Hybrid EP Map for Fractionated Electrograms
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Solution Overview
Problem
Current electrophysiological mapping techniques struggle to effectively integrate fractionated electrogram signals into cardiac maps, as they are difficult to calculate meaningful local activation times from, and traditional methods like ripple mapping can be computationally intensive and obscure other important information.
Innovation Solution
A hybrid-representation EP map is generated by separating the cardiac chamber into fractionated and non-fractionated areas, using different graphical representations to overlay well-defined EP propagation properties and fractionated signal amplitudes on anatomical maps, with fractionated areas represented by protruding geometric shapes and non-fractionated areas by color scales, allowing simultaneous display without obscuring other information.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If traditional ripple mapping is used to display fractionated electrogram signals, then time-dependent fractionated EGM behavior is visualized, but computational complexity increases and other important information becomes obscured
Solution Approach 1:
The patent segments the cardiac chamber surface into distinct regions based on EGM signal characteristics. Fractionated EGM regions are identified and separated from non-fractionated regions, allowing each to be represented using appropriate visualization methods. This segmentation enables the system to avoid computationally intensive ripple mapping for all areas while preserving important diagnostic information in fractionated regions through geometric protrusions.
2Reliability
If fractionated EGM signals are integrated into cardiac maps, then diagnostic value improves, but meaningful local activation times become difficult to calculate
Solution Approach 1:
The patent applies different representation methods to different regions based on their local signal characteristics. In fractionated EGM regions where traditional LAT calculation is difficult, the system uses geometric protrusions that preserve diagnostic information about fractionation without requiring precise LAT values. In non-fractionated regions, traditional color-scale LAT mapping is used. This local quality approach maintains measurement precision where applicable while preserving diagnostic value in fractionated regions.
3Loss of information
If protruding geometric shapes are used to represent fractionated areas, then fractionated EGM behavior is clearly presented, but the anatomical map becomes more complex
Solution Approach 1:
The patent adds a third dimension to the anatomical map by using protruding geometric shapes that extend perpendicular to the cardiac chamber surface. This dimensional change allows fractionated EGM behavior to be visualized clearly through the height and shape of protrusions, while the base anatomical map remains intact. The additional dimension provides intuitive visual encoding of fractionation severity without obscuring the underlying anatomy.
Data Source
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AI summary
A method includes storing an anatomical map of at least a portion of a surface of a heart. Respective electrogram (EGM) signal amplitudes measured at respective positions on the surface of the heart are stored. Based on the on the EGM signal amplitudes, defined are: one or more first regions of the surface in which the EGM signal amplitudes are fractionated, and one or more second regions of the surface in which the EGM signal amplitudes are non-fractionated. A first surface representation is generated for the fractionated EGM signal amplitudes in the first regions. Propagation times are extracted from the non-fractionated EGM signal amplitudes in the second regions, and a second surface representation of the propagation times is derived. The first and second surface representations of the respective first and second regions of the surface are simultaneously presented, overlaid on the anatomical map.