Abstract: Medical devices and methods for making and using medical devices are disclosed. An example system for mapping the electrical activity of the heart includes a catheter shaft. The catheter shaft includes a plurality of electrodes including a first and a second electrode. The system also includes a processor. The processor is capable of collecting a first signal corresponding to a first electrode over a time period and generating a first time-frequency distribution corresponding to the first signal. The first time-frequency distribution includes a first dominant frequency value representation occurring at one or more first base frequencies. The processor is also capable of applying a filter to the first signal or derivatives thereof to determine whether the first dominant frequency value representation includes a single first dominant frequency value at a first base frequency or two or more first dominant frequency values at two or more base frequencies.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example system for mapping the electrical activity of the heart includes a processor. The processor is capable of sensing a plurality of signals with a plurality of electrodes positioned within the heart and collecting a plurality of signals corresponding to the plurality of electrodes. Collecting the plurality of signals occurs over a time period.

Abstract: An anatomical mapping system includes a plurality of mapping electrodes each having an electrode location and configured to detect activation signals of intrinsic physiological activity within an anatomical structure. A mapping processor is associated with the plurality of mapping electrodes and is configured to record the detected activation signals and associate one of the plurality of mapping electrodes with each recorded activation signal. The mapping processor is further configured to analyze the recorded activation signals to identify at least one recurring pattern based on a relationship between a timing of the detected activation signals and the electrode locations of the mapping electrode associated with each detected activation signal.

Abstract: An anatomical mapping system and method includes mapping electrodes configured to detect activation signals of cardiac activity. A processing system is configured to record the detected activation signals and generate a vector field for each sensed activation signal during each instance of the physiological activity. The processing system determines an onset time and alternative onset time candidates, identifies an initial vector field template based on a degree of similarity between the initial vector field and a vector field template from a bank of templates, then determines an optimized onset time for each activation signal based on a degree similarity between the onset time candidates and initial vector field template.

Abstract: An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example method may include a method of mapping the electrical activity of a heart. The method may include sensing a plurality of signals with a plurality of electrodes positioned within the heart, determining a dominant frequency of the plurality of signals and generating an alternate signal for each of the plurality of signals corresponding to the dominant frequency. The alternate signals may have a phase-shift corresponding to one of the plurality of signals. The method may also include displaying a characteristic of the alternate signal over time.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a system for mapping the electrical activity of the heart. The system may include a catheter shaft with a plurality of electrodes. The system may also include a processor. The processor may be capable of collecting a set of signals from at least one of the plurality of electrodes. The set of signals may be collected over a time period. The processor may also be capable of calculating at least one propagation vector from the set of signals, generating a data set from the at least one propagation vector, generating a statistical distribution of the data set and generating a visual representation of the statistical distribution.

Abstract: Medical devices and methods for making and using medical devices are disclosed. A method for removing an artifact of a biological reference signal present in a biological source signal may comprise sensing a biological reference signal with one or more electrodes and sensing a biological source signal, wherein the biological source signal comprises an artifact of the biological reference signal. The method may further comprise determining, based on the biological reference signal, the artifact of the biological reference signal and subtracting the artifact of the biological reference signal from the sensed biological source signal.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example method may include a method of identifying an activation time in a cardiac electrical signal. The method may include sensing a cardiac electrical signal, generating an approximation signal based at least in part on one or more parameters of the cardiac electrical signal, identifying a fiducial point on the approximation signal and determining, based at least in part on a timing of the fiducial point in the approximation signal, an activation time in the cardiac electrical signal.

Abstract: A method and system for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of mapping electrodes disposed in or near the anatomical structure. The activation signals are used to determine a dominant frequency for each electrode from which a wavefront vector for each electrode is determined based on a difference between the dominant frequency at a first electrode location and the dominant frequency at neighboring electrodes. An anatomical map is generated based on the determined wavefront vectors.

Abstract: Cardiac anodal electrostimulation detection systems and methods are described, such as for distinguishing between cathodal-only capture and at least partially anodal capture (e.g., combined anodal and cathodal capture, or between two anodes of which only one captures nearby cardiac tissue, etc.).

Abstract: An anatomical mapping system and method includes mapping electrodes configured to detect activation signals of cardiac activity. A processing system is configured to record the detected activation signals and generate a vector field for each sensed activation signal during each instance of the physiological activity. The processing system determines an onset time and alternative onset time candidates, identifies an initial vector field template based on a degree of similarity between the initial vector field and a vector field template from a bank of templates, then determines an optimized onset time for each activation signal based on a degree similarity between the onset time candidates and initial vector field template.

Abstract: An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device.

Abstract: Medical devices and methods for making and using medical devices are disclosed. A method of mapping electrical activity of a heart may comprise sensing a plurality of signals with a plurality of electrodes positioned within the heart. The method may further comprise separating the plurality of signals into a first group of signals and a second group of signals, and generating a data set that includes at least one known data point and one or more unknown data points. In some examples, the at least one known data point is generated based on the first group of signals.

Abstract: Electrical activity propagation along an electrode array within a cardiac chamber is reconstructed. Signals are sampled from the electrode array including signals from a channel of interest. An N-dimensional signal vector is then constructed using signals from N neighboring channels referenced to the channel of interest. A change in the N-dimensional signal vector over time is then determined and compared to a predetermined threshold to establish whether local activation has occurred on the channel of interest.

Abstract: Methods for displaying physiological mapping data are disclosed. An example method may include storing a set of three-dimensional positional data on a memory, storing a set of metric data on the memory, and storing a set of electrogram data on the memory. The method may also include outputting the set of three-dimensional positional data, the set of two-dimensional metric data, and the set of electrogram data from the memory to a display unit and displaying the set of three-dimensional positional data, the set of two-dimensional metric data, and the set of electrogram data on the display unit as a dynamic display.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a catheter shaft with a plurality of electrodes coupled thereto and a processor coupled to the catheter shaft. The processor may be capable of collecting a set of signals from the plurality of electrodes and generating a data set from at least one of the set of signals. The data set may include at least one known data point and one or more unknown data points. The processor may also be capable of interpolating at least one of the unknown data points by conditioning the data set, assigning an interpolated value to at least one of the unknown data points, and assigning a confidence level to the interpolated value.

Abstract: Methods for displaying summarized physiological mapping data are disclosed. An example method may include storing a set of three-dimensional positional data on a memory, storing a set of metric data on the memory, and storing a set of electrogram data on the memory. The method may also include outputting the set of three-dimensional positional data, the set of two-dimensional metric data, and the set of electrogram data from the memory to a display unit and displaying the set of three-dimensional positional data, the set of two-dimensional metric data, and the set of electrogram data on the display unit as a summarized static display.

Abstract: A neurostimulation system measures a cardiac parameter at various cardiac intervals and analyzes its restitution, including computing a restitution slope being a rate of change of the restitution parameter with respect to change in the cardiac interval. In various embodiments, the system uses the restitution slope to provide for adaptive control of neurostimulation. In various embodiments, one or more cardiac parameters such as action potential duration (APD), conduction velocity (CV), QT interval (QT), and/or T-wave morphology (TM) parameter are measured and analyzed for restitution of each parameter, which is then used to control the delivery of the neurostimulation.

Abstract: A method for mapping an anatomical structure includes sensing activation signals of physiological activity with a plurality of electrodes disposed in or near the anatomical structure, each activation signal having an associated cycle length, estimating an action potential duration and diastolic interval for each cycle length, generating a restitution curve based on the estimated action potential duration and diastolic interval from a preceding cycle length, iteratively optimizing each estimated action potential duration and corresponding diastolic interval to maximize a functional relationship between the estimated action potential duration and estimated diastolic interval from preceding cycle length, and generating an action potential duration restitution curve based on the optimized action potential durations and diastolic intervals.