Bibliographic Details
| Title: |
THERAPY OPTIMIZATION VIA MULTI-DIMENSIONAL MAPPING |
| Document Number: |
20100268059 |
| Publication Date: |
October 21, 2010 |
| Appl. No: |
12/755366 |
| Application Filed: |
April 06, 2010 |
| Abstract: |
An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient where the cardiac information comprises position information, electrical information and mechanical information; mapping local electrical activation times to anatomic positions to generate an electrical activation time map; mapping local mechanical activation times to anatomic positions to generate a mechanical activation time map; generating an electromechanical delay map by subtracting local electrical activation times from corresponding local mechanical activation times; and rendering at least the electromechanical delay map to a display. Various other methods, devices, systems, etc., are also disclosed. |
| Inventors: |
Ryu, Kyungmoo (Palmdale, CA, US); Rosenberg, Stuart (Castaic, CA, US); Keel, Allen (San Francisco, CA, US); Hou, Wenbo (Lancaster, CA, US); Nguyen, Thao Thu (Bloomington, MN, US); Koh, Steve (South Pasadena, CA, US); Noren, Kjell (Solna, SE); Yang, Michael (Thousand Oaks, CA, US) |
| Assignees: |
PACESETTER, INC. (Sylmar, CA, US) |
| Claim: |
1. A method comprising: accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient wherein the cardiac information comprises position information, electrical information and mechanical information; for the various positions, mapping local electrical activation times to anatomic positions to generate an electrical activation time map, the electrical activation times based on the electrical information and the anatomic positions based on the position information; for the various positions, mapping local mechanical activation times to anatomic positions to generate a mechanical activation time map, the mechanical activation times based on the mechanical information and the anatomic positions based on the position information; generating an electromechanical delay map by subtracting local electrical activation times from corresponding local mechanical activation times; and rendering at least the electromechanical delay map to a display. |
| Claim: |
2. The method of claim 1 further comprising selecting a location for placement of an electrode in the venous network based on the electromechanical delay map. |
| Claim: |
3. The method of claim 1 further comprising locating one or more electrodes in the venous network based on the electromechanical delay map. |
| Claim: |
4. The method of claim 3 wherein locating comprises locating at least one electrode in a region of the map that comprises a highest electromechanical delay. |
| Claim: |
5. The method of claim 1 further comprising transforming coordinates for the various positions to a cardiac coordinate system. |
| Claim: |
6. The method of claim 5 wherein the cardiac coordinate system comprises a cylindrical coordinate system. |
| Claim: |
7. The method of claim 5 wherein the transforming comprises determining at least a principle component via a principle component analysis. |
| Claim: |
8. The method of claim 7 wherein the principle component corresponds to a long axis of the left ventricle and wherein another component corresponds to a radial axis of the left ventricle. |
| Claim: |
9. The method of claim 1 further comprising determining the local mechanical activation times based on motion along a radial direction of a cylindrical coordinate system configured to represent longitudinal, radial and circumferential coordinates of the left ventricle of the heart. |
| Claim: |
10. The method of claim 1 further comprising determining each of the local mechanical activation times based on a slope of electrode position with respect to time. |
| Claim: |
11. The method of claim 1 further comprising determining each of the local electrical activation times based on a slope of potential with respect to time. |
| Claim: |
12. The method of claim 1 further comprising identifying a region of greatest electrical activation latency and rendering the region to a display of an anatomic map of the venous network, the anatomic map based on the position information. |
| Claim: |
13. The method of claim 1 further comprising identifying a region of greatest mechanical activation latency and rendering the region to a display of an anatomic map of the venous network, the anatomic map based on the position information. |
| Claim: |
14. The method of claim 1 further comprising identifying a region of greatest electromechanical delay and rendering the region to a display of an anatomic map of the venous network, the anatomic map based on the position information. |
| Claim: |
15. The method of claim 1 further comprising analyzing the position information, the electrical information and the mechanical information to identify a region of discrepancy between electrical activation latency and mechanical activation latency. |
| Claim: |
16. The method of claim 15 wherein a region of discrepancy between electrical activation latency and mechanical activation latency corresponds to a region of functional abnormality. |
| Claim: |
17. The method of claim 15 wherein a region of discrepancy between electrical activation latency and mechanical activation latency corresponds to a region of structural abnormality. |
| Claim: |
18. The method of claim 15 wherein a region of discrepancy between electrical activation latency and mechanical activation latency corresponds to an ischemic region of the heart. |
| Claim: |
19. The method of claim 15 further comprising selecting a location for placement of an electrode in the venous network based on a region of discrepancy between electrical activation latency and mechanical activation latency. |
| Claim: |
20. The method of claim 1 wherein rendering comprises rendering the electromechanical delay map in color wherein a color scale quantitatively identifies electromechanical delay values. |
| Claim: |
21. The method of claim 1 further comprising generating an anatomic map based on the position information wherein the anatomic map comprises surfaces representative of at least a portion of the venous network. |
| Claim: |
22. The method of claim 1 wherein mapping local electrical activation times comprises mapping each of the times to a surface position of the anatomic map. |
| Claim: |
23. The method of claim 1 wherein mapping local mechanical activation times comprises mapping each of the times to a surface position of the anatomic map. |
| Claim: |
24. One or more computer-readable media comprising processor executable instructions to instruct a computing device to: access cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient wherein the cardiac information comprises position information, electrical information and mechanical information; for the various positions, map local electrical activation times to anatomic positions to generate an electrical activation time map, the electrical activation times based at least in part on the electrical information and the anatomic positions based at least in part on the position information; for the various positions, map local mechanical activation times to anatomic positions to generate a mechanical activation time map, the mechanical activation times based at least in part on the mechanical information and the anatomic positions based at least in part on the position information; generate an electromechanical delay map by subtracting local electrical activation times from corresponding local mechanical activation times; and render at least the electromechanical delay map to a display. |
| Claim: |
25. A method comprising: accessing physiologic information acquired via a catheter located at various positions in a venous network of a patient wherein the physiologic information comprises position information, electrical information and mechanical information; generating a surface rendered anatomic map of at least a portion of the venous network based on the position information; mapping electrical information to the anatomic map; mapping mechanical information to the anatomic map; and selecting a location for placement of therapeutic equipment based on the mapped electrical information and the mapped mechanical information. |
| Claim: |
26. The method of claim 25 wherein the therapeutic equipment comprises a left ventricular lead. |
| Claim: |
27. The method of claim 25 wherein the therapeutic equipment comprises a tissue ablation device. |
| Claim: |
28. The method of claim 25 wherein the therapeutic equipment comprises an electrode configured for nerve stimulation, nerve sensing or nerve stimulation and nerve sensing. |
| Claim: |
29. The method of claim 25 wherein the therapeutic equipment comprises a sensor. |
| Claim: |
30. The method of claim 25 wherein the venous network comprises at least a portion of the coronary sinus. |
| Claim: |
31. The method of claim 25 further comprising locating therapeutic equipment at the selected location and acquiring, via the therapeutic equipment located in the venous network, additional information. |
| Claim: |
32. The method of claim 31 wherein the additional information comprises information selected from a group consisting of position information, electrical information and mechanical information. |
| Claim: |
33. The method of claim 31 further comprising mapping at least some of the additional information to the anatomic map. |
| Claim: |
34. The method of claim 31 further comprising comparing at least some of the additional information to previously acquired electrical information. |
| Claim: |
35. The method of claim 31 further comprising comparing at least some of the additional information to previously acquired mechanical information. |
| Claim: |
36. One or more computer-readable media comprising processor executable instructions to instruct a computing device to: access physiologic information acquired via a catheter located at various positions in a venous network of a patient wherein the physiologic information comprises position information, electrical information and mechanical information; generate a surface rendered anatomic map of at least a portion of the venous network based at least in part on the position information; map electrical information to the anatomic map; map mechanical information to the anatomic map; and select a location for placement of therapeutic equipment based at least in part on the mapped electrical information and the mapped mechanical information. |
| Current U.S. Class: |
600/407 |
| Current International Class: |
61 |
| Accession Number: |
edspap.20100268059 |
| Database: |
USPTO Patent Applications |
