CN106714677A

CN106714677A - System and method for reconstructing cardiac activation information

Info

Publication number: CN106714677A
Application number: CN201580051983.4A
Authority: CN
Inventors: 桑吉夫·纳拉扬; 凯里·罗伯特·布里格斯
Original assignee: University of California; Topera Inc
Current assignee: University of California; Topera Inc
Priority date: 2014-08-29
Filing date: 2015-08-25
Publication date: 2017-05-24
Also published as: EP3185768A1; WO2016033075A1; EP3185768A4; IL250638A0

Abstract

A method of representing cardiac information associated with a heart rhythm disorder includes accessing a plurality of neighboring cardiac signals obtained from a patient. Far-field activations are eliminated from the plurality of neighboring cardiac signals using one or more divergence criteria that define local activations in the plurality of neighboring cardiac signals, where the divergence criteria are associated with divergence among the plurality of neighboring cardiac signals. The method may also include constructing a clinical representation of local activations in the plurality of neighboring cardiac signals.

Description

System and method for rebuilding heart excitement information

Related application

The application is the part continuation application of the U.S. Application No. 14/074,619 submitted on November 7th, 2013, the U.S. Application number 14/074,619 be submitted on April 3rd, 2012 U.S. Application No. 13/438,534, now for U.S. Patent number 8, 594,777 continuation application, U.S. Application No. 13/438,534 is in the U.S. Application No. 13/ of submission on the 24th of August in 2011 217,123, it is now the continuation application of U.S. Patent number 8,165,666, U.S. Application No. 13/217,123 was required in May, 2011 The benefit of priority of the U.S. Provisional Application No. 61/481,607 submitted to for 2nd, each of these applications is by quoting with it Full content is hereby incorporated by.

Government rights

The present invention be NIH subsidize fund R01HL83359, HL83359-S1 and Carried out by governmental support under HL103800.U.S. government has certain rights in the invention.

Background

Invention field

Present invention relates generally to cardiac dysrhythmia.More precisely, the application is directed to one kind for reconstruction and the heart The system and method for the related heart excitement information (exciting starting) of dirty RD.

The simple discussion of correlation technique

Heart (heart) RD is very common, and represents whole world morbidity and dead Important cause of disease.Electricity in heart The failure of system represents the immediate cause of cardiac dysrhythmia.Cardiac dysrhythmia exists in many forms, most complicated in the middle of them And difficult to treat is atrial fibrillation (AF), Ventricular Tachycardia (VT) and ventricular fibrillation (VF).Other RD treatment gets up simpler, it is also possible to being clinically significant, including atrial tachycardia (AT), supraventricular aroused in interest Overrun (SVT), auricular flutter (AFL), supraventricular dystopy syndrome/beating (SVE) and VPB syndrome/beating (PVC).Although under normal operation, sinoatrial node make heart keep sinus rhythm, under certain conditions, normal sinoatrial node it is fast Fast excitement can cause improperly nodal tachycardia or sino-atrial node reentry, both of these case also all to represent cardiac dysrhythmia.

The treatment of the complicated RD of cardiac dysrhythmia, especially AF, VF and polymorphy VT may be extremely difficult. Medicinal treatment for complicated RD is not optimal, and effect is poor and side effect is notable.Ablation by with Under type is used in terms of cardiac dysrhythmia more and more：Through blood vessel or directly in operation by a sensing Device/probe manipulation to heart, and to concealment cardiac dysrhythmia the heart of the cause of disease location delivery energy with Mitigate and eliminate cardiac dysrhythmia in some cases.However, in complicated RD, ablation it is generally highly difficult and It is invalid because differentiate and positioning cardiac dysrhythmia a cause of disease instrument it is poor and hinder and passed to the correct region of heart Energy is sent to eliminate the trial of disorder.

Become known for treating some system and method for simple cardiac dysrhythmia.In a kind of simple cardiac dysrhythmia In (such as atrial tachycardia), consistent exciting initial modes can generally trace back to an earliest position between beating and beating Put, the position can be ablated to mitigate and eliminate in some cases disorderly.Even if in simple cardiac dysrhythmia, one Such ablation of the cause of disease of kind of cardiac dysrhythmia is also challenging to, and skilled practitioner generally need it is several Hour melts the simple RD with consistent beating to beating activation pattern, such as atrial tachycardia.

There is no successful known in terms of the cause of disease for complicated RD (such as AF, VF or polymorphy VT) is differentiated System and method.In a kind of complicated RD, an earliest position of exciting starting can not possibly be authenticated, because exciting rise Beginning pattern changes between beating and beating and is " continuous ", so that without identifiable point at first (or beginning) or most Point (or end) afterwards.

Diagnosis and treatment cardiac dysrhythmia are usually directed to will be with multiple sensor/probes through the blood vessel of patient A conduit be introduced into heart.Cardiac electrical activity in these sensors detection heart at sensing station.The electrical activity is total The exciting electrogram signal for representing the heart at these sensing stations is processed on body.

In a kind of simple cardiac dysrhythmia, the signal at each sensing station is generally between beating and beating It is in sequential aspect and consistent generally in terms of its shape for deflecting with number of times, enabling to differentiate at each sensing station Exciting starting.However, in a kind of complicated RD, the signal at each sensing station between beating and beating can be with Change between one of different shapes, several and multiple deflections.For example, when in AF for sensing station One signal include 5,7,11 or more deflection when, even if not impossible, but also be difficult to relative to remaining to by the heart Sensor sensing in dirty another away from position (that is, far field exciting) or be only another from patient's heart Partly, relative to the noise of movement or the motion of heart or external electronic system, differentiating should for other anatomical structures, the sensor Which deflection in signal be at the sensing station in heart or near (that is, partial agonist).

There is no the known system and method can be in shape related to cardiac dysrhythmia, especially in complicated RD Heart excitement information (starting) is rebuild in different signals, so that a discriminating for the cause of disease for promoting cardiac dysrhythmia disappears with it Remove.

General introduction

Present invention can be suitably applied to rebuild the exciting information of different RDs, including cardiac dysrhythmia, and other lifes Thing RD, such as nerve epilepsy, esophageal spasm, bladder instability, intestinal irritable syndrome, and biological excitement information can be with It is reconstructed disorderly to permit the other biological of determination, diagnosis and/or the disorderly cause of disease for the treatment of or source.However, the present invention is especially Suitable for producing the complicated RD of complicated activation pattern, and it is particularly suited for the complicated RD of heart, to look for To one or more causes of disease of these disorders or one or more sources so that easily they can be treated.

Partial agonist is derived from ad-hoc location (sensing the feedback of position) or excitement associated there in heart.Sensor can be with Close on the sensing the feedback of position (if it is the sensor with the sensing the feedback of position directly contact) or be associated with the sensing the feedback of position (if It is not the sensor with the sensing the feedback of position directly contact).On the other hand, far field excitement be originate in heart with the biography Excitement at the different position of the associated sensing the feedback of position of sensor.

Routinely, the clinical detection of partial agonist is carried out by the feature mode in individual signals.For example, in simple office In stove arrhythmia cordis, routinely, single-phase feminine gender (" the QS ") compound on monopole EGM characterizes a kind of simple office The starting of stove arrhythmia cordis.However, in complicated RD, collision electric wave can be superimposed upon on the partial agonist so that It is difficult or impossible to be detected by these conventional methods.This is independently of relative sensing station.Therefore, in the complicated rhythm and pace of moving things In disorder, or even the sensor being associated with sensing the feedback of position closely swashs the partial agonist with superposition and far field It is dynamic.In addition, be associated with sensing the feedback of position, but the sensor being not directly contacted with is exciting by the partial agonist with change and far field (for example, being attributed to such as action, breathing, the factor of heart movement), its further limitation separately partial agonist and far field excitement Ability.

The present invention reliably recognizes and represent the ability of partial agonist by eliminating far field excitement from clinical manifestation to be made The accurate detection rotor related to complicated RD and focal source are obtained, and helps to be directly targeted treatment source. On the contrary, not eliminating the exciting method in far field can less detect consistent source, partly cause is that their analysis is limited to work as Far field exciting (for example, ventricular activation, collides ripple) less substantially or in the absence of when time interval.This limitation of existing method The detection in source is limited or precluded, this is possible by the present invention.

Complicated cardiac dysrhythmia typically produces the activation pattern of extremely difficult deciphering, and can not possibly still have the ability before this really The accurate exciting information of fixed complicated disorder cardiac beating.One of advantage of the invention causes disorder to rebuild heart excitement information The cause of disease and/or source the determination ability that can be determined and treat.Another advantage is, the present invention provide a kind of system and Method, the system and method (such as have one of sensor to lead thereon when in patient's body or nearby using a sensing device further Pipe) when can be rapidly performed, and can then treat heart tissue to improve disorder, and cure in many cases It is disorderly.Therefore can at once be treated after reconstructed heart information is calculated because it will provide the disorderly cause of disease or One or more positions in source.

System and method before are in the presence of the source that not can determine that cardiac dysrhythmia and therefore do not provide for intentional The problem of the means in the targeting source of justice and curative therapy.In addition, system and method before need a large amount of and complicated controlling Step is treated, and a kind of one or more causes of disease for being enough to differentiate cardiac dysrhythmia or one or more sources cannot be still provided Rebuild heart excitement information means.

Compared with system and method before, the present invention provides the relatively less step of number to rebuild exciting information, with When just determining the excitement starting at different sensors position for a heartbeat in hardly recognizable activation pattern Between.

As used herein, the one or many beating discriminating difference for being directed to a kind of biological or cardiac dysrhythmia is rebuild The exciting initial time in a heart or bio signal at neighbouring or proximity sensor position a sensing station A process.

As used herein, exciting initial time is the exciting time point started in a cell or tissue, with Other times point during excitement is relative.

As used herein, excitement is to make a cell start its running to become a kind of work from a kind of tranquillization (diastole) state One process of (electricity) state of jump.

According to one embodiment or aspect, the exemplary side for representing the heart information being associated with arrhythmia is disclosed Method.The method includes accessing the multiple adjacent cardiac signals obtained from patient.The method also includes using the multiple adjacent hearts of definition One or more emission standards of partial agonist in dirty signal, eliminate far field excitement, diverging from multiple adjacent cardiac signals Diverging between standard and multiple adjacent cardiac signals is associated.

Far field is eliminated from multiple adjacent cardiac signals exciting including following operation.Access in the plurality of adjacent signals One heart signal and the second heart signal.First heart signal and second heart signal are processed with determine this With the presence or absence of the change point of first heart signal, the derivative phase of first heart signal at the change point in one heart signal Derivative for second heart signal higher than critical value dissipates.If change point is specified in first heart signal Exciting initial time in first heart signal at change point is defining partial agonist.For first heart signal and For second heart signal, the change point can be defined at about the same time point.

The determination of the change point can include following operation.Can be by first heart signal and the second heart signal shape Into a compound heart signal.The ratio at multiple points in first heart signal can be determined.Each ratio can represent this Difference between the derivative of two heart signals and a derivative of the compound heart signal than first heart signal derivative with Difference between the derivative of the compound heart signal.The point conduct with maximum ratio in these determination ratios can be selected Change point in first heart signal.

If without point is changed in the first heart signal, at least one feature of the first heart signal can be believed with heart At least one characteristic matching of the reference heart signal in number catalogue.Hereafter, this can then be specified with reference in heart signal One exciting initial time as first heart signal an exciting initial time, to define the office in the first heart signal Portion is exciting.

Represent that the method for the heart information related to cardiac dysrhythmia to may further include repeatedly access from institute State the heart signal pair of multiple adjacent cardiac signals.All include first heart signal and different the second heart letters for every a pair Number.Every a pair that these centerings can be directed to are processed and specified, and are believed with the first heart in each pair at these in Multiple partial agonists are defined in number.Hereafter, clinic can be built based on multiple partial agonists of multiple adjacent cardiac signals Performance, to indicate the source of cardiac dysrhythmia.

In various embodiments or aspect, it is possible to use cardiac dysrhythmia is treated in the clinical manifestation of structure.

These and other purposes of the application, target and advantage will be described further below by combine that alterations read And be made apparent from.

Brief Description Of Drawings

Some embodiments or aspect are showed in the figure of alterations without limitation by means of example, in these figures：

Fig. 1 illustrates an example heart excitement reconstructing system；

Fig. 2 is illustrated from an a kind of simple electrogram signal of example of cardiac dysrhythmia of sensor, The sensor is placed at heart sensing station shown in Fig. 1；

Fig. 3 is illustrated from an a kind of example complexity electrogram signal for cardiac dysrhythmia of sensor, The sensor is placed at heart sensing station shown in Fig. 1；

Fig. 4 illustrates conduit example sensor arrays shown in Fig. 1 and from these sensors An example selection for rebuilding the signal of heart excitement information；

Fig. 5 illustrates the example comparison signal pair of the sensor from array shown in Fig. 4；

Fig. 6 is that signal Analysis (SIG1) are illustrated with an example signal of reference signal (SIG2) to one compared；

Fig. 7 is that signal Analysis (SIG1) are illustrated with another example signal of reference signal (SIG2) to one compared；

Fig. 8 is another example signal using a signal Analysis for composite signal (SIG1) and reference signal (SIG2) To the diagram for comparing；

Fig. 9 is an a kind of flow of exemplary method that the heart excitement information related to cardiac dysrhythmia is rebuild in displaying Figure；

Figure 10 is that signal Analysis (SIG1) are illustrated with an example signal of reference signal (SIG2) to one compared, should Signal Analysis can be processed with the reference signal according to the method for Fig. 9, so as to rebuild heart excitement information；

Figure 11 is example mappings diagram of the signal according to handled by Fig. 1-10；And

Figure 12 is a block diagram of general-purpose computing system illustrative embodiment.

Detailed description of the invention

There is disclosed herein a kind of system and method for rebuilding the heart excitement information related to cardiac dysrhythmia. In below illustrating, for purposes of explanation, illustrate many specific details to provide the thorough reason to example embodiment or aspect Solution.However, will be apparent to those skilled in the art is can not have disclosed whole details In the case of put into practice an example embodiment.

Fig. 1 illustrates an example heart excitement reconstructing system 100.The example system 100 is configured to detect and weight Build the heart excitement information related to a kind of cardiac dysrhythmia collected/detect from the heart of patient.Heart includes one Individual atrium dextrum 122, atrium sinistrum 124, right ventricle 126 and left ventricle 128.

The example system 100 includes conduit 102, signal processing apparatus 114, computing device 116 and an analyze data Storehouse 118.

The conduit 102 is configured to detect heart excitement information in heart and wirelessly or non-wirelessly connection will by one The heart excitement information transfer for detecting is to the signal processing apparatus 114.The conduit includes multiple probe/sensor 104-112, These probe/sensors can pass through the blood vessel insertion heart of patient.

In some embodiments or aspect, one or more in these sensors 104-112 are not inserted into the heart of the patient It is dirty.For example, some sensors can by patient body-surface (such as electrocardiogram) or not with patient contact in the case of remotely (such as magnetocardiogram) detection heart is exciting.Used as another example, some sensors can also be from a non-electrical sensing device further Heart movement obtain heart excitement information (such as echocardiogram).In different embodiments or aspect, these sensors can To separate or be used with different combinations, and further these separate or different combinations can also be with the insertion patient Sensor combinations in heart are used.

These sensors 104-112 (they are positioned at the sensing station in studied heart) can be at these Heart excitement information is detected at sensing station, and can further deliver energy to melt the heart at these sensing stations It is dirty.It is noted that these sensors 104-112 can also be examined from the overlapping region (such as atrium dextrum 122 and atrium sinistrum 124) of heart The dirty exciting information of thought-read.

The signal processing apparatus 114 are configured to the heart that will be detected by sensor 104-112 at sensing station Exciting information processing (for example illustrate and amplify) provides the heart through processing into electrogram signal to the computing device 116 Dirty signal, to be analyzed or processing according to method disclosed herein.Swash in heart of the treatment from sensor 104-112 During dynamic information, the signal processing apparatus 114 can subtract the heart excitement information of the overlapping region from heart 120, so as to The computing device 116 provides the heart signal through processing, to analyze.Although in some embodiments or aspect, at the signal Reason device 114 is configured to provide unipolar signal, but in other embodiment or aspect, the signal processing apparatus 114 can be carried For bipolar signal.

The computing device 116 is configured to receive (or access) heart signal from the signal processing apparatus 114, and enters One step is configured to according to method disclosed here, functionally or logically analyzes or process these heart signals, to rebuild these Heart excitement information in heart signal, it is possible to find out a kind of cause of disease of the cardiac dysrhythmia and eliminate the disease Cause.

For example, the computing device 116 can process first heart signal and from the heart signal for being received Individual second heart signal, to determine a derivative of the derivative relative to second heart signal of first heart signal With the presence or absence of a change point higher than a critical value.If it is determined that the change point is higher than the critical value, then the calculating is filled Putting 116 can then specify one in first heart signal exciting initial time at the change point, so as to be defined in this Indicate the heart once beaten excited in first signal.

Used as another example, the computing device 116 can repeatedly select multiple hearts from the heart signal for being received Dirty signal pair, every a pair with first heart signal and the second heart signal.The computing device 116 can be to these centerings Processed and specified for every a pair, so that the first heart signal for defining each centering for these centerings indicates repeatedly to fight Dynamic multiple hearts are exciting.For example, the computing device 116 is configured to be processed and is specified, so as to be defined in this Indicate multiple hearts of repeatedly beating excited in one heart signal.The computing device 116 can be next based on from being received The exciting exciting initial time specified of the heart of heart signal rebuilds a kind of heart activation pattern, so as to indicate a species rhythm disorderly A random source.In some embodiments or aspect, the computing device 116 can also show the heart activation pattern of the reconstruction To promote the treatment of the heart tissue at the source, to suppress, being mitigated or eliminated the cardiac dysrhythmia.

The analytical database 118 is configured to the signal analysis for supporting or aiding in be carried out by the computing device 116.At some In embodiment or aspect, the analytical database 118 can store reference signal and a related exciting catalogue, so that the meter Calculate device 116 can determine and studied a signal (for example when change point during a time window be less than critical value When) a related exciting starting, as will be described in more detail herein.

Fig. 2 illustrates a kind of simple electrogram signal 200 of an example of cardiac dysrhythmia, and the signal is from placement A sensor at a sensing station in heart 120.For example, the sensor 104 of conduit 102 can be positioned in At a sensing station in atrium dextrum 122, as shown in fig. 1.Used as an example, the cardiac dysrhythmia can be one Plant complexity RD AF, VF and polymorphy VT, or another cardiac dysrhythmia.

The example signal 200 continues a time period between about 300ms and about 900ms.During this time period, The expected signal 200 has four (4) partial agonist starting 204-208, such as in originating from the heart 120 of sensor 104 Sensing station at or nearby (part) those are exciting initial.Exactly, based on cardiac dysrhythmia in set sight Examine result, it is contemplated that the cycle duration between the excitement starting of AF is for about 100ms to about 300ms, and is expected complexity Cycle duration between the excitement starting of VA is for about 180ms to about 240ms.As an example, it is contemplated that exciting Cycle duration 210 between starting 202 and exciting starting 204 is for about 100ms to about 300ms.In the example signal 200, swash Dynamic starting 204-208 be as general as it is identifiable because they have the lesser degree of baseline drift being superimposed upon in local signal Move, and be mistakened as making the far field artifact of local movement with little possibility.The feature of local movement in this example Can be：One with a sharp keen flex point and slope high exciting starting, the gentle low deviation for being followed by a period of time is oblique Rate (it represents repolarization, typically continues between about 100ms and 250ms).

In the example signal 200, an example far field deflection 212 is showed in the exciting starting 206 of positioning and partial agonist Starting 208 (for example originates from be different from heart 120 at a position of the sensing station related to sensor 104 Individual exciting starting) between.Exactly, the excitement starting 206 in a shorter cycle compared with about 100ms to about 300ms Afterwards, the heart 120 at the sensing station related to sensor 104 cannot physiology ground it is exciting again because local organization It is subjected to repolarization.Additionally, when the deflection 212 is also significantly present in by the neighbour in the multiple directions of orientation sensor 104 When in the signal collected by nearly sensor, the deflection 212 cannot be in the part of the sensing station related to the sensor 104. For example, deflecting 212 a sensing stations that may be relevant with sensor 106 by the far field that sensor 104 is detected Exciting starting is related.

Fig. 3 illustrates a kind of example complexity electrogram signal 300 of cardiac dysrhythmia, and the signal is from placement A sensor at a sensing station in heart 120.For example, the sensor 106 of conduit 102 can be positioned in At a sensing station in atrium dextrum 122, as shown in fig. 1.Used as an example, the cardiac dysrhythmia can be one Plant complexity RD AF, VF and polymorphy VT, or another cardiac dysrhythmia.

Similar to example signal 200, the example signal 300 continues the time between about 300ms and about 900ms Section.During this time period, it is contemplated that signal 300 has four (4) partial agonist startings, such as in the heart of sensor 106 The excitement starting of the local origin of the sensing station in dirty 120.However, there is 11 (11 in the example signal 300 It is individual) possible excitement starting 302-322.Duration for being caused by cardiac dysrhythmia is short (during most short cycle than about 100ms Length is shorter) multiple deflections part for making at exciting with far field or the only relative sensor 104 of noise sensing stations Distinguishing for exciting starting is excessively difficult.

Fig. 4 illustrates an example sensor arrays 400 of conduit 102 and from these sensors for rebuilding the heart One example selection of the signal of dirty exciting information (such as exciting starting).For simplicity and clarity of illustration, the array 400 include 15 (15) exemplary sensors.It should be understood that the array 400 can include less or more sensor, such as it is The different piece of covering heart 120 and may determine it is so much.In some embodiments or aspect, the array 400 can be with Including 160 or more sensors.

The sensor of the array 400 is shown with the instance space arrangement of the atrium dextrum 122 relative to heart 120.Similarly, The array 400 can be spatially arranged in other chambers of heart, for example atrium sinistrum, right ventricle, left ventricle, or for including The combination of the chamber of the internal membrane of heart or epicardial surface.In fig. 4, for simplicity and clarity of illustration, electricity in the array 400 The arrangement space of pole is shown as uniform and plane.However, heart 120 is not a uniform or planar structure.Therefore, should The arrangement space of electrode can change relative to the shape of heart 120 in array 400, so as to improve in heart 120 to electricity The detection of activity.

In an example embodiment or aspect, the conduit 102 of Fig. 1 can be a basket catheter, wherein the array 400 Exemplary sensors along the spline 406-408 of basket catheter 102 with arrangement space form set.The sensor array can be used Sensor space arranges different different conduits, such as spiral, radial spoke or other arrangement spaces in 400.

Sensor (signal of sensor) in the array 400 is to repeatedly being selected for carrying out as herein will be more detailed The treatment of thin description, so as to the heart for rebuilding atrium dextrum 122 or can wherein be provided with another chamber of the array 400 120 heart excitement information (exciting starting).

As shown at 402, a signal Analysis (1) is selected for treatment.One (signal Analysis of reference signal 2 (1) a adjacent signal) one first pair is then selected to form, the first couple is processed to determine signal Analysis (1) In excitement starting.Similarly, as shown at 404, a signal Analysis (1) is selected for treatment.One reference signal (2) (adjacent signals of the signal Analysis (1)) are then selected to form one second pair, and the second couple is processed with true Excitement starting in setting analysis signal (1).The exciting starting of the signal from the first couple and the second couple can be stored in Fig. 1 Computing device 116 memory or database 118 in.These adjacent sensors (signal) can with but need not be neighbouring, following article Will be described in further detail.

For the sensor (signal) of the array 400 of the neighbouring signal Analysis (1), these selection and processing are repeated.Pin The memory or data of computing device 116 can also be stored in the exciting starting in the signal Analysis (1) of all signals pair In storehouse 118.Hereafter, another signal Analysis is chosen, and repeats these selection and processing for the signal Analysis.With this Mode, each in the multiple signal Analysis in array 400 is processed for its adjacent signals.For one given point The number for analysing the adjacent signals of signal may be less or more, depending on the arrangement space of the sensor in the array 400, divides The chamber of the heart of analysis and the cardiac dysrhythmia treated.

Fig. 5 illustrates the example comparison signal pair of the multiple sensors from array shown in Fig. 4 400.Adjacent signal Those signals close to signal Analysis can not only be included, and those signals of not adjacency analysis signal can be included.Space The effect that the region that separating these paired sensors can be considered as local movement with the deflection for spatially making thereon extends.Office Therefore portion's activity is generally defined by the separation of these paired sensors.As shown in the example 1 of Fig. 5, selected analysis Signal (1) is for adjacent signal (2)-(5) and also processed for a non-adjacent signal (6).Such as institute in the example 2 of Fig. 5 Further displaying, selected signal Analysis (1) are for adjacent signal (2)-(5) and also for non-adjacent signal (6) and (7) It is processed.Although immediate adjacent signal is preferred, can use and be oriented in different spaces relative to the signal Analysis On adjacent signal.

For each analysis signal, it is understood that there may be multiple reference signals (such as four (4) reference signals or more It is many).With reference to or based on these reference signals the exciting starting of possibility combination, determine one in the signal Analysis it is final exciting Starting.Exactly, can be for being referenced each other, so as in checking the signal Analysis by the exciting starting that determines for every a pair Exciting correspondence or correlation.Possible exciting starting based on referenced signal pair, finally fixs for analysis letter Number an exciting starting.

The final exciting starting for the signal Analysis can be determined by distinct methods.At one embodiment or aspect In, the final exciting starting for the signal Analysis can be based on the possible exciting starting from different reference signals pair One average value determines.In another embodiment or aspect, the final exciting starting for the signal Analysis can be with base Determine in an average value of possible exciting starting, these possible exciting startings come from wherein most of possible excitements Those signals pair of starting in mutual one section of predetermined time interval (for example, ± 5ms).The time interval for being used can be by Select as shorter or longer.Alternately, the final excitement can also be by performing by multiple possible in most of this " barycenter " of the significance value of each weighting in exciting starting is calculated and determined, or by analyze multiple excitement start-up phases for One Main way of multiple sensing stations determines.

Referring to the example 1 in Fig. 5, if a signal Analysis have determined have with five (5) reference signals to phase What is closed is respectively the possible exciting starting of 170ms, 190ms, 193ms, 165ms and 172ms, then for the signal Analysis Final exciting starting can be determined that (170+165+172)/3=169ms.190ms beyond the time interval and The exciting starting of 193ms can be converted according to the determination of the final exciting starting for the signal Analysis.For each letter Final excitement starting determined by number can be stored in the database 118 of Fig. 1.

Although in previous examples for brevity and clarity, believing for the analysis related to each reference signal Number, only one excitement starting is determined, it should be appreciated that each signal (sensor from array 400) can be represented such as Multiple continuous analysis intervals (such as exciting cycle) shown in Fig. 2, each continuously analyzes interval can have as based on multiple The exciting starting that the same time interval of reference signal (adjacent sensors of array 400) determines.

Fig. 6 is an example signal of example case study signal (SIG1) and example reference signal (SIG2) to comparing 600 One diagram.For example, these signals can come from comparing shown in Fig. 4 to 402 (or comparing to 404), or from exhibition in Fig. 5 Any comparing shown is right.It is noted that these signals are illustrative, and occur in same analysis interim.As this institute Point out, these signals there can be multiple continuous analysis intervals (such as exciting cycle), as shown in FIG. 2.

Processed under one or more continuous time points (such as every millisecond, two milliseconds or other times point) these signals with A derivative for determining the signal Analysis is higher than a critical value relative to whether there is in a derivative of the reference signal One change point.The change point can be by the slope of first heart signal and second heart signal, amplitude, sequential and shape One or more determination in shape.It is noted that in some embodiments or aspect, the treatment at some time points can be removed (such as every two in a time point or three time points).For each time point in these signals determines a single order Derivative (or second dervative can be used).For each signal determines a root mean square.For example, RMS1 and RMS2 are by obtaining One root mean square of the derivative of the whole signal of each of signal (such as all exciting cycles) determines.RMS can be with For the amplitude normalization by these signals relative to each other so that the amplitude (such as voltage) of the deflection in these signals will not Influence the treatment of signal as described below.

A time point (same time point or roughly the same time are continuously selected from each signal (SIG1, SIG2) Point) for studying and process.For each time point studied, can to starting from the time point at each signal in An incremental time 602,604 studied.For example, it is possible to use an incremental time of 10ms.Can select not Same incremental time.It is determined that studying at a little in being fixed on each signal and in the incremental time of each signal when Between put provide best fit a line.Identified line represent the signal for selected time point slope (for example volt/ It is per second).More precisely, identified line represent it is selected at the time point of same time increment (for example, 10ms) Signal slope.Determine a significance value (δ) relative to these slopes.

It absolute value that the significance value can be obtained by the related root-mean-square value obtained according to first slope And an absolute value being obtained according to the related root-mean-square value of the second slope is subtracted to determine.To on the result (δ)=- Whether 0.461 make a judgement higher than a conspicuousness critical value (for example, 0.25).Conspicuousness critical value is represented for being ground Be present a potential significant change point (being based on slope) in the time point in the signal studied carefully, such as sent out enough between derivative Dissipate.In the example signal is relatively to 600, conspicuousness critical value of the significance value (δ)=- 0.461 less than 0.25.According to preceding Emission standards are stated, low significance value represents that the deflection in SIG1 is far field, and be not enough in where signal origin The part of individual sensing station, such as a sensor shown in Fig. 4.Therefore, do not exist during the example signal is to comparing 600 Potential significant change point.

Other characteristics for the signal for being considered can also be used for determining emission standards, if so that one or more standards exceed Conspicuousness critical value, then separate partial agonist with far field excitement.These or other emission standards can independently be applied, or By combination application.

First characteristic is the voltage (or amplitude) of signal, wherein indicating partial agonist more than the voltage of conspicuousness critical value It is exciting rather than far field.For the conspicuousness critical value of voltage (or amplitude), in organic disease or scar, (it even can be The position of partial agonist reduces voltage), bad electrode contact (it even can also reduce voltage at the position of partial agonist), Larger electric transducer (it changes voltage according to the signal attribute in larger sensing region) signal filtering (decays if transition High voltage or low power event) and other factors in the presence of change.

Second feature is Cycle Length (CL), and wherein far-field signal can have and complicated RD (such as atrium Or ventricular fibrillation) in local signal differ by more than the CL of conspicuousness critical value.The conspicuousness critical value will be based on institute The rhythm and pace of moving things of consideration, the ventricle for being considered and feature (such as action potential duration (APD), conduction of velocity (CV), organic Whether the presence of disease or these sites are parallel or perpendicular to machine direction) and it is different.

3rd feature is that the slope of signal (rises or falls；DV/dt)-i.e. signal amplitude changes to indicate to dive from baseline In the speed of beating.Compared with another site, the partial agonist of the site indicates the partial agonist in the first site.This Three features will be sensitive to reducing the factor of dV/dt, such as bad electrode contact, delayed conduction are (inherence or different due to being metabolized Often or medicine), organic disease or increase dV/dt factor.Slope (it is very steep, for example>1mv/40ms) clearly with part Excitement is associated, but other slopes can also indicate that depending on the partial agonist of other factors.

4th characteristic be frequency content (or frequency square；Energy), wherein local signal has than far-field signal more Frequency (energy higher) high.Conspicuousness critical value will with signal filtering setting, sensor characteristics (such as size) and Change with the contact organized.Especially, the signal for being obtained by insulator can have the decay of some frequencies, for example, from The signal that esophagus or body surface are detected has already passed through more tissues, and its high-frequency signal that can decay is (compared to directly from heart The signal of acquisition), this will change characteristics of signals.Intervening tissue (such as bone) or device (signal amplifier) can occur can amplify The situation of some frequencies.

In addition it is possible to use any one in above-mentioned standard determines emission standards with the repeatability of time, to incite somebody to action Partial agonist is separated with far field excitement, because in complicated RD, exciting compared to the far field that may change, partial agonist can To keep more consistent.Correlation can be used, (such as Shannon entropy, differential entropy, Ke Shi (Kolmogorov) are complicated for disturbance index The measured value of property, and/or other entropys) carry out measurement reproducibility.

As indicated herein, these signals can have multiple continuous analysis intervals (such as exciting cycle), such as institute in Fig. 2 Displaying.In each analysis interval, may have zero, one or more potential significant change points as described above.Institute The time point of research and one or more potential significant change points can be recorded in as in database 118.

Fig. 7 is an example signal of example case study signal (SIG1) and example reference signal (SIG2) to comparing 700 One diagram.Similarly, these signals can come from comparing shown in Fig. 4 to 402 (or comparing to 404), or from Fig. 5 Any comparing of displaying is right.These signals are illustrative, and are occurred in same analysis interim.As indicated herein, These signals can have multiple continuous analysis intervals (such as exciting cycle), as shown in FIG. 2.

These signals are processed at one or more continuous time points, to determine the signal Analysis leads Number is relative to the change point that whether there is in a derivative of the reference signal higher than a critical value.In some embodiments Or in aspect, the treatment at some time points can be removed (such as every two in a time point or three time points). Determine a first derivative (or second dervative) for each time point in these signals.Further for each signal determines one Individual root mean square.A time point (same time point or roughly the same time are continuously selected from each signal (SIG1, SIG2) Point) for studying and process.For each time point studied, can to starting from the time point at each signal in An incremental time 702,704 (such as 10ms) studied.It is determined that studying at a little simultaneously in being fixed on each signal And a line of best fit is provided to the time point in the incremental time of each signal.Identified line is represented for selected Time point signal slope (such as volt/per second).More precisely, identified line represent it is selected for it is identical when Between increment time point at slope.Determine a significance value (δ) relative to these slopes.

It absolute value that the significance value can be obtained by the related root-mean-square value obtained according to first slope And an absolute value being obtained according to the related root-mean-square value of the second slope is subtracted to determine.To on the result (δ)=- Whether 0.063 make a judgement higher than a conspicuousness critical value (for example, 0.25).In the example signal is relatively to 700, Conspicuousness critical value of the significance value (δ)=- 0.063 far below 0.25.The low significance value represents short arc noise.Cause This, the example signal to comparing 700 in do not exist potential significant change point.

One noise level can be defined as conspicuousness critical value point rate or can be differently planned it is fixed Justice.For example, noise level can be 1/10th (0.025) of conspicuousness critical value (0.25).One kind can be selected not Same point rate level.Used as another example, the noise level can be defined as a Gauss standard difference of multiple significance value. Cover the other modes for defining noise level.It is noted that conspicuousness critical value (for example, 0.25) ratio may be with example signal pair Compare signal Analysis in 700 noise level related to reference signal high.Therefore, at noise level or a following change Change point can with other regions from heart, respiratory system, intestines and stomach, nervous system one or more signals and electronics Interference is related.

As indicated herein, these signals can have multiple continuous analysis intervals (such as exciting cycle), and every In individual analysis interval, may have zero, one or more potential significant change points as described above.The time studied Point and one or more potential significant change points can be recorded in as in database 118.

Fig. 8 is to be shown using the example case study signal (SIG1) of composite signal and of example reference signal (SIG2) A diagram of the example signal contrast compared with 800.As in other examples, these signals can come from more right shown in Fig. 4 402 (or comparing to 404), or it is right from any comparing shown in Fig. 5.These signals are illustrative, and at identical point Analysis interim occurs.As indicated herein, these signals can have multiple continuous analysis intervals (such as exciting cycle), such as It is demonstrated in Figure 2.

These signals are processed at one or more continuous time points, to determine the signal Analysis leads Number is relative to the change point that whether there is in a derivative of the reference signal higher than a critical value.In some embodiments Or in aspect, the treatment at some time points can be removed (such as every two in a time point or three time points). Determine a first derivative (zero order derivative or second dervative) for each time point in these signals.Further for each is believed Number determine a root mean square.A time point (same time point or substantially is continuously selected from each signal (SIG1, SIG2) Same time point) for studying and process.For each time point studied, it is possible to use at starting from the time point An incremental time 802,804 (such as 10ms) in each signal.It is determined that studying at a little in being fixed on each signal And a line of best fit is provided to the time point in the incremental time of each signal.Identified line is represented for selected The slope (such as volt/per second) of the signal at the time point selected.More precisely, identified line represent it is selected for identical The slope of the signal at the time point of incremental time.Determine a significance value (δ) relative to these slopes.

In some embodiments or aspect, the significance value can be by obtaining the related root-mean-square value according to first slope An absolute value that it absolute value obtaining and subtracting is obtained according to the related root-mean-square value of the second slope determines. To whether higher than a conspicuousness critical value (for example, 0.25) making a judgement on the result (δ)=0.546.Show at this Example signal is relatively in 800, the significance value (δ)=0.546 is confirmed as the conspicuousness critical value higher than 0.25.

Therefore, the example signal at the time point studied to comparing 800 in there is a potential significant change point. As indicated herein, these signals can have multiple continuous analysis intervals (such as exciting cycle), and between each analysis In, may have zero, one or more potential significant change points as described above.The time point studied and one Or multiple potential significant change points can be recorded in as in database 118.

In other embodiment or aspect, the significance value can be determined relative to a composite signal.Exactly, lead to Cross and SIG2 (reference signal) is subtracted from SIG1 (signal Analysis) calculate a composite signal (COMP), such as COMP= SIG2-SIG1.The composite signal can represent a bipolar signal (COMP) of component unipolar signal (SIG1, SIG2).Replacing In for embodiment or aspect, composite signal COMP can also be calculated by by signal SIG1 and SIG2 phases Calais.The signal It is illustrative to comparing the signal in 800, and occurs in same analysis interim.As indicated herein, these signals There can be multiple continuous analysis intervals (such as exciting cycle), as shown in FIG. 2.

Relative to composite signal COMP process signals SIG1, SIG2 at one or more continuous time points, to determine One derivative of the signal Analysis is relative to whether there is in a derivative of the reference signal higher than a critical value Change point.Determine a first derivative (or second dervative) for each time point in signal SIG1, SIG2, COMP.From every Continuously selected in individual signal (SIG1, SIG2, COMP) time point (same time point or roughly the same time point) with In research and treatment.For each time point studied, it is possible to use at starting from the time point in each signal one Individual incremental time 802,804,806 (such as 10ms).It is determined that studying at a little and to each in being fixed on each signal Time point in the incremental time of signal provides a line of best fit.Identified line is represented and is directed to selected time point Signal slope (such as volt/per second).More precisely, identified line represent it is selected for same time increment The slope of the signal at time point.Determine a significance value (δ) relative to these slopes.

In the embodiment or aspect using the composite signal, the significance value (δ) can determine in the following manner：Obtain Take an absolute value of second slope and subtract an absolute value of the compound slope, and divided by one of the first slope Absolute value subtracts a ratio for the logarithm of the result of absolute value of the compound slope.Gained for the time point studied Significance value be (δ)=31.63.Significance value can be calculated to the whole points studied.One conspicuousness critical value can be with An average value for being defined as calculated significance value (δ) adds a standard deviation.Hereafter, it is only above the conspicuousness critical value Those significance value (δ) can be considered as the potential significant change point relatively to 800.Signal contrast for Fig. 8 For example signal in compared with 800, identified conspicuousness critical value can be 10.It is noted that being higher than the conspicuousness critical value One or more significance value generally substantially extended above in the conspicuousness critical value.For example, tool therefore can be selected There is a significance value (δ) of maximum rate.

Fig. 9 is a kind of exemplary method that the heart excitement information (exciting starting) related to cardiac dysrhythmia is rebuild in displaying 900 flow chart.The exemplary method 900 computing device 116 can be performed as shown in Fig. 1.More precisely, this shows Example method 900 start from operation 902 at, at the operation, signal by signal processing apparatus 114 by the computing device 116 from It is arranged at the sensor in heart 120 and receives.For example, signal can be from being arranged in the atrium dextrum 122 of heart 120 Received at the sensor of sensor array 400, as shown in figs. 1 and 4.In some embodiments or aspect, from these sensings At least a portion signal of device can be recorded by signal processing apparatus 114, and be then provided to computing device 116.

At operation 904, first signal (signal Analysis) is selected.At operation 906, a secondary signal is selected (reference signal).The selection of the signal Analysis and the reference signal can be as carried out with reference to as Figure 4 and 5 more detailed description. In some embodiments or aspect, can be for first signal and for the secondary signal determines a root mean square (RMS).In operation At 908, select first signal and the secondary signal treat by comparing after a time interval.The time interval can be selected It is selected as an exciting cycle (such as 100ms to 300ms) as described in figure 2.In some embodiments or aspect, the time Interval can by first (analysis) signal average period duration a dominant-frequency analysis or other analyses determine.If The time interval determines in which cannot calculate, then can be spaced using a default time of 200ms.In other embodiment or side In face, the time interval can be from database (its patient for a certain age, sex and cardiac dysrhythmia type To this timelike interval editor catalogue) manually, with calculating selected using a kind of different analysis method, or it is defaulted as A value between about 100ms and about 300ms.

In some embodiments or aspect, a compound letter can be determined based on selected first signal and secondary signal Number, as by subtracting or determining plus the signal as described by reference Fig. 8.

At operation 910, one time point of selection is for the research in selected time interval.Selection is identical or substantially The research that identical time point is used in each signal (such as the first signal and secondary signal).At operation 912, for from every The incremental time (such as 10ms) extended at the point studied in individual signal calculates multiple derivatives.Using a compound letter Number those embodiments or aspect in, a same incremental time for the time point studied from composite signal place's extension (such as 10ms) calculates a derivative.Time point studied in the composite signal and other signals (such as the first signal and Secondary signal) in it is same or about.

At operation 914, to sentencing on whether the institute in selected time interval a little all makes one by treatment It is fixed.If it is determined that the institute in selected time interval is a little all by treatment, then method 900 continues at operation 916.Can Alternatively, the method 900 carries out institute of the operation 910,912 in determining selected time interval at operation 914 a little All by treatment.

At operation 916, determine the derivative of first signal relative to the secondary signal in the time interval studied Derivative between change point.For example, saliency value (δ) can be determined at each change point as described according to Fig. 6-8.

At operation 918, it is in the derivative to the derivative on first heart signal relative to second heart signal No one or more change points in the presence of higher than a critical value make a judgement.For example, it may be determined that aobvious at change point Whether work property value (δ) is higher than critical value.In some embodiments or aspect of composite signal are not used, Fig. 6-8 is such as referred to As described, the critical value can be 0.25 (or another value), and use those embodiments of composite signal Or in aspect, as described with reference to Figure 8, the average value that the critical value may be calculated all changes point adds one Individual standard deviation.

If it is determined that in the presence of one or more change points higher than the critical value, then the method 900 operation 920 at after It is continuous, at the operation, by one or more significant change points record (selection) by for being ground in first (analysis) signal One or more the possible exciting startings for the time interval studied carefully.However, if it is determined that in the absence of the change higher than the critical value Point (without significant change point), then the method 900 continues at operation 924, at the operation, when first signal is after this Between be spaced and compare with a reference signal catalogue.For example, the reference signal catalogue for cardiac dysrhythmia can be maintained In database 118.At operation 926, to making one with the presence or absence of being matched with a reference signal in the database Individual judgement.This can relatively be based at least one feature of first signal and at least one feature of the reference signal, such as shape Shape, slope, amplitude, frequency and/or sequential.Other features can be used together or the cited spy of replacement with cited feature Levy.

If with a reference signal without matching at operation 926, then the continuation at operation 922 of the method 900.Can replace Dai Di, the method 900 continues at operation 928, at the operation, one or more change points in the time interval studied It is recorded (selection), the one or more change point will be corresponding with one or more the exciting startings in the reference signal of matching.

At operation 922, sentence to whether all time intervals on these signals all make one by treatment It is fixed.If it is determined that simultaneously not all time interval has all passed through treatment, then the method 900 is worked on 908-922, so that Treatment subsequent time intervals, until it is determined that all of time interval has all passed through treatment.Possible excitement can be represented by 920 One or more change points of starting determine subsequent time intervals.Exactly, if only have recorded a change point at 920 (being higher than critical value), then next time interval (such as 100ms to 300ms) adds in the initial time relevant with the change point Upper half cycle duration (such as 50ms to 150ms) place starts.If multiple change points, then use and maximum change point (significance value) relevant initial time determines the next time interval for operating 908-922.It is noted that can extend The determination of next time interval is studying from all second (reference) signals being spaced for the same time studied Significant changes point.If however, determining that all of time interval has all passed through treatment at 922, then the method 900 is in operation Continue at 930.

At operation 930, to whether having combined selected first (analysis) signal on all second (reference) signals And make a judgement by treatment.If it is determined that simultaneously not all secondary signal has all passed through treatment, then the method 900 continues Operation 906-930 is carried out until it is determined that all second (references) have all been directed to first (analysis) signal by treatment.However, such as Fruit determines that all secondary signals have all passed through treatment, then the method 900 proceeds to operation 932.

At operation 932, if (at operation 918) determines that one or more change points are higher than the critical value, then will One or more exciting startings are specified at one or more change points in first signal, so as to be defined in first letter Indicate one or more hearts of one or many beating excited in number.Similarly, at operation 932, can be based on (operation At 928) one or more exciting startings are specified this or many in first signal reference signal of a matching At individual change point, indicate one or more hearts of one or many beating excited so as to be defined in first signal.It is more true Say with cutting, (or significant) one or more changes for being recorded based on first signal relative to one or more secondary signals Change point for the time interval of first signal specifies exciting starting.That is, being based on believing with one or more second (references) Number same time interval in relevant one or more of one or more significant changes points may exciting starting, for this first Each time interval in (analysis) signal specifies an exciting starting.As described in reference to fig. 5, can be based on relative to second One average value of the excitement starting of (reference) signal determines the excitement starting of the time interval for first (analysis) signal. In another embodiment or aspect, can be based on relative to most of exciting startings in mutual predetermined time interval (for example ± 5ms) in those secondary signals excitement starting an average value, it is determined that for first signal time interval swash Dynamic starting.Can be spaced specified home record in such as database 118 for each in first (analysis) signal.

Operation 934 at, on all signals whether all with the first (analysis) signal pin to second (reference) signal Form by treatment or analysis make a judgement.If it is determined that simultaneously not all signal has all passed through treatment, then the method 900 are worked on 904-932 until all signals have all passed through treatment.Alternately, if it is determined that all signals are all By treatment, then the method 900 terminates at operation 936.

At the conclusion of the method 900, the signal collected from heart 120 with heart excitement information (exciting starting) Rise and be reconstructed, so that a cause of disease of the cardiac dysrhythmia can be determined.More precisely, monopole EGM or list Phase action potential (MAP) can be mapped in the excitement starting for undergoing reconstruction of these signals, so as to show for these letters Number monopole or MAP sequences or expression.Can represent that one excitement of structure is reflected according to these unipolar voltages of signal or MAP voltages Penetrate or pattern, to find out the cause of disease of the cardiac dysrhythmia.One example MAP to be represented and be showed in Figure 11 with the exciting mapping of example In.

Figure 10 is that signal Analysis (SIG1) are schemed with an example signal of reference signal (SIG2) to one that compares 1000 Show, the signal Analysis can process to specify an exciting starting 1004 with the reference signal according to the method 900 of Fig. 9.Such as than Shown in 1000, one time interval 1002 (such as 100ms-300ms) of selection is used to compare and process.In some example realities Apply in example or aspect, smooth place is such as carried out to the signal (SIG1, SIG2, COMP) in the time interval by median filter Reason.Determine significance value (δ) for the change point in first derivative or flection of these signals, Fig. 1-9 is such as referred to herein Described.Such as signal contrast compared with 1100 in show, based on first derivative, will be in SIG1 higher than the change point of critical value 1010 1012 are appointed as the excitement starting 1004 for the time interval 1002 in SIG1.Alternately, based on second dervative, by SIG1 In be appointed as higher than the change point 1014 of critical value 1010 for the time interval 1002 in SIG1 excitement starting 1004.Such as exist This selection subsequent time intervals and specified exciting starting with reference to as Fig. 1-9 is described, until signal Analysis (SIG1) warp Cross treatment.

Figure 11 is example mappings 1100 diagram of the signal according to handled by Fig. 1-10.Primary signal 1101 represent a signal by processing to specify exciting starting (vertical line) as the described herein.For the mesh of reference , a composite signal 1102 is shown, it is produced by original (analysis) signal 1101 and another (reference) signal are (not shown). Monophasic action potential (MAP) voltage is produced to represent by each treated signal 1101.It is as the described herein such The multiple signals for the treatment of, and produce MAP based on these treated signals.The electrical activity of all MAP is mapped to example In one sequence of excitement mapping 1106, to be respectively displayed on the excitement starting 1108,1110,1112 at each time interval And 1114.These mappings can be shown by computing device 116.Although illustrate only four mappings for illustrative purpose, But there can be the mapping 1106 of less or more number based on the time interval represented in these signals.

As shown in the arrow (such as exciting starting 1108,1110,1112 and 1114) in example mappings 1106, the electrical activity Indicate rotation activation pattern (rotary body) of exciting starting in the cardiac dysrhythmia.Being somebody's turn to do indicated by the arrow in Figure 11 At least a portion region of the heart 120 indicated by rotation activation pattern can be by treating to eliminate the cardiac dysrhythmia The cause of disease, and therefore eliminate the cardiac dysrhythmia in itself.This kind for the treatment of can be by using different energy sources (including but not limited to Radio frequency, low temperature energy, microwave and ultrasonic wave) ablation, gene therapy, stem cell therapy, pacing stimulation, medicine or other therapies To deliver.It is noted that MAP is represented and exciting mapping is for showing a kind of example for rotating activation pattern.Other activation patterns The different example signals that can be collected into from heart 120 by sensor are produced.

Figure 12 is a block diagram of general-purpose computing system 1200 illustrative examples.The computer system 1200 can be the signal processing apparatus 114 and computing device 116 of Fig. 1.The computer system 1200 can include an instruction Collection, this instruction set can be performed so that the computer system 12800 performs any one or more of side disclosed herein Method or computer based function.The computer system 1200, or any part therein, can be as a self-contained unit behaviour Make or for example can be connected to other computer systems or peripheral unit using a network or other connections.Citing comes Say, the computer system 1200 is operatively connected to signal processing apparatus 114 and analytical database 118.

The computer system 1200 can also be implemented as different device or be merged into different device, such as one personal meter Calculation machine (PC), tablet PC, personal digital assistant (PDA), mobile device, palmtop computer, one Laptop computer, a desktop computer, a communicator, a control system, a WWW utensil (can connect Any other machine of instruction set is performed continuously or otherwise), and this instruction set specifies what the machine should be taken Action.Although in addition, showing single computer systems 1200, term " system " is it should also be understood that be to include performing alone or in combination One instruction set or multiple instruction collection are performing one or more any set of the system or subsystem of computer function.

As shown in Figure 12, the computer system 1200 can include (such as one centre of processor 1202 Reason unit (CPU)), GPU (GPU) or both.Additionally, the computer system 1200 can include leading to Cross a main storage 1204 and a static memory 1206 that a bus 1226 communicates with one another.As indicated, the computer System 1200 may further include a video display unit 1210, such as liquid crystal display (LCD), an organic light emission Diode (OLED), a flat-panel monitor, a solid state display or a cathode-ray tube (CRT).In addition, the computer System 1200 can include an input unit 1212, such as a such as keyboard, an and cursor control device 1214, a mouse Mark.The computer system 1200 can also include a disc drive unit 1216, a signal generating apparatus 1222, such as one Loudspeaker or remote control, and a Network Interface Unit 1208.

In a specific embodiment or aspect, as described in Figure 12, the disk drive unit 1216 can include One computer-readable medium 1218, can be implanted into one or more collection, example of instruction 1220 in the computer-readable medium Such as software.In addition, these instructions 1220 can embody one or more method as the described herein or logic.It is specific at one In embodiment or aspect, during the computer system 1200 is performed, these instructions 1220 can completely or at least partially be present In in the main storage 1204, the static memory 1206 and/or the processor 1202.The main storage 1204 and the processor 1202 may also comprise computer-readable medium.

In an alternate embodiment or aspect, can build specialized hardware realize (such as ASIC, can compile Journey logic array and other hardware units) realizing one or more method described herein.Potentially include different implementations The equipment and systematic difference of example or aspect can widely include various electronics and computer system.One described herein or Multiple embodiments or aspect can realize function using two or more special interconnected hardware modules or device, these modules or Device carries the associated control signal and data-signal that can be communicated between the modules and by module, or as application-specific collection Into the part of circuit.Therefore, the system covers software, firmware and hardware and implements.

According to different embodiments or aspect, method described herein can by being visibly embodied in a processor Read the software program realization in medium, and can be by a computing device.In addition, implementing in an exemplary, non-limitative In example or aspect, realization can include distributed treatment, component/object distributed treatment, and parallel processing.Alternately, Virtual computer system treatment can be built to realize one or more method as the described herein or feature.

It is also contemplated that a computer-readable medium includes instruction 1220 or receives and perform in response to a transmitting signal Instruction 1220, so as to be connected to network 1224 device can on the network 1224 communicating voice, video or Data.In addition, these instructions 1220 can be launched or received by Network Interface Unit 1208 on the network 1224.

Although display computer-readable medium is single medium, but term " computer-readable medium " includes single medium or many Medium, such as center type or distributed data base, and/or store one or more instruction set associated cache memory and Server.Term " computer-readable medium " should also include storing, encode or carrying any medium of instruction set, wherein These instruction set are by computing device or computer system is performed any one or more method disclosed here or operation.

In a specific non-limiting example embodiment or aspect, the computer-readable medium can include one admittedly State memory, such as a storage card or other encapsulation, the solid-state memory accommodate one or more non-volatile read-only storages. In addition, computer-readable medium can be random access memory or other volatibility recordable memorys.In addition, the computer Computer-readable recording medium can include magneto-optic or optical medium, and such as disk or tape or other storage devices is such as passed through with capturing carrier signal The signal of transmission medium communication.The digital file attachment of Email or other independent information archives or archive set can be considered as The distributed medium being equal to tangible media.Therefore, it can computer-readable medium or the distribution of data storage or instruction Any one of medium and other equivalents and successor media multinomial are included in this.

According to different embodiments or aspect, method described here may be embodied as being run on a computer processor One or more software programs.Similarly construction specialized hardware can realize, including but not limited to：The integrated electricity of application-specific Road, programmable logic array and other hardware devices, to implement method described herein.Further, it is also possible to construction is substituted Property software realize, including but not limited at distributed treatment or component/object distributed treatment, parallel processing, or virtual machine Reason, to implement method described herein.

It shall yet further be noted that realize that the software of disclosure method is optionally stored in a kind of tangible storage medium, such as：One Plant magnetizing mediums, such as one disk or tape；A kind of magneto-optic or optical medium, such as one disk；Or a kind of solid state medium, such as one Individual memory card or accommodate one or more read-only (non-volatile) memories other packaging, random access memory or other can Rewrite (volatibility) memory.The software can also utilize a signal containing computer instruction.By Email or other The digital file attachment of independent information archives or archive set is considered as the distributed medium being equal to tangible media.Therefore, may be used Storing that software in this realizes such as a tangible media listed herein or distribution medium and other equivalents and Successor media is included in this.

Therefore, the system and method for rebuilding heart excitement information have been described.Although described specific example embodiment or Aspect, it is apparent that, in the case of without departing from more broad range of the invention, these embodiments or aspect can be made not Same modifications and variations.Therefore, the specification and drawings should be treated with descriptive sense rather than with restrictive, sense.Form one part Accompanying drawing is by way of explanation and do not show in a restricted way wherein can be with the specific embodiment of practical matter or side Face.Description detailed enough is carried out to embodiment described or aspect so that one of ordinary skill in the art can put into practice Teachings disclosed by this.Can using other embodiment and aspect and they derived from wherein so that without departing from this Structural or logicality can be made in the case of the scope of disclosure to replace and change.Therefore this is not understood with restrictive, sense 【Describe in detail】, and different embodiment and aspect scope only by appended claims together with the complete of such claims issue The equivalent of whole scope is limited.

Such embodiment or aspect of present subject matter individually and/or can be carried jointly by term " invention " herein Arrive, the term is merely for for the sake of convenience and being not intended to that scope of the present application voluntarily is limited into any single invention or invention structure Think (if actually disclose it is more than one if).Therefore, although herein it is stated that and specific embodiment or aspect described, It will be appreciated that any arrangement for being adapted for carrying out identical purpose can substitute shown specific embodiment or aspect.Present disclosure is intended Cover any or all of usable condition or version of different embodiments or aspect.One of ordinary skill in the art is checking The combination of above-described embodiment or aspect and other embodiments or aspect that do not specifically describe herein is will be clear that during described above.

There is provided summary with defer to 37C.F.R. § 1.72 (b) and will make reader determine rapidly this technology disclose property and Main idea.Summary is submitted in the case where the understanding of scope or implication that it will not be used to explain or limit claim is reached.

In the described above of embodiment or aspect, in order to simplify the purpose of present disclosure, different characteristic is divided in list jointly In one embodiment.This disclosure method should not be construed as the embodiment or aspect and institute in each claim required by reflection Clearly enumerate compared to more features.On the contrary, as the following claims reflect, subject of the present invention exists It is few in all features than single disclosed embodiment or aspect.Therefore, following claims is integrated into herein【Specifically It is bright】In, and each claim is alone as independent an example embodiment or aspect.Expection is described herein not Can be combined with embodiment or aspect or be grouped in【Describe in detail】In be not known in the various combination pointed out.Additionally, further Expected, the claim for covering this kind of various combination can similarly alone as independent example embodiment or aspect, these Example embodiment or aspect can be merged into【Describe in detail】In.

Claims

1. a kind of method for representing the heart information related to cardiac dysrhythmia, the method includes：

Multiple adjacent cardiac signals that access is obtained from patient；

With one or more emission standards for defining the partial agonist in the plurality of adjacent cardiac signal, from the plurality of adjacent cardiac Far field excitement is eliminated in signal, the diverging between the emission standards and the plurality of adjacent cardiac signal is associated；And

Build the clinical manifestation of the partial agonist in the plurality of adjacent cardiac signal.

2. the method for claim 1, wherein far field excitement is eliminated from the plurality of adjacent signals including：

Access first heart signal and the second heart signal of the plurality of adjacent cardiac signal；

First heart signal and second heart signal are processed to determine to whether there is in first heart signal The change point of first heart signal, at the change point derivative of first heart signal relative to higher than critical value this The derivative diverging of two heart signals；And

If the change point is in first heart signal, exciting rising is specified at the change point in first heart signal Time beginning is defining partial agonist.

3. the derivative of method as claimed in claim 2, the wherein derivative of first heart signal and second heart signal is It is selected from the group, the group is made up of the following：Zero order derivative, first derivative, second dervative, higher derivative, and combinations thereof.

4. the derivative of method as claimed in claim 2, the wherein derivative of first heart signal and second heart signal is Zero order derivative.

5. the derivative of method as claimed in claim 2, the derivative of its first heart signal and second heart signal is one Order derivative.

6. the derivative of method as claimed in claim 2, the wherein derivative of first heart signal and second heart signal is Second dervative.

7. method as claimed in claim 2, further includes to use first sensor and second sensor respectively, from the patient Obtain first heart signal and second heart signal.

8. method as claimed in claim 7, wherein first heart signal and the second heart signal is obtained from the patient simultaneously.

9. method as claimed in claim 2, wherein for first heart signal and second heart signal, the change Point was defined at about the same time point.

10. method as claimed in claim 2, wherein for first heart signal and second heart signal, according to Determine the change point one or more in slope, amplitude, sequential and shape.

11. methods as claimed in claim 2, the determination of the wherein change point includes：

One compound heart signal is formed by first heart signal and second heart signal；

Determine ratio at multiple points in first heart signal, each ratio represent the derivative of second heart signal with Difference between one derivative of the compound heart signal is than the derivative of first heart signal and being somebody's turn to do for the compound heart signal Difference between derivative；And

A point of the selection with maximum ratio in these determination ratios is used as the change point in first heart signal.

12. methods as claimed in claim 2, wherein the critical value ratio and first heart signal and the second heart signal phase The noise level for closing is high.

13. methods as claimed in claim 12 a, wherein change at the noise level or below the noise level Point is related to one or more signals and electronic interferences from heart, respiratory system, intestines and stomach, nervous system.

14. methods as claimed in claim 2, further include：

If the change point is not in first heart signal, then by least one feature of first heart signal and one At least one characteristic matching with reference to heart signal in heart signal catalogue；And

When specifying one in first heart signal excited initial time that an excited starting of heart signal is referred to as this Between, so as to be defined in a partial agonist in first heart signal.

15. methods as claimed in claim 2, further include to conduct interviews, process and specify, so as to be defined in first heart Multiple partial agonists in dirty signal.

16. methods as claimed in claim 2, further include repeatedly to access from the plurality of adjacent cardiac signal this One heart signal and second heart signal.

17. methods as claimed in claim 2, further include：

The heart signal pair from the plurality of adjacent cardiac signal is accessed, every a pair there is first heart signal and different Second heart signal；

Every a pair of these centerings are processed and specified, so as to define first heart of each centering for these centerings Multiple partial agonists in dirty signal；And

The clinical manifestation of the plurality of partial agonist based on the plurality of adjacent cardiac signal is built, to indicate cardiac dysrhythmia Source.

18. methods as claimed in claim 17, further include the clinical manifestation constructed by presenting in order at the source Treatment heart tissue, so as to treat the cardiac dysrhythmia.

19. the method for claim 1, the wherein emission standards include signals diverging, signal amplitude or voltage, signal speed Rate or Cycle Length, the signal rate of climb (dV/dt), signal frequency component and signal repeatability.

The clinical manifestation of 20. the method for claim 1, the wherein partial agonist includes a rotor.

The clinical manifestation of 21. the method for claim 1, the wherein partial agonist includes a focal source.

A kind of 22. methods that cardiac dysrhythmia is treated using clinical manifestation as claimed in claim 1.