Cardiac Activation Detection Using Electrogram Energy and Max Flow
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Solution Overview
Problem
Current electrocardiography systems face challenges in accurately detecting cardiac activation times due to artifacts from far-field cardiac electrical activity, particularly when multiple cardiac activations occur within a selected time window, leading to incorrect detection of local activation times in electrogram maps.
Innovation Solution
The system employs a neighborhood of electrograms, including bipole and unipole electrograms, and surface electrocardiograms, with spatial and time constraints to detect cardiac activation times, utilizing a maximum flow solution on a constructed graph to mitigate far-field effects and ensure accurate activation time determination.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If traditional electrogram detection methods are used, then the system is simple to operate, but the detection precision deteriorates due to far-field artifacts and multiple activations within time window
Solution Approach 1:
The patent segments the detection process into multiple stages: (1) dividing electrograms into overlapping time windows, (2) segmenting the neighborhood into different spatial zones (near-field vs. far-field electrodes), and (3)分段 processing through multiple detection passes. This segmentation allows the system to handle far-field artifacts and multiple activations by treating them as separate detectable events rather than a single complex signal, thereby improving detection precision without overwhelming system complexity.
Solution Approach 2:
The patent introduces an intermediary energy metric that quantifies the strength of cardiac activations. This energy metric serves as a mediator between the raw electrogram signals and the final activation time detection, allowing the system to distinguish between near-field and far-field activations objectively. The energy calculation acts as an intermediary layer that filters out far-field artifacts while preserving true cardiac activations, improving precision without requiring complex manual analysis.
2Reliability
If multiple cardiac activations are detected within a time window, then the detection sensitivity increases, but the reliability deteriorates due to incorrect identification of local activation times
Solution Approach 1:
The patent applies local quality by differentiating between near-field electrodes (which provide high-quality local activation information) and far-field electrodes (which provide lower-quality remote activation information). The detection algorithm weights contributions from different electrodes based on their spatial relationship to the measurement point, giving higher reliability to near-field signals and lower weight to far-field signals. This local quality differentiation allows the system to reliably detect multiple activations while maintaining accuracy in identifying true local activation times.
Solution Approach 2:
The patent implements a dynamic detection process that adapts to the number and timing of activations within each time window. The system dynamically adjusts the analysis based on detected activation patterns, using a two-pass approach where the first pass identifies potential activations and the second pass refines the detection. This dynamic adaptation allows the system to maintain high reliability whether one or multiple activations occur within the time window, preventing incorrect identification of local activation times.
Data Source
AI summary
The present disclosure provides systems and methods for detecting cardiac activation times of a patient. A system includes a data acquisition system and a processor communicatively coupled thereto. The data acquisition system is configured to detect a plurality of electrograms generated at a plurality of respective electrodes coupled to the patient. The processor is configured to receive the plurality of electrograms from the data acquisition system. The processor is further configured to compute respective energies of the plurality of electrograms. The processor is further configured to detect a cardiac activation time for a first electrogram among the plurality of electrograms based on the respective energy of the first electrogram and the respective energy of a second electrogram that neighbors the first electrogram.