# US 10,441,187 B2 · System and method for diagnosing arrhythmias and directing catheter therapies

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- Number: US 10,441,187 B2
- Document ID: US10441187B2
- Status: Granted
- Kind: B2
- Application number: 15/592,290
- Filed: 2017-05-11
- Published: 2017-11-02
- Granted: 2019-10-15
- Earliest claimed: 2010-12-30
- Assignees: St. Jude Medical, Atrial Fibrillation Division, Inc.
- Applicants: St. Jude Medical, Atrial Fibrillation Division, Inc.
- Inventors: Valtino X. Afonso; Jiazheng Shi; Steven J. Kim; D. Curtis Deno; Dennis J. Morgan
- Web page: https://patentgrep.com/patent/US10441187B2

## CPC

- A61B 5/287: Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
- A61B 5/0036: {including treatment, e.g., using an implantable medical device, ablating, ventilating}
- A61B 5/0044: {for the heart}
- A61B 5/0538: invasively, e.g. using a catheter
- A61B 5/065: {Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe}
- A61B 5/066: {Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging}
- A61B 5/339: Displays specially adapted therefor
- A61B 5/367: Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
- A61B 5/6852: {Catheters}
- A61B 5/6855: {with a distal curved tip}
- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61B 5/068: {using impedance sensors}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 34/25: {User interfaces for surgical systems}
- A61B 2018/00577: {Ablation}
- A61B 2018/00839: {Bioelectrical parameters, e.g. ECG, EEG}
- A61B 2562/043: in a linear array
- A61B 2576/023: for the heart
- G16H 30/40: for processing medical images, e.g. editing
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

An efficient system for diagnosing arrhythmias and directing catheter therapies may allow for measuring, classifying, analyzing, and mapping spatial electrophysiological (EP) patterns within a body. The efficient system may further guide arrhythmia therapy and update maps as treatment is delivered. The efficient system may use a medical device having a high density of sensors with a known spatial configuration for collecting EP data and positioning data. Further, the efficient system may also use an electronic control system (ECU) for computing and providing the user with a variety of metrics, derivative metrics, high definition (HD) maps, HD composite maps, and general visual aids for association with a geometrical anatomical model shown on a display device.

## Claims

### Claim 1

A system for determining electrophysiological (EP) data from a tissue of a body, the system comprising:
a processor; and
a non-transitory computer readable medium coupled with the processor, the non-transitory computer readable medium storing instructions executable by the processor to:
receive EP data from a plurality of points located on the tissue of the body from a plurality of sensors;
compute an absolute activation time for each of the plurality of points based on the EP data: and
cause the EP data to be displayed to a user on a display device, wherein the EP data is associated with the absolute activation time.

### Claim 2 (depends on 1)

The system of claim 1, further comprising instructions executable by the processor to compute a vector that represents a direction and velocity magnitude of a depolarization wavefront traversing the tissue of the body based on the EP data received from the plurality of sensors.

### Claim 3 (depends on 2)

The system of claim 2, further comprising instructions executable to generate a map based on the absolute activation time for each of the plurality of points.

### Claim 4 (depends on 1)

The system of claim 1, wherein the absolute activation time is indicative of an amount of time that has elapsed since a most recent activation at each point.

### Claim 5 (depends on 4)

The system of claim 4, wherein the plurality of sensors include a plurality of electrodes and the absolute activation time is indicative of an amount of time that has elapse since a most recent activation at each of the plurality of electrodes.

### Claim 6 (depends on 1)

The system of claim 1, further comprising instructions executable to generate a gradient map of conduction velocity based on the EP data.

### Claim 7 (depends on 1)

The system of claim 1, further comprising instructions executable to generate a gradient map of activation amplitude based on the EP data.

### Claim 8 (depends on 1)

The system of claim 1, further comprising instructions executable to determine a time at which each of the points is activated based on the EP data.

### Claim 9 (depends on 1)

The system of claim 1, further comprising instructions executable to compute a derivative metric based on the EP data.

### Claim 10

A method, comprising:
receiving EP data from a plurality of points located on a tissue of a body from a plurality of sensors;
computing an amount of time that has elapsed since a most recent activation at each of the plurality of points; and
generate an absolute activation time map based on the amount of time that has elapsed since a most recent activation at each of the plurality of points.

### Claim 11 (depends on 10)

The method of claim 10, further comprising computing an amount of time that has elapsed since each of the plurality of sensors was last depolarized.

### Claim 12 (depends on 10)

The method of claim 10, further comprising computing an amount of time that the sensor spends depolarizing.

### Claim 13 (depends on 10)

The method of claim 10, further comprising determining a vector representative of an activation at each of the plurality of points based on the EP data.

### Claim 14 (depends on 13)

The method of claim 13, wherein the vector represents a wavefront associated with the activation for one of the sensors.

### Claim 15 (depends on 13)

The method of claim 13, wherein the vector represents a wavefront associated with the activation for a subset of the plurality of sensors.

### Claim 16

A system for determining electrophysiological (EP) data from a tissue of a body, the system comprising:
a processor; and
a non-transitory computer readable medium coupled with the processor, the non-transitory computer readable medium storing instructions executable by the processor to:
receive EP data from a plurality of points located on the tissue of the body from a plurality of sensors;
calculate a first plurality of absolute activation times based on the received EP data;
calculate a second plurality of absolute activation times based on the received EP data;
determine a first depolarization wavefront based on the first plurality of activation times;
determine a second depolarization wavefront based on the second plurality of activation times: and
cause a wavefront pattern to be displayed, on a display device, based on at least one of the first depolarization wavefront and the second depolarization wavefront.

### Claim 17 (depends on 16)

The system of claim 16, wherein the absolute activation time is defined as an amount of time that has elapsed since a most recent activation at each of the plurality of points.

### Claim 18 (depends on 17)

The system of claim 17, further comprising determining a depolarization amplitude voltage, the depolarization amplitude voltage being defined as an amount of change between a highest peak voltage and a lowest trough voltage experienced by a specific point on the tissue during the depolarization wavefront.

### Claim 19 (depends on 16)

The system of claim 16, further comprising instructions executable to define a time interval during which the EP data is collected from the plurality of points located on the tissue of the body.