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| (12) | CORRECTED EUROPEAN PATENT SPECIFICATION |
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DETERMINING ABLATION LOCATION USING PROBABILISTIC DECISION-MAKING BESTIMMUNG EINER ABLATIONSSTELLE MITTELS PROBABILISTISCHER ENTSCHEIDUNGSFINDUNG DÉTERMINATION D'EMPLACEMENT D'ABLATION PAR PRISE DE DÉCISION PROBABILISTE |
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| Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention). |
FIELD OF THE DISCLOSURE
[0001] The present disclosure relates generally to cardiac mapping systems. In particular, the present disclosure relates to cardiac mapping systems and methods for use in performing probabilistic decision-making during an electrophysiological (EP) procedure.
BACKGROUND
[0002] WO 2012/151301 A1 relates to the field of medicine and more specifically to a system and method for targeting rhythm irregularities and other rhythm disorders of biological rhythms using shaped ablation.
[0003] US 2006/111933 A1 relates to a computer-implemented expert system for medical decision making support and outcome analysis, which permits adaptive revisions of diagnoses and treatment rules based on outcome analysis.
[0004] Atrial arrhythmias are conditions causing an irregular heartbeat that can result in blood clots, stroke, heart failure, and other cardiac complications. It is believed that the primary cause of atrial arrhythmia is stray electrical signals within the left or right atrium of the heart. It is generally known that ablation therapy may be used to treat atrial arrhythmias, including atrial fibrillation (AF) and other conditions. When tissue is ablated, or at least subjected to ablative energy generated by an ablation generator and delivered by an ablation catheter, lesions form in the tissue. Electrodes mounted on or in ablation catheters are used to create tissue necrosis in cardiac tissue to correct atrial arrhythmia The ablation catheter imparts ablative energy (e.g., radiofrequency energy, cryoablation, lasers, chemicals, high-intensity focused ultrasound, etc.) to cardiac tissue to create a lesion in the cardiac tissue. This lesion disrupts undesirable electrical pathways and thereby limits or prevents stray electrical signals that lead to arrhythmias.
[0005] Determining an ablation location within a patient's heart may be relatively difficult. Different ablation locations are associated with different cardiac conditions, and each patient's heart is different. Although at least some solutions have been posed to identify ablation locations using software, it has been observed that many practitioners do not always follow software recommendations, instead choosing to rely on clinical knowledge in determining where to ablate.
BRIEF SUMMARY
[0006] The present disclosure generally relates to cardiac mapping systems and methods of using the same. The cardiac mapping system incorporates a probabilistic algorithm to identify candidate ablation locations. The algorithm is developed based upon ablation procedures that have been completed successfully, enabling non-expert practitioners to leverage the clinical knowledge of expert practitioners in determining ablation locations. Other embodiments and descriptions of the present disclosure are set forth below.
[0007] The invention is defined in independent claims 1, 7 and 10. Preferred embodiments are defined in the dependent claims. Any other embodiments not falling under the scope of the claims are merely exemplary.
[0008] The foregoing and other aspects, features, details, utilities and advantages of the present disclosure will be apparent from reading the following description and claims, and from reviewing the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009]
FIG. 1 is a schematic and block diagram view of an ablation system including a cardiac mapping system incorporating embodiments for probabilistic ablation location identification.
FIG. 2 illustrates an example visual interface of the cardiac mapping system shown in FIG. 1 including one or more visual indicators of a candidate ablation location.
FIG. 3 is a flowchart illustrated an example method for determining a candidate ablation location using probabilistic analysis of historical ablation data.
[0010] Corresponding reference characters indicate corresponding parts throughout the several views of the drawings. It is understood that that Figures are not necessarily to scale.
DETAILED DESCRIPTION
[0011] The present disclosure relates generally to cardiac mapping systems. In particular, the present disclosure relates to cardiac mapping systems and methods for use in performing probabilistic decision-making during an electrophysiological (EP) procedure. The disclosed embodiments may improve patient outcome in EP procedures performed by non-expert physicians and may improve consistency in the performance and outcomes of EP procedures across physicians. It is contemplated, however, that the described features and methods of the present disclosure as described herein may be incorporated into any number of systems as would be appreciated by one of ordinary skill in the art based on the disclosure herein.
[0012] Referring now to the drawings, FIG. 1 is a diagrammatic and block diagram view of an ablation system 10 for performing EP procedures, specifically cardiac ablation procedures. Ablation system 10 may be used for any type of ablation therapy, including radiofrequency (RF) ablation, cryoablation, ultrasound ablation, electroporation, and/or any other ablation procedure. In general, ablation system 10 includes, among other components, a catheter 12 and a cardiac mapping system 14. Catheter 12 includes an ablation and/or mapping catheter 12, and cardiac mapping system 14 includes, in part, a processing apparatus 16. Processing apparatus 16 may take the form of an electronic control unit, for example, that is configured to generate a three-dimensional model of the heart 20 within a patient's body 18, using data collected by catheter 12.
[0013] As illustrated in FIG. 1, catheter 12 is configured to be inserted into a patient's body 18, and more particularly, into the patient's heart 20. Catheter 12 may include a cable connector or interface 22, a handle 24, and a shaft 26 having a proximal end 28 and a distal end 30 (as used herein, "proximal" refers to a direction toward the portion of the catheter 12 near the clinician, and "distal" refers to a direction away from the clinician and (generally) inside the body of a patient). Catheter 12 may include one or more sensors 32 mounted in or on shaft 26 of catheter 12. In this embodiment, sensors 32 are disposed at or near distal end 30 of shaft 26. Catheter 12 may further include other conventional components such as, for example and without limitation, a temperature sensor, additional sensors or electrodes, ablation elements (e.g., ablation tip electrodes for delivering RF ablative energy, high intensity focused ultrasound ablation elements, etc.), and corresponding conductors or leads.
[0014] Connector 22 provides mechanical, fluid, and electrical connection(s) for cables, such as, for example, cables 34, 36 extending to cardiac mapping system 14 and/or other components of ablation system 10 (e.g., an ablation generator, irrigation source, etc.). Connector 22 is conventional in the art and is disposed at proximal end 28 of catheter 12, and handle 24 thereof, in particular.
[0015] Handle 24, which is disposed at proximal end 28 of shaft 26, provides a location for the clinician to hold catheter 12 and may further provide means for steering or guiding shaft 26 within body 18 of the patient. For example, handle 24 may include means to change the length of a steering wire extending through catheter 12 to distal end 30 of shaft 26 to steer shaft 26. Handle 24 is also conventional in the art and it will be understood that the construction of handle 24 may vary. In other embodiments, catheter 12 may be robotically driven or controlled. Accordingly, rather than a clinician manipulating a handle to steer or guide catheter 12 and shaft 26 thereof, in such an embodiment, a robot is used to manipulate catheter 12.
[0016] Shaft 26 is an elongate, tubular, flexible member configured for movement within body 18. Shaft 26 supports, for example and without limitation, sensors and/or electrodes mounted thereon, such as, for example, sensors 32, associated conductors, and possibly additional electronics used for signal processing and conditioning. Shaft 26 may also permit transport, delivery, and/or removal of fluids (including irrigation fluids, cryogenic ablation fluids, and bodily fluids), medicines, and/or surgical tools or instruments. Shaft 26 may be made from conventional materials such as polyurethane, and defines one or more lumens configured to house and/or transport electrical conductors, fluids, or surgical tools. Shaft 26 may be introduced into a blood vessel or other structure within the body 18 through a conventional introducer. Shaft 26 may then be steered or guided through body 18 to a desired location, such as heart 20, using means well known in the art.
[0017] Sensors 32 mounted in or on shaft 26 of catheter 12 may be provided for a variety of diagnostic and therapeutic purposes including, for example and without limitation, electrophysiological studies, pacing, cardiac mapping, and ablation. In this embodiment, one or more of sensors 32 are provided to perform a location or position sensing function. More particularly, one or more of sensors 32 are configured to be a positioning sensor(s) that provides information relating to the location (position and orientation) of catheter 12, and distal end 30 of shaft 26 thereof, in particular, at certain points in time. Accordingly, as catheter 12 is moved along a surface of a structure of interest of heart 20 and/or about the interior of the structure, sensor(s) 32 can be used to collect location data points that correspond to the surface of, and/or other locations within, the structure of interest. These location data points can then be used by, for example, cardiac mapping system 14, in the construction of a three-dimensional model of the patient's heart 20.
[0018] Cardiac mapping system 14 is configured to construct a three-dimensional model of structures within heart 20 using, in part, location data collected by catheter 12. More particularly, processing apparatus 16 of cardiac mapping system 14 is configured to acquire location data points collected by sensor(s) 32 and to then use those location data points in the construction or generation of a model of the structure(s) to which the location data points correspond. Cardiac mapping system 14 may comprise an electric field-based system, such as, for example, the EnSite™ NavX™ system commercially available from Abbott Laboratories, or an electric impedance- and magnetic field-based system such as the EnSite™ Precision™ system commercially available from Abbott Laboratories, and generally shown with reference to U.S. Pat. No. 7,263,397 entitled "Method and Apparatus for Catheter Navigation and Location and Mapping in the Heart". In other embodiments, however, cardiac mapping system 14 may comprise other types of systems, such as, for example and without limitation: a magnetic-field based system such as a system as generally shown with reference to one or more of U.S. Pat. Nos. 6,498,944 entitled "Intrabody Measurement," 6,788,967 entitled "Medical Diagnosis, Treatment and Imaging Systems," and 6,690,963 entitled "System and Method for Determining the Location and Orientation of an Invasive Medical Instrument," or the gMPS system from MediGuide Ltd., and as generally shown with reference to one or more of U.S. Pat. Nos. 6,233,476 entitled "Medical Positioning System," 7,197,354 entitled "System for Determining the Position and Orientation of a Catheter," and 7,386,339 entitled "Medical Imaging and Navigation System," a combination electric field-based and magnetic field-based system such as the Carto 3™ System also available from Biosense Webster; as well as other impedance-based localization systems, acoustic or ultrasound-based systems, and commonly available fluoroscopic, computed tomography (CT), and magnetic resonance imaging (MRI)-based systems. Cardiac mapping system 14 displays the generated cardiac models on a display device 40. Display device 40 may include a monitor (e.g., an output-only display device) or a touch-screen display (e.g., an input-output display device).
[0019] Cardiac mapping system 14 further includes and/or is in communication with a database 42. Database 42 includes a plurality of records of historical (i.e., already-performed) ablation procedures, or "ablation records." The ablation records are generated and stored in database 42 manually and/or automatically. In some embodiments, a subset of the plurality of ablation records are associated with ablation procedures performed and described in published literature, such as medical journals, scholarly articles, and the like. In some embodiments, a subset of the plurality of ablation records are associated with ablation procedures performed and observed/recorded by one or more medical professionals, such as medical directors. In some embodiments, a subset of the plurality of ablation records are associated with ablation procedures performed by expert physicians and recorded in database 42. A physician may be considered an "expert" when they meet one or more expert criteria, including, for example, a threshold number of EP procedures performed, a threshold number of successful EP procedures performed (e.g., EP procedures having a successful patient outcome, such as elimination of atrial fibrillation (AF)), a threshold percentage of successful EP procedures performed, a number of publications attributable to the physician, and/or any other expert criteria. Expert criteria may shift over time, as new physicians become experts and/or more EP procedures are performed.
[0020] Each ablation record includes data elements associated with the patient, such as age, condition, sex, weight, and/or additional data. Each ablation record also includes data elements associated with the EP condition, such as one or more type(s) of arrhythmia experienced (e.g., AF, ventricular tachycardia (VT), ventricular fibrillation (VF) atrial tachycardia (AT)), symptoms, and/or the type of EP condition being treated with an ablation procedure. Each ablation record also includes data elements associated with the ablation procedure, including what type of procedure was performed, any ablation locations at which ablation was performed, and an indication of outcome (e.g., successful, unsuccessful, partially successful). In some embodiments, ablation records include data elements identifying the physician that performed the EP procedure and/or whether the physician is an expert physician.
[0021] Processing apparatus 16 (and/or another processing component in communication with database 42) is configured to generate a set of probability parameters describing each ablation record of the plurality of ablation records. The probability parameters are associated with the different types of cases/conditions, as well as with the different types of patients. The probability parameters may be characterized as "pre-test" parameters or filtering criteria for developing an algorithm, as described further herein. Processing apparatus 16 stores the probability parameters in database 42 and/or in an additional memory component (not shown) in cardiac mapping system 14.
[0022] Processing apparatus 16 also develops an algorithm based upon the sets of probability parameters for the plurality of ablation records, stored in database 42. The algorithm is configured to output a probability that ablating in a particular ablation location will be successful, based on the historical ablation records in database 42 and associated probability parameters. More specifically, the algorithm is employed for each candidate (i.e., yet to be performed) ablation procedure. Generally, the algorithm may include a regression analysis configured to process the ablation records and identify probability parameters (or variables or filtering criteria) that tend to have some correlation with particular outcomes. In other words, the algorithm is developed without identifying a particular parameter or criterion that correlates with a particular condition or outcome. Rather, the algorithm employs a regression analysis to identify and then incorporate the parameters or criteria that correlate with condition or outcome to direct candidate ablation locations in later ablation procedures.
[0023] Processing apparatus 16 generates a table or matrix of candidate conditions and corresponding candidate ablation locations to be associated with each type of condition. More specifically, processing apparatus 16 matches or associates stored probability parameters with corresponding candidate conditions. For example, certain probability parameters are matched to an AF condition for those probability parameters having a strong correlation with that AF condition. Within the table or matrix, processing apparatus 16 applies probability adjusters to candidate conditions, the probability adjusters corresponding to the correlation between certain probability parameters and certain conditions. If no correlation is known, in the example embodiment, processing apparatus 16 applies a probability adjuster of "1" to a candidate condition. In the example embodiment, processing apparatus 16 generates a "probabilities tree" using the table and the stored probabilities. More specifically, processing apparatus 16 applies the Bayes theorem to the table to generate a probabilities tree of candidate conditions associated with the candidate ablation procedure:
where P(H) represents the prior probability that a hypothesis 'H' is true, P(E|H) represents the likelihood of evidence 'E' if hypothesis 'H' is true, and P(E) represents the prior probability that the evidence 'E' is true. In other words, P(H) and P(E) represents respective probabilities of observing hypothesis 'H' and observing evidence 'E' without regard to one another, and P(E|H) represents a conditional probability of observing hypothesis 'H' given that evidence 'E' is true. The outcome P(H|E) represents the probabilities tree, or the final probability of hypothesis 'H' given the evidence 'E.'
[0024] A simplified probabilities tree is illustrated below. Taking the following example values for successful ablation procedures:
| Candidate condition A | Candidate condition B | Candidate condition C | |
| Ablation Location 1 | 10% | 5% | 2% |
| Not Ablation Location 1 | 90% | 95% | 98% |
The probability of successfully ablating in ablation location 1 for any of candidate conditions A, B, and C, is .048.
[0025] In a first example, a 45-year-old patient presents with a paroxysmal AF. The patient has no history of alcohol use, no hypertension/high blood pressure, no diabetes, and a normal left atrium size. A "pre-test" probability prediction (e.g., a prediction based upon the literature associated with paroxysmal AF and/or expert opinion) is that there is a 90% chance that pulmonary vein ablation would be a successful treatment. Ablation in the location of pulmonary vein is chosen as the optimal treatment strategy. The patient undergoes cardiac mapping, during which a low voltage is seen on the posterior cardiac wall, and a rotor is seen on the posterior cardiac wall near a scar. The "post-test" probability (e.g., the probability based upon the actual characterization of the patient) indicates that pulmonary vein ablation has a 50% chance of being successful, and posterior wall ablation has a 50% chance of being successful. In this case, a posterior wall ablation location may be chosen, and a new data record wth patient and ablation procedure variables will be added to the database to update the algorithm.
[0026] In a second example, a 70-year-old patient presents with persistent AF. The patient has hypertension/high blood pressure and diabetes, as well as a left atrium size of 55. A "pre-test" probability prediction is that there is a 50% probability that pulmonary vein ablation would be a successful treatment, a 25% probability that posterior wall ablation would be successful, a 20% probability that left atrial appendage ablation would be successful, and a 5% probability that a superior vena cava ablation would be successful. Ablation in the location of the posterior wall, as well as possible left atrial appendage clipping, is chosen as the optimal treatment strategy. The patient undergoes cardiac mapping with isoproterenol, during which a driver from the superior vena cava is seen, and no scar in the left atrium is seen. The "post-test" probability indicates that ablation in the location of the pulmonary vein has a 50% chance of being successful, and ablation in the location of the superior vena cava has a 50% chance of being successful. In this case, a pulmonary vein and superior vena cava isolation (no posterior wall ablation) may be chosen for treatment, and a new data record with patient and ablation procedure variables will be added to the database to update the algorithm.
[0027] Processing apparatus 16 employs the above-described probabilistic analysis to identify and output candidate ablation locations on display device 40 during each candidate ablation procedure. Data specific to the candidate ablation procedure is input to cardiac mapping system 14. Specifically, in the example embodiment, an input device 44 is used to input patient- and case-specific data associated with the candidate ablation procedure. Input device 44 may include, for example, a keyboard, mouse, touch screen interface, and/or any other suitable input device. Such information as a patient age, a patient gender, a patient weight, one or more known patient conditions, and/or one or more known patient symptoms are input using input device 44.
[0028] In some embodiments, one or more patient conditions and/or symptoms are determined using diagnostic techniques. One or more diagnostic techniques may be performed using ablation system 10, such as complex fractionated atrial electrogram (CFAE), local activation time (LAT), direction of activation, curl/divergence analysis, phase mapping, dominant frequency mapping, and/or any other known diagnostic technique. Based on one or more diagnosed patient conditions ("candidate conditions"), processing apparatus 16 applies the algorithm described above to identify one or more candidate ablation locations and the corresponding probability that ablating in each ablation location will be successful (i.e., lead to a successful outcome for the patient). The algorithm factors in patient- and case-specific data to identify and display one or more candidate ablation locations that are most likely to provide successful patient outcomes if ablation is performed at those candidate ablation locations. Processing apparatus 16 may therefore provide probabilistic indicators to a physician to aid in decision-making during an EP procedure.
[0029] In the example embodiment, processing apparatus 16 causes display of the identified candidate ablation locations on display device 40. More specifically, processing apparatus 16 causes display of the identified candidate ablation locations with respect to the three-dimensional model of the patient's heart 20, providing visual indicators to the physician of where within the model (and therefore where within the heart 20) to ablate. In some embodiments, processing apparatus 16 displays the identified candidate ablation locations using a color map, a probability map, or similar visual indicator overlaid on an existing three-dimensional model. For example, FIG. 2 illustrates one example cardiac model 200 displayed on a visual interface 202 of display device 40. Visual indicators 204 are displayed as overlays on cardiac model 200 to identify a candidate ablation location 206 to a physician performing an EP procedure. Additionally or alternatively, visual indicators such as arrows, icons, labels, highlighting, bolding, shading, annotations, and/or any other visual indicator are further displayed on visual interface 202 of display device 40.
[0030] Additionally, after each EP procedure is completed, input device 44 (and/or any other input device in communication with database 42) is used to input details from the EP procedure into database 42 as an additional ablation record. In this manner, database 42 and the probabilistic algorithm are iteratively developed and refined in response to EP procedures initially performed using the algorithm. In some embodiments, a threshold amount of time between completion of the EP procedure and entry into database 42 is allowed to pass, such that accurate outcomes of the EP procedure may be determined.
[0031] FIG. 3 is a flowchart of a method 300 of determining a candidate ablation location using historical ablation data. In the example embodiment, method 300 is performed using cardiac mapping system 14 (shown in FIG. 1).
[0032] Method 300 includes generating 302 a database (e.g., database 42, shown in FIG. 1) including a plurality of ablation records. Each ablation record of the plurality of ablation records is associated with a corresponding ablation procedure that has already been performed. In some embodiments, generating 302 includes generating a subset of the plurality of ablation records based upon published data of the corresponding ablation procedures. In some embodiments, generating 302 includes generating a subset of the plurality of ablation records based upon historical ablation procedures performed by one or more ablation practitioners who meet at least one expert criterion. In some embodiments, each ablation record identifies a condition and an ablation location associated with the corresponding ablation procedure. Method 300 also includes generating 304 a set of probability parameters describing each ablation record of the plurality of ablation records.
[0033] Method 300 further includes developing 306 an algorithm based upon the sets of probability parameters for the plurality of ablation records. For each candidate ablation procedure to be performed using ablation system 10 (shown in FIG. 1), method 300 also includes receiving 308 a plurality of patient parameters associated with a patient receiving the candidate ablation procedure (e.g., using input device 44, shown in FIG. 1) and determining 310 at least one candidate condition associated with the patient and a respective probability associated with each candidate condition. In some embodiments, determining 310 including using one or more diagnostic techniques to identifying candidate conditions.
[0034] Method 300 includes applying 312 the algorithm to determine at least one candidate ablation location based upon the respective probabilities associated with the at least one candidate condition, and displaying 314 the at least one candidate ablation location on a visual interface (e.g., visual interface 202, shown in FIG. 2) of an ablation system. In some embodiments, displaying 314 includes adding at least one visual indicator of a corresponding ablation location onto an ablation map of the ablation system, such as cardiac model 200 (shown in FIG. 2). More particularly, adding a visual indicator may include adding at least one color to the ablation map to form a color map or probability map identifying the at least one candidate ablation location. Additionally or alternatively, adding a visual indicator may include adding at least one probability indicator to a respective location on the ablation map corresponding to the at least one candidate ablation location. In some embodiments, displaying 314 includes associating each at least one candidate ablation location with a corresponding point on an ablation map of the ablation system, and adding at least one visual indicator onto each point on the ablation map associated with each at least one candidate ablation location.
[0035] Method 300 may include additional steps. For example, in some embodiments, method 300 further includes performing 316 the candidate ablation procedure at least at one candidate ablation location. Method 300 may further include monitoring 318 an outcome of the candidate ablation procedure. Method 300 may also include adding 320 a data record associated with the candidate ablation procedure to the database. Adding 320 may include adding a data element associated with the outcome of the candidate ablation procedure to the data record associated with the candidate ablation procedure. Method 300 may still further include updating 322 the algorithm based upon the data record associated with the candidate ablation procedure.
[0036] Although certain embodiments of this disclosure have been described above with a certain degree of particularity, those skilled in the art could make numerous alterations to the disclosed embodiments without departing from the scope as defined in the claims. All directional references (e.g., upper, lower, upward, downward, left, right, leftward, rightward, top, bottom, above, below, vertical, horizontal, clockwise, and counterclockwise) are only used for identification purposes to aid the reader's understanding of the present disclosure, and do not create limitations, particularly as to the position, orientation, or use of the disclosure. Joinder references (e.g., attached, coupled, connected, and the like) are to be construed broadly and may include intermediate members between a connection of elements and relative movement between elements. As such, joinder references do not necessarily infer that two elements are directly connected and in fixed relation to each other. It is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative only and not limiting. Changes in detail or structure may be made without departing from the scope of the appended claims.
[0037] When introducing elements of the present disclosure or the preferred embodiment(s) thereof, the articles "a", "an", "the", and "said" are intended to mean that there are one or more of the elements. The terms "comprising", "including", and "having" are intended to be inclusive and mean that there may be additional elements other than the listed elements.
generating a database (42) including a plurality of ablation records, each ablation record of the plurality of ablation records associated with a corresponding ablation procedure;
generating a set of probability parameters associated with different types of conditions and different types of patients, and describing each ablation record of the plurality of ablation records;
developing, using a regression analysis, an algorithm based upon the sets of probability parameters for the plurality of ablation records; and
for a candidate ablation procedure:
receiving a plurality of patient parameters associated with a patient receiving the candidate ablation procedure;
determining at least one candidate condition associated with the patient and a respective probability associated with each candidate condition;
applying the algorithm to determine at least one candidate ablation location (206) and a probability that ablating in the at least one candidate ablation location will be successful based upon the respective probabilities associated with the at least one candidate condition; and
displaying the at least one candidate ablation location (206) on a visual interface of a cardiac mapping system.
associating each at least one candidate ablation location (206) with a corresponding point on an ablation map of the ablation system; and
adding at least one visual indicator (204) onto each point on the ablation map associated with each at least one candidate ablation location (206).
a database (42);
a display device (40); and
a processing apparatus (16) in communication with the database (42) and the display device (40), the processing apparatus (16) configured to:
populate the database (42) with a plurality of ablation records, each ablation record of the plurality of ablation records associated with a corresponding ablation procedure;
generate a set of probability parameters associated with different types of conditions and different types of patients, and describing each ablation record of the plurality of ablation records;
develop, using a regression analysis, an algorithm based upon the sets of probability parameters for the plurality of ablation records; and
for a candidate ablation procedure:
receive a plurality of patient parameters associated with a patient receiving the candidate ablation procedure;
determine at least one candidate condition associated with the patient and a respective probability associated with each candidate condition;
apply the algorithm to determine at least one candidate ablation location (206) and a probability that ablating in the at least one candidate ablation location will be successful based upon the respective probabilities associated with the at least one candidate condition; and
display the at least one candidate ablation location (206) on the display device (40).
receive an indication of an outcome of the candidate ablation procedure;
add a data element associated with the outcome of the candidate ablation procedure to the data record associated with the candidate ablation procedure; and
update the algorithm based upon the data record associated with the candidate ablation procedure, or wherein the processing apparatus is further configured to add at least one of a visual indicator (204) of a corresponding ablation location and a probability indicator onto a map displayed on the display device (40).
populate the database (42) with a plurality of ablation records, each ablation record of the plurality of ablation records associated with a corresponding ablation procedure;
generate a set of probability parameters associated with different types of conditions and different types of patients, and describing each ablation record of the plurality of ablation records;
develop, using a regression analysis, an algorithm based upon the sets of probability parameters for the plurality of ablation records; and
for a candidate ablation procedure:
receive a plurality of patient parameters associated with a patient receiving the candidate ablation procedure;
determine at least one candidate condition associated with the patient and a respective probability associated with each candidate condition;
apply the algorithm to determine at least one candidate ablation location (206) and a probability that ablating in the at least one candidate ablation location will be successful based upon the respective probabilities associated with the at least one candidate condition; and
display the at least one candidate ablation location (206) on the display device (40).
Erzeugen einer Datenbank (42), die eine Mehrzahl von Ablationsdatensätzen aufweist, wobei jeder Ablationsdatensatz von der Mehrzahl von Ablationsdatensätzen einer entsprechenden Ablationsprozedur zugeordnet ist;
Erzeugen eines Satzes von Wahrscheinlichkeitsparametern, die unterschiedlichen Typen von Bedingungen und unterschiedlichen Typen von Patienten zugeordnet sind, und der jeden Ablationsdatensatz von der Mehrzahl von Ablationsdatensätzen beschreibt;
Entwickeln, unter Verwendung einer Regressionsanalyse, eines Algorithmus basierend auf den Sätzen von Wahrscheinlichkeitsparametern für die Mehrzahl von Ablationsdatensätzen; und
für eine Ablationskandidatenprozedur:
Empfangen einer Mehrzahl von Patientenparametern, die einem Patienten, der die Ablationskandidatenprozedur empfängt, zugeordnet sind;
Bestimmen von mindestens einer Kandidatenbedingung, die dem Patienten zugeordnet ist, und einer jeweiligen Wahrscheinlichkeit, die zu jeder Kandidatenbedingung gehört;
Anwenden des Algorithmus zum Bestimmen von mindestens einem Ablationskandidatenort (206) und einer Wahrscheinlichkeit dafür, dass die Ablation an dem mindestens einen Ablationskandidatenort erfolgreich sein wird, basierend auf den jeweiligen Wahrscheinlichkeiten, die der mindestens einen Kandidatenbedingung zugeordnet sind; und
Anzeigen des mindestens einen Ablationskandidatenorts (206) auf einer visuellen Schnittstelle eines Herzabbildungssystems.
das Hinzufügen von mindestens einem visuellen Indikator (204) ein Hinzufügen von mindestens einem Wahrscheinlichkeitsindikator zu einem jeweiligen Ort auf der Karte aufweist, der dem mindestens einen Ablationskandidatenort (206) entspricht.
Zuordnen von jedem mindestens einen Ablationskandidatenort (206) zu einem entsprechenden Punkt auf einer Ablationskarte des Ablationssystems; und
Hinzufügen von mindestens einem visuellen Indikator (204) zu jeden Punkt auf der Ablationskarte, der zu jedem mindestens einen Ablationskandidatenort (206) gehört.
einer Datenbasis (42);
einer Anzeigevorrichtung (40); und
einer Verarbeitungsvorrichtung (16), die mit der Datenbank (42) und der Anzeigevorrichtung (40) kommuniziert, wobei die Verarbeitungsvorrichtung (16) konfiguriert ist zum:
Einpflegen der Datenbank (42) mit einer Mehrzahl von Ablationsdatensätzen, wobei jeder Ablationsdatensatz von der Mehrzahl von Ablationsdatensätzen zu einer entsprechenden Ablationsprozedur gehört;
Erzeugen eins Satzes von Wahrscheinlichkeitsparametern, die unterschiedlichen Typen von Bedingungen und unterschiedlichen Typen von Patienten zugeordnet sind, und der jeden Ablationsdatensatz der Mehrzahl von Ablationsdatensätzen beschreibt;
Entwickeln, unter Verwendung einer Regressionsanalyse, eines Algorithmus basierend auf den Sätzen von Wahrscheinlichkeitsparametern für die Mehrzahl von Ablationsdatensätzen; und
für eine Ablationskandidatenprozedur:
Empfangen einer Mehrzahl von Patientenparametern, die zu einem Patienten gehören, der die Ablationskandidatenprozedur empfängt;
Bestimmen von mindestens einer Kandidatenbedingung, die dem Patienten zugeordnet ist, und einer jeweiligen Wahrscheinlichkeit dafür, die jeder Kandidatenbedingung zugeordnet ist;
Anwenden des Algorithmus zum Bestimmen von mindestens einem Ablationskandidatenort (206) und einer Wahrscheinlichkeit, dass die Ablation an dem mindestens einen Ablationskandidatenort erfolgreich sein wird, basierend auf den jeweiligen Wahrscheinlichkeiten, die der mindestens einen Kandidatenbedingung zugeordnet sind; und
Anzeigen des mindestens einen Ablationskandidatenorts (206) auf der Anzeigevorrichtung (40).
Empfangen einer Anzeige eines Ergebnisses der Ablationskandidatenprozedur;
Hinzufügen eines Datenelements, das dem Ergebnis der Ablationskandidatenprozedur zugeordnet ist, zu dem Datensatz, der der Ablationskandidatenprozedur zugeordnet ist; und
Aktualisieren des Algorithmus basierend auf dem Datensatz, der zu der Ablationskandidatenprozedur zugeordnet ist, oder bei dem die Verarbeitungsvorrichtung ferner konfiguriert ist zum Hinzufügen von mindestens einem visuellen Indikator (204) eines entsprechenden Ablationsorts und eines Wahrscheinlichkeitsindikators zu einer Karte, die auf der Anzeigevorrichtung (40) angezeigt wird.
Einpflegen der Datenbank (42) mit einer Mehrzahl von Ablationsdatensätzen, wobei jeder Ablationsdatensatz der Mehrzahl von Ablationsdatensätzen einer entsprechenden Ablationsprozedur zugeordnet ist;
Erzeugen eines Satzes von Wahrscheinlichkeitsparametern, die unterschiedlichen Typen von Bedingungen und unterschiedlichen Typen von Patienten zugeordnet sind, und der jeden Ablationsdatensatz der Mehrzahl von Ablationsdatensätzen beschreibt;
Entwickeln, unter Verwendung einer Regressionsanalyse, eines Algorithmus basierend auf den Sätzen von Wahrscheinlichkeitsparametern für die Mehrzahl von Ablationsdatensätzen; und
für eine Ablationskandidatenprozedur:
Empfangen einer Mehrzahl von Patientenparametern, die einem Patienten zugeordnet sind, der die Ablationskandidatenprozedur erhält;
Bestimmen von mindestens einer Kandidatenbedingung, die dem Patienten zugeordnet ist, und einer jeweiligen Wahrscheinlichkeit, die jeder Kandidatenbedingung zugeordnet ist;
Anwenden des Algorithmus zum Bestimmen von mindestens einem Ablationskandidatenort (206) und einer Wahrscheinlichkeit dafür, dass die Ablation an dem mindestens einen Ablationskandidatenort erfolgreich sein wird, basierend auf jeweiligen Wahrscheinlichkeiten, die der mindestens einen Kandidatenbedingung zugeordnet sind, und
Anzeigen des mindestens einen Ablationskandidatenorts (206) auf der Anzeigevorrichtung (40).
générer une base de données (42) comprenant une pluralité d'enregistrements d'ablation, chaque enregistrement d'ablation de la pluralité d'enregistrements d'ablation étant associé à une procédure d'ablation correspondante ;
générer un ensemble de paramètres de probabilité associés à différents types de conditions et différents types de patients, et décrire chaque enregistrement d'ablation de la pluralité d'enregistrements d'ablation ;
développer, en utilisant une analyse de régression, un algorithme basé sur les ensembles de paramètres de probabilité pour la pluralité d'enregistrements d'ablation ; et
pour une procédure d'ablation candidate :
recevoir une pluralité de paramètres de patient associés à un patient recevant la procédure d'ablation candidate ;
déterminer au moins une condition candidate associée au patient et une probabilité respective associée à chaque condition candidate ;
appliquer l'algorithme pour déterminer au moins un emplacement d'ablation candidat (206) et une probabilité qu'ablatir dans ledit au moins un emplacement d'ablation candidat soit réussie basé sur les probabilités respectives associées à ladite au moins une condition candidate ; et
afficher ledit au moins un emplacement d'ablation candidat (206) sur une interface visuelle d'un système de cartographie cardiaque.
dans lequel la génération d'une base de données (42) comprenant
une pluralité d'enregistrements d'ablation comprend la génération d'un sous-ensemble de la pluralité d'enregistrements d'ablation basé sur les données publiées des procédures d'ablation correspondantes, ou dans lequel la génération d'une base de données (42) comprenant une pluralité d'enregistrements d'ablation comprend la génération d'un sous-ensemble de la pluralité d'enregistrements d'ablation basé sur des procédures d'ablation historiques réalisées par un ou plusieurs praticiens d'ablation qui répondent à au moins un critère d'expert, ou dans lequel la génération d'une base de données comprenant une pluralité d'enregistrements d'ablation comprend la génération de la base de données comprenant la pluralité d'enregistrements d'ablation, dans lequel chaque enregistrement d'ablation identifie une condition et un emplacement d'ablation associé à la procédure d'ablation correspondante.
dans lequel l'affichage dudit au moins un emplacement d'ablation candidat (206) sur une interface visuelle comprend l'ajout d'au moins un indicateur visuel (204) d'un emplacement d'ablation correspondant sur une carte du système de cartographie cardiaque.
où l'ajout d'au moins un indicateur visuel (204) comprend les étapes consistant à
ajouter au moins une couleur à la carte pour former une carte de probabilité identifiant ledit au moins un emplacement d'ablation candidat (206), ou dans lequel
ajouter au moins un indicateur visuel (204) comprend l'ajout d'au moins un indicateur de probabilité à un emplacement respectif sur la carte correspondant audit au moins un emplacement d'ablation candidat (206).
dans lequel la réception d'une pluralité de paramètres de patient associés à un patient recevant la procédure d'ablation candidate comprend la réception d'au moins un parmi un âge du patient, un sexe du patient, un poids du patient, un ou plusieurs conditions du patient connus, et un ou plusieurs symptômes du patient connus.
dans lequel l'affichage dudit au moins un emplacement d'ablation candidat (206) sur une interface visuelle comprend les étapes consistant à :
associer à chaque candidat au moins un des emplacements d'ablation candidats (206) avec un point correspondant sur une carte d'ablation du système d'ablation ; et
ajouter au moins un indicateur visuel (204) sur chaque point de la carte d'ablation associé à au moins un emplacement d'ablation candidat (206).
une base de données (42) ;
un dispositif d'affichage (40) ; et
un appareil de traitement (16) en communication avec la base de données (42) et le dispositif d'affichage (40), l'appareil de traitement (16) étant configuré pour :
remplir la base de données (42) avec une pluralité d'enregistrements d'ablation, chaque enregistrement d'ablation de la pluralité d'enregistrements d'ablation étant associé à une procédure d'ablation correspondante ;
générer un ensemble de paramètres de probabilité associés à différents types de conditions et différents types de patients, et décrivant chaque enregistrement d'ablation de la pluralité d'enregistrements d'ablation ;
développer, en utilisant une analyse de régression, un algorithme basé sur les ensembles de paramètres de probabilité pour la pluralité d'enregistrements d'ablation ; et
pour une procédure d'ablation candidate :
recevoir une pluralité de paramètres de patient associés à un patient recevant la procédure d'ablation candidate ;
déterminer au moins une condition candidate associée au patient et une probabilité respective associée à chaque condition candidate ;
appliquer l'algorithme pour déterminer au moins un emplacement d'ablation candidat (206) et une probabilité qu'ablatir dans ledit au moins un emplacement d'ablation candidat soit réussie basé sur des probabilités respectives associées à ladite au moins une condition candidate ; et
afficher sur le dispositif d'affichage (40) ledit au moins un emplacement d'ablation candidat (206).
dans lequel l'appareil de traitement est en outre configuré pour ajouter un enregistrement de données associé à la procédure d'ablation candidate à la base de données (42) après que la procédure d'ablation candidate ait été effectuée.
dans lequel l'appareil de traitement est en outre configuré pour :
recevoir une indication du résultat de la procédure d'ablation candidate ;
ajouter un élément de données associé au résultat de la procédure d'ablation candidate à l'enregistrement de données associé à la procédure d'ablation candidate ; et
mettre à jour l'algorithme basé sur l'enregistrement de données associé à la procédure d'ablation candidate, ou dans lequel l'appareil de traitement est en outre configuré pour ajouter au moins un indicateur visuel (204) d'un emplacement d'ablation correspondant et un indicateur de probabilité sur une carte affichée sur le dispositif d'affichage (40).
remplir la base de données (42) avec une pluralité d'enregistrements d'ablation, chaque enregistrement d'ablation de la pluralité d'enregistrements d'ablation étant associé à une procédure d'ablation correspondante ;
générer un ensemble de paramètres de probabilité associés à différents types de conditions et différents types de patients, et décrivant chaque enregistrement d'ablation de la pluralité d'enregistrements d'ablation ;
développer, en utilisant une analyse de régression, un algorithme basé sur les ensembles de paramètres de probabilité pour la pluralité d'enregistrements d'ablation ; et
pour une procédure d'ablation candidate :
recevoir une pluralité de paramètres de patient associés à un patient recevant la procédure d'ablation candidate ;
déterminer au moins une condition candidate associée au patient et une probabilité respective associée à chaque condition candidate ;
appliquer l'algorithme pour déterminer au moins un emplacement d'ablation candidat (206) et une probabilité qu'ablatir dans ledit au moins un emplacement d'ablation candidat soit réussie basé sur des probabilités respectives associées à ladite au moins une condition candidate ; et
afficher sur le dispositif d'affichage (40) ledit au moins un emplacement d'ablation candidat (206).
dans lequel les instructions exécutables par ordinateur amènent en outre ledit au moins un processeur (16) à ajouter au moins un indicateur visuel (204) d'un emplacement d'ablation correspondant sur une carte affichée sur le dispositif d'affichage (40), et/ou dans lequel les instructions exécutables par ordinateur amènent en outre ledit au moins un processeur (16) à ajouter au moins un indicateur de probabilité à un emplacement respectif sur la carte correspondant audit au moins un emplacement d'ablation candidat (206).
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