Computerized three-dimensional cardiac mapping with interactive visual displays

A digital computer for displaying dynamic motion of depolarization waves across mammalian heart surfaces as detected by an electrode array having multiple electrodes for contacting the heart surface, the digital computer comprising:

• a data input device for receiving input data from the multiple electrodes in the electrode array;
• at least one memory array for storing data;
• means for correlating data from each electrode with a position of contact between that electrode and the heart surface;
• digital processing circuitry for generating for each electrode a time-dependent record during at least one heartbeat of depolarization states at the electrode's position of contact with the heart surface;
• a color monitor;
• means for displaying on the color monitor a three-dimensional surface model of at least one endocardial or epicardial mammalian heart surface, the surface model comprising facets defined by vertex points stored in at least one memory array as three-dimensional coordinates, wherein the facets approximate an endocardial or epicardial heart surface being contacted by the electrode array;
• and
• means for generating and displaying, superimposed upon the three-dimensional surface model shown on the color monitor, a dynamic potential distribution map which provides a slow-motion depiction of a depolarization wavefront moving across the heart surface that was contacted and measured by the electrode array, the generating and displaying means including means for assigning a color to a specific facet of the three-dimensional surface model at a specific moment in time to indicate a depolarization potential, in millivolts, at an area of heart tissue corresponding to the specific facet.

A digital computer for displaying dynamic motion of depolarization waves across mammalian heart surfaces as measured by a cardiac electrode array having multiple electrodes, the digital computer comprising:

• a color monitor;
• a data input device for receiving multiple-channel or multiplexed input data gathered by the cardiac electrode array;
• a first memory array for storing three-dimensional coordinates for vertex points correlating to at least one cardiac surface, and for storing data indicating how the vertex points are connected to form facets that approximate the cardiac surface;
• a second memory array for storing data correlating locations of the multiple electrodes to locations of facets stored in the first memory array;
• a third memory array for storing input data gathered by the cardiac electrode array;
• a data processing system, which includes a set of software instructions, for compiling data stored in the memory arrays, and for interacting with the color monitor to display a three-dimensional surface model of at least one cardiac surface and to display, in the form of an activation time map, movement of a depolarization wavefront across the three-dimensional surface model to provide a slow-motion depiction of a depolarization wavefront moving across the heart surface measured by the cardiac electrode array, wherein the surface model comprises facets which approximate the cardiac surface, wherein colors are assigned to facets of the three-dimensional surface model at each moment in time, and wherein colors assigned to a specific facet at a specific moment in time indicate how many milliseconds elapsed during a heartbeat since depolarization began at an area of tissue on the heart surface which corresponds to that facet on the surface model;
• and
• a control mechanism for rotating the three-dimensional surface model about at least one axis.

A digital computer for displaying dynamic motion of depolarization waves across mammalian heart surfaces as measured by a cardiac electrode array having multiple electrodes, the digital computer comprising:

• a data input device for receiving multiple-channel or multiplexed input data gathered by the cardiac electrode array;
• a first memory array for storing three-dimensional coordinates for vertex points correlating to at least one cardiac surface, and for storing data indicating how the vertex points are connected to form facets that approximate the cardiac surface;
• a second memory array for storing data correlating locations of the multiple electrodes to locations of facets stored in the first memory array;
• a third memory array for storing input data gathered by the cardiac electrode array;
• a color monitor;
• a data processing system, which includes a set of software instructions, for compiling data stored in the memory arrays, and for interacting with the color monitor to display a three-dimensional surface model of at least one cardiac surface and to display, in the form of a potential distribution map, movement of a depolarization wavefront across the three-dimensional surface model to provide a slow-motion depiction of a depolarization wavefront moving across the heart surface measured by the cardiac electrode array, wherein the surface model comprises facets which approximate the cardiac surface, wherein colors are assigned to facets of the three-dimensional surface model at each moment in time, and wherein colors assigned to each facet at each moment in time indicate depolarization potentials, in millivolts, at each area of heart tissue corresponding to each facet of the surface model;
• and
• a control mechanism for rotating the three-dimensional surface model about at least one axis.

A computer-implemented method of treating a cardiac arrhythmia in a patient, which comprises the use of a (1) a digital computer comprising a data input device, memory arrays, digital processing circuitry, and a color monitor, (2) interacting software, (3) an electrode array which has multiple electrodes and which is initially coupled to the digital computer, and (4) a voltage supply which is adjusted to supply, to any selected electrode in the electrode array, a controlled voltage useful for killing myocardial cells in a limited region of heart tissue adjacent to the selected electrode, in order to ablate a selected region of cardiac tissue which contributes to the cardiac arrhythmia, by steps comprising:

• a. placing the electrode array in contact with a cardiac surface of a beating mammalian heart, wherein the electrode array is electronically coupled to the data input device of the digital computer which contains, in one or more memory arrays, data used to generate a three-dimensional surface model of the cardiac surface, said surface model comprising facets defined by vertex points which are stored in the computer as three-dimensional coordinates, wherein said facets approximate the cardiac surface, and wherein each electrode in the electrode array has a known position in the electrode array which correlates to a known position on the three-dimensional surface model stored in the computer;
• b. using the digital computer to process data from the electrode array to generate and store a time-dependent record of cellular depolarization states on the cardiac surface as measured by the electrodes in the electrode array;
• c. using the digital computer to display, on the color monitor, the three-dimensional surface model of the mammalian heart;
• d. using the digital computer to generate and display a slow-motion dynamic depiction of cellular depolarization states, superimposed upon the three-dimensional surface model displayed on the color monitor, wherein the dynamic display of the cellular depolarization states provides a slow-motion depiction of a depolarization wavefront moving across the cardiac surface being contacted by the electrodes;
• e. visually inspecting the dynamic depiction on the color monitor to identify at least one area of tissue on the cardiac surface which is contributing to an arrhythmia which afflicts the patient's heart;
• f. identifying a selected electrode which is located in closest proximity to the area of tissue on the cardiac surface which is contributing to the arrhythmia;
• g. using the electrode array, after it has been coupled to the voltage supply, to generate current through the selected electrode, wherein the current which passes through the selected electrode kills myocardial cells located in close proximity to the electrode.

A computer-implemented method for displaying cardiac activation data for a mammalian heart, the method comprising the steps of:

• generating an anatomically accurate, three-dimensional surface model of at least one surface of a mammalian heart;
• processing activation data collected for a heart of a mammalian subject;
• and
• displaying the processed activation data on the three-dimensional surface model under operator control.

A programmed computer for displaying cardiac activation data for a mammalian heart, the programmed computer comprising:

• means for generating an anatomically accurate, three-dimensional surface model of at least one surface of a mammalian heart;
• means for inputting activation data collected for a heart of a mammalian subject;
• means for processing the input activation data;
• and
• means for displaying the processed activation data on the three-dimensional surface model under operator control.