AT), supraventricular tachycardia (SVT), and atrial flutter (AFL).
Minimally invasive catheter-based ablation therapy guided by localized source identification to terminate or eliminate heart rhythm disorders.
Offline review and analysis of previously recorded electrogram data from implanted devices or prior procedures to inform diagnosis and therapy planning.
Application to surgical therapies involving direct heart exposure for identification and targeted treatment of rhythm disorder causes.
Use in non-cardiac biological rhythms, such as seizure foci localization in the brain, and detection of impulse propagation abnormalities in skeletal muscle, gastrointestinal tract, bladder, and uterus.
Potential applications outside of medicine, including locating sources of seismic events or energy sources using radar or sonar in combination with the data processing methods described.
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