# US 10,863,916 B2 · Dynamic repolarization substrate mapping

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- Number: US 10,863,916 B2
- Document ID: US10863916B2
- Status: Granted
- Kind: B2
- Application number: 16/013,146
- Filed: 2018-06-20
- Published: 2018-12-27
- Granted: 2020-12-15
- Earliest claimed: 2017-06-21
- Assignees: Boston Scientific Scimed, Inc.
- Applicants: Boston Scientific Scimed Inc.
- Inventors: Sarah R. Gutbrod; Jacob I. Laughner; Allan C. Shuros; Matthew S. Sulkin
- Web page: https://patentgrep.com/patent/US10863916B2

## CPC

- A61B 5/339: Displays specially adapted therefor
- A61B 5/287: Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
- A61B 5/333: Recording apparatus specially adapted therefor
- A61B 5/349: Detecting specific parameters of the electrocardiograph cycle
- A61B 5/6858: {with a distal basket, e.g. expandable basket}
- A61B 5/7203: {for noise prevention, reduction or removal}
- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61N 1/362: Heart stimulators (heart defibrillators A61N1/39)
- A61B 5/4848: {Monitoring or testing the effects of treatment, e.g. of medication}
- A61B 5/7239: {using differentiation including higher order derivatives}
- A61B 2018/00357: {Endocardium}
- A61B 2018/00577: {Ablation}
- A61B 2018/00839: {Bioelectrical parameters, e.g. ECG, EEG}
- A61B 2562/0209: Special features of electrodes classified in A61B5/24, A61B5/25, A61B5/283, A61B5/291, A61B5/296, A61B5/053
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

Methods and systems for cardiac mapping are disclosed. An example system includes a catheter shaft with one or more electrodes coupled to a distal end of the catheter shaft. Electrodes sense electrical signals at anatomical locations within a heart. A processor coupled to the catheter shaft acquires electrogram signals of the heart using the electrodes. Each electrogram signal relates to three-dimensional positional data corresponding to the anatomical locations. The processor also store the electrogram signals of the heart corresponding to electrical activities sensed at corresponding anatomical locations, calculate an activation recovery interval associated with each of the corresponding anatomical locations, determine spatial gradient data of the activation recovery interval based on a distance between at least two neighboring anatomical locations. The system also includes a display device to display a three-dimensional graphical representation of the spatial gradient data between the at least two neighboring anatomical.

## Claims

### Claim 1

A method for displaying physiological mapping data, the method comprising:
acquiring, at a plurality of signal-acquiring times, a plurality of electrogram signals of a body chamber at a plurality of anatomical locations within the body chamber, each electrogram signal relating to three-dimensional positional data corresponding to the plurality of anatomical locations;
storing, in memory, the plurality of electrogram signals of the body chamber corresponding to electrical activities at corresponding anatomical locations at the plurality of signal-acquiring times;
calculating, based on each of the plurality of electrogram signals of the body chamber, an activation recovery interval associated with each of the corresponding anatomical locations;
determining, for each corresponding anatomical location, spatial gradient data of the activation recovery interval based on a distance between at least two neighboring anatomical locations; and
displaying a three-dimensional graphical representation of the spatial gradient data of the activation recovery interval between the at least two neighboring anatomical locations on a display device,
wherein determining the spatial gradient data of the activation recovery interval comprises calculating, for each corresponding anatomical location, a derivative of the activation recovery interval.

### Claim 2 (depends on 1)

The method of claim 1, wherein calculating the activation recovery interval comprises determining an activation time and a recovery time for each corresponding anatomical location based on the plurality of electrogram signals with respect to the plurality of signal-acquiring times.

### Claim 3 (depends on 2)

The method of claim 2, further comprising calculating the activation recovery interval based on a difference between the activation time and the recovery time for each corresponding anatomical location.

### Claim 4 (depends on 1)

The method of claim 1, wherein calculating the activation recovery interval comprises performing at least one of spatial smoothing and temporal smoothing of the activation recovery interval between the at least two neighboring anatomical locations for providing a gradual change of the activation recovery interval on the display device.

### Claim 5 (depends on 1)

The method of claim 1, wherein displaying the three-dimensional graphical representation of the spatial gradient data of the activation recovery interval comprises selectively displaying a region associated with the spatial gradient data satisfying a predetermined selection standard.

### Claim 6 (depends on 5)

The method of claim 5, wherein selectively displaying the region associated with the spatial gradient data comprises displaying the region exhibiting at least one predetermined characteristic of the spatial gradient data of the activation recovery interval between the at least two neighboring anatomical locations.

### Claim 7 (depends on 5)

The method of claim 5, wherein selectively displaying the region associated with the spatial gradient data comprises identifying, for display, the region representing a rate of change in the spatial gradient data that is greater than a predetermined threshold between the at least two neighboring anatomical locations.

### Claim 8

A method for displaying physiological mapping data, the method comprising:
acquiring, at a plurality of signal-acquiring times, a plurality of electrogram signals of a body chamber at a plurality of anatomical locations within the body chamber, each electrogram signal relating to three-dimensional positional data corresponding to the plurality of anatomical locations;
storing, in memory, the plurality of electrogram signals of the body chamber corresponding to electrical activities at corresponding anatomical locations at the plurality of signal-acquiring times;
calculating, based on each of the plurality of electrogram signals of the body chamber, an activation recovery interval associated with each of the corresponding anatomical locations;
determining, for each corresponding anatomical location, spatial gradient data of the activation recovery interval based on a distance between at least two neighboring anatomical locations; and
displaying a three-dimensional graphical representation of the spatial gradient data of the activation recovery interval between the at least two neighboring anatomical locations on a display device,
wherein determining the spatial gradient data of the activation recovery interval comprises calculating, for each corresponding anatomical location, a derivative of the activation recovery interval, and comprising calculating the derivative of the activation recovery interval with respect to a change in the distance between the at least two neighboring anatomical locations based on the plurality of signal-acquiring times.

### Claim 9 (depends on 8)

The method of claim 8, wherein calculating the activation recovery interval comprises determining an activation time and a recovery time for each corresponding anatomical location based on the plurality of electrogram signals with respect to the plurality of signal-acquiring times.

### Claim 10 (depends on 9)

The method of claim 9, further comprising calculating the activation recovery interval based on a difference between the activation time and the recovery time for each corresponding anatomical location.

### Claim 11 (depends on 8)

The method of claim 8, wherein calculating the activation recovery interval comprises performing at least one of spatial smoothing and temporal smoothing of the activation recovery interval between the at least two neighboring anatomical locations for providing a gradual change of the activation recovery interval on the display device.

### Claim 12 (depends on 8)

The method of claim 8, wherein displaying the three-dimensional graphical representation of the spatial gradient data of the activation recovery interval comprises selectively displaying a region associated with the spatial gradient data satisfying a predetermined selection standard.

### Claim 13 (depends on 12)

The method of claim 12, wherein selectively displaying the region associated with the spatial gradient data comprises displaying the region exhibiting at least one predetermined characteristic of the spatial gradient data of the activation recovery interval between the at least two neighboring anatomical locations.

### Claim 14 (depends on 12)

The method of claim 12, wherein selectively displaying the region associated with the spatial gradient data comprises identifying, for display, the region representing a rate of change in the spatial gradient data that is greater than a predetermined threshold between the at least two neighboring anatomical locations.

### Claim 15

A method for displaying physiological mapping data, the method comprising:
acquiring, at a plurality of signal-acquiring times, a plurality of electrogram signals of a body chamber at a plurality of anatomical locations within the body chamber, each electrogram signal relating to three-dimensional positional data corresponding to the plurality of anatomical locations;
storing, in memory, the plurality of electrogram signals of the body chamber corresponding to electrical activities at corresponding anatomical locations at the plurality of signal-acquiring times;
calculating, based on each of the plurality of electrogram signals of the body chamber, an activation recovery interval associated with each of the corresponding anatomical locations;
determining, for each corresponding anatomical location, spatial gradient data of the activation recovery interval based on a distance between at least two neighboring anatomical locations; and
displaying a three-dimensional graphical representation of the spatial gradient data of the activation recovery interval between the at least two neighboring anatomical locations on a display device,
wherein displaying the three-dimensional graphical representation of the spatial gradient data of the activation recovery interval comprises selectively displaying a region associated with the spatial gradient data satisfying a predetermined selection standard, and selectively displaying the region associated with the spatial gradient data comprises identifying, for display, the region representing a rate of change in the spatial gradient data that is greater than a predetermined threshold between the at least two neighboring anatomical locations.
