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: A system and method for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of electrodes disposed in or near the anatomical structure. A most recent intrinsic event at a selected time is determined based on the sensed activation signals and a persistent display of relevant characteristics is generated based on the sensed activation signals of the most recent intrinsic event. The persistent display is updated upon detection of a subsequent intrinsic event.

Abstract: A method and system for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of electrodes disposed in or near the anatomical structure. Substantially similar activation signals are binned according to a self-correlation algorithm which identifies patterns among the sensed activation signals. A template is generated for each bin and compared to a characteristic template to identify at least one bin which corresponds to a far-field activation signal.

Abstract: An example of a system includes an implantable medical device (IMD) for implantation in a patient, where the IMD includes a cardiac pace generator, phrenic nerve stimulation (PS) sensor, a memory, and a controller, and where the controller is operably connected to the cardiac pace generator to generate cardiac paces. The controller is configured to provide a trigger for conducting a PS detection procedure and perform the PS detection procedure in response to the trigger. In performing the PS detection procedure the controller is configured to receive a signal from the sensor, detect PS using the signal from the sensor, and record the PS detection in storage within the IMD.

Abstract: A method and a system of phrenic nerve stimulation detection in conjunction with posture sensing is disclosed. In an embodiment, the method may include receiving a trigger for conducting a pace-induced phrenic nerve stimulation (PS) search using the IMD within the patient. On receiving the trigger, the IMD may be used for conducting the PS search. A procedure of conducting the PS search may include measuring a posture of the patient using an implantable posture sensor, searching for PS while the patient is in the measured posture and obtaining a PS result from the PS search for the measured posture. The method may include recording both the PS result and the measured posture in a memory of the IMD.

Abstract: An anatomical mapping system includes a plurality of mapping electrodes, a plurality of mechanical sensors, and a mapping processor associated with the plurality of mapping electrodes and mechanical sensors. The mapping electrodes are configured to detect electrical activation signals of intrinsic physiological activity within an anatomical structure. The mechanical sensors are configured to detect mechanical activity associated with the intrinsic physiological activity. The mapping processor is configured to record the detected activation signals and associate one of the plurality of mapping electrodes and mechanical sensors with each recorded activation signal. The mapping processor is further configured to determine activation times of the intrinsic physiological activity based on a correlation of corresponding electrical activation signals and mechanical activity.

Abstract: Approaches for rate initialization and overdrive pacing used during capture threshold testing are described. Cardiac cycles are detected and the cardiac events of a cardiac chamber that occur during the cardiac cycles are monitored. The number of intrinsic beats in the cardiac events is counted. Initialization for a capture threshold test involves maintaining a pre-test pacing rate for the capture threshold test if the number of intrinsic beats in the cardiac events is less than a threshold. The pacing rate is increased for the capture threshold test if the number of intrinsic beats in the cardiac events is greater than the threshold.

Abstract: A method for mapping a cardiac chamber includes sensing activation signals of intrinsic physiological activity with a plurality of electrodes disposed in or near the cardiac chamber, the activation signals including a near-field activation signal component and a far-field activation signal component, isolating R-wave events in the activation signals, generating a far-field activation template representative of the far-field activation signal component based on the R-wave events, and filtering the far-field activation template from the activation signals to identify the near-field activation signal components in the activation signals.

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.

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: A catheter system includes a mapping catheter having a plurality of splines, each of the plurality of splines including a plurality of mapping electrodes. The system further includes a processor operatively coupled to the plurality of mapping electrodes and configured to receive signals sensed by the plurality of mapping electrodes. The processor is further configured to estimate an interspline distance between adjacent splines in the plurality of splines based on the signals sensed by the mapping electrodes on the adjacent splines.

Abstract: A method for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of electrodes disposed in or near the anatomical structure, identifying at least one of the electrodes not in direct contact with the anatomical structure, and adjusting the activation signals sensed by each of the plurality of electrodes based on the activation signals sensed by the identified at least one of the electrodes not in direct contact with the anatomical structure.

Abstract: A catheter system includes a mapping catheter including a plurality of mapping electrodes, each mapping electrode configured to sense signals associated with an anatomical structure. The catheter system further includes a processor operatively coupled to the plurality of mapping electrodes and configured to receive the signals sensed by the plurality of mapping electrodes, characterize the signals sensed by the plurality of mapping electrodes based on amplitudes of the sensed signals, and generate an output of a quality of contact of the plurality of mapping electrodes with the anatomical structure based on the signal characterization.

Abstract: Approaches for rate initialization and overdrive pacing used during capture threshold testing are described. Cardiac cycles are detected and the cardiac events of a cardiac chamber that occur during the cardiac cycles are monitored. The number of intrinsic beats in the cardiac events is counted. Initialization for a capture threshold test involves maintaining a pre-test pacing rate for the capture threshold test if the number of intrinsic beats in the cardiac events is less than a threshold. The pacing rate is increased for the capture threshold test if the number of intrinsic beats in the cardiac events is greater than the threshold.

Abstract: A catheter system includes a plurality of mapping electrodes, an electrode movable relative to the plurality of mapping electrodes, and a guidance system coupled to the plurality of mapping electrodes and the ablation electrode. The guidance system is configured to receive signals associated with intrinsic cardiac activity sensed by the plurality of mapping electrodes and the movable electrode, and to correlate in real-time the intrinsic cardiac activity sensed by the movable electrode with the intrinsic cardiac activity sensed by the plurality of mapping electrodes based on the signals received by the plurality of mapping electrodes and movable electrode to determine a location of the movable electrode with respect to the plurality of mapping electrodes.

Abstract: An example of a system comprises a cardiac pulse generator configured to generate cardiac paces to pace the heart, a sensor configured to sense a physiological signal for use in detecting pace-induced phrenic nerve stimulation (PS), a storage, and a phrenic nerve stimulation detector. The storage is configured for use to store patient-specific PS features for PS beats with a desirably large signal-to-noise ratio. The phrenic nerve stimulation detector may be configured to detect PS features for the patient by analyzing a PS beat with a desirably large signal-to-noise ratio induced using a pacing pulse with a large energy output and store patient-specific PS features in the storage, and use the patient-specific PS features stored in the memory to detect PS beats when the heart is paced heart using cardiac pacing pulses with a smaller energy output.

Abstract: Various techniques are disclosed for quickly and efficiently determining cardiac pacing vectors that minimize phrenic nerve stimulation.

Abstract: Electrical activity propagation along an electrode array within a cardiac chamber is reconstructed. Signals are sampled from the electrode array and the signals are plotted in multi-dimensional space with each axis corresponding to a channel in the electrode array. An excursion direction of global activation in the multi-dimensional space is estimated and a change in vectors of the sampled signals over time is determined. Signals with vectors that change over time in the excursion direction are suppressed.

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: Electrical activity propagation along an electrode array within a cardiac chamber is reconstructed. Signals from the electrode array are sampled, and the signals are plotted in multi-dimensional space with each axis corresponding to a channel in the electrode array. A covariance matrix of the plotted signals is decomposed to characterize the spread of a data cloud of the signals in the multi-dimensional space. The data cloud is then decorrelated, such as through whitening, to suppress excursions along correlated directions (global activation) and enhance excursions along each axis (local activation).