Cardiac electrical mapping and ablation

Abstract

Improved mapping and ablation procedures and corresponding devices are provided. A variety of methods and apparatuses can be used for the treatment of cardiac arrhythmias by identifying the location of an arrhythmia source and ablating that source. The methods and apparatuses can provide an improved means of electrical mapping of the heart to identify the location of the arrhythmia source and advancing an ablation electrode to that location so that it may be ablated.

1 - 21 . (canceled) 
     
     
         22 . An apparatus for treating cardiac arrhythmias, comprising:
 a digital computer and a display screen, the computer being configured:
 to receive digitized signals obtained from an array of electrodes used to record cardiac electrical activity of cardiovascular tissue; 
 to receive digital images; 
 to display on the display screen a digital image and to determine locations of at least some of the array of electrodes on the digital image; 
 to process the digitized signals to determine arrival times of an electrical impulse emanating from an arrhythmia source of the cardiovascular tissue; 
 to compute a location of the arrhythmia source based on the locations of the array of electrodes and the arrival times; 
 to display the computed location of the arrhythmia source superposed on the digital image; and 
 to display sequential digital images configured to guide positioning of a catheter in a patient such that an ablation electrode is positioned adjacent to the arrhythmia source. 
   
     
     
         23 . The apparatus of  claim 22 , wherein the computer is configured to compute the distance of the ablation electrode to the arrhythmia source. 
     
     
         24 . The apparatus of  claim 22 , wherein the computer is configured to compute the position and orientation of a simulated model of the array of electrodes. 
     
     
         25 . The apparatus of  claim 22 , wherein the computer is configured to compute the orientation of a tissue plane on which the array of electrodes rests. 
     
     
         26 . The apparatus of  claim 25 , wherein the computer is configured to compute the location of the arrhythmia source in the tissue plane. 
     
     
         27 . The apparatus of  claim 22 , wherein the computer is configured to compute a scalar or two-component vector representation of a conduction velocity of the electrical impulse. 
     
     
         28 . The apparatus of  claim 22 , wherein the computer is configured to compute a depth of the arrhythmia source within the cardiovascular tissue. 
     
     
         29 . The apparatus of  claim 22  further comprising:
 an imaging system; 
 a catheter containing an array of electrodes, at least one of the array of electrodes being configured to ablate biological tissue; 
 a filter configured to amplify and filter analog signals recorded from the array of electrodes; 
 a converter configured to convert the analog signals to digital signals; and 
 a plurality of interfaces configured to electrically connect the computer, the imaging system, the catheter, the filter, and the converter. 
 
     
     
         30 . The apparatus of  claim 29 , wherein the catheter includes markers configured to identify individual electrodes in the array of electrodes. 
     
     
         31 . The apparatus of  claim 29 , wherein the array of electrodes comprises a central electrode and a plurality of electrodes located on deployable wings surrounding the central electrode. 
     
     
         32 . The apparatus of  claim 31 , wherein each deployable wing includes one or more electrodes. 
     
     
         33 . The apparatus of  claim 29  in which the imaging system is either an X-ray or an electroanatomic imaging system. 
     
     
         34 . The apparatus of  claim 29 , wherein the catheter contains an irrigation tube, and the electrode configured to ablate biological tissue is configured to be irrigated with irrigation fluid from the irrigation tube. 
     
     
         35 . The apparatus of  claim 29 , further comprising an energy source configured to provide energy for ablating biological tissue. 
     
     
         36 . The apparatus of  claim 35 , wherein the energy source is configured to deliver one of radiofrequency electrical energy or electrical energy configured to induce irreversible electroporation of biological tissue. 
     
     
         37 . An apparatus for treating cardiac arrhythmias comprising:
 a digital computer and a display screen, the computer being configured:
 to receive digitized signals recorded from an array of electrodes; 
 to receive digital images; 
 to display on the display screen the digital image and to determine locations of one or more electrodes in the array of electrodes on the digital image; 
 to process the digitized signals to obtain electrical measures; 
 to compute a location of an arrhythmia source based on the locations of the one or more electrodes and the electrical measures; 
 to display on the display screen the computed location of the arrhythmia source superposed on the digital image; 
 to display sequential digital images configured to guide positioning of an ablation electrode on a catheter adjacent to the arrhythmia source. 
   
     
     
         38 . The apparatus of  claim 37 , wherein the electrical measures are at least one of arrival times at the one or more electrodes of an electrical impulse emanating from the arrhythmia source, electrical impedances, and amplitudes of electrical signals. 
     
     
         39 . The apparatus of  claim 37 , further comprising:
 an imaging system;   a catheter containing an array of electrodes, at least one electrode of the array of electrodes being configured to ablate biological tissue;   a filter configured to amplify and filter analog signals recorded from the array of electrodes;   a converter configured to convert the analog signals to digital signals;   a plurality of interfaces configured to connect one or more elements of the apparatus with each other.   
     
     
         40 . The apparatus of  claim 39 , wherein the catheter includes markers configured to identify individual electrodes of the array of electrodes. 
     
     
         41 . The apparatus of  claim 39 , wherein the array of electrodes comprises a central electrode and a plurality of electrodes located on deployable wings surrounding the central electrode. 
     
     
         42 . The apparatus of  claim 39 , wherein the imaging system is one of an X-ray or an electroanatomic imaging system. 
     
     
         43 . An apparatus for determining a location of an arrhythmia source of a cardiac arrhythmia, comprising:
 a digital computer and a display screen, the computer being configured:
 to receive digitized signals recorded from an array of electrodes; 
 to receive digital images; 
 to display on the display screen the digital image and to determine locations of one or more electrodes in the array of electrodes on the digital image; 
 to process the digitized signals to obtain electrical measures; 
 to compute a location of an arrhythmia source based on the locations of the one or more electrodes and the electrical measures; 
 to display on the display screen the computed location of the arrhythmia source superposed on the digital image. 
   
     
     
         44 . The apparatus of  claim 43 , wherein the electrical measures are at least one of arrival times at the one or more electrodes of an electrical impulse emanating from the arrhythmia source, electrical impedances, and amplitudes of electrical signals.