Multi-electrode panel system for sensing electrical activity of the heart

Abstract

Improved systems, devices, and methods sense heart signals through a torso surface of a patient. These improved systems facilitate mounting of an array of sensors upon the patient's torso by supporting the sensor arrays on one or more panels. Four separate panels can be adapted for engaging the torso surface, with the four panels supporting most and/or all of the sensors necessary for localizing an arrhythmia within a chamber of a heart of a patient. The panels may have integrated components for use with other electrophysiology lab equipment such as cardiac imagers, defibrillation power sources, therapeutic probes, standard 12-lead electrocardiogram (ECG) systems, and the like. An exemplary arrhythmia sensing system is adapted for use in the high-noise environment of an electrophysiology lab includes a series of powered circuits distributed among the electrodes of the array. A separate low-noise environment sensing system may initially record an abnormal irregular or regular heartbeat outside the electrophysiology lab.

What is claimed is:  
     
         1 . An sensing system for use diagnosing and/or treating a heart of a patient, the patient having a torso surface, the sensing system comprising: 
 an array of sensors for sensing heart cycle signals;    four sensor support panels having inner panel surfaces adapted for engaging the torso surface, the four panels supporting a majority of the sensors of the array in operative association with the torso surface when the panels engage the torso surface.    
     
     
         2 . The sensing system of  claim 1 , wherein the array defines at least 40 sensing locations, and wherein each panel supports at least 7 sensors.  
     
     
         3 . The sensing system of  claim 2 , wherein each panel is adapted for alignment with the torso surface so as to define a superior-inferior length and a lateral width, the sensors of each panel being distributed in an at least two-dimensional array across the length and width of the panel.  
     
     
         4 . The sensing system of  claim 1 , wherein the panels have leads extending from the sensors for transmitting sensor signals to the analyzer, the leads extending from the panels toward a first side of the patient to enhance access to the patient via a second side of the patient.  
     
     
         5 . The sensing system of  claim 4 , wherein each panel comprises a flexible panel substrate, the leads being defined by selectively depositing or etching a lead material along the substrate.  
     
     
         6 . The sensing system of  claim 6 , wherein openings through the substrate define at least one separable panel cross-member, the panel having a first configuration adapted to accommodate a first external anatomy before separation of the cross-member, the panel having a second configuration adapted to accommodate a second external anatomy after the cross-member is separated, the leads being routed around the cross-member so as to remain contiguous if the cross-member is separated.  
     
     
         7 . The sensing system of  claim 1 , the torso having four quadrants including a right front quadrant, a left front quadrant, a right rear quadrant, and a left rear quadrant, wherein each panel is adapted for sensing the heart cycle signals at a majority of the sensing locations uses by the analyzer for an associated quadrant of the torso.  
     
     
         8 . The sensing system of  claim 1 , further comprising means for accessing standard heart cycle signals at 12 standard sensing locations.  
     
     
         9 . The sensing system of  claim 1 , further comprising means for independently supporting each panel against the torso surface.  
     
     
         10 . The sensing system of  claim 9 , further comprising indicia of panel positioning visible on the panels.  
     
     
         11 . The sensing system of  claim 1 , further comprising a cardiac stimulation or defibrillation electrode mounted to at least one of the panels.  
     
     
         12 . The sensing system of  claim 1 , further comprising at least one imaging window extending through at least one of the panels for imaging the heart.  
     
     
         13 . The sensing system of  claim 1 , further comprising sensor signal transmission circuitry, the transmission circuitry comprising a plurality of powered circuits distributed among the sensors of the array.  
     
     
         14 . An apparatus for use with a cardiac stimulation power source and an arrhythmia analyzer for localizing an arrhythmia within a chamber of a heart of a patient, the patient having a torso surface, the apparatus comprising: 
 at least one panel adapted for engaging the torso surface;    a cardiac stimulation electrode mounted to the at least one panel for transmitting energy from the stimulation power source to stimulate the heart; and    an array of sensors mounted to the at least one panel, the sensor array transmitting sensor signals to the analyzer for localizing the arrhythmia.    
     
     
         15 . The apparatus of  claim 14 , wherein the stimulation electrode comprises a defibrillation electrode, and wherein at least one of the sensors is disposed within a perimeter of the stimulation electrode and is electrically isolated from the stimulation electrode.  
     
     
         16 . The apparatus of  claim 14 , further comprising a pair of stimulation electrodes mounted to the at least one panel for positioning the heart of the patient therebetween.  
     
     
         17 . The apparatus of  claim 14 , further comprising at least one imaging window extending through the at least one panel for imaging the heart.  
     
     
         18 . The apparatus of  claim 17 , wherein at least a portion of the stimulation electrode is disposed within the imaging window, the at least a portion of the electrode adapted to allow imaging therethrough.  
     
     
         19 . The apparatus of  claim 14 , wherein a plurality of powered circuits are distributed among the sensors of the array, and wherein at least one of the circuits is disposed on an electrode.  
     
     
         20 . The apparatus of  claim 14 , further comprising a plurality of panels, the panels independently mountable on the torso surface.  
     
     
         21 . An apparatus for use with an heart signal analyzer and one or more remote imagers when diagnosing or treating a patient, the patient having a heart within a torso surface, the apparatus comprising: 
 at least one panel having an inner panel surface suitable for engaging at least a portion of the torso surface;    an array of cardiac signal sensors mounted to the at least one panel, the sensor array generating signals in response to heart cycle signals for transmission to the analyzer; and    an imaging window through the at least one panel for imaging the heart.    
     
     
         22 . The apparatus of  claim 21 , further comprising a plurality of imaging windows through the at least one panel for three-dimensional imaging of the heart.  
     
     
         23 . The apparatus of  claim 21 , wherein at least one sensor of the array is disposed within the imaging window, the at least one sensor being more transparent to the imager than at least some of the sensors disposed beyond the imaging window, and wherein at least one lead portion is disposed within the imaging window, the at least one lead portion being more transparent than at least some of the lead portions disposed beyond the imaging window.  
     
     
         24 . The apparatus of  claim 21 , wherein a plurality of amplifier circuits are distributed among the sensors of the array outside the imaging window.  
     
     
         25 . The apparatus of  claim 21 , further comprising a cardiac stimulation electrode mounted to at least one of the panels.  
     
     
         26 . An arrhythmia localization system for diagnosing a heart within a torso surface of a patient, the arrhythmia localization system comprising: 
 a noisy-environment sensor system including a substrate for mounting upon the torso surface, an array of sensors mounted to the substrate, and a plurality of powered circuits distributed among the sensors for transmitting sensor signals; and    an arrhythmia analyzer coupleable to the powered circuits for identifying a candidate arrhythmia site within a chamber of the heart of the patient.    
     
     
         27 . The arrhythmia localization system of  claim 26 , further comprising a low-noise environment sensor system including a substrate for mounting upon the torso surface with an array of sensors mounted to the substrate for recording an abnormal heartbeat, wherein the arrhythmia analyzer identifies the candidate arrhythmia site in response to heart cycle signals sensed by the noisy-environment sensor system, and in response to the recorded abnormal heartbeat.  
     
     
         28 . The arrhythmia localization system of  claim 26 , further comprising at least one element selected from a group consisting of a cardiac imaging window, a cardiac stimulation electrode, and means for accessing 12 standard ECG signals.