Repetitive Activation Mapping for Abnormal Heart Rhythms
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Solution Overview
Problem
Current mapping techniques struggle to identify the relative importance of early activation sites in heart rhythm abnormalities, particularly in areas where recordings have not been made or are on the border of multipolar catheters, leading to complex and inefficient cardiac mapping procedures.
Innovation Solution
A computer-implemented method using electrogram data from multipolar cardiac catheters to identify repetitive patterns of activation (RPAs), trace back paths from earliest activating sites, and calculate statistical measures to highlight regions of potential drivers, enhancing the prominence of these regions based on distance, direction, and consistency, thereby guiding clinicians to focus on relevant areas for further investigation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If comprehensive point-by-point mapping is performed to identify all activation sites, then measurement precision is improved, but loss of time increases and productivity decreases
Solution Approach 1:
The patent extracts and identifies only the most critical activation sites (earliest activating sites and potential drivers) rather than mapping every point comprehensively. By focusing on extracting the essential information about driver locations and characteristics, the system achieves accurate identification without the time cost of exhaustive mapping.
Solution Approach 2:
The system performs preliminary analysis of electrogram data to identify potential driver sites and earliest activating sites before comprehensive mapping is attempted. This preliminary identification guides subsequent mapping efforts, allowing the system to focus resources on the most relevant areas and avoid wasting time on less critical regions.
2Measurement precision
If comprehensive mapping of all heart surfaces is performed, then measurement precision is improved, but device complexity and ease of operation worsen due to the large number of electrodes and complex data interpretation
Solution Approach 1:
The patent extracts only the essential activation information needed to identify drivers and earliest sites, rather than processing and interpreting all electrogram data from every electrode. This selective extraction reduces data processing complexity while maintaining precision for the critical measurement objectives.
Solution Approach 2:
Instead of using comprehensive mapping data to infer driver locations, the patent inverts the approach by using electrogram characteristics and activation patterns to directly identify potential driver sites, then verifying these locations. This inversion simplifies the process by working from the most informative features rather than from complete surface mapping.
3Productivity
If rapid tachycardia mapping is attempted, then productivity is improved, but measurement precision deteriorates due to the rapid rate preventing comprehensive mapping
Solution Approach 1:
The system performs preliminary identification of potential driver sites using electrogram characteristics before attempting rapid mapping. This preliminary step allows the system to focus subsequent rapid mapping efforts on specific high-probability areas, maintaining measurement precision even at rapid tachycardia rates.
Solution Approach 2:
The patent applies different mapping strategies to different regions: comprehensive analysis is applied to areas identified as potential drivers, while simplified methods are used in less critical regions. This local differentiation allows rapid overall mapping while maintaining precision where it matters most.
4Productivity
If electrogram characteristics are used as surrogate markers for localized drivers, then productivity is improved by reducing mapping complexity, but measurement precision deteriorates due to poor correlation between electrogram features and actual driver sites
Solution Approach 1:
The patent applies different levels of analysis to different regions: electrogram characteristics are used as initial screening tools in all areas, but comprehensive analysis and verification are applied specifically to regions identified as high-probability driver sites. This local differentiation maintains efficiency while improving precision for critical identifications.
Solution Approach 2:
The system uses electrogram characteristics as a preliminary screening method to identify potential driver sites, then applies more rigorous verification methods to these specific locations. This two-stage approach maintains productivity by using efficient screening while ensuring precision through targeted verification.
Data Source
AI summary
A computer program and system are described that support identification of regions of the heart responsible for supporting or initiating abnormal heart rhythms. Electrode activation sequences contributing to a repetitive pattern of activation are identified. An earliest activating site, a vector of activation from the identified electrode activation sequences and a path back from the earliest activating site over a surface of the heart chamber are determined. A statistical measure is computed for the repetitive pattern of activation and data identifying the repetitive pattern of activation including the path is output, the data varying the prominence of the repetitive pattern of activation in dependence on the statistical measure.