Pacesetter, Inc.

St. Jude Medical International Holding S.a.r.l.

Hoda Razavi

Yelena Nabutovsky

Fujian Qu

Kyungmoo Ryu

Rohan More

Stuart Rosenberg

Edward Karst

Michael E Benser

Edith Merle Arnold

Kwangdeok Lee

Craig A Hewitt

Luke C McSpadden

Sergio Richter

Philipp Sommer

An apparatus and method for characterizing a region of interest (ROI) including measuring position and orientation data within the ROI; and generating a geometric data set to include one or more of: length, bifurcation location, angle and curvature characteristics of the ROI. Also, sequentially taking an image of a tool within the ROI; comparing tool dimensions with ROI dimensions; and estimating diameter, length, take-off angle, and/or tortuosity characteristics based on the comparisons.

Vascular branch characterization

A method and system are provided for assigning map points to anatomical segments of a heart. The method and system utilize an intravascular mapping tool configured to be inserted into at least one of the endocardial or epicardial space. The mapping tool is maneuvered to select locations proximate to surfaces of the heart, while collecting map points at the select locations to form a ROI data set. The method and system store the ROI data set in a data storage and defines apical, basal and circumferential landmarks within the ROI data set. The method and system automatically calculate circumferential and longitudinal segment boundaries, associated with wall segments of the heart, based on the apical, basal and circumferential landmarks. The method and system automatically assign segment identifiers (IDs) to the map points based on locations of the map points relative to the circumferential and longitudinal boundaries, the segment IDs associated with wall segments of the heart.

Method and system to automatically assign map points to anatomical segments and determine mechanical activation time

A method and system is provided for calculating a strain from characterization motion data. The method and system utilize an intravascular mapping tool configured to be inserted into at least one of the endocardial or epicardial space. The mapping tool is maneuvered to select locations proximate to surfaces of the heart, while collecting map points at the select locations to form a point cloud data set during at least one cardiac cycle. The method and system further include automatically assigning segment identifiers (IDs) to the map points based on a position of the map point within the point cloud data set. The method and system further select a first and second reference from a group of map points. Further, the method and system calculate a linear strain based on an instantaneous distance and a reference distance between the first and second references.

Method and system for calculating strain from characterization data of a cardiac chamber

A method and system is provided for determining the mechanical activation of a region of interest. The system and method include using a triangulation technique algorithm to generate at least one triangle within a region of interest, wherein the triangle is formed from map points acquired from an intravascular mapping tool. The system and method further include calculating an area strain for each triangle, determining abnormal areas of the region of interest, and excluding triangles that include the abnormal area. Further, the system and method include determining a mechanical activation time for the region of interest based on the remaining triangles.

Methods and systems to calculate time of mechanical activation using characterization motion data area strains

A method and system are provided for analyzing data for a region of interest in connection with cardiac mapping. The method and system acquire data recordings of at least one of electrical sensor measurements from an electrical sensor and motion data from a motion sensor in contact with the region of interest, determine cycle lengths associated with cardiac events in the data recordings; and identify a reference cycle length from the cycle lengths determined. The method and system analyze the cycle lengths such that differences in heart rate and cycle length have limited effect on an overall map.

Method and system to determine cardiac cycle length in connection with cardiac mapping

Embodiments of the present disclosure provide a method of determining an inter-chamber delay within a heart of an individual that may include determining a position of a first sensor in a first chamber of the heart, determining a position of a second sensor in a second chamber of the heart, automatically computing a distance between the first and second sensors, and automatically determining the inter-chamber delay based on the automatically computing operation.

Cardiac resynchronization system and method

Methods and system are provided that identify motion data associated with consistent electrical and mechanical behavior for a region of interest of the heart. The methods and systems acquire electrical cardiac signals indicative of physiologic behavior of at least a portion of the heart over a plurality of cardiac cycles. The methods and systems acquires motion data indicative of mechanical behavior of a motion sensor over the plurality of cardiac cycles to form a motion data collection, the motion data indicative of mechanical behavior of the region of interest when the motion sensor is in contact with the region of interest. The designating ectopic beats within the cardiac cycles may be based on the electrical cardiac signals, the ectopic beats producing electrically inconsistent (EI) data within the motion data collection. The methods and systems identify mechanically inconsistent (MI) data within the motion data collection based on irregular changes in the motion data. The methods and systems remove at least a portion of the EI and MI data from the motion data collection based on the designating and identifying operations to form an electrically/mechanically consistent (EMC) motion data collection.

Method and system to identify motion data associated with consistent electrical and mechanical behavior for a region of interest

A method and system are provided for subdividing a region of interest. The method and system utilize an intravascular mapping tool configured to be inserted into at least one of the endocardial or epicardial space. The mapping tool is maneuvered to select locations proximate to surfaces of the heart, while collecting map points at the select locations to form a point cloud data set during at least one cardiac cycle. The method and system further include selecting a region of interest from the point cloud data set, and forming a triangulation area that include a set of map points from the point cloud data set corresponding to the region of interest. Further, the method and system use a triangulation technique algorithm to generate at least one triangle within the triangulation area formed from at least a portion of the set of map points.

Method and system to subdivide a mapping area for mechanical activation analysis

A method and system are provided for equalizing cycle lengths among different map points during mapping studies. Different embodiments may be applicable to different circumstances and physiological settings. A compression embodiment encapsulates the entire behavior of a map point throughout its native cycle length. A truncation and rotation embodiment, and an extension and rotation embodiment allow for a more physiologically-relevant processing of the motion data.

Method and system to equalizing cardiac cycle length between map points

The present disclosure provides systems and methods for estimating a change in an intracardiac distance between systole and diastole. A system includes a pacing electrode configured to generate a pacing pulse, a sensing electrode configured to measure an electrical artifact corresponding to the pacing pulse, and a computing device communicatively coupled to the pacing electrode and the sensing electrode, the computing device configured to determine a first amplitude of a first electrical artifact measured at the sensing electrode during systole, determine a second amplitude of a second electrical artifact measured at the sensing electrode during diastole, and calculate a mechanical index based on the first amplitude and the second amplitude, wherein the mechanical index is representative of the change in the intracardiac distance.

Systems and methods for estimating intracardiac distance using sensed electrical pulses

A method and system for displaying a three dimensional visualization of cardiac motion. The method and system obtain point specific (PS) motion data for a plurality of map points. The PS motion data indicates an amount of motion that occurred at the corresponding map point on a wall of the heart during at least one cardiac cycle. The method and system determine three dimensional (3D) positions of the map points during the cardiac cycle based on the PS motion data and select a set of 3D positions based on a frame rate. The method and system further generate 3D visualizations for each selected set of 3D positions.

Method and system for displaying a three dimensional visualization of cardiac motion

A method and system are provided for characterizing motion data. The method and system obtain point specific (PS) motion data for a plurality of map points. The PS motion data indicates an amount of motion that occurred at the corresponding map point on a wall of the heart during at least one cardiac cycle. The method and system, calculate mechanical activation times (MAT) for the map points, identifying a group of neighbor map points for a current map point, and modifying the MAT corresponding to the current map point based on the MATs corresponding to at least a portion of the group of neighboring map points. Further, the method and system repeat the identifying and modifying operations for at least a subset of the map points.

Method and system to characterize motion data based on neighboring map points

A method and system for characterizing an accessibility of potential left ventricular stimulus sites in connection with surgical planning for transvenous implant of a cardiac medical lead in or near a heart of a patient are provided. The method and system include obtaining image data representative of a coronary venous system for the heart of the patient to receive the lead. The method and system generate a venous map, based on the image data, representative of venous pathways for the heart of the patient. The method and system analyze the venous map to identify pathway features of interest (PFOI) within at least one select region of the venous pathways. The method and system assign scores to the PFOI based on at least one of predetermined feature-complexity relations or physician-entered complexity updates. The method and system display treatment planning information to a user based on the scores.

Method and system for characterizing stimulus sites and providing implant guidance

A method and system are provided to measure cardiac motion data using a cardiovascular navigation system. The method and system position a patient reference sensor (PRS) on a patient, wherein the PRS determines a position of the patient relative to a reference point. The method and system determine a reference orientation matrix based on an orientation of the PRS relative to a reference point and determining a normalization time based on an electrical signal. The method and system obtain point specific (PS) motion data for a plurality of map points. The PS motion data indicates a three dimensional trajectory that occurs at the corresponding map point on a wall of a heart of the patient during at least one cardiac cycle. Further the method and system compensate the PS motion data based on the PRS.

Method and system to measure cardiac motion using a cardiovascular navigation system

A method and system are provided for analyzing motion data collected by a cardiovascular navigation system to determine a level of dyssynchrony exhibited by a heart. The method and system comprise obtaining a motion data (MD) set that includes a plurality of map point specific motion data (PSMD) collections of motion data. The motion data in each PSMD collection includes information indicating an amount and direction of motion that occurred at a corresponding map point on a wall of the heart during a select period of time, such as during at least one cardiac cycle. The method and system divide the PSMD collections of data into sectors which may be associated with corresponding phases of the cardiac cycle, and analyze the sectors of the PSMD collections to determine at least one of a slope, a magnitude and a direction of motion at the corresponding map point of the wall of the heart during the associated sector. The method and system assess at least one of the slope, magnitude and direction of motion occurring at the corresponding map points of the wall, and calculate a measure of dyssynchrony in the map points of the wall based on at least one of i) whether the map points move in a select direction during select sectors, ii) whether the map points move by a select amount during the select sectors, iii) a direction of strain waveform during select phases of the cardiac cycle and/or iv) an extent of strain during the select phases.

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San Jose, CA, United States of America

Hoda Razavi