IP Library Granted Patent US 10,092,196
Granted Patent B2
US 10,092,196 · App. 15/261,013 · Granted Oct 9, 2018

Method for analysis of complex rhythm disorders

Inventors: Sanjiv M. Narayan (La Jolla, CA); Wouter-Jan Rappel (San Diego, CA)
Assignees: The Regents of the University of California; The United States of America as Represented by the Department of Veterans Affairs
A61B5/02405A61B5/02A61B5/0245A61B5/02416A61B5/04A61B5/042A61B5/0402A61B5/044A61B5/046A61B5/04007A61B5/04011A61B5/04012A61B5/0422A61B5/0452A61B5/0464A61B5/04525A61B5/4836A61B5/6857A61B5/6858A61B5/6859A61B5/7203A61B5/7405A61B7/04A61B8/0883A61B18/1206A61B18/1492A61B5/726A61B2018/00214A61B2018/00351A61B2018/00357A61B2018/00375A61B2018/00839A61B2018/1435
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Quick Facts
Patent No.
US 10,092,196
App. No.
15/261,013
Granted
Oct 9, 2018
Kind
B2
Abstract

A method of analyzing a complex rhythm disorder in a human heart includes accessing signals from a plurality of sensors disposed spatially in relation to the heart, where the signals are associated with activations of the heart, and identifying a region of the heart having an activation trail that is rotational or radially emanating, where the activation trail is indicative of the complex rhythm disorder and is based on activation times associated with the activations of the heart.

Claims (43)

1. A computer-implemented method for identifying a cause of a heart rhythm disorder, the method comprising:

computing diagnostic values from data received from a plurality of sensor locations corresponding to a plurality of points within a cardiac anatomy;

comparing the diagnostic values for each of the plurality of points within the cardiac anatomy to a reference comprising previously-stored diagnostic values to assign probability values indicating a likelihood that the cause of the cardiac rhythm disorder is associated with the points, the likelihood being associated with a rate of activation at each point;

generating a probability map based on the probability values in relation to the plurality of points within the cardiac anatomy; and

generating a clinical representation based on the probability map indicating the likelihood that one or more points within the cardiac anatomy corresponds to the cause of the heart rhythm disorder.

2. The method of claim 1 , wherein the probability map represents a map of one or more causes of a complex heart rhythm disorder.

3. The method of claim 2 , wherein the diagnostic values are one or more of phase singularities, an activation trail, phase values, and an activation trail surrogate.

4. The method of claim 3 , wherein the diagnostic values are phase values, and computing diagnostic values comprises generating a phase map to identify phase singularities.

5. The method of claim 4 , wherein locations of the phase singularities within the phase map indicate that a potential source of a complex heart rhythm disorder is located at a corresponding point of the cardiac anatomy.

6. The method of claim 3 , wherein the diagnostic values are an activation trail that represents one or more of a rotor, a focal source or another source of the complex heart rhythm disorder.

7. The method of claim 3 , wherein the activation trail surrogate comprises one or a combination of: sites of rapid rate during the rhythm disorder, presence of more regular sites surrounded by less regular sites, presence of stable beat-to-beat configuration for successive signals as opposed to varying signal configurations, signals having a relatively low amplitude, signals that are prolonged for each activation, proximity to anatomic features known to be associated with rhythm disorders, and vectorial analysis of an ECG for regions of regularity and rate.

8. The method of claim 1 , wherein the plurality of points is derived from one or more of an electrocardiogram, magnetocardiogram, echocardiogram, ultrasound, electromagnetic radiation, sound waves, microwaves, and electrical impedance changes.

9. The method of claim 1 , wherein the probability value is assigned a higher relative value for locations: at which core regions sustain for longer periods of time, at which the rate of activation is faster, at which the rate of activation is more organized, that activate surrounding tissue in a 1:1 fashion, and activate larger regions of tissue in phase, when fewer concurrent sources are identified, for sources disposed near known regions of high likelihood for rhythm disorders, for sources with less migration over time, or for rotor versus focal beat types of source.

10. The method of claim 1 , wherein the previously-stored diagnostic values comprise one or more of computed diagnostic values from existing patient-acquired data, computed diagnostic values from a different patient's prior-acquired data, the different patient having similar clinical characteristics, stored signals from a database, and computational estimates representing a cardiac information signal.

11. A non-transitory computer readable medium comprising instructions which, when executed by a computing device, cause the computing device to perform:

computing diagnostic values from data received from a plurality of sensor locations corresponding to a plurality of points within a cardiac anatomy;

comparing the diagnostic values for each of the plurality of points within the cardiac anatomy to a reference comprising previously-stored diagnostic values to assign probability values indicating a likelihood that the cause of the cardiac rhythm disorder is associated with the points, the likelihood being associated with a rate of activation at each point;

generating a probability map based on the probability values in relation to the plurality of points within the cardiac anatomy; and

generating a clinical representation based on the probability map indicating the likelihood that one or more points within the cardiac anatomy corresponds to the cause of the heart rhythm disorder.

12. The computer readable medium of claim 11 , wherein the probability map represents a map of a complex heart rhythm disorder.

13. The computer readable medium of claim 12 , wherein the diagnostic values are one or more of phase singularities, an activation trail, phase values, and an activation trail surrogate.

14. The computer readable medium of claim 13 , wherein the diagnostic values are phase values, and computing diagnostic values comprises generating a phase map to identify phase singularities.

15. The computer readable medium of claim 14 , wherein locations of the phase singularities within the phase map indicate that a potential source of a complex heart rhythm disorder is located at a corresponding point of the cardiac anatomy.

16. The computer readable medium of claim 13 , wherein the diagnostic values are an activation trail that represents one or more of a rotor, a focal source or another source of the complex heart rhythm disorder.

17. The method of claim 13 , wherein the activation trail surrogate comprises one or a combination of: sites of rapid rate during the rhythm disorder, presence of more regular sites surrounded by less regular sites, presence of stable beat-to-beat configuration for successive signals as opposed to varying signal configurations, signals having a relatively low amplitude, signals that are prolonged for each activation, proximity to anatomic features known to be associated with rhythm disorders, and vectorial analysis of an ECG for regions of regularity and rate.

18. The method of claim 12 , wherein the probability value is assigned a higher relative value for locations: at which core regions sustain for longer periods of time, at which the rate of activation is faster, at which the rate of activation is more organized, that activate surrounding tissue in a 1:1 fashion, and activate larger regions of tissue in phase, when fewer concurrent sources are identified, for sources disposed near known regions of high likelihood for rhythm disorders, for sources with less migration over time, or for rotor versus focal beat types of source.

19. The method of claim 12 , wherein the previously-stored diagnostic values comprise one or more of computed diagnostic values from existing patient-acquired data, computed diagnostic values from a different patient's prior-acquired data, the different patient having similar clinical characteristics, stored signals from a database, and computational estimates representing a cardiac information signal.

20. The computer readable medium of claim 11 , wherein said plurality of points is derived from one or more of an electrocardiogram, magnetocardiogram, echocardiogram, ultrasound, electromagnetic radiation, sound waves, microwaves, and electrical impedance changes.

21. A method for generating a map of a complex heart rhythm disorder, the method comprising:

receiving in a computer processor data associated with cardiac information signals generated by a plurality of sensors disposed at multiple sensor locations;

processing the data within the computer processor to:

compute diagnostic values from data received from a plurality of sensor locations corresponding to a plurality of points within a cardiac anatomy;

compare the diagnostic values for each of the plurality of points within the cardiac anatomy to a reference comprising previously-stored diagnostic values to assign probability values indicating a likelihood that the cause of the cardiac rhythm disorder is associated with the points, the likelihood being associated with a rate of activation at each point;

generate a probability map based on the probability values in relation to the plurality of points within the cardiac anatomy; and

generate a clinical representation based on the probability map indicating the likelihood that one or more points within the cardiac anatomy corresponds to the cause of the heart rhythm disorder.

22. The method of claim 21 , wherein the diagnostic values are one or more of phase singularities, an activation trail, phase values, and an activation trail surrogate.

23. The method of claim 22 , wherein the diagnostic values are phase values, and computing diagnostic values comprises generating a phase map to identify phase singularities.

24. The method of claim 23 , wherein locations of the phase singularities within the phase map indicate that a potential source of a complex heart rhythm disorder is located at a corresponding point of the cardiac anatomy.

25. The method of claim 22 , wherein the diagnostic values correspond to an activation trail that one or more of a rotor, a focal source or another source of the complex heart rhythm disorder.

26. The method of claim 22 , wherein the activation trail surrogate comprises one or a combination of: sites of rapid rate during the rhythm disorder, presence of more regular sites surrounded by less regular sites, presence of stable beat-to-beat configuration for successive signals as opposed to varying signal configurations, signals having a relatively low amplitude, signals that are prolonged for each activation, proximity to anatomic features known to be associated with rhythm disorders, and vectorial analysis of an ECG for regions of regularity and rate.

27. The method of claim 21 , wherein the plurality of points is derived from one or more of an electrocardiogram, magnetocardiogram, echocardiogram, ultrasound, electromagnetic radiation, sound waves, microwaves, and electrical impedance changes.

28. The method of claim 21 , wherein the probability value is assigned a higher relative value for locations: at which core regions sustain for longer periods of time, at which the rate of activation is faster, at which the rate of activation is more organized, that activate surrounding tissue in a 1:1 fashion, and activate larger regions of tissue in phase, when fewer concurrent sources are identified, for sources disposed near known regions of high likelihood for rhythm disorders, for sources with less migration over time, or for rotor versus focal beat types of source.

29. The method of claim 21 , wherein the previously-stored diagnostic values comprise one or more of computed diagnostic values from existing patient-acquired data, computed diagnostic values from a different patient's prior-acquired data, the different patient having similar clinical characteristics, stored signals from a database, and computational estimates representing a cardiac information signal.

Assignments (2)
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Sep 6, 2018
From: THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
To: THE REGENTS OF THE UNIVERSITY OF CALIFORNIA; THE UNITED STATES OF AMERICA AS REPRESENTED BY THE DEPARTMENT OF VETERANS AFFAIRS
Reel/Frame 046808/0108 →
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Jun 20, 2018
From: NARAYAN, SANJIV; RAPPEL, WOUTER-JAN
To: THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Reel/Frame 046147/0359 →
Continuity (6)
Continuation 14473456 · Aug 29, 2014
Continuation 14062848 · Oct 24, 2013
Continuation 13964604 · Aug 12, 2013
Continuation 12576809 · Oct 9, 2009
Provisional Application 61195866 · Oct 9, 2008
Related Publication 20160374571A1 · Dec 29, 2016