Cardiac Activation Localization via BSPM Comparison
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Solution Overview
Problem
Current cardiac mapping techniques for localizing the site of origin of ventricular tachycardia (VT) are limited by subjective interpretation, imperfect accuracy, and spatial resolution, particularly in hemodynamically unstable or non-sustained tachycardias, which hampers effective catheter ablation procedures.
Innovation Solution
A computer-aided system that compares body surface potential maps (BSPMs) of interest to pre-defined templates for each heart segment, using interpolation and regression coefficients to identify the segment of origin, providing an objective measure of similarity and facilitating precise localization of the VT site during pacemapping.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional endocardial mapping techniques with fluoroscopy are used, then catheter localization and navigation can be achieved, but the technique is hampered by hemodynamic instability or non-sustained nature of some tachycardias and suffers from subjective interpretation limitations
Solution Approach 1:
The patent replaces the mechanical/visual fluoroscopy-based mapping system with an electrocardiographic signal-based system. Instead of relying on visual localization through fluoroscopy and subjective interpretation of activation sequences, the invention uses quantitative comparison of body surface potential maps (BSPMs) to objectively identify the site of origin, thereby eliminating the limitations of hemodynamic instability and non-sustained tachycardia detection
Solution Approach 2:
The patent creates a virtual copy or model of the electrical activation pattern by comparing the recorded BSPM during tachycardia with BSPMs recorded during normal sinus rhythm. This copying approach allows identification of the site of origin by finding where the tachycardia BSPM most closely matches the sinus rhythm BSPMs, providing objective and reproducible localization without requiring sustained tachycardia
2Ease of operation
If subjective interpretation of activation sequences is used, then mapping can be performed, but accuracy is limited by operator intuition and experience
Solution Approach 1:
The patent implements a feedback mechanism where the system quantitatively compares the BSPM during tachycardia with BSPMs from multiple potential sites during sinus rhythm, calculates similarity metrics, and provides objective feedback to identify the most likely site of origin. This eliminates subjective interpretation while maintaining ease of operation through automated computation
Solution Approach 2:
The patent transforms the mapping approach by changing from qualitative visual assessment to quantitative parameter comparison. Specifically, it uses parameters such as BSPM morphology, amplitude, and temporal characteristics to objectively determine the site of origin, thereby improving measurement precision while keeping the procedure simple through automated analysis
3Measurement precision
If more comprehensive mapping techniques are used to improve accuracy, then localization precision may improve, but the complexity of the procedure and processing time increase
Solution Approach 1:
The patent extracts only the essential information needed for localization by comparing BSPMs from a limited set of key locations during sinus rhythm with the BSPM during tachycardia. This extraction approach achieves accurate localization without requiring complex comprehensive mapping of the entire heart surface, thereby reducing system complexity while maintaining precision
Data Source
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AI summary
A method for quantifying, during pacemapping, a comparison of a BSPM of interest to a pace site BSPM. The method may include receiving at a computing device a plurality of ECG signals from an acquisition system. The pace site BSPM may be calculated using the plurality of ECG signals. The BSPM of interest may be compared to the pace site BSPM, by: retrieving the BSPM of interest from memory accessible by the computing device; and, calculating one or more comparison metrics for the BSPM of interest as compared to the pace site BSPM. An indication of similarity between the BSPM of interest and the pace site BSPM based on the comparison metric calculated may be displayed on a user interface in communication with the computing device.