Electrogram Processing for Cardiac Rhythm Disorder Source Detection

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Solution Overview

Problem

Current diagnostic tools for cardiac rhythm disorders, such as atrial fibrillation, lack precision in determining the source and location of drivers, leading to inadequate cardiac ablation procedures and reduced therapeutic success rates.

Innovation Solution

A system and method that process electrogram signals to generate an electrographical volatility index (EVI) by analyzing source activity levels, flow angle variability, and active fractionation, providing a probability of a patient being free from atrial fibrillation, which helps in accurately identifying the source and location of cardiac rhythm disorders.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If conventional diagnostic tools (e.g., TOPERA system) are used to localize AF drivers, then the procedure can be performed with standard equipment, but the measurement precision and resolution of AF driver sources are insufficient

Engineering Contradiction:
Improveprecision in determining source and location of AF driversVSAvoidcomplexity of diagnostic system
Core Design Contradiction:
Measurement precisionVSDevice complexity

Solution Approach 1:

The patent segments the analysis of electrogram signals by separating the detection of circular patterns from the analysis of wavefront propagation characteristics. This allows the system to first identify potential rotor locations using standard basket catheter data, then apply additional analytical layers (phase singularity detection, wavefront curvature analysis) to determine active versus passive rotors, thereby improving precision without requiring a completely new device

Inventive Principle:
Principle #1Segmentation

Solution Approach 2:

The patent adds temporal and spatial dimensionality to the analysis by examining wavefront propagation characteristics over time and across multiple electrodes. By analyzing the propagation of wavefronts through the atrial tissue in multiple dimensions, the system can distinguish active rotors (which generate circular wavefronts) from passive rotors (which merely reflect turbulence), thereby improving measurement precision using extended analysis of existing signal data

Inventive Principle:
Principle #17Another dimension (Dimensionality change)

2Reliability

If RF ablation is performed without precise diagnostic localization, then the procedure can be completed, but the therapeutic success rate is reduced and lesion load increases

Engineering Contradiction:
Improvetherapeutic success rate of cardiac ablationVSAvoidease of performing ablation procedure
Core Design Contradiction:
ReliabilityVSEase of manufacture

Solution Approach 1:

The patent applies preliminary diagnostic action by thoroughly characterizing AF drivers before ablation using electrogram analysis and wavefront propagation detection. The system identifies and classifies active rotors versus passive rotors prior to the ablation procedure, allowing clinicians to target only the真正 therapeutic sites (active rotors) with RF ablation, thereby improving success rates while avoiding unnecessary lesions in passive rotor regions

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The patent implements feedback by continuously monitoring electrogram signals during the ablation procedure and comparing them against the pre-procedure mapping data. This allows real-time verification that ablation is effectively eliminating the identified active rotors, enabling adjustment of the ablation strategy to maintain high therapeutic success rates while minimizing unnecessary procedure complexity

Inventive Principle:
Principle #23Feedback

Data Source

PatentUS20210282693A1Systems, Devices, Components and Methods for Detecting the Locations of Sources of Cardiac Rhythm Disorders in a Patient's Heart and Generating an Estimate or Probability of the Patient Being Free from Atrial Fibrillation
Publication Date: 2021.09.16 BOSTON SCIENTIFIC SCIMED INC
  • US20210282693A1 patent drawing
  • US20210282693A1 patent drawing
  • US20210282693A1 patent drawing

AI summary

Disclosed are various examples and embodiments of systems, devices, components and methods configured to detect the locations of sources of cardiac rhythm disorders in a patient's heart, and then to generate an estimate or probability of the patient being free from atrial fibrillation. The various embodiments employ at least one computing device to process a plurality of electrogram surfaces through time to generate at least one electrographical flow (EGF) map, representation, pattern, or data set, and then process the at least one EGF map, representation, pattern, or data set to determine at least two of source activity levels, flow angle variability (FAV) levels, and active fractionation (AFR) levels corresponding thereto. On the basis of a combination of the determined at least two of source activity levels, FAV levels, and AFR levels, an electrographical volatility index (EVI) score or metric representative of the estimate or probability of the patient being free from AF is generated.