System and method to define an aggregated stability map of a rotational source over a plurality of time intervals associated with a biological rhythm disorder
Provided are a system and method of generating an aggregated stability map of one or more rotational sources associated with a heart rhythm disorder. In accordance therewith, a plurality of rotational area profile maps is accessed for a plurality of analysis intervals. Each of the profile maps includes rotation intensity values for a plurality of locations associated with rotation of the one or more rotational sources. An aggregated stability map is generated based on the profile maps, wherein the stability map includes a plurality of locations. Each location includes a rotation intensity value based at least on a filter number of highest rotation intensity values from corresponding locations of the profile maps, the filter number being automatically determined from a plurality of filter numbers such that the plurality of profile maps as filtered includes a predetermined number of rotation intensity values in excess of a threshold intensity value.
G16H 50/50 - ICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
H04W 4/35 - Services specially adapted for particular environments, situations or purposes for the management of goods or merchandise
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 5/0245 - Measuring pulse rate or heart rate using sensing means generating electric signals
H04L 67/12 - Protocols specially adapted for proprietary or special-purpose networking environments, e.g. medical networks, sensor networks, networks in vehicles or remote metering networks
2.
System and method of identifying sources associated with biological rhythm disorders
The United States of America as Represented by the Department of Veterans Affairs (USA)
Topera, Inc. (USA)
Inventor
Narayan, Sanjiv M.
Briggs, Carey Robert
Sehra, Ruchir
Abstract
An example system and method associated with identifying and treating a source of a heart rhythm disorder are disclosed. In accordance therewith, a spatial element associated with a region of the heart is selected. Progressive rotational activations or progressive focal activations are determined in relation to the selected spatial element over a period of time. The selecting and determining are repeated over multiple periods of time. A source parameter of rotation activations or focal activations is determined, wherein the source parameter indicates consistency of successive rotational activations or focal activations in relation to a portion of the region of the heart. The determining of a source parameter is repeated for multiple regions of the heart. Thereafter, representation of the source parameter is displayed for each of the multiple regions of the heart to identify a shape representing the source of the heart rhythm disorder.
A system for sensing multiple local electric voltages from endocardial surface of a heart, includes: an elongate tubular member having a lumen, a proximal end and a distal end; a plurality of flexible splines; an anchor for securably affixing the proximal portions of the splines, where the anchor is securably affixed within the lumen of the elongate tubular member at the distal end of the elongate tubular member; and a metallic tip for securably affixing the distal portions of the splines.
A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A61B 5/05 - Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fieldsMeasuring using microwaves or radio waves
A system to generate a representation of a rhythm disorder that includes identifying remote or polar sources associated with a cardiac rhythm disorder is disclosed. The system includes generated a representation based on the cardiac information signals received from the sensors by transformation of spline- sensor locations of the catheter to x-y coordinate pairs of locations. A first offset is determined resulting from a perturbation to corresponding x-y coordinate pairs of locations associated with the representation, the first offset displacing coordinate pairs of sensor locations of the representation at least one unit of displacement in a first direction. A remote source associated with a cardiac rhythm disorder is identified when activations associated with the cardiac information signals rotate in sequence at least once, or emanate centrifugally for at least a first time period, the source being identified based on the representation as displaced. A corresponding method and computer-readable medium are also disclosed.
Provided is a system and method of generating an aggregated stability map of one or more rotational sources associated with a heart rhythm disorder. In accordance therewith, a plurality of rotational area profile maps is accessed for a plurality of analysis intervals. Each of the rotational area profile maps includes rotation intensity values for a plurality of locations associated with rotation of the one or more rotational sources. Thereafter, an aggregated stability map is generated map based on the plurality of rotational area profile maps, wherein the aggregated stability map includes a plurality of locations. Each location includes a rotation intensity value based at least on a filter level of highest rotation intensity values for that location from corresponding locations of the plurality of rotational area profile maps.
An example system and method associated with identifying and treating a source of a heart rhythm disorder are disclosed. In accordance therewith, a spatial element associated with a region of the heart is selected. Progressive rotational activations or progressive focal activations are determined in relation to the selected spatial element over a period of time. The selecting and determining are repeated over multiple periods of time. A source parameter of rotation activations or focal activations is determined, wherein the source parameter indicates consistency of successive rotational activations or focal activations in relation to a portion of the region of the heart. The determining of a source parameter is repeated for multiple regions of the heart. Thereafter, representation of the source parameter is displayed for each of the multiple regions of the heart to identify a shape representing the source of the heart rhythm disorder.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv M.
Sehra, Ruchir
Abstract
A system for processing cardiac activation information associated with a complex rhythm disorder identifies a location of the heart rhythm disorder by determining activations within cardiac signals obtained at neighboring locations of the heart and arranging the activations to identify an activation trail. The activation trail may define a rotational pattern or radially emanating pattern corresponding to an approximate core of the heart rhythm disorder.
System and method to define an aggregated stability map of a rotational source over a plurality of time intervals associated with a biological rhythm disorder
Provided is a system and method of generating an aggregated stability map of one or more rotational sources associated with a heart rhythm disorder. In accordance therewith, a plurality of rotational area profile maps is accessed for a plurality of analysis intervals. Each of the rotational area profile maps includes rotation intensity values for a plurality of locations associated with rotation of the one or more rotational sources. Thereafter, an aggregated stability map is generated map based on the plurality of rotational area profile maps, wherein the aggregated stability map includes a plurality of locations. Each location includes a rotation intensity value based at least on a filter level of highest rotation intensity values for that location from corresponding locations of the plurality of rotational area profile maps.
G16H 50/50 - ICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
H04W 4/35 - Services specially adapted for particular environments, situations or purposes for the management of goods or merchandise
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 5/0245 - Measuring pulse rate or heart rate using sensing means generating electric signals
H04L 29/08 - Transmission control procedure, e.g. data link level control procedure
9.
System and method for targeting heart rhythm disorders using shaped ablation
The United States of America as Represented by the Department of Veterans Affairs (USA)
Topera, Inc. (USA)
Inventor
Narayan, Sanjiv M.
Briggs, Carey Robert
Abstract
A system and method to target a biological 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 biological rhythm disorder.
A61M 5/00 - Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular wayAccessories therefor, e.g. filling or cleaning devices, arm rests
The United States of America as Represented by the Department of Veterans Affairs (USA)
Topera, Inc. (USA)
Inventor
Narayan, Sanjiv M.
Briggs, Carey Robert
Sehra, Ruchir
Abstract
An example system and method associated with identifying and treating a source of a heart rhythm disorder are disclosed. In accordance therewith, a spatial element associated with a region of the heart is selected. Progressive rotational activations or progressive focal activations are determined in relation to the selected spatial element over a period of time. The selecting and determining are repeated over multiple periods of time. A source parameter of rotation activations or focal activations is determined, wherein the source parameter indicates consistency of successive rotational activations or focal activations in relation to a portion of the region of the heart. The determining of a source parameter is repeated for multiple regions of the heart. Thereafter, representation of the source parameter is displayed for each of the multiple regions of the heart to identify a shape representing the source of the heart rhythm disorder.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv M.
Briggs, Carey Robert
Sehra, Ruchir
Abstract
In a system and method for reconstructing cardiac activation information, an analysis cardiac signal and a reference cardiac signal are accessed and processed to determine a first point of change in the analysis cardiac signal at which a derivative of the analysis cardiac signal diverges with respect to a derivative of the reference cardiac signal. The signals are processed to determine a second point of change in the analysis cardiac signal at which a different derivative of the analysis cardiac signal with respect to a different derivative of the reference cardiac signal. An activation onset time is assigned in the analysis cardiac signal at a point based on a mathematical association among the first point of change and the second point of change to define cardiac activation indicating a beat in the analysis cardiac signal.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Topera, Inc. (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
Reconstruction of cardiac information associated with a heart rhythm disorder includes accessing a plurality of neighboring cardiac signals and eliminating far-field activations from the neighboring cardiac signals using one or more divergence criteria that define local activations, where the divergence criteria is associated with divergence among the plurality of neighboring cardiac signals. The local activations in the plurality of neighboring cardiac signals may be used to construct a clinical representation of the heart rhythm disorder.
A61B 5/042 - Electrodes specially adapted therefor for introducing into the body
A61B 5/04 - Measuring bioelectric signals of the body or parts thereof
G06F 19/00 - Digital computing or data processing equipment or methods, specially adapted for specific applications (specially adapted for specific functions G06F 17/00;data processing systems or methods specially adapted for administrative, commercial, financial, managerial, supervisory or forecasting purposes G06Q;healthcare informatics G16H)
G16H 10/60 - ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
13.
System and method for reconstructing cardiac activation information
The United States of America as Represented by the Department of Veteran's Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
In a system and method of reconstructing cardiac activation information, pairs of cardiac signals obtained from a patient are accessed. The pairs have a first cardiac signal that is common among the pairs and second cardiac signals that are different among the pairs. The first cardiac signal and the second cardiac signals are processed to identify points of change in the first cardiac signal at which a derivative of the first cardiac signal diverges with respect to derivatives of the second cardiac signals. An activation onset time is assigned at a point in the first cardiac signal based on correspondence of the points of change to define a cardiac activation indicating a beat.
A61B 18/02 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
14.
System and method of identifying sources for biological rhythms
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Briggs, Carey Robert
Narayan, Sanjiv M.
Abstract
In a system and method of determining regularity associated with a rhythm disorder of a heart, a derivative of a first cardiac signal at a plurality of first time points is processed against a derivative of a second cardiac signal at a plurality of second time points to define a plurality of coordinate pairs of the first cardiac signal against the second cardiac signal. Thereafter, an index of regularity that exceeds a threshold is determined. The index of regularity indicates an approximate congruence of the plurality of coordinate pairs among the first cardiac signal and the second cardiac signal.
An example system and method of defining a rotational source associated with a heart rhythm disorder are disclosed. A plurality of center locations of wave fronts are calculated at a plurality of time points associated with the heart rhythm disorder. A rotational path that connects the plurality of center locations is then determined. Thereafter, a clinical representation that identifies a region of heart tissue associated with the rotational path is generated. The system and method can also determine a likely core associated with the rotational path. A plurality of relative diffusion shapes associated with the plurality of the center locations is calculated. A plurality of intersecting points of a smallest relative diffusion shape and other relative diffusion shapes is determined within the rotational path. A bounded polygon of the intersecting points is defined as the likely core.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Sehra, Ruchir
Abstract
In a system and method for reconstructing cardiac activation information, an analysis cardiac signal and a reference cardiac signal are accessed and processed to determine a first point of change in the analysis cardiac signal at which a derivative of the analysis cardiac signal diverges with respect to a derivative of the reference cardiac signal. The signals are processed to determine a second point of change in the analysis cardiac signal at which a different derivative of the analysis cardiac signal with respect to a different derivative of the reference cardiac signal. An activation onset time is assigned in the analysis cardiac signal at a point based on a mathematical association of the first point of change and the second point of change to define cardiac activation indicating a beat in the analysis cardiac signal.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Topera, Inc. (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Sehra, Ruchir
Abstract
In a system and method for identifying a driver of a source associated with a heart rhythm disorder, data are accessed from a plurality of sensors representing biological activity in the heart. A first region and a second region of the heart, which comprise the source of the heart rhythm disorder, are identified. If the first region of the heart has repeating centrifugal activation and controls the second region of the heart for at least a predetermined number of beats, the first region is identified as controlling the source of the heart rhythm disorder.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
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.
A method of representing cardiac information associated with a heart rhythm disorder includes accessing a plurality of neighboring cardiac signals obtained from a patient. Far-field activations are eliminated from the plurality of neighboring cardiac signals using one or more divergence criteria that define local activations in the plurality of neighboring cardiac signals, where the divergence criteria are associated with divergence among the plurality of neighboring cardiac signals. The method may also include constructing a clinical representation of local activations in the plurality of neighboring cardiac signals.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Topera, Inc. (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Sehra, Ruchir
Abstract
A system and method are provided for identifying a driver of a source associated with a heart rhythm disorder. Data are accessed from a plurality of sensors representing biological activity in the heart. A local first region of the heart that has repeating activation and determine whether the first region controls a second distant region of the heart for at least a predetermined number of beats is identified. The first local region is assigned as a driver of a source of the heart rhythm disorder, the source including the first local region and the second distant region.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Sehra, Ruchir
Abstract
A system and method are provided to define a driver of a source associated with a cardiac rhythm disorder of a human heart. A plurality of cardiac signals associated with sensors arranged spatially in relation to an area of the heart are processed to determine a sequence of arcs of rotation in relation to the sensors over a time interval. Rotational directions of the arcs of rotation in the sequence are determined. The area of the heart is identified as controlling the source when the rotational directions of the arcs of rotation in the sequence continue in a same rotational direction in excess of a threshold.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
An example method of representing cardiac information associated with a heart rhythm disorder includes accessing a plurality of neighboring cardiac signals obtained from a patient. The method also includes eliminating far-field activations from the plurality of neighboring cardiac signals using one or more divergence criteria that define local activations in the plurality of neighboring cardiac signals, the divergence criteria being associated with divergence among the plurality of neighboring cardiac signals. The method further includes constructing a clinical representation of local activations in the plurality of neighboring cardiac signals.
The United States of America as Represented by the Department of Veterans Affairs, Office of General Counsel (USA)
Inventor
Narayan, Sanjiv
Sehra, Ruchir
Abstract
System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.
A system and method for identifying and treating a source of a heart rhythm disorder are provided in which a spatial element associated with a region of the heart is selected. Progressive rotational activations or progressive focal activations are determined in relation to the selected spatial element. A plurality of indexes of progressive rotational activations or progressive focal activations over time is formed. One or more indexes are selected from the plurality of indexes that indicate consistency of the successive rotational activations or the progressive focal activations in relation to a portion of the region of the heart.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
An example system and method of reconstructing cardiac activation information are disclosed. In accordance therewith, there are accessed pairs of cardiac signals out of a plurality of cardiac signals obtained from a patient. The pairs have a first cardiac signal that is common among the pairs and second cardiac signals that are different among the pairs. The first cardiac signal and the second cardiac signals of the pairs are processed to identify points of change in the first cardiac signal at which a derivative of the first cardiac signal diverges with respect to derivatives of the second cardiac signals. An activation onset time is assigned at a point in the first cardiac signal based on correspondence of the points of change to define a cardiac activation indicating a beat.
The United States of America as Represented by the Department of Veterans Affairs, Office of the General Counsel (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Sehra, Ruchir
Abstract
In a system and method for reconstructing cardiac activation information, an analysis cardiac signal and a reference cardiac signal are processed to determine a first point of change in a derivative of the analysis cardiac signal with respect to a derivative of the reference cardiac signal. The analysis cardiac signal and the reference cardiac signal are processed to determine a second point of change in a different derivative of the analysis cardiac signal with respect to a different derivative of the reference cardiac signal. An activation onset time is assigned in the analysis cardiac signal at a point based on a mathematical association of the first point of change and the second point of change to define cardiac activation indicating a beat in the analysis cardiac signal.
A system and method to process segments of cardiac signals. Each of a plurality of segments in a first signal is correlated at a plurality of offsets to determine a highest correlation coefficient for each of the plurality of segments in the first signal. Each of a plurality of segments in a second signal is correlated at the plurality of offsets to determine a highest correlation coefficient for each of the plurality of segments in the second signal. A plurality of composite correlation coefficients is generated using highest correlation coefficients for segments of the first signal and segments of the second signal. The segments of the first and second signals are approximately contemporaneous. A set of segments including a segment from the first signal and a segment from the second signal is selected. The set is associated with a highest composite correlation coefficient from the plurality of composite correlation coefficients.
The United State of America as represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
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.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Sehra, Ruchir
Abstract
System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.
The United States of America as represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
An example method of representing cardiac information associated with a heart rhythm disorder is disclosed. The method includes accessing a plurality of neighboring cardiac signals obtained from a patient. The method also includes eliminating far-field activations from the plurality of neighboring cardiac signals using one or more divergence criteria that define local activations in the plurality of neighboring cardiac signals, the divergence criteria being associated with divergence among the plurality of neighboring cardiac signals. The method further includes constructing a clinical representation of local activations in the plurality of neighboring cardiac signals.
The United States of America as represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
An example system and method of reconstructing cardiac activation information are disclosed. In accordance therewith, there are accessed pairs of cardiac signals out of a plurality of cardiac signals obtained from a patient. The pairs have a first cardiac signal that is common among the pairs and second cardiac signals that are different among the pairs. The first cardiac signal and the second cardiac signals of the pairs are processed to determine whether there are points of change in the first cardiac signal at which a derivative of the first cardiac signal diverges with respect to derivatives of the second cardiac signals above a threshold. An activation onset time is assigned at a point in the first cardiac signal based on correspondence of the points of change to define a cardiac activation indicating a beat if the points of change are in the first signal.
THE UNITED STATES OF AMERICA AS REPRESENTED BY THE DEPARTMENT OF VETERANS AFFAIRE (USA)
TOPERA, INC. (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Sehra, Ruchir
Abstract
An example system and method associated with identifying and treating a source of a heart rhythm disorder are disclosed. In accordance with therewith, a spatial element associated with a region of the heart is selected. Progressive rotational activations or progressive focal activations are determined in relation to the selected spatial element. A plurality of indexes of progressive rotational activations or progressive focal activations over time is formed. One or more indexes are selected from the plurality of indexes that indicate consistency of the successive rotational activations or the progressive focal activations in relation to a portion of the region of the heart.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61N 1/32 - Applying electric currents by contact electrodes alternating or intermittent currents
A61N 1/368 - Heart stimulators controlled by a physiological parameter, e.g. by heart potential comprising more than one electrode co-operating with different heart regions
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A61B 5/042 - Electrodes specially adapted therefor for introducing into the body
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
33.
SYSTEM AND METHOD TO DEFINE A ROTATIONAL SOURCE ASSOCIATED WITH A BIOLOGICAL RHYTHM DISORDER
An example system and method of defining a rotational source associated with a heart rhythm disorder are disclosed. A plurality of center locations of wave fronts are calculated at a plurality of time points associated with the heart rhythm disorder. A rotational path that connects the plurality of center locations is then determined. The system and method can also determine a likely core associated with the rotational path. A plurality of relative diffusion shapes associated with the plurality of the center locations is calculated. A plurality of intersecting points of a smallest relative diffusion shape and other relative diffusion shapes is determined within the rotational path. A bounded polygon of the intersecting points is defined as the likely core.
An example system and method of reconstructing cardiac activation information are disclosed. An analysis signal and a reference signal are processed to determine whether there is a first point of change in a first selected-order derivative of the analysis signal with respect to a first selected-order derivative of the reference signal above a first threshold. The analysis signal and the reference signal are processed to determine whether there is a second point of change in a second selected-order derivative of the analysis cardiac signal above a second threshold. An activation onset time is assigned in the analysis cardiac signal at a point based on a mathematical association of the first point of change and the second point of change to define cardiac activation indicating a beat in the analysis cardiac signal.
The United States of America as Represented by the Department of Veterans Affairs, Office of the General Counsel (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Sehra, Ruchir
Abstract
In a system and method for identifying a driver of a source associated with a heart rhythm disorder, data are accessed from a plurality of sensors representing biological activity in the heart. A first region and a second region of the heart are identified as the source of the heart rhythm disorder. If the first region has repeating activation and controls the second region for at least a predetermined number of beats, the first region is identified as controlling the source of the heart rhythm disorder.
An example system and method of determining a likely core of a rotational source associated with a heart rhythm disorder are disclosed. A plurality of relative diffusion shapes associated with wave fronts is calculated at a plurality of time points associated with the rotational source. The wave fronts associated with heart signals. A plurality of intersecting points of a smallest relative diffusion shape and other relative diffusion shapes is determined. A bounded polygon of the intersecting points is defined as the likely core.
A system and method of identifying a driver of a source associated with a heart rhythm disorder are disclosed. Data is accessed from a plurality of sensors representing biological activity in the heart. A local first region of the heart that has repeating activation and that controls a second distant region of the heart for at least a predetermined number of beats is identified. The first local region is assigned as a driver of a source of the heart rhythm disorder, the source including the first local region and the second distant region.
(1) Medical devices that help identify abnormal heart rhythms, namely, catheters and associated extension cables, adapter cables, and replacement parts.
39.
System and method for reconstructing cardiac signals associated with a complex rhythm disorder
The United States of America as Represented by the Department of Veterans Affairs, Office of General Counsel (USA)
Inventor
Narayan, Sanjiv
Sehra, Ruchir
Abstract
System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.
An example system and method of defining a rotational source associated with a heart rhythm disorder are disclosed. A plurality of center locations of wave fronts are calculated at a plurality of time points associated with the heart rhythm disorder. A rotational path that connects the plurality of center locations is then determined. The system and method can also determine a likely core associated with the rotational path. A plurality of relative diffusion shapes associated with the plurality of the center locations is calculated. A plurality of intersecting points of a smallest relative diffusion shape and other relative diffusion shapes is determined within the rotational path. A bounded polygon of the intersecting points is defined as the likely core.
The United States of America as represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Sehra, Ruchir
Abstract
System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.
The United States of America as represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
An example system and method of processing cardiac activation information are disclosed. The method includes accessing a first cardiac signal and a second cardiac signal obtained from a patient. The first cardiac signal and the second cardiac signal are processed to identify a point of change in the first cardiac signal at which a derivative of the first cardiac signal diverges with respect to a derivative of the second cardiac signal. An activation onset time is assigned in the first cardiac signal at the point of change to define a cardiac activation.
The United States of America as represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
An example system and method of processing cardiac activation information are disclosed. The method includes accessing a first cardiac signal and a second cardiac signal obtained from a patient. The first cardiac signal and the second cardiac signal are processed to determine whether there is a point of change in the first cardiac signal at which a derivative of the first cardiac signal diverges with respect to a derivative of the second cardiac signal above a threshold. An activation onset time is assigned in the first cardiac signal at the point of change to define a cardiac activation if the point of change is in the first cardiac signal.
A61B 3/12 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
A61B 5/04 - Measuring bioelectric signals of the body or parts thereof
A61B 5/042 - Electrodes specially adapted therefor for introducing into the body
A61B 5/0452 - Detecting specific parameters of the electrocardiograph cycle
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A61B 5/0205 - Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
A system for sensing monophasic action potentials from endocardial tissue of a heart, includes: a plurality of flexible splines; an anchor for securably affixing the proximal portions of the splines; a tip for securably affixing the distal portions of the splines; and a polymeric member including opposed a first open end and a second open end defining an open lumen therein between, where at least one of the plurality of flexible splines is at least partially disposed within the lumen of the polymeric member; a flexible electrode assembly strip with two or more exposed electrodes oppositely disposed on at least a portion of the outer surface of the polymeric member.
A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
A61B 5/042 - Electrodes specially adapted therefor for introducing into the body
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
An example system and method of reconstructing cardiac activation information are disclosed. An analysis signal and a reference signal are processed to determine whether there is a first point of change in a first selected-order derivative of the analysis signal with respect to a first selected-order derivative of the reference signal above a first threshold. The analysis signal and the reference signal are processed to determine whether there is a second point of change in a second selected-order derivative of the analysis cardiac signal with respect to a second selected-order derivative of the reference cardiac signal above a second threshold. An activation onset time is assigned in the analysis cardiac signal at a point based on a mathematical association of the first point of change and the second point of change to define cardiac activation indicating a beat in the analysis cardiac signal.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Briggs, Carey Robert
Narayan, Sanjiv
Abstract
In a system and method of determining regularity associated with a rhythm disorder of a heart, a derivative of a first cardiac signal at a plurality of first time points is processed against a derivative of a second cardiac signal at a plurality of second time points to define a plurality of coordinate pairs of the first cardiac signal against the second cardiac signal. Thereafter, an index of regularity that exceeds a threshold is determined. The index of regularity indicates an approximate congruence of the plurality of coordinate pairs among the first cardiac signal and the second cardiac signal.
An example system and method of locating a source of a heart rhythm disorder are disclosed. In accordance with the method, 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. Further, 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.
The United States of America as Represented by the Department of Veterans Affairs (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
Abstract
An example system and method of locating a source of a heart rhythm disorder are disclosed. In accordance with the method, 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. Further, 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.
An example system and method of determining regularity associated with a rhythm disorder of a heart are disclosed. In accordance with the method, a derivative of a first cardiac signal at a plurality of first time points is processed against a derivative of a second cardiac signal at a plurality of second time points to define a plurality of coordinate pairs of the first cardiac signal against the second cardial signal. Thereafter, an index of regularity that exceeds a threshold is determined. The index of regularity indicates an approximate congruence of the plurality of coordinate pairs among the first cardiac signal and the second cardiac signal.
A system for sensing multiple local electric voltages from endocardial surface of a heart, includes: an elongate tubular member; a plurality of flexible splines having proximal portions, distal portions and medial portions therein between; an anchor for securably affixing the proximal portions of the splines; an atraumatic tip for securably affixing the distal portions of the splines; and a polymeric member including opposed a first open end and a second open end defining an open lumen therein between and an inner member surface and an outer member surface, wherein at least one of the plurality of flexible splines is at least partially disposed within the lumen of the polymeric member; a flexible electrode assembly strip with one or more exposed electrodes disposed on at least a portion of the outer surface of the polymeric member.
The United States of America as Represented by the Department of Veterans Affairs, Office of the General Counsel (USA)
Inventor
Narayan, Sanjiv
Briggs, Carey Robert
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.
A61B 5/02 - Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61B 5/042 - Electrodes specially adapted therefor for introducing into the body
An example system and method of reconstructing cardiac activation information are disclosed. A first cardiac signal and a second cardiac signal are processed via a computing device to determine whether there is a point of change in a derivative of the first cardiac signal with respect to a derivative of the second cardiac signal above a threshold. An activation onset time is assigned in the first cardiac signal at the point of change to define cardiac activation indicating a beat in the first cardiac signal if it is determined that the point of change is above the threshold.
Provided is a system and method to target a biological rhythm disorder, such as a heart rhythm disorder. The system and method 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.
A system (10) for sensing multiple local electric voltages from endocardial surface of a heart, may comprise: an elongate tubular member (20); a plurality of flexible splines (14); a polymeric member (185) comprising opposed a first open end (202) and a second open end (200) defining an open lumen (208) therein, wherein at least one of the plurality of flexible splines (14) is at least partially disposed within the lumen (208) of said polymeric member; a flexible electrode assembly strip (188) with one or more exposed electrodes (186) disposed on at least a portion of the outer surface (208A) of said polymeric member (185); wherein a portion of the flexible electrode assembly (188) transitions from the outer surface (208A) of said polymeric member (185) towards the inner surface (208B) of said polymeric member (185).
A system (10) for sensing multiple local electric voltages from endocardial surface of a heart, may comprise: a first elongate tubular member (20); a basket assembly (12) comprising: a plurality of flexible splines (14); a proximal anchor (18) for securably affixing the proximal portions (62) of the splines (14); said proximal anchor (18) being secured at the distal end (20B) of the first elongate tubular member (20); a distal tip (16) for securably affixing the distal portions (66) of the splines (14), said proximal anchor (18) and said distal tip (16) defining a longitudinal axis therein between about which the splines (14) are disposed; wherein the splines (14) approach the distal tip (18) at an angle (a) of about 90° or less; wherein the splines (14) in the radially expanded non - spherical shape contain a distal excurvate outward bend (80) disposed at the distal portion (66) of the spline (14) to bend the splines (14) back towards the proximal anchor (18).
A system (10) for sensing multiple local electric voltages from endocardial surface of a heart is provided. The system may comprise a first elongate tubular member (20) having a lumen (20C), a proximal end (20A) and a distal end (20B); and a basket assembly (12) comprising: a plurality of flexible splines (14) for guiding a plurality of exposed electrodes (186), the splines (14) having proximal portions (62) and distal portions (66); an anchor (18) for securably affixing the proximal portions (62) of the splines (14); said anchor (18) being secured at the distal end (20B) of the first elongate tubular member (20); an encapsulated and filament -wrapped distal tip (16, 120) comprising an encapsulant (122) and a filament (124) for securably affixing the distal portions (66) of the splines (14) in a predetermined angular relationship at said distal tip (16, 120); wherein the splines (14) comprise a superelastic material; and wherein the basket assembly (12) has a radially expanded non - cylindrical shape.
A device for insertion into a body lumen, may comprise: an electrode assembly strip (188) with exposed electrodes (186) comprising: a polymeric substrate (236) having an upper surface (236A) and an opposed lower surface (236B); one or more electrodes (186) disposed over a portion of the upper surface (236A) of the polymeric substrate (236); one or more electrical traces (228) disposed over a portion of the lower surface (236B) of the polymeric substrate (236) in electrical communication with the one or more electrodes (186) by way of metal plated holes (230) through the substrate (236); and a flexible polymeric substrate (246) having a substrate surface (246A) and a substrate wall (246C); wherein the electrode assembly strip (188) is compressingly and thermally bonded to the substrate surface (246A) of the flexible polymeric substrate (246) to define a flexible electrode assembly strip (247); and wherein the electrode assembly strip (188) has a thickness from about 0.0005 inches to about 0.008 inches.
A method for sensing local electric voltages from endocardial surface of a heart, comprising: providing a system (10) for sensing multiple local electric voltages from endocardial surface of a heart, comprising: an elongate tubular member (20); a basket assembly (12) comprising: a plurality of flexible splines (14); wherein the splines (14) comprise a superelastic material such that the basket assembly (12) exhibits a radially expanded non-spherical shape when not radially compressed; and wherein each of the splines (14) in the radially expanded non-spherical shape contain a proximal recurve (76) in the proximate portion (62) of the spline (14), the proximal recurve (76) comprises a proximal excurvate outward bend (84) and a proximal incurvate inward bend (82); delivering the system (10) to the heart so that the basket assembly (12) is disposed within the right atrium of the heart; and contacting atrial tissue with the electrodes (186) disposed on the spline to detect local electric voltages from endocardial surface thereat.
A system a system for sensing multiple local electric voltages from endocardial surface of a heart, includes: a first elongate tubular member; a basket assembly including: a plurality of flexible splines for guiding a plurality of exposed electrodes, the splines having proximal portions, distal portions and medial portions therein between; a proximal anchor for securably affixing the proximal portions of the splines; the proximal anchor being secured at the distal end of the first elongate tubular member; a distal tip for securably affixing the distal portions of the splines wherein at least some of the splines in the radially expanded non-spherical shape contain a distal excurvate outward bend disposed at the distal portion of the spline at a location near to the distal tip of the basket assembly to bend the splines back towards the proximal anchor.
A device for insertion into a body lumen, includes: an electrode assembly strip with exposed electrodes including: a polymeric substrate having an upper surface and an opposed lower surface; one or more electrodes disposed over a portion of the upper surface of the polymeric substrate; one or more electrical traces disposed over a portion of the lower surface of the polymeric substrate in electrical communication with the one or more electrodes by way of metal plated holes through the substrate; and a flexible polymeric substrate having a substrate surface and a substrate wall; wherein the electrode assembly strip is compressingly and thermally bonded to the substrate surface of the flexible polymeric substrate to define a flexible electrode assembly strip; and wherein the electrode assembly strip has a thickness from about 0.0005 inches to about 0.008 inches.
A system for sensing multiple local electric voltages from endocardial surface of a heart, includes: an elongate tubular member; a plurality of flexible splines having proximal portions, distal portions and medial portions therein between; an anchor for securably affixing the proximal portions of the splines; a tip for securably affixing the distal portions of the splines; and a polymeric member including opposed a first open end and a second open end defining an open lumen therein between and an inner member surface and an outer member surface, wherein at least one of the plurality of flexible splines is at least partially disposed within the lumen of the polymeric member; a flexible electrode assembly strip with one or more exposed electrodes disposed on at least a portion of the outer surface of the polymeric member.
System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.
System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.
