l l l l l l l Il l l l l l l ?gl gljgmglgl l l l l l l l l l l l l l l l
United States Patent 1191
[11] Patent Number:
Panescu
[45]
[54]
Date of Patent:
SYSTEMS AND METHODS FOR DERIVING
5,246,008
AND DISPLAYING THE PROPAGATION
5,255,679 10/ 1993 111111111 -
lljlnefrlll?k
'
,
THE HEART
.
ggztgdzt
...................... .. 128/642
21353323 211333
APPL No_; 183,242
[22] Filed:
Jan. 28, 1994
.......................... .. 666/15
5,341,807
8/1994 Nardella.
5,345,936
9/1994 Pomeranz et a1. .
5,383,917
1/1995 Desai et a1. .
5,397,339
3/ 1995 Desai .
OTHER PUBLICATIONS
Int. Cl.6 .................................................... .. G06F 15/42
[52] U.S. c1. ........................ .. 128/699; 128/696; 128/642;
607/119
[58]
u
3/1994 Edwards et a1. .
Darin Panescu’ Sunnyvale, Calif‘
callf-
[51]
,
5,293,869
[731 Asegnee EeTehneoges, Inc», Sunnyvale
[21]
Jan. 30, 1996
9/1993 Mueller .
VELOCITIES OF ELECTRICAL EVENTS IN
[.75] Inventor:
5,487,391
Field Of Search ................................... .. 128/695, 696,
128/702, 642, 699; 607/115, 116, 119, 122
_
_
_
Mlch‘tel A- Fall“: MD’ Mymmdlal Electrlcal Impedance
Mapping of Ischermc Sheep Hearts and Healing Aneurysms,
cuculatw“ "01' 87’ N°' 1 Jan‘ 1993’ 199407‘
Primary Examiner—William E. Karnm
Assistant Examiner—Marianne Parker
[56]
References Cited
Attorney, Agent, or Firm-Ryan, Maki & Hohenfeldt
U.S. PATENT DOCUMENTS
4,380,237
4/1983 Newbower -
13;
4’674’518
[57]
gig‘: it al- '
6,1987 S810 _
ABSTRACT
Systems and methods examine heart tissue morphology by
128/642
‘ """"""""""""""" "
locating electrodes in contact with a region of heart tissue to
sense the timing of a local depolarization events. From this,
4:699:147 10/1987 Chilson et a1_ _
the systems and methods derive the propagation velocities of
4,852,580 8,1989 wood _
4,911,174 3/1990 pederson et a1_ _
5,041,973 8/1991 Lebran et a1. ................... .. 364/413.05
5,058,583 10/1991 Geddes et a1. .
5,092,339 31/1992 Geddes 9t 31- -
the depolarization events and create an output that displays
the derived propagation velocities in spatial relation to
sensing electrode. The systems and methods can anange the
derived propagation velocities into groups of equal propa
gation velocities and generate in three dimensions an output
5,109,870
5/ 1992 silny et a1- -
of the groups of equal propagation velocities in spatial
13;
E2350“ 6‘ a1- 5’195’968 3,1993 Lundqilist et a1
5:197:46.’ 3,1993 steinhaus et a1; _'
relation to the location of the sensing electrodes. The iso
conduction display more rapidly identi?es the regions of
slow conduction which are candidate ablation sites, than an
5,224,475
7/1993 Berg et al .
1SO-ChI'OIl?l OI‘ ISO-d613,)’ display.
5,228,442
7/1993
5,239,999
8/1993 Irnran .
Imran .................................... .. 128/642
32 Claims, 26 Drawing Sheets
34
US. Patent
Jan. 30, 1996
Sheet 1 of 26
5,487,391
US. Patent
Jan. 30, 1996
Sheet 2 of 26
5,487,391
US. Patent
Jan. 30, 1996
Sheet 3 of 26
5,487,391
US. Patent
FIG.4
Jan. 30, 1996
Sheet 4 0f 26
5,487,391
US. Patent
Jan. 30, 1996
Sheet 5 0f 26
US. Patent
Jan. 30, 1996
Sheet 6 0f 26
5,487,391
US. Patent
Jan. 30, 1996
50
FIG. 7
r
_
l
_
__
//
I
|
_
_
56
_
_
5s
/ //
wrsnmcs
i|
_
___,
54
__
_
f
\ 60
__|
62
-
—
*
~
~
—
68
64
|
Luz/146510 I
k
came” I
L}
// 38 46
CDM/ER‘ERJ/
?0 I u‘E
\l
\ee
—
5,487,391
w
arc/1mm?
|
L-
_
Sheet 7 of 26
—
—
*
~
-
—
l
E
“I
S
j
36
PRLC'ESSOKAZOG
FIG. 8
E1
E2
[46
E3
E4
E5
(in/5mm?
f2
No
JE’LMTC/Nl
my 1 CURRENT
PATH
E1
/
72
US. Patent
I
Jan. 30, 1996
[so(
68 /64
Sheet 8 of 26
5,487,391
CURRENT
A5243mm
)
\
E1
E2
GENERATOR
66
\l
FIG. .9
M
/50
CURRENT
PATH
<68 /64
Il
E1
E2
E3
I
65/50: Top
FI6'.I0
70
US. Patent
f
Jan. 30, 1996
lmd
Sheet 11 of 26
.lmvol
5,487,391
1
US. Patent
Jan. 30, 1996
Sheet 12 of 26,
5,487,391
COMPUTE ELECTRODE
LOCATION
3D COORDINATES
OVERLAY
3D MESH
DERIVE
E-CHARACTERISTICS
AT
MESH NODES
MATCH
\égmucnom
VALUES
(FIG. 26)
ASSIGN
INDICiA
'
TO
E-CHARACTERISTICS
VALUES
|
PROJECT
MAP
DISPLAY
FIG. ,6
E
US. Patent
Jan. 30, 1996
Sheet 13 0f 26
5,487,391
<2065
N\6?‘
|_
Imd
lo
lmdl
US. Patent
Sheet 14 of 26
Jan. 30, 1996
5,487,391
200
FIG. '8 /50
I
CURRENT
QEA/ER'ATOQ
p/lg/Alg MODUZE' //-‘202
EZE6TQD6FAM
PROCESSOR
SIG/VAL
PIOCESS/NG
H067 PROCé'SSOR/A 206
I
\52
FIG. I9
[208
m Q
L? O
m
mm
\N \O
pm
38
#057‘
WOC'ESR
04 m
US. Patent
Jan. 30, 1996
Sheet 17 of 26
5,487,391
CHOOSE
REFERENCE
TIMES
FIG.ZIB
CLUSTER
BEATS
SELECT
EARLIEST
DEPOLARIZATION EVENT
COM PUTE
PROPAGATION
TIMES
US. Patent
Jan. 30, 1996
Sheet 18 0f 26
5,487,391
COMPUTE ELECTRODE
252
LOCATION
\
FIG. 22
3D COORDINATES
OVERLAY
3D MESH
DERIVE
ELECTROGRAM
EVENTS
AT
MESH NODES
ASSIGN INDICIA
TO
ELECTROGRAM
EVENTS
I
PROJECT
MAP
DISPLAY
US. Patent
Jan. 30, 1996
Sheet ‘19 0f 26
5,487,391
0.5'-
AREGION
23FIG.
1-‘