JP6483717B2 - 不整脈源の分類のために電気生理学的性質を利用するためのシステムおよび方法 - Google Patents
不整脈源の分類のために電気生理学的性質を利用するためのシステムおよび方法 Download PDFInfo
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- JP6483717B2 JP6483717B2 JP2016551832A JP2016551832A JP6483717B2 JP 6483717 B2 JP6483717 B2 JP 6483717B2 JP 2016551832 A JP2016551832 A JP 2016551832A JP 2016551832 A JP2016551832 A JP 2016551832A JP 6483717 B2 JP6483717 B2 JP 6483717B2
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Description
本願は、2014年2月25日に出願された米国仮出願第61/944,426号の利益を主張し、同出願は、参照により、本明細書にすべてが記載されるものとして組み込まれる。
φ −単極電位のベクトル
dφ −共通の参照電極に対する双極電位のベクトル
X −電極に対応するマッピング・システム座標の行列
dX −参照電極の場所に対する双極変位の行列
A+は、行列AのMoore−Penroseの一般化逆行列である。
電極団#6
速度の大きさ=1.35±0.06mm/ms
興奮方向=(0.12,−0.91,0.40)
電極団#8
速度の大きさ=1.29±0.05mm/ms
興奮方向=(0.10,−0.80,0.58)
電極団#5
速度の大きさ=3.48±0.02mm/ms
興奮方向=(−0.79,−0.61,−0.02)
以下の項目は、国際出願時の特許請求の範囲に記載の要素である。
(項目1)
組織の電気生理学性質を決定する方法であって、
1つまたは複数のカテーテルの複数の電極から電気信号データを取得するステップと、
複数の隣接する電極から、少なくとも1つの電極団を決定するステップと、
前記少なくとも1つの電極団について局所的な伝導速度ベクトルを算出するステップと、
前記局所的な速度伝導ベクトルの流れ場に関連付けられた角度依存性パラメータと、局所的な伝導速度の均一度を反映した偏心性パラメータと、前記局所的な速度ベクトルに関連付けられた発散および回転様の和または閉路積分パラメータと、の1つまたは複数に基づいて、不整脈源を分類するための、カテーテルの向きに依存しない少なくとも1つの指標を決定するステップと、
カテーテルの移動に応答して律動の分類を表示することにより、不整脈障害の種類および原因の特定を容易にするステップと
を含む方法。
(項目2)
前記局所的な伝導速度ベクトルをディスプレイに表示するステップをさらに含み、前記局所的な伝導速度ベクトルはそれぞれ、大きさおよび方向を含む、項目1に記載の方法。
(項目3)
前記局所的な伝導速度ベクトルの大きさをディスプレイに表示するステップが、内挿された色マップを表示するステップを含む項目2に記載の方法。
(項目4)
前記電気生理学的流れ場に対する均一な角度の依存性と、その流れ場の回転および発散とを参照表と比較することにより、組織の対象部位の分類を自動的に決定するステップをさらに含む項目1に記載の方法。
(項目5)
前記電気生理学的流れ場が、前記組織の対象部位の1つまたは複数の特定の状態と一致する度合いをディスプレイに表示するステップをさらに含む項目4に記載の方法。
(項目6)
前記少なくとも1つの電極団それぞれをスコア付けするステップをさらに含む請求項1に記載の方法。
(項目7)
前記対象部位の計算された電気生理学的性質を、前記少なくとも1つの電極団それぞれのスコア付けの視覚的表現と共に表示するステップをさらに含む項目6に記載の方法。
(項目8)
前記対象部位の電気生理学的性質は、伝導速度の方向または興奮タイミングの等時線を含むことが可能である項目7に記載の方法。
(項目9)
導出された組成を表示するステップをさらに含み、前記少なくとも1つの電極団それぞれをスコア付けするステップは、内挿された色マップの上に色を表示するか、または電気生理学的性質のマップの上に重畳されたグラフィックを表示するステップを含む項目6に記載の方法。
(項目10)
等電原点からの電場データ点の距離に基づいて前記電気信号データを重み付けするステップをさらに含む項目1に記載の方法。
(項目11)
カテーテルの向きに依存しない信号Etを決定し、|d/dt(E(t))|に基づいて、前記導出された向きに依存しない電気信号データを重み付けするステップをさらに含む項目1に記載の方法。
(項目12)
組織の電気生理学性質を決定するシステムであって、
1つまたは複数のカテーテルの複数の電極から電気信号データを取得し、複数の隣接する電極から、少なくとも1つの電極団を決定し、前記少なくとも1つの電極団について局所的な伝導速度ベクトルを算出し、前記局所的な速度伝導ベクトルの流れ場に関連付けられた角度依存性パラメータと、局所的な伝導速度の均一度を反映した偏心性パラメータと、前記局所的な速度ベクトルに関連付けられた発散および回転様の和または閉路積分パラメータと、の1つまたは複数に基づいて、不整脈源を分類するための、カテーテルの向きに依存しない少なくとも1つの指標を決定し、カテーテルの移動に応答して律動の分類を表示することにより、不整脈障害の種類および原因の特定を容易にする、ように構成された電子制御ユニットを備えるシステム。
(項目13)
前記電子制御ユニットがさらに、等電原点からの電場データ点の距離に基づいて前記電気信号データを重み付けするように構成される項目12に記載のシステム。
(項目14)
前記電子制御ユニットがさらに、前記組織の対象部位が、均一な伝播、ロータ、発生源、衝突部位、または瘢痕、の1つまたは複数を含むかどうかを決定するように構成される項目12に記載のシステム。
(項目15)
前記電子制御ユニットがさらに、前記少なくとも1つの電極団それぞれをスコア付けするように構成される項目14に記載のシステム。
(項目16)
前記電子制御ユニットがさらに、計算された前記対象部位の電気生理学的性質と、前記少なくとも1つの電極団のスコアとを表示するように構成される項目15に記載のシステム。
(項目17)
前記電子制御ユニットがさらに、内挿されたマップの上に色またはグラフィックを表示することにより、導出された前記少なくとも1つの電極団それぞれの組成およびスコア付けを表示するように構成される項目16に記載のシステム。
(項目18)
組織の電機生理学的性質を決定する方法であって、
1つまたは複数のカテーテルの複数の電極から電気信号データを取得するステップと、
前記複数の電極それぞれの場所および向きを決定するステップと、
前記少なくとも1つの電極団に存在する下位電極団を決定するステップと、
前記局所的な速度伝導ベクトルの流れ場に関連付けられた角度依存性パラメータと、局所的な伝導速度の均一度を反映した偏心性パラメータと、前記局所的な速度ベクトルに関連付けられた発散および回転様の和または閉路積分パラメータと、の1つまたは複数に基づいて、不整脈源を分類するための、カテーテルの向きに依存しない少なくとも1つの指標を決定するステップと、
カテーテルの移動に応答して律動の分類を表示することにより、不整脈障害の種類および原因の特定を容易にするステップと
を含む方法。
(項目19)
等電原点からの電場内の点の距離に基づいて前記電気信号データを重み付けするステップをさらに含む項目18に記載の方法。
(項目20)
前記律動の分類の確実度に基づいて、前記内挿された色マップの不透明度を変えるステップをさらに含む項目18に記載の方法。
Claims (17)
- 組織の電気生理学性質を決定するシステムの作動方法であって、
1つまたは複数のカテーテルの複数の電極から電気信号データを取得するステップと、
複数の隣接する電極から、少なくとも1つの電極団を決定するステップと、
前記少なくとも1つの電極団について局所的な伝導速度ベクトルをその電極団の局所電場に基づいて算出するステップと、
前記局所的な速度伝導ベクトルの流れ場に関連付けられた角度依存性パラメータと、局所的な伝導速度の均一度を反映した偏心性パラメータと、前記局所的な速度ベクトルに関連付けられた発散および回転様の和または閉路積分パラメータと、の1つまたは複数に基づいて、不整脈源を分類するための、カテーテルの向きに依存しない少なくとも1つの指標を決定するステップと、
カテーテルの移動に応答して律動の分類を表示することにより、不整脈障害の種類および原因の特定を容易にするステップと、を含み、
前記少なくとも1つの電極団は、少なくともN個(Nは3以上の整数)の電極を有しており、
前記局所電場は、(1)前記少なくとも1つの電極団から1つの電極を参照電極として選択し、N−1個の双極電位およびその参照電極に対する変位を決定すること、(2)前記少なくとも1つの電極団のN個の電極から得られる(N×(N−1)/2)個の双極を決定し、双極電位および変位を算出すること、のいずれかに基づいて決定される、作動方法。 - 前記局所的な伝導速度ベクトルをディスプレイに表示するステップをさらに含み、前記局所的な伝導速度ベクトルはそれぞれ、大きさおよび方向を含む、請求項1に記載の作動方法。
- 前記局所的な伝導速度ベクトルの大きさをディスプレイに表示するステップが、内挿された色マップを表示するステップを含む請求項2に記載の作動方法。
- 前記電気生理学的流れ場に対する均一な角度の依存性と、その流れ場の回転および発散とを参照表と比較することにより、組織の対象部位の分類を自動的に決定するステップをさらに含む請求項1に記載の作動方法。
- 前記電気生理学的流れ場が、前記組織の対象部位の1つまたは複数の特定の状態と一致する度合いをディスプレイに表示するステップをさらに含む請求項4に記載の作動方法。
- 前記少なくとも1つの電極団それぞれをスコア付けするステップをさらに含む請求項1に記載の作動方法。
- 前記対象部位の計算された電気生理学的性質を、前記少なくとも1つの電極団それぞれのスコア付けの視覚的表現と共に表示するステップをさらに含む請求項6に記載の作動方法。
- 前記対象部位の電気生理学的性質は、伝導速度の方向または興奮タイミングの等時線を含むことが可能である請求項7に記載の作動方法。
- 導出された組成を表示するステップをさらに含み、前記少なくとも1つの電極団それぞれをスコア付けするステップは、内挿された色マップの上に色を表示するか、または電気生理学的性質のマップの上に重畳されたグラフィックを表示するステップを含む請求項6に記載の作動方法。
- 等電原点からの電場データ点の距離に基づいて前記電気信号データを重み付けするステップをさらに含む請求項1に記載の作動方法。
- カテーテルの向きに依存しない信号Etを決定し、|d/dt(E(t))|に基づいて、前記導出された向きに依存しない電気信号データを重み付けするステップをさらに含む請求項1に記載の作動方法。
- 組織の電気生理学性質を決定するシステムであって、
1つまたは複数のカテーテルの複数の電極から電気信号データを取得し、複数の隣接する電極から、少なくとも1つの電極団を決定し、前記少なくとも1つの電極団について局所的な伝導速度ベクトルをその電極団の局所電場に基づいて算出し、前記局所的な速度伝導ベクトルの流れ場に関連付けられた角度依存性パラメータと、局所的な伝導速度の均一度を反映した偏心性パラメータと、前記局所的な速度ベクトルに関連付けられた発散および回転様の和または閉路積分パラメータと、の1つまたは複数に基づいて、不整脈源を分類するための、カテーテルの向きに依存しない少なくとも1つの指標を決定し、カテーテルの移動に応答して律動の分類を表示することにより、不整脈障害の種類および原因の特定を容易にする、ように構成された電子制御ユニットを備え、
前記少なくとも1つの電極団は、少なくともN個(Nは3以上の整数)の電極を有しており、
前記局所電場は、(1)前記少なくとも1つの電極団から1つの電極を参照電極として選択し、N−1個の双極電位およびその参照電極に対する変位を決定すること、(2)前記少なくとも1つの電極団のN個の電極から得られる(N×(N−1)/2)個の双極を決定し、双極電位および変位を算出すること、のいずれかに基づいて決定される、システム。 - 前記電子制御ユニットがさらに、等電原点からの電場データ点の距離に基づいて前記電気信号データを重み付けするように構成される請求項12に記載のシステム。
- 前記電子制御ユニットがさらに、前記組織の対象部位が、均一な伝播、ロータ、発生源、衝突部位、または瘢痕、の1つまたは複数を含むかどうかを決定するように構成される請求項12に記載のシステム。
- 前記電子制御ユニットがさらに、前記少なくとも1つの電極団それぞれをスコア付けするように構成される請求項14に記載のシステム。
- 前記電子制御ユニットがさらに、計算された前記対象部位の電気生理学的性質と、前記少なくとも1つの電極団のスコアとを表示するように構成される請求項15に記載のシステム。
- 前記電子制御ユニットがさらに、内挿されたマップの上に色またはグラフィックを表示することにより、導出された前記少なくとも1つの電極団それぞれの組成およびスコア付けを表示するように構成される請求項16に記載のシステム。
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