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 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61B 5/349 - Détection de paramètres spécifiques du cycle de l'électrocardiogramme
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
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 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
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 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par des moyens introduits dans le corps
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61B 5/0538 - Mesure de l'impédance ou de la conductivité électrique d'une partie du corps invasive, p. ex. en utilisant un cathéter
A61B 5/055 - Détection, mesure ou enregistrement pour établir un diagnostic au moyen de courants électriques ou de champs magnétiquesMesure utilisant des micro-ondes ou des ondes radio faisant intervenir la résonance magnétique nucléaire [RMN] ou électronique [RME], p. ex. formation d'images par résonance magnétique
A61B 5/327 - Génération de signaux ECG artificiels à partir de signaux mesurés, p. ex. pour pallier l’absence d’électrodes
A61B 5/343 - Indication de la répartition des potentiels électriques
A61B 5/349 - Détection de paramètres spécifiques du cycle de l'électrocardiogramme
A61B 5/367 - Études électrophysiologiques [EEP], p. ex. cartographie de l’activation électrique ou cartographie électroanatomique
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
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.
A61B 6/00 - Appareils ou dispositifs pour le diagnostic par radiationsAppareils ou dispositifs pour le diagnostic par radiations combinés avec un équipement de thérapie par radiations
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).
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 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61N 1/372 - Aménagements en relation avec l'implantation des stimulateurs
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 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61N 1/365 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
G06T 17/20 - Description filaire, p. ex. polygonalisation ou tessellation
9.
CHARACTERISATION OF CARDIAC DYSSYNCHRONY AND DYSSYNERGY
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 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 - Détection, mesure ou enregistrement pour établir un diagnostic au moyen de courants électriques ou de champs magnétiquesMesure utilisant des micro-ondes ou des ondes radio faisant intervenir la résonance magnétique nucléaire [RMN] ou électronique [RME], p. ex. formation d'images par résonance magnétique
A61B 6/00 - Appareils ou dispositifs pour le diagnostic par radiationsAppareils ou dispositifs pour le diagnostic par radiations combinés avec un équipement de thérapie par radiations
A61B 34/10 - Planification, simulation ou modélisation assistées par ordinateur d’opérations chirurgicales
G06T 17/00 - Modélisation tridimensionnelle [3D] pour infographie
11.
CHARACTERISATION OF CARDIAC DYSSYNCHRONY AND DYSSYNERGY
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.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
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