# US 2024/0197233 A1 · Identifying and indicating cardiac areas exhibiting progressively slowing activation (psa) > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2024/0197233 A1 - Document ID: US20240197233A1 - Status: Published application - Kind: A1 - Application number: 18/080,875 - Filed: 2022-12-14 - Published: 2024-06-20 - Earliest claimed: 2022-12-14 - Assignees: Biosense Webster (Israel) Ltd. - Applicants: Biosense Webster (Israel) Ltd. - Inventors: EINAT SHAPIRA; AMIR BEN-DOR; GAL HAYAM; TAL HAIM BAR-ON; MEIR BAR-TAL; KUMARASWAMY NANTHAKUMAR; AHMED NIRI; STEPHANE MASSE - Web page: https://patentgrep.com/patent/US20240197233A1 ## CPC - A61B 5/364: Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats - A61B 5/061: {Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body (A61B1/00158 takes precedence)} - A61B 5/287: Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS] - A61B 5/339: Displays specially adapted therefor - A61B 5/367: Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A method includes receiving a cardiac signal that is sensed by electrodes at a location in a heart of a patient, the cardiac signal including signal components evoked by respective activations. The signal components in the cardiac signal are found and annotated. Respective time differences are calculated between the annotations and the corresponding activations. Based on the time differences, one or more cardiac tissue locations are identified, that demonstrate progressively slowing activation (PSA). An EP map of at least a portion of the heart is presented to a user, including providing a graphical indication of the one or more tissue locations that demonstrate the PSA. ## Claims ### Claim 1 A method, comprising: receiving a cardiac signal that is sensed by electrodes at a location in a heart of a patient, the cardiac signal comprising signal components evoked by respective activations; finding and annotating the signal components in the cardiac signal; calculating respective time differences between the annotations and the corresponding activations; based on the time differences, identifying one or more cardiac tissue locations that demonstrate progressively slowing activation (PSA); and presenting an EP map of at least a portion of the heart to a user, including providing a graphical indication of the one or more tissue locations that demonstrate the PSA. ### Claim 2 (depends on 1) The method according to claim 1, wherein the activations comprise pacing stimuli applied to the heart. ### Claim 3 (depends on 1) The method according to claim 1, wherein the activations comprise naturally-occurring sinus rhythm activations of the heart. ### Claim 4 (depends on 1) The method according to claim 1, wherein identifying the tissue locations that demonstrates the PSA comprises identifying one or more tissue locations that exhibit monotonically increasing time differences over at least three consecutive cardiac cycles. ### Claim 5 (depends on 1) The method according to claim 1, wherein providing the graphical indication comprises delineating a boundary around a cluster of tissue locations that demonstrate the PSA. ### Claim 6 (depends on 1) The method according to claim 1, wherein receiving the cardiac signal comprises receiving unipolar and bipolar electrograms acquired using a catheter. ### Claim 7 (depends on 1) The method according to claim 1, wherein annotating the signal components comprises annotating a bipolar electrogram, a unipolar electrogram, or a multipolar electrogram. ### Claim 8 A system, including: an interface configured to receive a cardiac signal that is sensed by electrodes at a location in a heart of a patient, the cardiac signal comprising signal components evoked by respective activations; and a processor, which is configured to: find and annotate the signal components in the cardiac signal; calculate respective time differences between the annotations and the corresponding activations; based on the time differences, identify one or more cardiac tissue locations that demonstrate progressively slowing activation (PSA); and present an EP map of at least a portion of the heart to a user, including providing a graphical indication of the one or more tissue locations that demonstrate the PSA. ### Claim 9 (depends on 8) The system according to claim 8, wherein the activations comprise pacing stimuli applied to the heart. ### Claim 10 (depends on 8) The system according to claim 8, wherein the activations comprise naturally-occurring sinus rhythm activations of the heart. ### Claim 11 (depends on 1) The system according to claim 1, wherein the processor is configured to identify the tissue locations that demonstrates the PSA by identifying one or more tissue locations that exhibit monotonically increasing time differences over at least three consecutive cardiac cycles. ### Claim 12 (depends on 8) The system according to claim 8, wherein the processor is configured to provide the graphical indication by delineating a boundary around a cluster of tissue locations that demonstrate the PSA. ### Claim 13 (depends on 8) The system according to claim 8, wherein the interface is configured to receive the cardiac signal by receiving unipolar and bipolar electrograms acquired using a catheter. ### Claim 14 (depends on 8) The system according to claim 8, wherein the processor is configured to annotate the signal components by annotating a bipolar electrogram, a unipolar electrogram, or a multipolar electrogram.