Abstract: Devices, systems, and methods for localizing and/or treating arrhythmias of a patient's heart, which are particularly useful for localizing focal atrial fibrillation, allow locating arrhythmogenic regions of a chamber of the heart using heart cycle signals measured from a body surface of the patient. Non-invasive localization of the ectopic origin or exit site allows focal, circular, and/or perimeter treatment to be directed so as to inhibit complex arrhythmias without having to rely on wide-spread and time consuming sequential searches and/or on massively invasive simultaneous electrocardial sensors. The invention recognizes that effective localization of these complex arrhythmias can be significantly enhanced by techniques and structures which separate heart cycle signals originating from differing chambers and/or regions of the heart tissue.

Abstract: A system and method are provided for developing a database of body surface ECG P-wave maps for classification and localization of left-sided atrial arrhythmias. The system and method include generating and receiving P-wave data in a subject by left atrial pacing or receiving P-wave data in a subject during spontaneously occurring or induced left atrial arrhythmias; computing (e.g. potential or integral) maps of the P-wave data; classifying the maps specific to a left atrial ectopic origin; verifying the classification procedure; averaging the classified maps into mean maps; and storing and accessing the mean maps in the database. The mean maps of the P-wave data in the database can be used to automatically classify and localize P-wave data from a patient obtained during a left atrial arrhythmia such as atrial tachycardia, focal atrial fibrillation, or orthodromic atrioventricular reentrant tachycardia.

Abstract: Methods and apparatus for enhancing diagnosis of myocardial infarctions generally compare cardiac data from multiple-lead ECG devices with similar stored data for previous patients with cardiac ischemia. Generally, data from between about 30 and about 130 leads is used to construct body surface maps of multiple patients and those maps are sorted and stored based on presence of ischemia, location of ischemia, size of ischemia and/or the like, for each patient. When a new patient is then evaluated with a multiple-lead ECG, data from that patient can be compared with stored data from the previous patients and the new-patient data can be matched to similar stored data. Thus, characteristics about the new patient's ischemia can be determined, such as presence, location and/or size of a myocardial infarction. The ECG device may be deployed as a set of panels to be applied to the patient, and a display device may be provided to a physician for enhanced diagnosis.

Abstract: Devices, systems, and methods for localizing and/or treating arrhythmias of a patient's heart, which are particularly useful for localizing focal atrial fibrillation, allow locating arrhythmogenic regions of a chamber of the heart using heart cycle signals measured from a body surface of the patient. Non-invasive localization of the ectopic origin or exit site allows focal, circular, and/or perimeter treatment to be directed so as to inhibit complex arrhythmias without having to rely on wide-spread and time consuming sequential searches and/or on massively invasive simultaneous electrocardial sensors. The invention recognizes that effective localization of these complex arrhythmias can be significantly enhanced by techniques and structures which separate heart cycle signals originating from differing chambers and/or regions of the heart tissue.

Abstract: Improved systems, devices, and methods sense heart signals through a torso surface of a patient. These improved systems facilitate mounting of an array of sensors upon the patient's torso by supporting the sensor arrays on one or more panels. Four separate panels can be adapted for engaging the torso surface, with the four panels supporting most and/or all of the sensors necessary for localizing an arrhythmia within a chamber of a heart of a patient. The panels may have integrated components for use with other electrophysiology lab equipment such as cardiac imagers, defibrillation power sources, therapeutic probes, standard 12-lead electrocardiogram (ECG) systems, and the like. An exemplary arrhythmia sensing system is adapted for use in the high-noise environment of an electrophysiology lab includes a series of powered circuits distributed among the electrodes of the array.

Abstract: Systems, devices, and methods localize and/or treat arrhythmias of a heart of a patient using signals sensed at an accessible body surface. Based on a database of known heart signals and associated ectopic origin sites or exit sites for treatment guidance, continuous localization identifies candidate ectopic or exit sites throughout a continuous region of tissue. An integral from a selected time interval of a reference heart cycle can be compared statistically with known body surface maps. Statistical interpolation can identify a candidate ectopic or exit site which is different than the known ectopic or exit sites. Relative localization provides accurate site identification from one or more known pacing sites (and the associated heart signals) taken from the patient.

Abstract: The present invention provides a noninvasive localization, characterization and classification apparatus and method for cardiac arrhythmias. The invention enables discrete isolation of the intricate spatial and temporal detail in morphology of the atrial activity of interest from superimposed ventricular activity of a preceding heartbeat in a particular arrhythmia. An adaptive QRST subtraction template is used that is modulated for discrepancies in voltage and rate between the QRST template and arrhythmia signal. The QRST template modulation is accomplished by using one or more fiducial points and windows that are annotated in both the QRST template and the arrhythmia signal. The invention includes, but is not limited to, the isolation of atrial activity that are commonly known as: (1) P waves in case of focal atrial fibrillation, atrial tachycardia, and orthodromic AV reentrant tachycardia; (2) fibrillation waves in case of chronic atrial fibrillation; and (3) flutter waves in case of atrial flutter.

Abstract: Improved systems, devices, and methods sense heart signals through a torso surface of a patient. These improved systems facilitate mounting of an array of sensors upon the patient's torso by supporting the sensor arrays on one or more panels. Four separate panels can be adapted for engaging the torso surface, with the four panels supporting most and/or all of the sensors necessary for localizing an arrhythmia within a chamber of a heart of a patient. The panels may have integrated components for use with other electrophysiology lab equipment such as cardiac imagers, defibrillation power sources, therapeutic probes, standard 12-lead electrocardiogram (ECG) systems, and the like. An exemplary arrhythmia sensing system is adapted for use in the high-noise environment of an electrophysiology lab includes a series of powered circuits distributed among the electrodes of the array.

Abstract: A method and apparatus for developing a database of mean body surface ECG flutter wave data maps for classification of atrial flutter are described. ECG signals from a plurality of torso sites and multisite endocardial recordings are obtained during CCW and CW typical atrial flutter and atypical atrial flutter. Flutter wave episodes are divided into two or three successive time intervals showing stable potential distributions from which data maps are computed. Body surface mapping of CCW and CW typical atrial flutter and atypical atrial flutter is compared with endocardial activation sequence mapping to confirm validity between the body surface ECG pattern and the underlying right or left atrial activation sequence. The body surface ECG map patterns of CCW and CW typical atrial flutter are characterized by a stereotypical spatial voltage distribution that can be directly related to the underlying activation sequence and are highly specific to the direction of flutter wave rotation.

Abstract: Systems, devices, and methods localize and/or treat arrhythmias of a heart of a patient using signals sensed at an accessible body surface. Based on a database of known heart signals and associated ectopic origin sites or exit sites for treatment guidance, continuous localization identifies candidate ectopic or exit sites throughout a continuous region of tissue. An integral from a selected time interval of a reference heart cycle can be compared statistically with known body surface maps. Statistical interpolation can identify a candidate ectopic or exit site which is different than the known ectopic or exit sites. Relative localization provides accurate site identification from one or more known pacing sites (and the associated heart signals) taken from the patient.

Abstract: The present invention relates to classification and localization of arrhythmias. More specifically, a system and method is provided for developing a database of body surface ECG P wave maps for classification and localization of left-sided atrial arrhythmias. The invention includes generating and receiving P wave data in a subject by left atrial pacing or receiving P wave data in a subject during spontaneously occurring or induced left atrial arrhythmias; computing (e.g. potential or integral) maps of the P wave data; classifying the maps specific to a left atrial ectopic origin; verifying the classification procedure; averaging the classified maps into mean maps; and storing and accessing the mean maps in the database. The mean maps of the P wave data in the database can be used to automatically classify and localize P wave data from a patient obtained during a left atrial arrhythmia such as atrial tachycardia, focal atrial fibrillation or orthodromic atrioventricular reentrant tachycardia.

Abstract: The present invention provides a noninvasive localization, characterization and classification apparatus and method for cardiac arrhythmias. The invention enables discrete isolation of the intricate spatial and temporal detail in morphology of the atrial activity of interest from superimposed ventricular activity of a preceding heartbeat in a particular arrhythmia. An adaptive QRST subtraction template is used that is modulated for discrepancies in voltage and rate between the QRST template and arrhythmia signal. The QRST template modulation is accomplished by using one or more fiducial points and windows that are annotated in both the QRST template and the arrhythmia signal. The invention includes, but is not limited to, the isolation of atrial activity that are commonly known as: (1) P waves in case of focal atrial fibrillation, atrial tachycardia, and orthodromic AV reentrant tachycardia; (2) fibrillation waves in case of chronic atrial fibrillation; and (3) flutter waves in case of atrial flutter.