IP Library › Granted Patent US 10,918,863

Granted Patent B2

US 10,918,863 · App. 16/047,625 · Granted Feb 16, 2021

Generating activation times

Inventors: Subham Ghosh (Blaine, MN); Karen J. Kleckner (Blaine, MN)

Assignee: Medtronic, Inc.

A61N1/3603 A61B5/0452 A61B5/04085 A61B5/0531 A61N1/0484 A61N1/3625 A61B5/024 A61B5/02405 A61B5/0456 A61B5/0464 A61B5/0468 A61B5/0472 A61B5/4836 A61B5/6823 A61B5/6831 A61B2562/046 A61N1/362

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Quick Facts

Patent No.: US 10,918,863
App. No.: 16/047,625
Granted: Feb 16, 2021
Kind: B2

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Abstract

Systems and methods are described herein for generating surrogate cardiac electrical activation times from electrical activity monitored by a plurality of external electrodes. Surrogate cardiac electrical activation times that should be corrected may be identified, or determined, according to one or more metrics, and then such surrogate cardiac electrical activation times may be corrected according to various criterion.

Claims (153)

1. A system for use in cardiac evaluation comprising:

electrode apparatus comprising a plurality of external electrodes to be located proximate a patient's skin; and

computing apparatus comprising one or more processors, the computing apparatus coupled to the electrode apparatus and configured to:

monitor electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle,

generate a surrogate cardiac electrical activation time based on the monitored electrical activity using baseline criterion,

determine whether to correct the surrogate cardiac electrical activation time, wherein determining whether to correct the surrogate cardiac electrical activation time comprises determining to correct the surrogate cardiac electrical activation time with late correction if the surrogate cardiac electrical activation time is greater than or equal to a selected late correction threshold, and

regenerate the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time, wherein the correction criterion comprises at least one of early correction criterion and late correction criterion, wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the late correction criterion in response to determination to correct the surrogate cardiac electrical activation time with late correction.

2. The system of claim 1 , wherein monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle comprises monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac depolarization cycle.

3. The system of claim 1 , wherein the baseline criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to the time at which the maximum negative slope occurs within the electrical activity over the cardiac cycle.

4. The system of claim 1 , wherein the selected late correction threshold is a percentage of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle to an offset of the QRS complex, wherein the percentage is greater than or equal to 75%.

5. The system of claim 1 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with early correction if the surrogate cardiac electrical activation time is less than or equal to a selected early correction threshold,

wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time further comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the early correction criterion in response to determination to correct the surrogate cardiac electrical activation time with early correction.

6. The system of claim 5 , wherein the selected early correction threshold is a percentage of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle to an offset of the QRS complex, wherein the percentage is less than or equal to 25%.

7. The system of claim 1 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with late correction if:

right ventricular cardiac pacing or no cardiac pacing is being delivered to the patient;

a minimum value of the electrical activity over the cardiac cycle occurs within a selected minimum time window of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle to an offset of the QRS complex; and

a maximum value of the electrical activity over the cardiac cycle occurs within a selected maximum time window of the QRS complex time.

8. The system of claim 7 , wherein the selected minimum time window extends between 15% and 50% of the QRS complex time, and the selected maximum time window extends between 50% and 85% of the QRS complex time.

9. The system of claim 7 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with late correction further if:

a magnitude of the maximum value of the electrical activity over the cardiac cycle relative a baseline value of the electrical activity is greater than a maximum threshold;

a magnitude of the minimum value of the electrical activity over the cardiac cycle relative the baseline value of the electrical activity is greater than a minimum threshold; and

a difference between the maximum value of the electrical activity and the minimum value of the electrical activity over the cardiac cycle is greater than a peak-to-peak threshold.

10. The system of claim 1 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with early correction if:

left ventricular cardiac pacing or biventricular cardiac pacing is being delivered to the patient;

a difference between a maximum value of the electrical activity and a minimum value of the electrical activity over the cardiac cycle is less than a peak-to-peak threshold,

a ratio of a magnitude of the minimum value of the electrical activity relative to a baseline value of the electrical activity over the cardiac cycle to a magnitude of the maximum value of the electrical activity relative to the baseline value of the electrical activity over the cardiac cycle is greater than a ratio threshold;

the magnitude of the maximum value of the electrical activity relative to the baseline value over the cardiac cycle is less than a maximum threshold; and

the minimum value occurs before the maximum value within the electrical activity over the cardiac cycle,

11. The system of claim 10 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with early correction further if:

the minimum value does not occur within a selected onset time window of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle; and

the maximum value does not occur within a selected offset time window of the QRS complex time extending to an offset of the QRS complex.

12. The system of claim 1 , wherein the correction criterion further comprises correlation criterion, wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with correlation correction if:

a morphology of the electrical activity over the cardiac cycle monitored by a selected electrode is similar to the morphology of electrical activity over the cardiac cycle monitored by one or more electrodes located proximate to the selected electrode; and

the surrogate cardiac electrical activation time generated from the electrical activity over the cardiac cycle monitored by the selected electrode is outside of a selected range from a median of the surrogate cardiac electrical activation times generated from the electrical activity monitored by the one or more electrodes located proximate to the selected electrode,

wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time further comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the correlation correction criterion in response to determination to correct the surrogate cardiac electrical activation time with correlation correction.

13. The system of claim 12 , wherein the correlation correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to a median end time point of the surrogate cardiac electrical activation times generated from the electrical activity monitored by the one or more electrodes located proximate to the selected electrode when regenerating the surrogate cardiac electrical activation time using correlation correction.

14. The system of claim 1 , wherein the late correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point is set to when the electrical activity is less than half of a maximum value of the electrical activity after occurrence of the maximum value of the electrical activity when regenerating the surrogate cardiac electrical activation time using late correction.

15. The system of claim 1 , wherein the early correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point is set to when the electrical activity is less than half of a minimum value of the electrical activity before occurrence of the minimum value of the electrical activity when regenerating the surrogate cardiac electrical activation time using early correction.

16. A method for use in cardiac evaluation comprising:

monitoring electrical activity from a patient's skin using a plurality of external electrodes to generate over a cardiac cycle;

generating a surrogate cardiac electrical activation time based on the monitored electrical activity using baseline criterion;

determining whether to correct the surrogate cardiac electrical activation time, wherein determining whether to correct the surrogate cardiac electrical activation time comprises determining to correct the surrogate cardiac electrical activation time with late correction if the surrogate cardiac electrical activation time is greater than or equal to a selected late correction threshold; and

regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time, wherein the correction criterion comprises at least one of early correction criterion and late correction criterion, wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the late correction criterion in response to determination to correct the surrogate cardiac electrical activation time with late correction.

17. The method of claim 16 , wherein monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle comprises monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac depolarization cycle.

18. The method of claim 16 , wherein the baseline criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to the time at which the maximum negative slope occurs within the electrical activity over the cardiac cycle.

19. The method of claim 16 , wherein the selected late correction threshold is a percentage of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle to an offset of the QRS complex, wherein the percentage is greater than or equal to 75%.

20. The method of claim 16 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with early correction if the surrogate cardiac electrical activation time is less than or equal to a selected early correction threshold,

21. The method of claim 20 , wherein the selected early correction threshold is a percentage of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle to an offset of the QRS complex, wherein the percentage is less than or equal to 25%.

22. The method of claim 16 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with late correction if:

right ventricular cardiac pacing or no cardiac pacing is being delivered to the patient;

a maximum value of the electrical activity over the cardiac cycle occurs within a selected maximum time window of the QRS complex time.

23. The method of claim 22 , wherein the selected minimum time window extends between 15% and 50% of the QRS complex time, and the selected maximum time window extends between 50% and 85% of the QRS complex time.

24. The method of claim 22 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with late correction further if:

a magnitude of the maximum value of the electrical activity over the cardiac cycle relative a baseline value of the electrical activity is greater than a maximum threshold;

a magnitude of the minimum value of the electrical activity over the cardiac cycle relative the baseline value of the electrical activity is greater than a minimum threshold; and

a difference between the maximum value of the electrical activity and the minimum value of the electrical activity over the cardiac cycle is greater than a peak-to-peak threshold.

25. The method of claim 16 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with early correction if:

left ventricular cardiac pacing or biventricular cardiac pacing is being delivered to the patient;

a difference between a maximum value of the electrical activity and a minimum value of the electrical activity over the cardiac cycle is less than a peak-to-peak threshold,

the magnitude of the maximum value of the electrical activity relative to the baseline value over the cardiac cycle is less than a maximum threshold; and

the minimum value occurs before the maximum value within the electrical activity over the cardiac cycle,

26. The method of claim 25 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with early correction further if:

the minimum value does not occur within a selected onset time window of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle; and

the maximum value does not occur within a selected offset time window of the QRS complex time extending to an offset of the QRS complex.

27. The method of claim 16 , wherein the correction criterion further comprises correlation criterion, wherein determining whether to correct the surrogate cardiac electrical activation time comprises determining to correct the surrogate cardiac electrical activation time with correlation correction if:

wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the correlation correction criterion in response to determination to correct the surrogate cardiac electrical activation time with correlation correction.

28. The method of claim 27 , wherein the correlation correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to a median end time point of the surrogate cardiac electrical activation times generated from the electrical activity monitored by the one or more electrodes located proximate to the selected electrode when regenerating the surrogate cardiac electrical activation time using correlation correction.

29. The method of claim 16 , wherein the late correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point is set to when the electrical activity is less than half of a maximum value of the electrical activity after occurrence of the maximum value of the electrical activity when regenerating the surrogate cardiac electrical activation time using late correction.

30. The method of claim 16 , wherein the early correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point is set to when the electrical activity is less than half of a minimum value of the electrical activity before occurrence of the minimum value of the electrical activity when regenerating the surrogate cardiac electrical activation time using early correction.

31. A system for use in cardiac evaluation comprising:

electrode apparatus comprising a plurality of external electrodes to be located proximate a patient's skin; and

computing apparatus comprising one or more processors, the computing apparatus coupled to the electrode apparatus and configured to:

monitor electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle,

generate a surrogate cardiac electrical activation time based on the monitored electrical activity using baseline criterion,

determine whether to correct the surrogate cardiac electrical activation time, wherein determining whether to correct the surrogate cardiac electrical activation time comprises determining to correct the surrogate cardiac electrical activation time with early correction if the surrogate cardiac electrical activation time is less than or equal to a selected early correction threshold, and

regenerate the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time, wherein the correction criterion comprises at least one of early correction criterion and late correction criterion, wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the early correction criterion in response to determination to correct the surrogate cardiac electrical activation time with early correction.

32. The system of claim 31 , wherein monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle comprises monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac depolarization cycle.

33. The system of claim 31 , wherein the baseline criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to the time at which the maximum negative slope occurs within the electrical activity over the cardiac cycle.

34. The system of claim 31 , wherein the selected early correction threshold is a percentage of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle to an offset of the QRS complex, wherein the percentage is less than or equal to 25%.

35. The system of claim 31 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with late correction if:

right ventricular cardiac pacing or no cardiac pacing is being delivered to the patient;

a maximum value of the electrical activity over the cardiac cycle occurs within a selected maximum time window of the QRS complex time,

wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time further comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the late correction criterion in response to determination to correct the surrogate cardiac electrical activation time with late correction.

36. The system of claim 31 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with early correction if:

left ventricular cardiac pacing or biventricular cardiac pacing is being delivered to the patient;

a difference between a maximum value of the electrical activity and a minimum value of the electrical activity over the cardiac cycle is less than a peak-to-peak threshold,

the magnitude of the maximum value of the electrical activity relative to the baseline value over the cardiac cycle is less than a maximum threshold; and

the minimum value occurs before the maximum value within the electrical activity over the cardiac cycle.

37. The system of claim 31 , wherein the correction criterion further comprises correlation criterion, wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with correlation correction if:

wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the correlation correction criterion in response to determination to correct the surrogate cardiac electrical activation time with correlation correction.

38. The system of claim 37 , wherein the correlation correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to a median end time point of the surrogate cardiac electrical activation times generated from the electrical activity monitored by the one or more electrodes located proximate to the selected electrode when regenerating the surrogate cardiac electrical activation time using correlation correction.

39. The system of claim 31 , wherein the late correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point is set to when the electrical activity is less than half of a maximum value of the electrical activity after occurrence of the maximum value of the electrical activity when regenerating the surrogate cardiac electrical activation time using late correction.

40. The system of claim 31 , wherein the early correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point is set to when the electrical activity is less than half of a minimum value of the electrical activity before occurrence of the minimum value of the electrical activity when regenerating the surrogate cardiac electrical activation time using early correction.

41. A method for use in cardiac evaluation comprising:

monitoring electrical activity from a patient's skin using a plurality of external electrodes to generate over a cardiac cycle;

generating a surrogate cardiac electrical activation time based on the monitored electrical activity using baseline criterion;

determining whether to correct the surrogate cardiac electrical activation time, wherein determining whether to correct the surrogate cardiac electrical activation time comprises determining to correct the surrogate cardiac electrical activation time with early correction if the surrogate cardiac electrical activation time is less than or equal to a selected early correction threshold; and

regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time, wherein the correction criterion comprises at least one of early correction criterion and late correction criterion, wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the early correction criterion in response to determination to correct the surrogate cardiac electrical activation time with early correction.

42. The method of claim 41 , wherein monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle comprises monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac depolarization cycle.

43. The method of claim 41 , wherein the baseline criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to the time at which the maximum negative slope occurs within the electrical activity over the cardiac cycle.

44. The method of claim 41 , wherein the selected early correction threshold is a percentage of a QRS complex time extending from an onset of a QRS complex within the electrical activity over the cardiac cycle to an offset of the QRS complex, wherein the percentage is less than or equal to 25%.

45. The method of claim 41 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with late correction if:

right ventricular cardiac pacing or no cardiac pacing is being delivered to the patient;

a maximum value of the electrical activity over the cardiac cycle occurs within a selected maximum time window of the QRS complex time,

wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the late correction criterion in response to determination to correct the surrogate cardiac electrical activation time with late correction.

46. The method of claim 41 , wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with early correction if:

left ventricular cardiac pacing or biventricular cardiac pacing is being delivered to the patient;

a difference between a maximum value of the electrical activity and a minimum value of the electrical activity over the cardiac cycle is less than a peak-to-peak threshold,

the magnitude of the maximum value of the electrical activity relative to the baseline value over the cardiac cycle is less than a maximum threshold; and

the minimum value occurs before the maximum value within the electrical activity over the cardiac cycle,

wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the early correction criterion in response to determination to correct the surrogate cardiac electrical activation time with early correction.

47. The method of claim 41 , wherein the correction criterion further comprises correlation criterion, wherein determining whether to correct the surrogate cardiac electrical activation time further comprises determining to correct the surrogate cardiac electrical activation time with correlation correction if:

wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time further comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the correlation correction criterion in response to determination to correct the surrogate cardiac electrical activation time with correlation correction.

48. The method of claim 47 , wherein the correlation correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to a median end time point of the surrogate cardiac electrical activation times generated from the electrical activity monitored by the one or more electrodes located proximate to the selected electrode when regenerating the surrogate cardiac electrical activation time using correlation correction.

49. The method of claim 41 , wherein the late correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point is set to when the electrical activity is less than half of a maximum value of the electrical activity after occurrence of the maximum value of the electrical activity when regenerating the surrogate cardiac electrical activation time using late correction.

50. The method of claim 41 , wherein the early correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point is set to when the electrical activity is less than half of a minimum value of the electrical activity before occurrence of the minimum value of the electrical activity when regenerating the surrogate cardiac electrical activation time using early correction.

51. A system for use in cardiac evaluation comprising:

electrode apparatus comprising a plurality of external electrodes to be located proximate a patient's skin; and

computing apparatus comprising one or more processors, the computing apparatus coupled to the electrode apparatus and configured to:

monitor electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle,

generate a surrogate cardiac electrical activation time based on the monitored electrical activity using baseline criterion,

regenerate the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time, wherein the correction criterion comprises at least one of early correction criterion, late correction criterion, and correlation criterion, wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the correlation correction criterion in response to determination to correct the surrogate cardiac electrical activation time with correlation correction.

52. The system of claim 51 , wherein monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle comprises monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac depolarization cycle.

53. The system of claim 51 , wherein the baseline criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to the time at which the maximum negative slope occurs within the electrical activity over the cardiac cycle.

54. The system of claim 51 , wherein the correlation correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to a median end time point of the surrogate cardiac electrical activation times generated from the electrical activity monitored by the one or more electrodes located proximate to the selected electrode when regenerating the surrogate cardiac electrical activation time using correlation correction.

55. A method for use in cardiac evaluation comprising:

monitoring electrical activity from a patient's skin using a plurality of external electrodes to generate over a cardiac cycle;

generating a surrogate cardiac electrical activation time based on the monitored electrical activity using baseline criterion;

determining whether to correct the surrogate cardiac electrical activation time wherein determining whether to correct the surrogate cardiac electrical activation time comprises determining to correct the surrogate cardiac electrical activation time with correlation correction if:

regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time, wherein the correction criterion comprises at least one of early correction criterion, late correction criterion, and correlation criterion, wherein regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using correction criterion in response to a determination to correct the surrogate electrical activation time comprises regenerating the surrogate cardiac electrical activation time based on the monitored electrical activity using the correlation correction criterion in response to determination to correct the surrogate cardiac electrical activation time with correlation correction.

56. The method of claim 55 , wherein monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac cycle comprises monitoring electrical activity from the patient's skin using the plurality of external electrodes over a cardiac depolarization cycle.

57. The method of claim 55 , wherein the baseline criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to the time at which the maximum negative slope occurs within the electrical activity over the cardiac cycle.

58. The method of claim 55 , wherein the correlation correction criterion defines a start time point and an end time point for the surrogate cardiac electrical activation time, wherein the end time point corresponds to a median end time point of the surrogate cardiac electrical activation times generated from the electrical activity monitored by the one or more electrodes located proximate to the selected electrode when regenerating the surrogate cardiac electrical activation time using correlation correction.

Assignments (1)

ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Nov 20, 2018

From: GHOSH, SUBHAM; KLECKNER, KAREN J.

To: MEDTRONIC, INC.

Reel/Frame 047556/0789 →

Continuity (2)

Provisional Application 62538396 · Jul 28, 2017

Related Publication 20190030332A1 · Jan 31, 2019