EP-4538984-B1 - ANALYZING MULTI-ELECTRODE CATHETER SIGNALS TO DETERMINE ELECTROPHYSIOLOGICAL (EP) WAVE PROPAGATION VECTOR

Inventors

• GOVARI, ASSAF
• Gliner, Vadim
• PALTI, Yair

Dates

Publication Date

20260513

Application Date

20210630

Claims (10)

1. A system (10), comprising: an interface (34) configured to receive (i) multiple electrophysiological (EP) signals acquired by multiple electrodes (16, 116) of a multi-electrode catheter (14, 114) that are in contact with tissue (19, 50) in a region of a cardiac chamber, and (ii) respective tissue locations at which the electrodes acquired the EP signals; and a processor (22), which is configured to: divide the region into two sections with a virtual plane containing a longitudinal axis (L-L) of the catheter; using the EP signals acquired by the electrodes, calculate local activation time (LAT) values for the respective tissue locations, and find a first section of the two sections having a smaller average LAT value, and a second section of the two sections having a higher average value; determine a first representative location in the first section, and a second representative location in the second section; calculate between the first and second representative locations a propagation vector indicative of propagation of an EP wave that has generated the EP signals; and present the propagation vector to a user;
2. The system according to claim 1, wherein the processor is configured to present the propagation vector by overlaying an arrow on a map of the cardiac chamber.
3. The system according to claim 2, wherein the processor is configured to use a graphical property of the arrow to indicate a speed of the EP wave between the first and second representative locations.
4. The system according to claim 3, wherein the graphical property of the arrow comprises one or more of a color, a length, a width, or a graphical pattern.
5. The system according to any preceding claim, wherein the processor is further configured to, in case a reentering EP wave is detected, calculate an additional propagation vector for the reentering EP wave.
6. The system according to claim 5, wherein the processor is further configured to overlay the additional arrow on a map of the cardiac chamber.
7. The system according to claim 6, wherein the processor is configured to use a graphical property of the additional arrow to indicate at least one of a LAT difference and a cycle time of reentry of the reentering EP wave.
8. The system according to any preceding claim, wherein the processor is configured to determine the first representative location by determining a tissue location having a smallest LAT value among the tissue locations in the first section, and to determine the second representative location by determining a tissue location having a largest LAT value among the tissue locations in the second section.
9. The system according to any one of claim 1 to claim 7, wherein the processor is configured to determine the first representative location by calculating a first center-of-mass of the tissue locations in the first section, and to determine the second representative location by calculating a second center-of-mass of the tissue locations in the second section.
10. The system according to claim 9, wherein the processor is configured to calculate the first center-of-mass by calculating a first weighted average of the tissue locations in the first section using two or more of the LAT values of the first section as weights, and calculate the second center-of-mass by calculating a second weighted average of the tissue locations in the second section using two or more of the LAT values of the second section as weights.

Description

FIELD OF THE INVENTION The present invention relates generally to electrophysiological mapping, and particularly to cardiac electrophysiological mapping. BACKGROUND OF THE INVENTION Invasive cardiac techniques for mapping electrophysiological (EP) properties of cardiac tissue were previously proposed in the patent literature. For example, U.S. Patent Application Publication 2017/0311833 describes an efficient system for diagnosing arrhythmias and directing catheter therapies that may allow for measuring, classifying, analyzing, and mapping spatial EP patterns within a body. The efficient system may further guide arrhythmia therapy and update maps as treatment is delivered. The efficient system may use a medical device having a high density of sensors with a known spatial configuration for collecting EP data and positioning data. Further, the efficient system may also use an electronic control system for computing and providing the user with a variety of metrics, derivative metrics, high definition (HD) maps, HD composite maps, and general visual aids for association with a geometrical anatomical model shown on a display device. As another example, U.S. Patent Application Publication 2017/0042449 describes a system for determining EP data, the system comprising an electronic control unit configured to acquire electrophysiology signals from a plurality of electrodes of one or more catheters, select at least one clique of electrodes from the plurality of electrodes to determine a plurality of local E field data points, determine the location and orientation of the plurality of electrodes, process the electrophysiology signals from the at least one clique from a full set of bi-pole sub-cliques to derive the local E field data points associated with the at least one clique of electrodes, derive at least one orientation independent signal from the at least one clique of electrodes from the information content corresponding to weighted parts of electrogram signals, and display or output catheter-orientation-independent EP information to a user or process. U.S. Patent Application Publication 2018/0153426 describes method and system for mapping an anatomical structure, that include sensing activation signals of intrinsic physiological activity with a plurality of mapping electrodes disposed in or near the anatomical structure, each of the plurality of mapping electrodes having an electrode location. A vector field map which represents a direction of propagation of the activation signals at each electrode location is generated to identify a signature pattern and a location in the vector field map according to at least one vector field template. A target location of the identified signature pattern is identified according to a corresponding electrode location. Document EP 3639740 A1 discloses a cardiac mapping system comprising a medical examination device to capture data over time at multiple sample locations over a surface of at least one chamber of a heart. The device includes a display screen and processing circuitry configured to: process the captured data to determine a description of a propagation of activation wavefronts associated with a plurality of activation times over the surface of the at least one chamber of the heart, calculate a plurality of activation wavefront propagation path traces wherein each one activation wavefront propagation path trace of the plurality of activation wavefront propagation path traces describes a point on one activation wavefront of the activation wavefronts being propagated over the surface of the at least one chamber of the heart according to an advancement of the one activation wavefront such that the plurality of activation wavefront propagation path traces describe the propagation of a plurality of different points according to corresponding ones of the activation wavefronts. The processor also prepares a visualization showing the plurality of activation wavefront propagation path traces on a representation of the at least one chamber of the heart; and render the visualization to the display screen. Document US 2017/0055864 A1 discloses a map of cardiac activation wavefronts that can be created from a plurality of mesh nodes, each of which is assigned a conduction velocity vector. Directed edges are defined to interconnect the mesh nodes, and weights are assigned to the directed edges, thereby creating a weighted directed conduction velocity graph. A user can select one or more points within the weighted directed conduction velocity graph (which do not necessarily correspond to nodes), and one or more cardiac activation wavefronts passing through these points can be identified using the weighted directed conduction velocity graph. The cardiac activation wavefronts can then be displayed on a graphical representation of the cardiac geometry SUMMARY OF THE INVENTION The invention is defined by appended claim 1. Embodiments are defined in the dependent claims. In some embodim