Cardiac Isolation Detection via Multi-Channel Electrogram Segmentation

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Solution Overview

Problem

Current methods for determining cardiac isolation status during atrial fibrillation rely on a reference CS-potential, which is unreliable, and require multiple catheters, making it challenging to assess isolation status in the presence of far field interference without prior knowledge of local activation potentials.

Innovation Solution

A method analyzing multiple channels of an intracardiac electrogram using an activation search algorithm with analysis windows of at least 400 ms in different channels, allowing for the identification and classification of local activation potentials without relying on a reference CS-potential, and incorporating interference signal removal and quality control to enhance accuracy.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If a reference CS-potential is used to detect local activation potentials, then the method is simple and reliable in sinus rhythm, but the method becomes unreliable during atrial fibrillation when the time relation between CS-potential and local activations is broken

Engineering Contradiction:

Improvereliability of local activation potential detectionVSAvoidadaptability to different rhythm conditions

Core Design Contradiction:

ReliabilityVSAdaptability or versatility

Solution Approach 1:

The method divides the electrogram signal into multiple analysis windows (at least 400 ms each) and processes each window independently across different channels. This segmentation allows the system to identify local activation potentials without relying on a single reference CS-potential timing, making the detection reliable during atrial fibrillation when the traditional time relation between CS-potential and local activations is broken.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The patent introduces an intermediary activation search algorithm that acts as a mediator between the raw electrogram signal and the local activation potential identification. This algorithm analyzes multiple channels independently and identifies potential activation events without requiring a reference CS-potential, thereby maintaining reliability during arrhythmias.

Inventive Principle:

Principle #24Intermediary (Mediator)

2Measurement precision

If multiple catheters are used to measure CS-potential and local activations, then the measurement accuracy is improved, but the device complexity and procedure difficulty increase

Engineering Contradiction:

Improveprecision of cardiac isolation status determinationVSAvoidnumber of catheters required

Core Design Contradiction:

Measurement precisionVSDevice complexity

Solution Approach 1:

The patent makes the single catheter universal by enabling it to perform multiple functions: measuring both the local activation potentials at the measurement location and detecting the CS-potential for reference. The control system processes signals from multiple channels of the single catheter to identify local activation potentials, eliminating the need for a separate CS-catheter while maintaining measurement precision.

Inventive Principle:

Principle #6Universality (Multi-functionality)

Solution Approach 2:

The single catheter system serves itself by using its own multiple channels to provide both the local activation signals and the reference CS-potential. The control system automatically identifies and uses appropriate channels for each function, allowing the catheter to determine cardiac isolation status independently without external reference equipment.

Inventive Principle:

Principle #25Self-service

3Device complexity

If a single catheter is used to simplify the procedure, then the device complexity is reduced, but the ability to accurately detect local activation potentials in the presence of far field interference is compromised

Engineering Contradiction:

Improvenumber of cathetersVSAvoidaccuracy of local activation potential detection

Core Design Contradiction:

Device complexityVSMeasurement precision

Solution Approach 1:

The method segments the electrogram into multiple analysis windows and processes different channels independently. This segmentation allows the control system to distinguish local activation potentials from far field interference by analyzing the temporal and spatial characteristics of signals across multiple channels, maintaining measurement precision despite using a single catheter.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The patent applies local quality analysis by examining the specific characteristics of signals in different channels and time windows. The control system identifies local activation potentials based on their unique morphological features and temporal patterns, separating them from far field interference through localized signal analysis rather than global processing.

Inventive Principle:

Principle #3Local quality

Data Source

PatentUS20240350065A1Method for detecting a cardiac isolation status of a measurement location in the presence of far field interference

Publication Date: 2024.10.24 CATHVISION APS

AI summary

The invention concerns a method for determining a cardiac isolation status of a measurement location (1) in the presence of far field interference by analysing a multi-channel intracardiac electrogram (2) of the measurement location (1) via a control system (3), wherein in an identification routine (9) the control system (3) applies an activation search algorithm to analysis windows (10) of at least 400 ms in at least two different channels (11) of the intracardiac electrogram (2), wherein the activation search algorithm identifies windows (W) of local activation potentials (12) inside of the analysis windows (10), wherein in a classification routine (15) the control system (3) analyses the local activation potentials (12) to determine the cardiac isolation status of the measurement location (1).