St. Jude Medical, Cardiology Division, Inc.

Jatin Surendra Relan

Valtino X Afonso

Pierre Jais

Kyungmoo Ryu

Stuart Rosenberg

Don Curtis Deno

Louis-Philippe Richer

Mark Hagfors

Steven Kim

An electroanatomical mapping system graphically represents local activation time (LAT) information contained in data set including a plurality of electrophysiology (EP) data points. The system computes a spatial gradient over a spatial kernel centered at an EP data point and a plurality of temporal gradients for the EP data points set. Using the gradients, the electroanatomical mapping system can detect spatial outlier EP data points and temporal outlier EP data points. These outlier EP data points can then be corrected prior to outputting a graphical representation of the LAT map on a model of a cardiac surface.

System, method, and apparatus for mapping local activation times

Pulmonary vein isolation has become a first-line treatment for symptomatic drug refractory atrial fibrillation (AF). In the context of PVI procedures, linear ablation lesions are delivered in order to achieve PV isolation. Electrophysiological maps from data collected by high density (HD) grid catheters can be used to identify conduction gaps associated within circumferential pulmonary vein isolation lesions.

System and method for detection and mapping of near field conduction in scar tissue

Cardiac activity can be mapped by receiving an electrogram, transforming the electrogram into the wavelet domain (e.g., using a continuous wavelet transformation) to create a scalogram of the electrogram, computing at least one energy function of the scalogram, and computing at least one metric of the electrogram using the at least one energy function. The metrics of the electrogram can include, without limitation: a QRS activity duration for the electrogram; a near-field component duration for the electrogram; a far-field component duration for the electrogram; a number of multiple components for the electrogram; a slope of a sharpest component of the electrogram; a scalogram width; an energy ratio in the electrogram; and a cycle-length based metric of the electrogram.

Methods and systems for mapping cardiac activity

Cardiac activity (e.g., a cardiac electrogram) is analyzed for local abnormal ventricular activity (LAVA), such as by using a LAVA detection and analysis module incorporated into an electroanatomical mapping system. The module transforms the electrogram signal into the wavelet domain to compute as scalogram; computes a one-dimensional LAVA function of the scalogram; detects one or more peaks in the LAVA function; and computes a peak-to-peak amplitude of the electrogram signal. If the peak-to-peak amplitude does not exceed a preset amplitude threshold, then the module can compute one or more of a LAVA lateness parameter for the electrogram signal using one of the one or more peaks detected in the LAVA function and a LAVA probability parameter for the electrogram signal.

Methods and systems for statistically analyzing electrograms for local abnormal ventricular activities and mapping the same

QRS activity duration may be indicative of cardiac tissue health. Accordingly, maps of QRS activity duration may be beneficial to practitioners. To this end, an electroanatomical mapping system can receive an electrogram signal and analyze it by transforming it into the wavelet domain, computing an energy function of the resultant scalogram, and computing QRS activity duration using the energy function. A graphical representation of the QRS activity duration can be output, for example on a three-dimensional cardiac model. Areas of diseased substrate can be identified on the output; in some aspects of the disclosure, diseased substrate corresponds to areas where the QRS activity duration exceeds a preset threshold, such as about 70 ms.

System and method for mapping cardiac activity

Cardiac repolarization activity can be mapped using action potential duration ('APD') and/or activation recovery interval ('ARI'). APD can be measured using a bipolar electrogram signal measured, for example, using a monophasic action potential (&#x201c;MAP&#x201d;) catheter. ARI can be measured using unipolar electrogram signals. The electrogram signal is used to identify a depolarization tick time. A repolarization tick time can be identified using either a point in time when the electrogram signal passes below a threshold or via local maxima and minima of a first derivative of the electrogram signal. Diastolic intervals can also be computed using depolarization and repolarization tick times.

Methods and systems for mapping cardiac repolarization

The present disclosure provides apparatuses and methods for navigating a medical device into the body of a patient during an intracoronary or other medical procedure. In many embodiments, the present disclosure includes the use of a guidewire managing assembly that may be used in combination with a guidewire that includes a medical positioning system sensor. This guidewire managing assembly and sensor enabled guidewire are used in combination with a medical positioning system to determine the position of a medical device, such as a catheter or catheter sheath, and specifically the tip of the catheter or catheter sheath, that is threaded over the guidewire during a procedure. The present disclosure further relates to methods of tracking a medical device, such as a catheter tip, inside the body of a subject during a procedure.

Apparatus and method for navigating a medical device

A method of mapping cardiac restitution includes: receiving a plurality of EP data points including location and restitution data; identifying a subset of the EP data points forming an EP data point cluster; fitting a restitution curve to the restitution data of the EP data points forming the cluster; and identifying at least one restitution metric for a region of the cardiac surface corresponding to the cluster from the restitution curve. The restitution curve can be an exponential function using quiescent interval data (e.g., DI and/or CL) as the independent variable and cardiac repolarization activity data (e.g., APD, ARI, and/or EGM width) as the dependent variable. The parameters of the exponential function can be determined by optimizing a cost function. A graphical representation of the restitution metric can also be output on a three-dimensional model of the cardiac surface.

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Bordeaux, France

Jatin Surendra Relan