JP7396988B2 - 再分極をマッピング及び調整するためのシステム及び方法 - Google Patents
再分極をマッピング及び調整するためのシステム及び方法 Download PDFInfo
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Description
本出願は、2018年2月5日出願の米国仮特許出願第62/626,448号の優先権を主張する。先行出願の開示は、本出願の開示の一部であるとみなされ、及びその全体が本出願に援用される。
1.技術分野
本書は、再分極をマッピング及び調整(modulating)するための方法及び材料に関する。例えば、本書は、電気刺激ペーシング、アブレーション、及び/又は電気穿孔を行う(deliver)ために、心房性及び心室性不整脈を標的にするように、再分極をマッピング及び調整するための方法及び機器に関する。
心再分極の異常、例えば空間的不均一性における一時的なゆらぎ(fluctuations)及び逸脱(aberrations)は、心不整脈の発生、特に心不整脈による突然死、心室細動、及び多形性心室性頻拍に本質的に関連する電気生理的基質の異常を促進させる。現在の心臓マッピング技術、例えば局所電位図の取得は、これらの不整脈による突然死に対する最低限貢献し得る心臓活性化シーケンス及び脱分極に焦点を当てた異常を検出する。
本書は、再分極をマッピング及び調整するための方法及び材料について説明している。例えば、本書は、電気刺激ペーシング、アブレーション、及び/又は電気穿孔を行うために、心房性及び心室性不整脈を標的とするように、再分極をマッピング及び調整するための方法及び機器に関する。
本書は、再分極をマッピング及び調整するための方法及び材料について説明している。例えば、本書は、電気刺激ペーシング、アブレーション、及び/又は電気穿孔を行うために、心房性及び心室性不整脈を標的とするように、再分極をマッピング及び調整するための方法及び機器に関する。
Claims (13)
- 心不整脈を治療するためのシステムであって、
患者の心臓内に配置された第1の電極と、
コンピュータの実行可能命令を記憶可能なメモリと、
前記メモリに記憶された前記実行可能命令を実行するように構成されたプロセッサと、を備え、前記実行可能命令が実行されると、前記実行可能命令が前記プロセッサに、
マッピングカテーテルの遠位部分が患者の前記心臓に挿入されて、前記第1の電極が第1の位置に置かれている間に、前記マッピングカテーテルの前記遠位部分上の前記第1の電極から再分極信号を受信することと、
前記第1の電極から受信した前記再分極信号をフィルタリングすることと、
前記第1の電極を介して前記心臓に刺激を与えることと、
前記心臓の再分極マップを作成することと、
前記第1の電極を介して心臓に電気穿孔を与えることであって、前記電気穿孔を与えることは、不可逆的な電気穿孔、又は、可逆的な電気穿孔を与えることを含む、前記電気穿孔を与えることと、
前記心臓に対して外部にある、第2の位置の第2の電極から外部信号を受信することと、
前記第1の電極からの前記再分極信号によって前記外部信号を較正することであって、前記外部信号を較正することは、基線と交差するT波の下に向かう傾斜を測定することを含む、前記外部信号を較正することと、
を行わせる、システム。 - 前記再分極信号をフィルタリングすることは、前記再分極信号からの雑音を低減させることを含む、請求項1に記載のシステム。
- 前記再分極信号をフィルタリングすることは、
前記再分極信号の微分を計算することと、
前記再分極信号から派生信号を除去することと、
を含む、請求項1に記載のシステム。 - 前記第1の位置及び前記第2の位置は、前記心臓の同様の領域からの信号を受信する、請求項1に記載のシステム。
- 前記外部信号を較正することは、前記第2の電極を第3の位置へ動かすことをさらに含み、及び、前記心臓の前記再分極マップを作成することは、前記外部信号を使用して前記再分極マップを作成することを含む、請求項1に記載のシステム。
- 前記外部信号を較正することは、前記外部信号の一次微分を入手することを含む、請求項1に記載のシステム。
- 前記実行可能命令が前記プロセッサに、前記電気穿孔を行うことによって引き起こされた電気穿孔信号を受信することと、前記再分極信号に対する前記電気穿孔の予測可能な効果を検出することと、をさらに行わせる、請求項1に記載のシステム。
- 刺激を与えることは、前記刺激によって前記患者の心拍数を変化させることをさらに含み、前記患者の前記心拍数を変化させることによって、前記患者の前記再分極信号の変化を引き起こす、請求項1に記載のシステム。
- 前記再分極マップを作成することは、磁石を用いたナビゲーション及びポイント入手によって前記再分極マップを作成することを含む、請求項1に記載のシステム。
- 前記再分極マップを作成することは、前記再分極信号における基準点を決定することを含む、請求項1に記載のシステム。
- 前記再分極マップを作成することは、前記再分極マップを作成するために前記基準点を使用することを含み、前記基準点は、再分極の終了である、請求項10に記載のシステム。
- 前記実行可能命令が前記プロセッサに、正常な再分極マップからの前記再分極マップの変異を決定することをさらに行わせる、請求項1に記載のシステム。
- 前記再分極マップの変異を決定することは、前記再分極マップを前記正常な再分極マップと比較することと、前記再分極マップと前記正常な再分極マップとの間の差を検出することと、を含む、請求項12に記載のシステム。
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Families Citing this family (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20170189097A1 (en) | 2016-01-05 | 2017-07-06 | Iowa Approach Inc. | Systems, apparatuses and methods for delivery of ablative energy to tissue |
US9987081B1 (en) | 2017-04-27 | 2018-06-05 | Iowa Approach, Inc. | Systems, devices, and methods for signal generation |
KR20200118472A (ko) | 2018-02-05 | 2020-10-15 | 메이오 파운데이션 포 메디칼 에쥬케이션 앤드 리써치 | 재분극을 매핑 및 조절하기 위한 시스템 및 방법 |
EP3790483A1 (en) | 2018-05-07 | 2021-03-17 | Farapulse, Inc. | Systems, apparatuses, and methods for filtering high voltage noise induced by pulsed electric field ablation |
EP3790486A1 (en) | 2018-05-07 | 2021-03-17 | Farapulse, Inc. | Systems, apparatuses and methods for delivery of ablative energy to tissue |
US10625080B1 (en) | 2019-09-17 | 2020-04-21 | Farapulse, Inc. | Systems, apparatuses, and methods for detecting ectopic electrocardiogram signals during pulsed electric field ablation |
US11497541B2 (en) | 2019-11-20 | 2022-11-15 | Boston Scientific Scimed, Inc. | Systems, apparatuses, and methods for protecting electronic components from high power noise induced by high voltage pulses |
US11065047B2 (en) | 2019-11-20 | 2021-07-20 | Farapulse, Inc. | Systems, apparatuses, and methods for protecting electronic components from high power noise induced by high voltage pulses |
EP4061206A4 (en) * | 2019-11-22 | 2023-12-20 | Acutus Medical, Inc. | TISSUE TREATMENT SYSTEMS, APPARATUS AND METHODS |
US10842572B1 (en) | 2019-11-25 | 2020-11-24 | Farapulse, Inc. | Methods, systems, and apparatuses for tracking ablation devices and generating lesion lines |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2010534549A (ja) | 2007-08-07 | 2010-11-11 | カーディアック ペースメイカーズ, インコーポレイテッド | 電極コンビネーションを選択する心調律管理システム |
US20110054559A1 (en) | 2009-09-03 | 2011-03-03 | Pacesetter, Inc. | Pacing, sensing and other parameter maps based on localization system data |
WO2011094073A4 (en) | 2010-01-29 | 2012-01-19 | Medtronic, Inc. | Needle design for recording monophasic action potential and delivery of therapy |
JP2012505047A (ja) | 2008-10-09 | 2012-03-01 | ザ リージェンツ オブ ザ ユニバーシティ オブ カリフォルニア | バイオリズム障害の検出、診断、及び治療のための方法、システム、及び装置 |
JP2012508079A (ja) | 2008-11-10 | 2012-04-05 | カーディオインサイト テクノロジーズ インコーポレイテッド | 電気生理学データの視覚化 |
US20120172942A1 (en) | 2010-12-30 | 2012-07-05 | Medtronic, Inc. | Synchronization of electrical stimulation therapy to treat cardiac arrhythmias |
Family Cites Families (19)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5813991A (en) * | 1997-04-25 | 1998-09-29 | Cardiac Pathways Corporation | Endocardial mapping system and method |
US7215993B2 (en) * | 2002-08-06 | 2007-05-08 | Cardiac Pacemakers, Inc. | Cardiac rhythm management systems and methods for detecting or validating cardiac beats in the presence of noise |
US6970743B2 (en) * | 2002-08-30 | 2005-11-29 | Pacesetter, Inc. | System and method for treating abnormal ventricular activation-recovery time |
US7813792B2 (en) * | 2006-04-17 | 2010-10-12 | General Electric Company | Method and apparatus for analyzing and editing ECG morphology and time series |
US10018613B2 (en) | 2006-11-16 | 2018-07-10 | General Electric Company | Sensing system and method for analyzing a fluid at an industrial site |
CZ2007376A3 (cs) * | 2007-05-30 | 2008-12-10 | Ústav prístrojové techniky AV CR, v.v.i. | Zpusob analýzy ventrikulární repolarizace |
US8504144B2 (en) | 2007-07-11 | 2013-08-06 | Pacesetter, Inc. | Systems and methods for employing multiple filters to detect T-wave oversensing and to improve tachyarrhythmia detection within an implantable medical device |
WO2011060284A2 (en) * | 2009-11-13 | 2011-05-19 | The General Hospital Corporation | Method and apparatus for the detection and control of repolarization alternans |
US8838224B2 (en) * | 2012-03-30 | 2014-09-16 | General Electric Company | Method, apparatus and computer program product for predicting ventricular tachyarrhythmias |
US9757190B2 (en) * | 2012-08-17 | 2017-09-12 | Medtronic Ablation Frontiers Llc | Methods of manufacturing monophasic action potential mapping catheters |
US9132274B2 (en) * | 2013-07-26 | 2015-09-15 | Medtronic, Inc. | Determining onsets and offsets of cardiac depolarization and repolarization waves |
US9265954B2 (en) * | 2013-07-26 | 2016-02-23 | Medtronic, Inc. | Method and system for improved estimation of time of left ventricular pacing with respect to intrinsic right ventricular activation in cardiac resynchronization therapy |
JP2017535318A (ja) * | 2014-10-03 | 2017-11-30 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | 心臓組織をマッピングするための医療システム |
US9737223B2 (en) * | 2015-05-13 | 2017-08-22 | Medtronic, Inc. | Determining onset of cardiac depolarization and repolarization waves for signal processing |
CN108289631B (zh) * | 2015-10-07 | 2021-03-02 | 圣犹达医疗用品心脏病学部门有限公司 | 用于标测心脏复极的方法和*** |
US20170189097A1 (en) | 2016-01-05 | 2017-07-06 | Iowa Approach Inc. | Systems, apparatuses and methods for delivery of ablative energy to tissue |
US20190246930A1 (en) * | 2016-05-03 | 2019-08-15 | Acutus Medical, Inc. | Cardiac information dynamic display system and method |
WO2018237099A1 (en) * | 2017-06-21 | 2018-12-27 | Boston Scientific Scimed Inc. | DYNAMIC REPOLARIZATION SUBSTRATE CARTOGRAPHY |
KR20200118472A (ko) | 2018-02-05 | 2020-10-15 | 메이오 파운데이션 포 메디칼 에쥬케이션 앤드 리써치 | 재분극을 매핑 및 조절하기 위한 시스템 및 방법 |
-
2019
- 2019-02-05 KR KR1020207025706A patent/KR20200118472A/ko active Application Filing
- 2019-02-05 CN CN201980011735.5A patent/CN111867506A/zh active Pending
- 2019-02-05 EP EP19748294.6A patent/EP3723649A4/en active Pending
- 2019-02-05 WO PCT/US2019/016644 patent/WO2019152986A1/en unknown
- 2019-02-05 JP JP2020539714A patent/JP7396988B2/ja active Active
-
2020
- 2020-02-28 US US16/805,094 patent/US11000202B2/en active Active
-
2021
- 2021-04-07 US US17/224,647 patent/US11771905B2/en active Active
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2010534549A (ja) | 2007-08-07 | 2010-11-11 | カーディアック ペースメイカーズ, インコーポレイテッド | 電極コンビネーションを選択する心調律管理システム |
JP2012505047A (ja) | 2008-10-09 | 2012-03-01 | ザ リージェンツ オブ ザ ユニバーシティ オブ カリフォルニア | バイオリズム障害の検出、診断、及び治療のための方法、システム、及び装置 |
JP2012508079A (ja) | 2008-11-10 | 2012-04-05 | カーディオインサイト テクノロジーズ インコーポレイテッド | 電気生理学データの視覚化 |
US20110054559A1 (en) | 2009-09-03 | 2011-03-03 | Pacesetter, Inc. | Pacing, sensing and other parameter maps based on localization system data |
WO2011094073A4 (en) | 2010-01-29 | 2012-01-19 | Medtronic, Inc. | Needle design for recording monophasic action potential and delivery of therapy |
US20120172942A1 (en) | 2010-12-30 | 2012-07-05 | Medtronic, Inc. | Synchronization of electrical stimulation therapy to treat cardiac arrhythmias |
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