Apparatus and Methods for Arrhythmia Treatment Based on Spectral Mapping During Sinus Rhythm

An apparatus, comprising:

• an electrophysiology (EP) recording system, including a computer processor, a memory, and a display;
• and
• at least a pair of electrodes coupled through an elongate catheter shaft to the EP recording system, wherein said EP recording system is configured to monitor endocardial signals from at least one atrial wall point having high-density autonomic innervation and adapted to perform endocardial spectral mapping of said at least one atrial wall point and provide a spectral mapping output signal related to the endocardial signals of said wall point, wherein said spectral mapping output signal includes a fractionated spectrum in the frequency domain of a Fourier transform of the spectral mapping output signal.

An apparatus, comprising:

• an electrophysiology (EP) recording system, including a computer processor, a memory, and a display;
• at least a pair of electrodes coupled through an elongate catheter to the EP recording system, wherein said EP recording system is configured to monitor endocardial signals from a plurality of atrial wall points having high-density autonomic innervation and to perform endocardial spectral mapping of said plurality of atrial wall points and provide a spectral mapping output signal related to the endocardial signals of said plurality of wall points, wherein said spectral mapping output signal includes a fractionated spectrum in the frequency domain of a Fourier transform of the spectral mapping output signal, and
• a source of ablation energy operatively coupled to a distal portion of the elongate catheter, wherein the elongate catheter is adapted to endocardially ablate a plurality of nerve fibers of at least one of said plurality of atrial wall points sufficient to destroy only a portion of said nerve fibers such that other of said nerve fibers may recover.

An apparatus according to 34, wherein the spectral mapping output signal is used to identify at least one of the plurality of atrial wall points having high density autonomic innervation for ablation during one of normal sinus rhythm and an episode of an atrial arrhythmia.

A tangible computer-readable medium comprising instructions to cause at least one processor to control:

• mapping of a plurality of atrial wall points having high density autonomic innervation;
• and
• activating an ablation energy source coupled to a distal portion of a catheter to effectively ablate a plurality of nerve fibers of at least one of said plurality of atrial wall points sufficiently to destroy only a portion of said plurality of nerve fibers such that other of said plurality of nerve fibers may recover.

A method according to 64, wherein the distal portion of the catheter includes an expandable distal mapping portion having a plurality of electrodes coupled thereto.