CA2357729A1 - Method and apparatus for characterizing cardiac tissue from local electrograms - Google Patents

Method and apparatus for characterizing cardiac tissue from local electrograms Download PDF

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Publication number
CA2357729A1
CA2357729A1 CA002357729A CA2357729A CA2357729A1 CA 2357729 A1 CA2357729 A1 CA 2357729A1 CA 002357729 A CA002357729 A CA 002357729A CA 2357729 A CA2357729 A CA 2357729A CA 2357729 A1 CA2357729 A1 CA 2357729A1
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Prior art keywords
electrograms
property
local
electrogram
tissue
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Granted
Application number
CA002357729A
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French (fr)
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CA2357729C (en
Inventor
Armin Schwartzman
Daniel Reisfeld
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Biosense Webster Inc
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Biosense, Inc.
Armin Schwartzman
Daniel Reisfeld
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Publication of CA2357729A1 publication Critical patent/CA2357729A1/en
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Publication of CA2357729C publication Critical patent/CA2357729C/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
    • A61B5/7267—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems involving training the classification device
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/339—Displays specially adapted therefor
    • A61B5/341—Vectorcardiography [VCG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/70—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients

Abstract

The property of cardiac tissue at a local site, a plurality of sites or in a region of a heart may be characterized based on local electrograms measured at the local site, at a plurality of sites or in the region, respectively. The property may be characterized by normalizing the local electrogram, extracting a feature vector from the normalized electrogram, and classifying the tissue property based on the feature vector. The method of the invention may further comprise computing a map of the tissue property and treating the tissue based on the resultant map. Apparatus to characterize the property includes a catheter and a processor to normalize the local electrogram, extract the feature vector from the electrogram and classify the tissue based on the feature vector.

Claims (57)

1. A method of characterizing a property of cardiac tissue at a local site of a heart based on a local electrogram measured at said local site, said method comprising the steps of:
(a) normalizing said local electrogram;
(b) extracting a feature vector from said normalized local electrogram; and (c) classifying said property of said cardiac tissue at said local site based on said feature vector.
2. A method according to claim 1 wherein said normalizing step (a) comprises:
(i) annotating said electrogram;
(ii) selecting a single cardiac cycle from said electrogram; and (iii) representing said cardiac cycle of said electrogram as a vector such that said annotation is at a fixed position within said vector.
3. A method according to claim 2 wherein said normalizing step further comprises the step of scaling said electrogram.
4. A method according to claim 3 wherein said electrogram is scaled so as to have a fixed value at a feature of said electrogram.
5. A method according to claim 4 wherein said feature corresponds to said annotation.
6. A method according to claim 2 wherein said normalizing step further comprises the step of centering said electrogram.
7. A method according to claim 1 wherein said feature vector is a projection of said normalized electrogram onto a pre-computed subspace.
8. A method according to claim 7 wherein said subspace is computed by principal component analysis of a training set of electrograms.
9. A method according to claim 7 wherein said classifying step is based on the location of said feature vector in said subspace.
10. A method according to claim 1 wherein said property is indicative of the anatomy of said site.
11. A method according to claim 1 wherein said property is indicative of a pathological state of said cardiac tissue at said local site.
12. A method according to claim 1 wherein said property comprises the degree of ischemia of said tissue at said local site.
13. A method according to claim 1 which further comprises delivering treatment to said tissue at said local site.
14. A method according to claim 13 which comprises follow-up characterization of the property of said cardiac tissue at said local site to determine the effectiveness of said treatment.
15. A method according to claim 1 wherein said local electrogram is measured with an electrode on a catheter, said catheter further comprising a position sensor, said position sensor measuring the three-dimensional position of said electrode during measurement of said electrogram.
16. A method according to claim 15 wherein said three-dimensional sensor is an electromagnetic sensor.
17. A method of characterizing a property of cardiac tissue at a plurality of local sites of a heart based on a plurality of local electrograms, said method comprising the steps of:

(a) normalizing said local electrograms;
(b) extracting feature vectors from said normalized local electrograms;
(c) classifying said property of said cardiac tissue at said plurality of local sites based on said feature vectors.
18. A method according to claim 17 wherein said normalizing step (a) comprises:
(i) annotating said electrograms;
(ii) selecting a single cardiac cycle from each of said electrograms;
(iii) representing said single cardiac cycle of each of said electrograms as a vector such that said annotation is at a fixed position within said vectors.
19. A method according to claim 18 wherein said normalizing step further comprises the step of scaling said electrograms.
20. A method according to claim 19 wherein said electrograms are scaled so as to have a fixed value at a feature of said electrograms.
21. A method according to claim 20 wherein said feature corresponds to said annotation.
22. A method according to claim 18 wherein said normalizing step further comprises the step of centering said electrograms.
23. A method according to claim 17 wherein said feature vectors are projections of said normalized electrograms onto a pre-computed subspace.
24. A method according to claim 23 wherein said subspace is computed by principal component analysis of a training set of electrograms.
25. A method according to claim 23 wherein said classifying step is based on the location of said feature vectors in said subspace.
26. A method according to claim 18 wherein said normalization step further comprises rejecting outlying electrograms.
27. A method according to claim 17 wherein said property is indicative of the anatomy of said sites.
28. A method according to claim 17 wherein said property is indicative of a pathological state of said cardiac tissue at said local sites.
29. A method according to claim 17 wherein said property comprises the degree of ischemia of said tissue at said local sites.
30. A method according to claim 17 wherein a plurality of said sites are in a chamber of said heart and wherein said method further comprises constructing a map of said property of said chamber of said heart.
31. A method according to claim 27 which further comprises delivering treatment to said tissue.
32. A method according to claim 31 which comprises follow-up characterization of the property of said cardiac tissue to determine the effectiveness of said treatment.
33. A method according to claim 17 wherein said local electrograms are measured with an electrode on a catheter, said catheter further comprising a position sensor, said position sensor measuring the three-dimensional position of said electrode during measurement of said electrograms.
34. A method according to claim 33 wherein said three-dimensional sensor is an electromagnetic sensor.
35. A method of characterizing a property of a region of cardiac tissue of a heart based on a plurality of local electrograms measured in said region, said method comprising the steps of:

(a) normalizing said local electrograms;
(b) computing a representative electrogram of said region from said normalized electrograms;
(c) extracting a representative feature vector from said representative electrogram;
(d) classifying said property of said cardiac tissue at said region based on said representative feature vector.
36. A method according to claim 35 wherein said normalizing step (a) comprises:
(i) annotating said electrograms;
(ii) selecting a single cardiac cycle from each of said electrograms; and (iii) representing said cardiac cycle of each of said electrograms as a vector such that said annotation is at a fixed position within said vector.
37. A method according to claim 36 wherein said normalizing step further comprises the step of scaling said electrograms.
38. A method according to claim 37 wherein said electrograms are scaled so as to have a fixed value at a feature of said electrograms.
39. A method according to claim 38 wherein said feature corresponds to said annotation.
40. A method according to claim 36 wherein said normalizing step further comprises the step of centering said electrograms.
41. A method according to claim 35 wherein said representative feature vector is a projection of said representative electrogram onto a pre-computed subspace.
42. A method according to claim 41 wherein said subspace is computed by principal component analysis of a training set of electrograms.
43. A method according to claim 41 wherein said classifying step is based on the location of said representative feature vector in said subspace.
44. A method according to claim 35 wherein said property is indicative of the anatomy of said region.
45. A method according to claim 35 wherein said property is indicative of a pathological state of said cardiac tissue at said region.
46. A method according to claim 35 wherein said property comprises the degree of ischemia of said tissue at said region.
47. A,method according to claim 35 wherein said method is repeated for a plurality of regions of said heart.
48. A method according to claim 47 wherein the plurality regions are in a chamber of said heart and wherein said method further comprises constructing a map of said property of said chamber of said heart.
49. A method according to claim 48 which further comprises delivering treatment to said tissue based on said map of said property of said chamber of said heart.
50. A method according to claim 49 which comprises follow-up characterization of the property of said cardiac tissue to determine the effectiveness of said treatment.
51. A method according to claim 35 wherein said local electrograms are measured with an electrode on a catheter, said catheter further comprising a position sensor, said position sensor measuring the three-dimensional position of said electrode during measurement of said electrograms.
52. A method according to claim 51 wherein said three-dimensional sensor is an electromagnetic sensor.
53. Apparatus for characterizing a property of cardiac tissue at a local site of a heart based on a local electrogram measured at said site, said apparatus comprising:
(a) a catheter; and (b) a processor which performs the functions of:
(i) normalizing said electrogram;
(ii) extracting a feature vector from said normalized electrogram;
and (iii) classifying said property of said cardiac tissue at said local site based on said feature vector.
54. Apparatus according to claim 53 wherein the processor further performs the function of computing a map of said property of said tissue of said heart.
55. Apparatus according to claim 53 wherein the catheter comprises an electrode for measuring said local electrogram, said catheter further comprising a position sensor for measuring the three-dimensional position of said electrode during measurement of said electrogram.
56. Apparatus according to claim 55 wherein said three-dimensional sensor is an electromagnetic sensor.
57. Apparatus according to claim 53 which further comprises means for delivering treatment to said tissue.
CA002357729A 2000-09-22 2001-09-20 Method and apparatus for characterizing cardiac tissue from local electrograms Expired - Lifetime CA2357729C (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US23449400P 2000-09-22 2000-09-22
US60/234,494 2000-09-22
US09/934,476 2001-08-22
US09/934,476 US6725085B2 (en) 2000-09-22 2001-08-22 Method and apparatus for characterizing cardiac tissue from local electrograms

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CA2357729A1 true CA2357729A1 (en) 2002-03-22
CA2357729C CA2357729C (en) 2009-11-10

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US (1) US6725085B2 (en)
EP (1) EP1190671B1 (en)
JP (1) JP5054873B2 (en)
KR (1) KR20020023656A (en)
AU (1) AU781902B2 (en)
CA (1) CA2357729C (en)
DE (1) DE60125115T2 (en)
ES (1) ES2278694T3 (en)
HK (1) HK1042840B (en)
IL (1) IL145517A (en)

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EP1190671A2 (en) 2002-03-27
US20020151808A1 (en) 2002-10-17
IL145517A (en) 2006-10-31
HK1042840A1 (en) 2002-08-30
DE60125115T2 (en) 2007-06-28
EP1190671B1 (en) 2006-12-13
JP2002172097A (en) 2002-06-18
US6725085B2 (en) 2004-04-20
CA2357729C (en) 2009-11-10
HK1042840B (en) 2007-05-25
ES2278694T3 (en) 2007-08-16
JP5054873B2 (en) 2012-10-24
DE60125115D1 (en) 2007-01-25
AU7607501A (en) 2002-03-28
AU781902B2 (en) 2005-06-23
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