System and method to identify sources associated with biological rhythm disorders
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.
1. A method of identifying a region associated with controlling a source of a heart rhythm disorder, the method comprising:
accessing, by a computing device, data from a plurality of sensors representing biological activity in the heart;
identifying, by the computing device, a first region and a second region of the heart comprising the source of the heart rhythm disorder, wherein the first region of the heart has repeating activation;
determining, by the computing device, whether the first region controls the second region of the heart for at least a predetermined number of beats; and
identifying the first region as controlling the source when the first region controls the second region for at least the predetermined number of beats.
2. The method of claim 1 , wherein a sequence of activation within the first region directly controls the second region.
3. The method of claim 1 , wherein a sequence of activation within the first region directly controls the second region in a centrifugal pattern.
4. The method of claim 1 , wherein a sequence of activation within the first region is rotational.
5. The method of claim 1 , wherein a sequence of activation within the first region is rotational and includes outward spread to the second region.
6. The method of claim 1 , wherein a sequence of activation is spatially located within the first region between the beats.
7. The method of claim 1 , wherein a sequence of activation spatially moves within the first region between the beats.
8. The method of claim 1 , wherein the first region has an area of less than 5 cm 2 .
9. The method of claim 1 , further comprising determining stability of the repeating activation by computing indexes of centrifugal activation within the first region.
10. The method of claim 9 , wherein the indexes of centrifugal activation is one or more of vectors of activation, linear velocity, correlation analysis or and spatial maps showing progressive spatial activation.
11. The method of claim 9 , wherein the indexes of centrifugal activation are displayed on a map of sensor locations indicating higher and lower indexes of centrifugal activation.
12. The method of claim 1 , further comprising determining persistence of the repeating activation by computing indexes of rotational activation within the first region.
13. The method of claim 12 , wherein the indexes of rotational activation is one or more of progression over time in angles of rotational arc of activation sequence, sectors of rotation, traversal of a rotational perimeter, angular velocity and phase mapping.
14. The method of claim 13 , wherein the indexes of rotational activation are displayed on a map of sensor locations indicating higher and lower indexes of rotational activation.
15. The method of claim 1 , further comprising classifying the first region as a driver if the first region controls the second region for a plurality of the beats.
16. The method of claim 1 , wherein the first region is a driver of the source.
17. The method of claim 16 , wherein the driver is an internal driver of the source.
18. The method of claim 16 , wherein the source comprises a focal source and the driver is a core of the focal source.
19. The method of claim 16 , wherein the source comprises a rotational source and the driver is a core of the rotational source.
20. The method of claim 1 , wherein the source is a focal source.
21. The method of claim 20 , wherein the first region is a core of the focal source.
22. The method of claim 1 , wherein the source is a rotational source.
23. The method of claim 22 , wherein the first region is a core of the rotational source.
24. A system of identifying a region associated with controlling a source of a heart rhythm disorder, the system comprising:
a processor; and
a storage medium storing instructions that, when executed by the processor, cause the processor to perform operations comprising:
accessing data from a plurality of sensors representing biological activity in the heart;
identifying a first and a second region of the heart comprising the source of the heart rhythm disorder, wherein the first region of the heart has repeating activation;
determining whether the first region controls the second region of the heart for at least a predetermined number of beats; and
identifying the first region as controlling the source when the first region controls the second region for at least the predetermined number of beats.
25. The system of claim 24 , wherein a sequence of activation within the first region directly controls the second region.
26. The system of claim 24 , wherein a sequence of activation within the first region directly controls the second region in a centrifugal pattern.
27. The system of claim 24 , wherein a sequence of activation within the first region is rotational.
28. The system of claim 24 , wherein a sequence of activation within the first region is rotational and includes outward spread to the second region.
29. The system of claim 24 , wherein a sequence of activation is spatially located within the first region between the beats.
30. The system of claim 24 , wherein a sequence of activation moves spatially within the first region between the beats.
31. The system of claim 24 , wherein the first region has an area of less than 5 cm 2 .
32. The system of claim 24 , further comprising determining stability of the repeating activation by computing indexes of centrifugal activation within the first region.
33. The system of claim 32 , wherein the indexes of centrifugal activation includes one or more of vectors of activation, linear velocity, correlation analysis and spatial maps showing progressive spatial activation.
34. The system of claim 33 , wherein the indexes of centrifugal activation are displayed on a map of sensor locations indicating higher and lower indexes of centrifugal activation.
35. The system of claim 24 , further comprising determining persistence of the repeating activation by computing indexes of rotational activation within the first region.
36. The system of claim 35 , wherein the indexes of rotational activation include one or more of progression over time in angles of rotational arc of activation sequence, sectors of rotation, traversal of a rotational perimeter, angular velocity and phase mapping.
37. The system of claim 36 , wherein the indexes of rotational activation are displayed on a map of sensor locations indicating higher and lower indexes of rotational activation.
38. The system of claim 24 , further comprising classifying the first region as a driver if the first region controls the second region for a plurality of the beats.
39. The system of claim 24 , wherein the first region is a driver of the source.
40. The system of claim 39 , wherein the driver is an internal driver of the source.
41. The system of claim 39 , wherein the source comprises a focal source and the driver is a core of the focal source.
42. The system of claim 39 , wherein the source comprises a rotational source and the driver is a core of the rotational source.
43. The system of claim 24 , wherein the source is a focal source.
44. The system of claim 43 , wherein the first region is a core of the focal source.
45. The system of claim 24 , wherein the source is a rotational source.
46. The system of claim 45 , wherein the first region is a core of the rotational source.