Medtronic, Inc.

Biosense Webster (israel) Ltd.

Biosense Webster, Inc.

Richard P M Houben

Meir Bar-Tal

Roy Urman

Yaniv Ben Zriham

Shmuel Auerbach

Yaniv Ben Zrihem

Stanislav Goldberg

Gal Hayam

Michael F Mattes

Rogier Receveur

Ziyad Zeidan

Ralph B Danzl

Assaf Pressman

Yariv Avraham Amos

Atul Verma

Philippe Habets

Koen J Weijand

Robert W Stadler

Mark A Christopherson

Berthold Stegemann

Richard N Cornelussen

Robert Leinders

Adrianus P Donders

Lior Botzer

Daniel R Greeninger

Roger Kessels

Tim Dirk Jan Jongen

Henri G M Heynen

Alexis C M Renirie

Mark Ver Heyen

Curtis D Deno

Patrick J Combs

Henri G Heynen

Electroanatomic mapping is carried out by inserting a multi-electrode probe into a heart of a living subject, recording electrograms from the electrodes concurrently at respective locations in the heart, delimiting respective activation time intervals in the electrograms, generating a map of electrical propagation waves from the activation time intervals, maximizing coherence of the waves by adjusting local activation times within the activation time intervals of the electrograms, and reporting the adjusted local activation times.

Mapping of atrial fibrillation

A system and method of identifying focal sources is presented. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals over time, each ECG signal detected via one of the sensors having a location in a heart and indicating electrical activity of the heart, each signal comprising at least an R wave and an S wave; creating an R-S map comprising an R-to-S ratio for each of the ECG signals, the R-to-S ratio comprising a ratio of absolute magnitude of the R wave to absolute magnitude of the S wave; identifying, for each of the ECG signals, local activation times (LATs); and correlating the R-to-S ratios for the ECG signals on the R-S map and the identified LATs and using the correlation to identify the focal sources.

Region of interest focal source detection using comparisons of R-S wave magnitudes and LATs of RS complexes

Catheterization of the heart is carried out by inserting a probe having electrodes into a heart of a living subject, recording a bipolar electrogram and a unipolar electrogram from one of the electrodes at a location in the heart, and defining a window of interest wherein a rate of change in a potential of the bipolar electrogram exceeds a predetermined value. An annotation is established in the unipolar electrogram, wherein the annotation denotes a maximum rate of change in a potential of the unipolar electrogram within the window of interest. A quality value is assigned to the annotation, and a 3-dimensional map is generated of a portion of the heart that includes the annotation and the quality value thereof.

Double bipolar configuration for atrial fibrillation annotation

A method of atrial focal source detection is provided which includes detecting, via sensors, electro-cardiogram (ECG) signals over time. Each ECG signal is detected via one of the sensors and indicates electrical activity of a heart. The method also includes determining, for each ECG signal, local activation times (LATs) each indicating a time of one of a plurality of atrial activations of a corresponding ECG signal and detecting whether one or more focal source areas of activation in the heart is indicated based on the detected ECG signals and the one or more local LATs. S-waves can be distinguished from non-S-waves by generating models for each atrial activation and classifying atrial activations. Maps can be generated by visually indicating, for each sensor, a level of incidence of the atrial activations occurring before atrial activations of neighboring sensors within a period of time.

Region of interest focal source detection

A system and method of determining regions of interest for heart ablation using fractionation. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals, each ECG signal detected via one of the sensors and indicating electrical activity of a heart, determining, for each of the ECG signals, activation times (LATs) each indicating a time of activation of a corresponding ECG signal, generating, based on the determined LATs of each of the ECG signals, one or more driver maps and one or more perpetuator maps, each representing the electrical activity of the heart, deriving parameters from the driver and perpetuator maps, using at least fractionation, processing and combining the derived parameters into driver evidence and perpetuator evidence, and determining the regions of interest for heart ablation in accordance with the fractionation used to derive the driver evidence and the perpetuator evidence.

Identification of fractionated signals

Cardiac catheterization is performed by recording electrograms from a multi-electrode probe at respective locations in the heart, determining slopes and annotations in the electrograms within time windows, establishing relationships among the slopes and annotations of the electrograms, and determining lines of conduction block in the heart from the relationships.

Line of block detection

A method and apparatus for detecting a cardiac event in a medical device that includes sensing a cardiac signal, detecting a cardiac event in response to the sensed signal, determining whether an interval associated with the cardiac signal is less than an interval threshold, determining a noise metric in response to an interval associated with the cardiac signal being less than the interval threshold, determining whether the noise metric is greater than a noise metric threshold, and determining whether to inhibit detecting in response to determining whether an interval associated with the cardiac signal is less than the interval threshold and determining whether the noise metric is greater than the noise metric threshold.

Method and apparatus for reducing noise in a medical device

Far field reduction is carried out in a cardiac electrogram by extracting unipolar beats of an intracardiac electrogram that occur within a predetermined time interval that includes QRS peaks, constructing a first mean unipolar beat by averaging the extracted unipolar beats, and accepting unipolar beats that cross-correlate with the first mean unipolar beat. A second mean unipolar beat is constructed from the accepted unipolar beats. A ventricular far field component is determined from the extracted unipolar beats and subtracted from the intracardiac electrogram to distinguish a local component of the intracardiac electrogram.

Ventricular far field reduction

A bipolar electrogram and a unipolar electrogram are recorded from electrodes of a probe, and differentiated with respect to time. Peaks are identified in the differentiated bipolar electrogram. An activity window is defined that includes bipolar activity about the peaks. An extreme negative value in the differentiated unipolar electrogram within the activity window is reported as a unipolar activation onset. In one aspect, an annotation is selected from candidate minima in the differentiated unipolar electrogram within the activity window by excluding candidates that fail to correlate with activity in the bipolar electrogram.

Hybrid bipolar/unipolar detection of activation wavefront

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Lanaken, Belgium

Richard P M Houben