# US 9,872,653 B2 · Methods and systems for mapping local conduction velocity

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- Number: US 9,872,653 B2
- Document ID: US9872653B2
- Status: Granted
- Kind: B2
- Application number: 15/278,092
- Filed: 2016-09-28
- Published: 2017-01-19
- Granted: 2018-01-23
- Earliest claimed: 2014-10-15
- Assignees: St. Jude Medical, Cardiology Division, Inc.
- Applicants: St. Jude Medical, Cardiology Division, Inc.
- Inventors: Wenwen Li; Erhan Erdemir; Eric J. Voth; Valtino X. Afonso; Carlo Pappone
- Web page: https://patentgrep.com/patent/US9872653B2

## CPC

- A61B 5/7278: {Artificial waveform generation or derivation, e.g. synthesizing signals from measured signals}
- A61B 5/0538: invasively, e.g. using a catheter
- A61B 5/287: Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
- A61B 5/349: Detecting specific parameters of the electrocardiograph cycle
- A61B 5/6852: {Catheters}
- A61B 5/743: {Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots}
- A61B 5/7264: {Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems}
- A61B 5/7282: {Event detection, e.g. detecting unique waveforms indicative of a medical condition (cough events A61B5/0823; seizures A61B5/4094; sleep apnoea A61B5/4818)}
- A61B 2505/05: Surgical care
- A61B 2562/04: Arrangements of multiple sensors of the same type
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

The local conduction velocity of a cardiac activation wavefront can be computed by collecting a plurality of electrophysiology (“EP”) data points using a multi-electrode catheter, with each EP data point including both position data and local activation time (“LAT”) data. For any EP data point, a neighborhood of EP data points, including the selected EP data point and at least two additional EP data points, can be defined. Planes of position and LATs can then be defined using the positions and LATs, respectively, of the EP data points within the neighborhood. A conduction velocity can be computed from an intersection of the planes of positions and LATs. The resultant plurality of conduction velocities can be output as a graphical representation (e.g., an electrophysiology map), for example by displaying vector icons arranged in a uniform grid over a three-dimensional cardiac model.

## Claims

### Claim 1

A method of computing local conduction velocity of a cardiac activation wavefront, comprising:
collecting a plurality of electrophysiology (“EP”) data points using a multi-electrode catheter, each EP data point of the plurality of EP data points comprising position data and local activation time (“LAT”) data;
repeating the following steps a plurality of times, thereby computing a plurality of conduction velocities:
selecting an EP data point from the plurality of EP data points;
defining a neighborhood of EP data points including the selected EP data point and at least two additional EP data points from the plurality of EP data points; and
computing a conduction velocity for the selected EP data point using the position data of the EP data points within the neighborhood of EP data points and the LAT data of the EP data points within the neighborhood of EP data points; and
outputting a three-dimensional graphical representation of the plurality of conduction velocities, wherein the graphical representation includes a plurality of conduction velocity vector icons arranged in a uniform grid over a three-dimensional model of at least a portion of a heart.

### Claim 2 (depends on 1)

The method according to claim 1, wherein the LAT data for the plurality of EP data points are computed relative to activation at an electrode carried by the multi-electrode catheter.

### Claim 3 (depends on 1)

The method according to claim 1, wherein computing a conduction velocity for the selected EP data point using the position data of the EP data points within the neighborhood of EP data points and the LAT data of the EP data points within the neighborhood of EP data points comprises:
computing a plurality of conduction velocity constituents for the selected EP data point, each of the plurality of conduction velocity constituents corresponding to a conduction velocity during one of a plurality of activation windows of a time segment; and
computing a composite conduction velocity over the time segment for the selected EP data point from the plurality of conduction velocity constituents.

### Claim 4 (depends on 3)

The method according to claim 3, wherein computing a composite conduction velocity over the time segment for the selected EP data point from the plurality of conduction velocity constituents comprises computing a mean of the plurality of conduction velocity constituents.

### Claim 5 (depends on 3)

The method according to claim 3, wherein computing a composite conduction velocity over the time segment for the selected EP data point from the plurality of conduction velocity constituents comprises determining a dominant conduction velocity from the plurality of conduction velocity constituents.

### Claim 6 (depends on 3)

The method according to claim 3, further comprising a conduction velocity consistency index for the selected EP data point, wherein the conduction velocity consistency index indicates a degree of consistency in a direction of the conduction velocity constituents for the selected EP data point.

### Claim 7 (depends on 6)

The method according to claim 6, wherein the conduction velocity consistency index comprises a ratio of an absolute magnitude of the composite conduction velocity and an average absolute magnitude of the conduction velocity constituents.

### Claim 8 (depends on 6)

The method according to claim 6, wherein the conduction velocity consistency index comprises a ratio of an absolute magnitude of the composite conduction velocity and an absolute magnitude of an average of the conduction velocity constituents.

### Claim 9 (depends on 6)

The method according to claim 6, wherein the conduction velocity consistency index comprises an average normalized dot product of the conduction velocity constituents and the composite conduction velocity.

### Claim 10

A method of computing local conduction velocity of a cardiac activation wavefront, comprising:
collecting a plurality of electrophysiology (“EP”) data points using a multi-electrode catheter, each EP data point of the plurality of EP data points comprising position data and local activation time (“LAT”) data;
selecting an EP data point from the plurality of EP data points;
defining a neighborhood of EP data points including the selected EP data point and at least two additional EP data points from the plurality of EP data points; and
computing a conduction velocity for the selected EP data point using the position data of the EP data points within the neighborhood of EP data points and the LAT data of the EP data points within the neighborhood of EP data points,
wherein the LAT data for the plurality of EP data points are computed relative to activation at a reference electrode carried by the multi-electrode catheter.

### Claim 11 (depends on 10)

The method according to claim 10, further comprising repeating the following steps a plurality of times, thereby computing a plurality of conduction velocities:
selecting an EP data point from the plurality of EP data points;
defining a neighborhood of EP data points including the selected EP data point and at least two additional EP data points from the plurality of EP data points; and
computing a conduction velocity for the selected EP data point using the position data of the EP data points within the neighborhood of EP data points and the LAT data of the EP data points within the neighborhood of EP data points.

### Claim 12 (depends on 11)

The method according to claim 11, further comprising outputting a three-dimensional graphical representation of the plurality of conduction velocities.

### Claim 13 (depends on 12)

The method according to claim 12, wherein the three-dimensional graphical representation of the plurality of conduction velocities represents the plurality of conduction velocities as uniformly distributed over a three-dimensional model of at least a portion of a heart.

### Claim 14 (depends on 10)

The method according to claim 10, wherein computing a conduction velocity for the selected EP data point using the position data of the EP data points within the neighborhood of EP data points and the LAT data of the EP data points within the neighborhood of EP data points comprises:
computing a plurality of conduction velocity constituents for the selected EP data point, each of the plurality of conduction velocity constituents corresponding to a conduction velocity during one of a plurality of activation windows of a time segment; and
computing a composite conduction velocity over the time segment for the selected EP data point from the plurality of conduction velocity constituents.

### Claim 15 (depends on 14)

The method according to claim 14, wherein the reference electrode is an electrode carried by the multi-electrode catheter having a greatest number of activations within the time segment.

### Claim 16 (depends on 14)

The method according to claim 14, further comprising computing a conduction velocity consistency index for the selected EP data point, wherein the conduction velocity consistency index indicates a degree of consistency in a direction of the conduction velocity constituents for the selected EP data point.

### Claim 17

A method of computing local conduction velocity of a cardiac activation wavefront, comprising:
collecting a plurality of electrophysiology (“EP”) data points using a multi-electrode catheter, each EP data point of the plurality of EP data points comprising position data and local activation time (“LAT”) data;
selecting an EP data point from the plurality of EP data points;
defining a neighborhood of EP data points including the selected EP data point and at least two additional EP data points from the plurality of EP data points;
computing a plurality of conduction velocity constituents for the selected EP data point using the position data of the EP data points within the neighborhood of EP data points and the LAT data of the EP data points within the neighborhood of EP data points, each of the plurality of conduction velocity constituents corresponding to a conduction velocity during one of a plurality of activation windows of a time segment;
computing a composite conduction velocity over the time segment for the selected EP data point from the plurality of conduction velocity constituents; and
computing a conduction velocity consistency index for the selected EP data point, wherein the conduction velocity consistency index indicates a degree of consistency in a direction of the conduction velocity constituents for the selected EP data point.

### Claim 18 (depends on 17)

The method according to claim 17, wherein the conduction velocity consistency index comprises a ratio of an absolute magnitude of the composite conduction velocity and an average absolute magnitude of the conduction velocity constituents.

### Claim 19 (depends on 17)

The method according to claim 17, wherein the conduction velocity consistency index comprises a ratio of an absolute magnitude of the composite conduction velocity and an absolute magnitude of an average of the conduction velocity constituents.

### Claim 20 (depends on 17)

The method according to claim 17, wherein the conduction velocity consistency index comprises an average normalized dot product of the conduction velocity constituents and the composite conduction velocity.