A catheter and method for detecting dyssynergy resulting from dyssynchrony There is provided a catheter for assessing cardiac function, the catheter comprising an elongate shaft extending from a proximal end to a distal end, where the shaft comprises a lumen for a guidewire and/or a saline flush. The catheter further comprises at least one electrode disposed on the shaft for sensing electrical signals in a bipolar or unipolar fashion and applying pacing to a patient's heart, at least one sensor disposed on the shaft for detecting an event relating to the rapid increase in the rate of pressure increase within the left ventricle of a patient; and communication means configured to transmit data received from the electrode(s) and the sensor(s).
A method for identifying reversible cardiac dyssynchrony (RCD) of a patient and treating the RCD measures an event relating to a rapid increase in the rate of pressure increase within the left ventricle. The method calculates a first time delay between the event and a first reference time. If the first time delay is longer than a set fraction of electrical activation of the heart, then the presence of cardiac dyssynchrony in the patient is identified. Pacing is applied to the heart, and a second time delay between the event following pacing and a second reference time following pacing is calculated. If the second time delay is shorter than the first time delay, the method identifies a shortening of a delay to onset of myocardial synergy, OoS, thereby identifying the presence of RCD in the patient. Treatment of the RCD is performed.
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 5/349 - Detecting specific parameters of the electrocardiograph cycle
A61N 1/05 - Electrodes for implantation or insertion into the body, e.g. heart electrode
A61N 1/36 - Applying electric currents by contact electrodes alternating or intermittent currents for stimulation, e.g. heart pace-makers
There is provided a catheter for assessing cardiac function, the catheter comprising an elongate shaft extending from a proximal end to a distal end, where the shaft comprises a lumen for a guidewire and/or a saline flush. The catheter further comprises at least one electrode disposed on the shaft for sensing electrical signals in a bipolar or unipolar fashion and applying pacing to a patient's heart, at least one sensor disposed on the shaft for detecting an event relating to the rapid increase in the rate of pressure increase within the left ventricle of a patient; and communication means configured to transmit data received from the electrode(s) and the sensor(s).
A61N 1/365 - Heart stimulators controlled by a physiological parameter, e.g. by heart potential
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
A catheter and method for detecting dyssynergy resulting from dyssynchrony There is provided a catheter for assessing cardiac function, the catheter comprising an elongate shaft extending from a proximal end to a distal end, where the shaft comprises a lumen for a guidewire and/or a saline flush. The catheter further comprises at least one electrode disposed on the shaft for sensing electrical signals in a bipolar or unipolar fashion and applying pacing to a patient's heart, at least one sensor disposed on the shaft for detecting an event relating to the rapid increase in the rate of pressure increase within the left ventricle of a patient; and communication means configured to transmit data received from the electrode(s) and the sensor(s).
A method for determining the degree of parallel activation of a heart undergoing pacing includes calculating vectorcardiogram (VCG), or electrocardiogram (ECG), or electrogram (EGM) waveforms from right ventricular pacing (RVp) and left ventricular pacing (LVp). A synthetic biventricular pacing (BIVP) waveform is generated by summing the VCG of the RVp and LVp, or by summing the ECG of the RVp and the LVp, or by summing the EGM of the RVp and the LVp. A corresponding EGM or ECG or VCG waveform from real BIVP is calculated. The method includes comparing the synthetic BIVP waveform and the real BIVP waveform and calculating time to fusion by determining the point in time in which the activation from RVp and LVp meets and the synthetic and the real BIVP curves start to deviate. A delay in time to fusion indicates a higher degree of parallel activation.
A61B 5/0215 - Measuring pressure in heart or blood vessels by means inserted into the body
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 5/0538 - Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
A61B 5/055 - Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fieldsMeasuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
A61B 5/327 - Generation of artificial ECG signals based on measured signals, e.g. to compensate for missing leads
A method for determining optimal electrode number and positions for cardiac resynchronization therapy on a heart of a patient is described. The method comprises: generating a 3D mesh of at least part of the heart from a 3D model of at least part of the heart of the patient, the 3D mesh of at least a part of the heart comprising a plurality of nodes; aligning the 3D mesh of at least part of a heart to images of the heart of the patient; and placing additional nodes onto the 3D mesh corresponding to a location of at least two electrodes on the patient. The 3D mesh is used in determining the optimal electrode number and position on the heart of the patient.
There is provided a catheter for assessing cardiac function, the catheter comprising an elongate shaft extending from a proximal end to a distal end, where the shaft comprises a lumen for a guidewire and/or a saline flush. The catheter further comprises at least one electrode disposed on the shaft for sensing electrical signals in a bipolar or unipolar fashion and applying pacing to a patient's heart, at least one sensor disposed on the shaft for detecting an event relating to the rapid increase in the rate of pressure increase within the left ventricle of a patient; and communication means configured to transmit data received from the electrode(s) and the sensor(s).
A61N 1/365 - Heart stimulators controlled by a physiological parameter, e.g. by heart potential
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
A61N 1/372 - Arrangements in connection with the implantation of stimulators
A method for identifying reversible cardiac dyssynchrony (RCD) of a patient and treating the RCD measures an event relating to a rapid increase in the rate of pressure increase within the left ventricle. The method calculates a first time delay between the event and a first reference time. If the first time delay is longer than a set fraction of electrical activation of the heart, then the presence of cardiac dyssynchrony in the patient is identified. Pacing is applied to the heart, and a second time delay between the event following pacing and a second reference time following pacing is calculated. If the second time delay is shorter than the first time delay, the method identifies a shortening of a delay to onset of myocardial synergy, OoS, thereby identifying the presence of RCD in the patient. Treatment of the RCD is performed.
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
A61N 1/365 - Heart stimulators controlled by a physiological parameter, e.g. by heart potential
A method for determining optimal electrode number and positions for cardiac resynchronization therapy on a heart of a patient is described. The method comprises: generating a 3D mesh of at least part of the heart from a 3D model of at least part of the heart of the patient, the 3D mesh of at least a part of the heart comprising a plurality of nodes; aligning the 3D mesh of at least part of a heart to images of the heart of the patient; and placing additional nodes onto the 3D mesh corresponding to a location of at least two electrodes on the patient. The 3D mesh is used in determining the optimal electrode number and position on the heart of the patient by: calculating a propagation velocity of the electrical activation between the nodes of the 3D mesh corresponding to the location of the at least two electrodes; extrapolating the propagation velocity to all of the nodes of the 3D mesh; calculating the degree of parallel activation of the myocardium for each node of the 3D mesh; and determining the optimal electrode number and position on the heart of the patient based on the node(s) of the 3D mesh with a calculated degree of parallel activation of the myocardium above a predetermined threshold.
A61B 5/055 - Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fieldsMeasuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
A method for identifying reversible cardiac dyssynchrony of a patient is disclosed. The method uses measurements of an event relating to a rapid increase in the rate of pressure increase within the left ventricle, and the method comprises: calculating a first time delay between the event relating to the rapid increase in the rate of pressure increase within the left ventricle and a first reference time by: using data received from one or more sensor(s) to measure the time when an event relating to the rapid increase in the rate of pressure increase within the left ventricle occurs by identifying a characteristic response in the data received from the one or more sensors, the event relating to the rapid increase in the rate of pressure increase within the left ventricle being identifiable in each contraction of the heart; processing signals from the same sensor(s), or one or more other sensor of the one or more sensor(s), to determine the first time delay between the measured time of the identified characteristic response relating to the rapid increase in the rate of pressure increase within the left ventricle and the first reference time; measuring biopotentials representing electrical activation of the heart; and comparing the first time delay between the measured time of the identified characteristic response relating to the rapid increase in the rate of pressure increase within the left ventricle and the first reference time with the duration of electrical activation of the heart. If the first time delay is longer than a set fraction of electrical activation of the heart, then the presence of cardiac dyssynchrony in the patient is identified. Pacing is then applied to the heart of the patient, and a second time delay between the identified characteristic response relating to the rapid increase in the rate of pressure increase within the left ventricle following pacing and a second reference time following pacing is calculated by: using the at least one sensor to measure the timing of the identified characteristic response relating to the rapid increase in the rate of pressure increase within the left ventricle following pacing; and processing signals from the one or more sensor(s) to determine the second time delay between the determined time of the identified characteristic response relating to rapid increase in the rate of pressure increase within the left ventricle and the second reference time following pacing; comparing the first time delay and the second time delay; wherein if the second time delay is shorter than the first time delay, identifying a shortening of a delay to onset of myocardial synergy, OoS, indicating that the time period until the point where all segments of the heart begin to actively or passively stiffen has shortened, thereby identifying the presence of reversible cardiac dyssynchrony in the patient.
A method for determining the degree of parallel activation of a heart undergoing pacing is disclosed. The method comprises calculating vectorcardiogram (VCG) or electrocardiogram (ECG) or electrogram (EGM) waveforms from right ventricular pacing (RVp) and left ventricular pacing (LVp). A synthetic biventricular pacing (BIVP) waveform is then generated by summing the VCG of the RVp and the LVp, or by summing the ECG of the RVp and the LVp, or by summing the EGM of the RVp and the LVp; and a corresponding EGM or ECG or VCG waveform from real BIVP is calculated. The method further comprises comparing the synthetic BIVP waveform and the real BIVP waveform; and calculating time to fusion by determining the point in time in which the activation from RVp and LVp meets and the synthetic and the real BIVP curves start to deviate. A delay in time to fusion indicates that a larger amount of tissue is activated before wave fronts for electrical activation meet, thereby indicating a higher degree of parallel activation.
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