US 10,893,819 B2Granted

Analyzing and mapping ECG signals and determining ablation points to eliminate Brugada syndrome

AssigneeBiosense Webster (Israel) Ltd.

InventorsCarlo Pappone, Aharon Turgeman, Paolo Roberto Pozzi, Andrea Natalizia

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Abstract

A system and method for Brugada syndrome epicardial ablation comprising preparing an endocardial duration map; preparing a baseline epicardial duration map comprising at least one or more areas of delimination; and when some of the areas of delimination are greater than 200 ms, performing epicardial ablation of the areas of delimination greater than 200 ms. The method may further comprise preparing an updated epicardial duration map after performing epicardial ablation, and determining whether or not a BrS pattern appears in the updated epicardial duration map; and when the BrS pattern appears, performing epicardial ablation. The method may further comprise preparing an updated epicardial duration map after performing epicardial ablation, and determining whether or not an abnormal EGM exists in the updated epicardial duration map; and when the abnormal EGM exists, performing epicardial ablation. The method may further comprise preparing an updated epicardial map comprising maintaining anatomical volume data and adding electroanatomical data.

Claims20

Dependent claims

A computer implemented method of identifying target ablation areas in a heart, comprising:

acquiring electrical signals of the heart over time via a plurality of electrodes disposed at different areas of the heart;
providing an endocardial duration map for display based on the electrical signals;
providing an epicardial duration map, comprising at least one or more areas of delimination, for display based on the electrical signals;
determining when one or more of the areas of delimination have a potential duration greater than a threshold duration amount;
and
identifying the one or more areas of delimination determined as having a potential duration greater than the threshold duration amount as areas to be ablated,
wherein epicardial ablation is performed on the one or more identified areas of delimination,
the method further comprising:
after epicardial ablation is performed on the one or more identified areas of delimination, providing an updated epicardial duration map and determining whether or not a Brugada syndrome (BrS) pattern appears in the updated epicardial duration map;
when it is determined that the BrS pattern appears in the updated epicardial duration map:
repeating the determining of whether one or more of the areas of delimination have a potential duration greater than the threshold duration amount;
and
repeating the identifying of the one or more areas of delimination determined as having a potential duration greater than the threshold duration amount as the areas to be ablated;
and
when it is determined that the BrS pattern does not appear in the updated epicardial duration map:
providing a remapped epicardial duration map;
and
determining when one or more areas of delimination in the remapped epicardial duration map are abnormal,
wherein epicardial ablation is performed on the one or more abnormal areas of delimination.

16 more elements

A system for identifying target ablation areas in a heart, the system comprising:

a catheter configured to acquire electrical signals acquired over time from different areas of the heart;
memory configured to store the electrical signals;
one or more processors configured to:
provide an endocardial duration map for display based on the electrical signals;
provide an epicardial duration map, comprising at least one or more areas of delimination, for display based on the electrical signals;
and
determine when one or more of the areas of delimination have a potential duration greater than a threshold duration amount;
and
identify the one or more areas of delimination determined as having a potential duration greater than the threshold duration amount as areas to be ablated,
wherein epicardial ablation is performed on the one or more identified areas of delimination;
and
a display device for displaying the endocardial duration map and the epicardial map,
the one or more processors are further configured to:
after epicardial ablation is performed on the one or more identified areas of delimination, provide an updated epicardial duration map and determine whether or not a Brugada syndrome (BrS) pattern appears in the updated epicardial duration map:
when it is determined that the BrS pattern appears in the updated epicardial duration map:
repeat the determining of whether one or more of the areas of delimination have a potential duration greater than the threshold duration amount;
and
repeat the identifying of the one or more areas of delimination determined as having a potential duration greater than the threshold duration amount as the areas to be ablated;
and
when it is determined that the BrS pattern does not appear in the updated epicardial duration map:
provide a remapped epicardial duration map;
and
determine when one or more areas of delimination in the remapped epicardial duration map are abnormal,
wherein epicardial ablation is performed on the one or more abnormal areas of delimination.

21 more elements

A computer software product for identifying target ablation areas in a heart, including a non-transitory computer readable storage medium in which computer program instructions are stored, which instructions, when executed by a computer, cause the computer to:

acquire electrical signals of the heart over time via a plurality of electrodes disposed at different areas of the heart;
provide an endocardial duration map for display based on the electrical signals;
provide an epicardial duration map, comprising at least one or more areas of delimination, for display based on the electrical signals;
determine when one or more of the areas of delimination have a potential duration greater than a threshold duration amount;
and
identify the one or more areas of delimination determined as having a potential duration greater than the threshold duration amount as areas to be ablated,
wherein epicardial ablation is performed on the one or more identified areas of delimination,
the computer software product further comprising:
after epicardial ablation is performed on the one or more identified areas of delimination, provide an updated epicardial duration map and determine whether or not a Brugada syndrome (BrS) pattern appears in the updated epicardial duration map;
when it is determined that the BrS pattern appears in the updated epicardial duration map:
repeat the determining of whether one or more of the areas of delimination have a potential duration greater than the threshold duration amount;
and
repeat the identifying of the one or more areas of delimination determined as having a potential duration greater than the threshold duration amount as the areas to be ablated;
and
when it is determined that the BrS pattern does not appear in the updated epicardial duration map:
provide a remapped epicardial duration map;
and
determine when one or more areas of delimination in the remapped epicardial duration map are abnormal,
wherein epicardial ablation is performed on the one or more abnormal areas of delimination.

16 more elements

Dependencies are inferred from the claim text.

Facts

Application: 15/854,485Filed 26 Dec 2017 · us provisional application
Priority: 25 Jan 2017
Published: US 2018/0206750 A126 Jul 2018
Granted: 19 Jan 2021
Term ends: Not estimatedThe source records don’t support an estimate.

Classification18 codes

A61B 5/283
For electrocardiography [ECG]: invasive
A61B 5/33
Heart-related electrical modalities, e.g. electrocardiography [ECG]: specially adapted for cooperation with other devices
A61B 5/343
Displays specially adapted therefor: potential distribution indication
A61B 5/346
Heart-related electrical modalities, e.g. electrocardiography [ECG]: analysis of electrocardiograms