Automated tool for identifying and correcting tenting artifact in anatomical mapping

Abstract

To provide a method and a system for detecting and correcting an error in an electro-anatomical map.SOLUTION: An electro-anatomical map is generated from first position information that defines an initial map surface. Second position information is acquired and used to determine an updated map surface. A difference between the initial and updated map surfaces corresponds to a change in the map. A first tenting analysis volume is determined based on at least part of the updated map surface. Third position information is acquired and used to define a second tenting analysis volume. The change in the map is identified as potentially corresponding to tenting in accordance with whether the first tenting analysis volume fails to overlap the second tenting analysis volume by a predetermined amount.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to anatomical mapping, and more particularly to the detection and correction of tenting artifacts in anatomical mapping. [Background technology]

[0002] Currently, catheter-based radiofrequency (RF) ablation for pulmonary vein isolation is the first line of treatment for atrial fibrillation (AF). RF ablation requires highly accurate maps.

[0003] For example, during an electrophysiology (EP) procedure, an anatomical map of the heart chambers is generated. Fast anatomical mapping (FAM) is one algorithm for constructing such an anatomical map from electrical signals captured by a catheter on the myocardium. The anatomical map is used to guide the physician to the desired ablation site.

[0004] During an EP procedure, errors in the electroanatomical map can be created as a result of "tenting." Tenting occurs, for example, when the catheter hits a tissue wall, creating a protrusion in the map. In such an example, the protrusion does not represent the anatomical structure being mapped. Summary of the Invention [Problem to be solved by the invention]

[0005] Improvements are needed for both the detection and correction of tenting errors during a procedure so that a more accurate electroanatomical map is presented to the physician. [Means for solving the problem]

[0006] According to one or more embodiments, a method and system are provided for detecting and correcting errors in an electroanatomical map. The electroanatomical map is generated using a catheter positioned within the human body, and the errors are the result of tenting in the electroanatomical map caused by collision of the catheter against a tissue wall. First position information defining an initial map surface of the electroanatomical map is acquired as the catheter moves within the body. After acquiring the first position information, second position information is acquired using the catheter, and an updated map surface is determined based on the second position information. A difference between the initial map surface and the updated map surface corresponds to a change in the map. A first tenting analysis volume is determined based at least in part on the updated map surface. After acquiring the second position information, third position information is acquired using the catheter, and the third position information is used to define a second tenting analysis volume for the second position information. A change in the map is identified as potentially corresponding to tenting according to whether the first tenting analysis volume does not overlap the second tenting analysis volume by a predetermined amount. A visual representation including the electroanatomical map is presented to a user on a user interface, the visual representation providing a visual indication that changes in the map potentially correspond to tenting. The user interface is operable to remove the changes in the map from the visual representation.

[0007] In some embodiments, the first tenting analysis volume corresponds to a spherical volume centered around a point on the updated map surface, and in some examples, changes in the map are identified as potentially corresponding to tenting based on whether the third location information falls within the spherical volume.

[0008] In some embodiments, the offset surface is determined by projecting a predetermined distance from the updated map surface, and the first tenting analysis volume corresponds to the volume between the updated map surface and the offset surface.

[0009] In some embodiments, changes in the map are identified as potentially corresponding to tenting based on whether previously acquired location information is within the first tenting analysis volume.

[0010] In some embodiments, a change in the map is identified as potentially corresponding to tenting based on whether the volume corresponding to the change in the map is less than a threshold value.

[0011] In some embodiments, the predetermined amount of overlap used to identify tenting corresponds to a ratio between the sizes of the first tenting analysis volume and the second tenting analysis volume.

[0012] In some embodiments, the electroanatomical map is a high-speed anatomical map generated during a cardiac ablation procedure.

[0013] According to one or more embodiments, the techniques for detecting and correcting tenting described herein may be implemented as methods, apparatus, systems, and / or computer program products. [Brief explanation of the drawings]

[0014] A more detailed understanding may be had from the following description, given by way of example in conjunction with the accompanying drawings, in which like reference numerals indicate similar elements and in which: [Figure 1] 1 illustrates an exemplary catheter-based electrophysiology mapping and ablation system according to one or more embodiments. [Figure 2] FIG. 1 is a block diagram of an exemplary system for remotely monitoring and communicating patient biometric data, according to one or more embodiments. [Figure 3] FIG. 1 is a system diagram of an exemplary computing environment in communication with a network, according to one or more embodiments. [Figure 4]FIG. 1 is a system diagram of an exemplary computing environment in accordance with one or more embodiments. [Figure 5A] FIG. 10 is a rear view illustrating a tenting example according to one or more embodiments. [Figure 5B] FIG. 5B is a side view of the embodiment of FIG. 5A. [Figure 6A] 1 depicts the collection of data points using a catheter, according to one or more embodiments. [Figure 6B] 6B depicts the determination of an initial map surface based on the data points shown in FIG. 6A. [Figure 7A] 10 depicts the collection of additional data points using a catheter, according to one or more embodiments. [Figure 7B] 7B depicts the determination of an updated map surface based on the data points shown in FIG. 7A. [Figure 8] 1 depicts an initial map surface, an updated map surface, and an offset surface, according to one or more embodiments. [Figure 9A] 1 depicts the acquisition of data points identified as tenting, according to one or more embodiments. [Figure 9B] 1 depicts the acquisition of data points identified as tenting, according to one or more embodiments. [Figure 10A] 1 depicts data point acquisition that is not identified as tenting, according to one or more embodiments. [Figure 10B] 1 depicts data point acquisition that is not identified as tenting, according to one or more embodiments. [Figure 11A] 1 depicts data point acquisition that is not identified as tenting, according to one or more embodiments. [Figure 11B] 1 depicts data point acquisition that is not identified as tenting, according to one or more embodiments. [Figure 12] 1 depicts a user interface that identifies regions on an electroanatomical map as potentially corresponding to tenting. [Figure 13]1 depicts a method according to one or more embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0015] Disclosed herein are methods and / or systems for anatomical mapping. The methods and / or systems include processor-executable code or software that are necessarily mediated by the process operations and hardware operations of medical device equipment that perform and use the anatomical mapping. For ease of explanation, the anatomical maps are described herein with reference to mapping the heart. However, any anatomical structure, body part, organ, or portion thereof can be targeted for mapping using the techniques described herein.

[0016] According to one or more embodiments, the methods and systems disclosed herein generate an anatomical map of the heart, including the endocardial surface of the left atrium (LA). The map can be a three-dimensional (3D) model or a combination of multiple 3D models. The methods and systems can generate and edit cardiac maps and provide real-time or post-processed maps during or in conjunction with an EP procedure (e.g., an ablation procedure). As an example, the methods and systems can detect tenting errors in the initial visualization (e.g., output of a FAM) and provide an opportunity for the user to correct such errors, thereby improving the performance and results of the anatomical mapping.

[0017] Reference is made to FIG. 1 , which illustrates an exemplary system (e.g., a medical device instrument and / or catheter-based electrophysiological mapping and ablation system) designated as system 10, in which one or more features of the subject matter herein may be implemented according to one or more embodiments. All or a portion of system 100 may be used to collect information (e.g., biometric data) and / or to perform machine learning and / or tenting detection and correction techniques, as described herein. In some examples, tenting error and correction techniques are implemented using processor-executable code or software stored on the memory of system 10 and inherently ingrained in the process operations by system 10 and its hardware processing. As described herein, system 10 may generate maps (also known as visualizations), detect tenting errors therein, and provide an operator with an opportunity to correct such errors during a medical procedure.

[0018] FIG. 1 illustrates a recorder 11, a heart 12, a catheter 14, a model or anatomical map 20, an electrogram 21, a spline 22, a patient 23, a physician 24 (representing any medical professional, technician, clinician, operator, clinical support specialist, clinical account specialist, healthcare worker, etc.), a location pad 25, one or more electrodes 26, a display device 27, a distal tip 28, a sensor 29, a coil 32, a patient interface unit (PIU) 30, an electrode skin patch 38, an ablation energy generator 50, and a workstation 55. It is further noted that each element and / or item in the system 10 represents one or more of that element and / or item. The exemplary system 10 illustrated in FIG. 1 implements embodiments disclosed herein. The disclosed embodiments may be similarly applied using other system components and configurations. Additionally, the system 10 may include additional components, such as elements for sensing electrical activity, wired or wireless connectors, processing and display devices, or other components.

[0019] The system 10 includes multiple catheters 14 that are percutaneously inserted by a physician 24 through the patient's vascular system into the chambers or vasculature of the heart 12. Typically, a delivery sheath catheter is inserted into the left or right atrium near a desired location within the heart 12. Multiple catheters can then be inserted into the delivery sheath catheters to reach the desired locations. The multiple catheters 14 may include catheters dedicated to sensing intracardiac electrogram (IEGM) signals, catheters dedicated for ablation, and / or catheters dedicated for both sensing and ablation. An exemplary catheter 14 configured for sensing IEGMs is shown herein. To sense a target site within the heart 12, the physician 24 brings a distal tip 28 of the catheter 14 into contact with the heart wall. For ablation, the physician 24 similarly delivers the distal end of an ablation catheter to the target site for ablation.

[0020] The catheter 14 is an exemplary catheter including at least one, and preferably multiple, electrodes 26, optionally distributed across multiple splines 22 at the distal tip 28, configured to sense IEGM signals. The catheter 14 may additionally include a sensor 29 embedded in or near the distal tip 28 to track the position and orientation of the distal tip 28. Optionally, and preferably, the position sensor 29 is a magnetic-based position sensor including three magnetic coils for sensing 3D position and orientation. According to one or more embodiments, the shape and parameters of the catheter 14 vary based on whether the catheter 14 is used for diagnostic or ablation purposes, the type of arrhythmia, the patient's anatomy, and other factors affecting catheter maneuverability (e.g., the ability to touch the surface of the catheter 14 and the tracked portion without bending it). The shape and parameters of the catheter 14 also affect the accuracy of the anatomical map. Large, spherical, single-shot catheters capable of ablating pulmonary veins within seconds are common but require guidance from fluoroscopy, CT / MRI, or an additional mapping catheter. The tenting error detection and correction operations described herein address shortcomings of the catheter 14 by identifying and correcting mapping errors that may result from the catheter 14 colliding with tissue walls during an EP procedure, as described herein.

[0021] The sensor 29 (e.g., a position-based or magnetic-based position sensor) may operate in conjunction with a location pad 25 that includes a plurality of magnetic coils 32 configured to generate a magnetic field within a predetermined working volume. The real-time position of the distal tip 28 of the catheter 14 may be tracked based on the magnetic fields generated by the location pad 25 and sensed by the sensor 29. Details of magnetic-based position sensing technology are described in U.S. Patent Nos. 5,5391,199; 5,443,489; 5,558,091; 6,172,499; 6,239,724; 6,332,089; 6,484,118; 6,618,612; 6,690,963; 6,788,967; and 6,892,091.

[0022] System 10 includes one or more electrode patches 38 positioned on patient 23 for skin contact to establish location references for location pads 25 and impedance-based tracking of electrodes 26. For impedance-based tracking, current is directed to electrodes 26 and sensed at patches 38, allowing the location of each electrode to be triangulated via patches 38. Details of impedance-based position tracking techniques are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182, which are incorporated herein by reference.

[0023] Recorder 11 displays electrograms 21 captured by electrodes 18 (e.g., surface electrocardiogram (ECG) electrodes) and intracardiac electrograms (IEGMs) captured by electrodes 26 on catheter 14. Recorder 11 may include pacing capability for pacing the cardiac rhythm and / or may be electrically connected to a stand-alone pacer.

[0024] The system 10 may include an ablation energy generator 50 adapted to deliver ablation energy to one or more electrodes 26 at the distal tip 28 of the catheter 14 configured for ablation. The energy generated by the ablation energy generator 50 may include, but is not limited to, radiofrequency (RF) energy or pulsed-field ablation (PFA) energy, including monopolar or bipolar high-voltage DC pulses such as may be used to effect irreversible electroporation (IRE), or a combination thereof.

[0025] PIU 30 is an interface configured to establish electrical communication between catheters, electrophysiology equipment, a power source, and a workstation 55 that controls the operation of system 10. The electrophysiology equipment of system 10 may include, for example, multiple catheters 14, location pads 25, body surface ECG electrodes 18, electrode patches 38, ablation energy generators 50, and recorder 11. Optionally and preferably, PIU 30 additionally includes processing capability for implementing real-time calculations of catheter locations and performing ECG calculations.

[0026] The workstation 55 includes a processor unit having memory, memory or storage loaded with appropriate operating software, and user interface functionality. The workstation 55 may optionally provide multiple functions, including three-dimensional (3D) modeling of endocardial anatomical structures and rendering a model or anatomical map 20 (e.g., visualization) for display on the display device 27, displaying activation sequences (or other data) compiled from recorded electrograms 21 with representative visual indicators or images superimposed on the rendered anatomical map 20 on the display device 27, displaying real-time locations and orientations of multiple catheters within the cardiac chambers, and displaying sites of interest, e.g., locations where ablation energy has been applied, on the display device 27. One commercially available product embodying elements of the system 10 is available as the CARTO™ 3 system, commercially available from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA 92618. It should be noted that modeling the endocardial anatomy in 3D can include generating its surface as a triangular mesh.

[0027] For example, system 10 may be part of a surgical system (e.g., the CARTO® system sold by Biosense Webster) configured to obtain biometric data (e.g., of a patient's organs, e.g., heart 12, and anatomical and electrical measurements as described herein) and perform cardiac ablation procedures. More specifically, treatment of cardiac conditions, e.g., cardiac arrhythmias, often requires obtaining detailed mapping of cardiac tissue, chambers, veins, arteries, and / or electrical pathways. For example, a prerequisite for successfully performing catheter ablation is accurate localization of the cause of the cardiac arrhythmia in a chamber of heart 12. Such localization may be performed by an electrophysiological study, during which electrical potentials are detected and spatially resolved by a mapping catheter (e.g., catheter 14) introduced into a chamber of heart 12. This electrophysiological study, so-called electroanatomical mapping, provides 3D mapping data that can be displayed on display device 27. Often, the mapping and therapy functions (eg, ablation) are provided by a single catheter or a group of catheters, such that the mapping catheter also simultaneously acts as a therapy catheter.

[0028] 2 is a block diagram of an exemplary system 100 for remotely monitoring and communicating biometric data (e.g., patient biometrics). In the example shown in FIG. 2, the system 100 includes a patient biometric monitoring and processing unit 102 associated with a patient 104, a local computing device 106, a remote computing system 108, a first network 110, a patient biometric sensor 112, a processor 114, a user input (UI) sensor 116, a memory 118, a second network 120, and a transmitter-receiver (i.e., transceiver) 122.

[0029] According to one or more embodiments, the patient biometric monitoring and processing device 102 may be a device internal to the patient's body (e.g., subcutaneously implantable), such as the catheter 14 of Figure 1. The patient biometric monitoring and processing device 102 may be inserted into the patient via any applicable method, including oral injection, surgical insertion via a vein or artery, an endoscopic procedure, or a laparoscopic procedure.

[0030] According to one or more embodiments, the patient biometric monitoring and processing device 102 may be a device external to the patient, such as the electrode patch 38 of FIG. 1. For example, as described in more detail below, the patient biometric monitoring and processing device 102 may include an attachable patch (e.g., attached to the patient's skin). The monitoring and processing device 102 may also include a catheter with one or more electrodes, a probe, a blood pressure cuff, a weight scale, a bracelet or smartwatch biometric tracker, a glucose monitor, a continuous positive airway pressure (CPAP) machine, or virtually any device that can provide input regarding the patient's health or biometrics.

[0031] According to one or more embodiments, the patient biometric monitoring and processing device 102 may include both components internal to the patient and components external to the patient.

[0032] A single patient biometric monitoring and processing device 102 is shown in Figure 2. However, an exemplary system may include multiple patient biometric monitoring and processing devices. A patient biometric monitoring and processing device may be in communication with one or more other patient biometric monitoring and processing devices. Additionally or alternatively, a patient biometric monitoring and processing device may be in communication with a network 110.

[0033] One or more patient biometric monitoring and processing devices 102 may acquire biometric data (e.g., patient biometric values, such as electrical signals, blood pressure, body temperature, blood glucose levels, or other biometric data) and may receive at least a portion of the biometric data representative of the acquired patient biometrics, as well as additional information associated with the acquired patient biometric values, from one or more other patient biometric monitoring and processing devices 102. The additional information may be, for example, diagnostic information and / or additional information obtained from additional devices, such as wearable devices. Each patient biometric monitoring and processing device 102 may process data including its own biometric data and data received from one or more other patient biometric monitoring and processing devices 102.

[0034] The biometric data (e.g., patient biometrics, patient data, or patient biometric data) may include one or more of local activation time (LAT), electrical activity, topology, bipolar mapping, baseline activity, ventricular activity, dominant frequency, impedance, or other data. LAT may be a time point of threshold activity corresponding to local activation calculated based on a normalized initial starting point. Electrical activity may be any applicable electrical signal that can be measured based on one or more thresholds and may be sensed and / or enhanced based on signal-to-noise ratio and / or other filters. Topology may correspond to the physical structure of a body part or portion of a body part, or may correspond to changes in the physical structure for different parts of the body part or for different body parts. The dominant frequency may be a frequency or range of frequencies commonly found in a portion of a body part and may differ in different parts of the same body part. For example, the dominant frequency of the PVs of a heart may differ from the dominant frequency of the right atrium of the same heart. Impedance may be a resistance measurement in a specific region of a body part.

[0035] Examples of biometric data include, but are not limited to, patient identification data, intracardiac electrocardiogram (IC ECG) data, bipolar intracardiac reference signals, anatomical and electrical measurements, trajectory information, body surface (BS) ECG data, historical data, brain biometrics, blood pressure data, ultrasound signals, radio signals, audio signals, two-dimensional or three-dimensional image data, blood glucose data, and temperature data. Biometric data may generally be used to monitor, diagnose, and treat any number of various diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathies, and coronary artery disease) and autoimmune diseases (e.g., type I and type II diabetes). Note that BS ECG data may include data and signals collected from electrodes on the patient's surface, IC ECG data may include data and signals collected from electrodes inside the patient's body, and ablation data may include data and signals collected from ablated tissue. Additionally, the BS ECG data, IC ECG data, and ablation data, along with catheter electrode position data, may be derived from one or more treatment records.

[0036] 2, network 110 is an example of a short-range network (e.g., a local area network (LAN) or a personal area network (PAN)). Information can be transmitted between the patient biometric monitoring and processing device 102 and the local computing device 106 over network 110 using any one of a variety of short-range wireless communication protocols, such as Bluetooth, Wi-Fi, ZigBee, Z-Wave, near field communication (NFC), ultra-wideband, or infrared (IR).

[0037] Network 120 may be a wired network, a wireless network, or may include one or more wired and wireless networks. For example, network 120 may be a long-range network (e.g., a wide area network (WAN), the Internet, or a cellular network). Information may be transmitted over network 120 using any one of a variety of long-range wireless communication protocols (e.g., TCP / IP, HTTP, 3G, 4G / LTE, or 5G / New Radio).

[0038] The patient biometric monitoring and processing device 102 may include patient biometric sensors 112, a processor 114, UI sensors 116, memory 118, and a transceiver 122. The patient biometric monitoring and processing device 102 may continuously or periodically monitor, store, process, and communicate any number of different biometric data over the network 110. Examples of biometric data include electrical signals (e.g., ECG signals and brain biometrics), blood pressure data, blood glucose data, and temperature data. The biometric data may be monitored and communicated to treat any number of different diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathies, and coronary artery disease) and autoimmune diseases (e.g., type 1 and type 2 diabetes).

[0039] The patient biometric sensors 112 may include, for example, one or more sensors configured to sense types of biometric data. For example, the patient biometric sensors 112 may include electrodes configured to acquire electrical signals (e.g., cardiac signals, brain signals, or other bioelectrical signals), a temperature sensor, a blood pressure sensor, a blood glucose sensor, a blood oxygen sensor, a pH sensor, an accelerometer, and a microphone.

[0040] As described in more detail below, the patient biometric monitoring and processing device 102 may be an ECG monitor for monitoring ECG signals of a heart (e.g., heart 12). The patient biometric sensor 112 of the ECG monitor may include one or more electrodes for acquiring the ECG signals. The ECG signals may be used in the treatment of various cardiovascular diseases, as well as anatomical mapping.

[0041] The transceiver 122 may include a separate transmitter and receiver, or alternatively, the transceiver 122 may include a transmitter and receiver integrated into a single device.

[0042] The processor 114 may be configured to store biometric data acquired by the patient biometric sensors 112 in the memory 118 and to communicate the biometric data over the network 110 via the transmitter of the transceiver 122. Data from one or more other patient biometric monitoring and processing devices 102 may also be received by the receiver of the transceiver 122, as described in more detail herein. As an example, the tenting error detection and correction techniques described herein are implemented as processor-executable code or software that may be stored on the memory 118 (as shown) and executed by the processor 114. As a further example, the tenting error and correction techniques are implemented as code that is stored and executed on the local computing device 106 and / or the remote computing system 108. Thus, the operation of the tenting error and correction techniques is necessarily rooted in the process operations of the system 100 and its hardware processing.

[0043] According to one or more embodiments, system 100 operates to generate an initial visualization (e.g., an electroanatomical map) on a display (e.g., display device 27) during an ablation procedure. The initial visualization is generated from data points sensed by a catheter positioned within the patient. Based on these data points, system 100 generates a greater or greater initial map surface associated with such data points for display. During the procedure, additional data points are acquired using catheter 14, including, for example, data points collected while the catheter is impinging against a tissue wall. The additional data points are used to update the initial map surface for display. A difference between the initial map surface and the updated map surface corresponds to a change in the map, and techniques described herein (e.g., in connection with FIGS. 5-12 below) analyze this change to determine whether it is the result of, or potentially the result of, a tenting error. Generally, in one example, in connection with this analysis, an offset surface is determined by adding an offset to at least a portion of the updated map surface. The offset surface defines at least a portion of a first tenting analysis volume. Additional data points are acquired (again using catheter 14) and used to define a second tenting analysis volume. According to embodiments of the analysis techniques disclosed herein, changes in the map are identified as potentially corresponding to tenting based on whether the first tenting analysis volume does not overlap with the second tenting analysis volume by a predetermined amount. If tenting is detected to be present, a visual representation including the electroanatomical map is presented to the user on a user interface, the visual representation providing a visual indication that the changes in the map potentially correspond to tenting. The user interface is operable by the user to remove the changes in the map from the visual representation. Alternatively, data associated with the changes in the map are automatically removed.

[0044] In some embodiments of the tenting analysis techniques disclosed herein, a spherical volume centered around a point on the updated map surface is determined, and changes in the map are identified as potentially corresponding to tenting based on additional position information (e.g., sensed data points) subsequently collected within the spherical volume. In some embodiments, changes in the map are identified as potentially corresponding to tenting based on whether previously acquired position information is within the first tenting analysis volume. In some embodiments, changes in the map are identified as potentially corresponding to tenting based on whether a volume corresponding to the change in the map is greater than a threshold.

[0045] According to one or more embodiments, the patient biometric monitoring and processing device 102 includes a UI sensor 116, which may be, for example, a piezoelectric or capacitive sensor configured to receive user input, such as a tap or touch. For example, the UI sensor 116 may be controlled to perform capacitive coupling in response to the patient 104 tapping or touching the surface of the patient biometric monitoring and processing device 102. Gesture recognition may be implemented by any one of a variety of capacitive types, such as resistive-capacitive, surface-capacitive, projected-capacitive, surface ultrasonic, piezoelectric, and infrared touch. The capacitive sensor may be positioned over a small area or over the length of the surface such that a tap or touch on the surface activates the monitoring device.

[0046] As described in more detail below, the processor 114 may be configured to selectively respond to different tapping patterns (e.g., single tap or double tap) of a capacitive sensor, which may be the UI sensor 116, so that different tasks of the patch (e.g., data acquisition, storage, or transmission) may be initiated based on the detected pattern. In some embodiments, when a gesture is detected, audible feedback may be provided to the user from the patient biometric monitoring and processing device 102.

[0047] The local computing device 106 of the system 100 may be configured to communicate with the patient biometric monitoring and processing device 102 and to act as a gateway to the remote computing system 108 via the second network 120. The local computing device 106 may be, for example, a smartphone, smartwatch, tablet, or other portable smart device configured to communicate with other devices via the network 120. Alternatively, the local computing device 106 may be a fixed or stand-alone device, such as, for example, a fixed base station including, for example, modem and / or router capabilities, a desktop or laptop computer using an executable program to communicate information between the patient biometric monitoring and processing device 102 and the remote computing system 108 via a wireless module in the PC, or a USB dongle. Biometric measurements may be communicated between the local computing device 106 and the patient biometric monitoring and processing device 102 via a short-range wireless network 110, for example, a local area network (LAN) (e.g., a personal area network (PAN)), using short-range wireless technology standards (e.g., Bluetooth, Wi-Fi, ZigBee, Z-wave, and other short-range wireless standards). In some embodiments, the local computing device 106 may also be configured to display the acquired patient electrical signals and information associated with the acquired patient electrical signals, as described in further detail herein.

[0048] In some embodiments, the remote computing system 108 may be configured to receive at least one of the monitored patient's biometric indicators and information associated with the monitored patient via a long-range network, the network 120. For example, if the local computing device 106 is a cellular phone, the network 120 may be a wireless cellular network, and information may be communicated between the local computing device 106 and the remote computing system 108 via a wireless technology standard, such as any of the wireless technologies described above. As described in more detail below, the remote computing system 108 may be configured to provide (e.g., visually display and / or audibly provide) at least one of the patient's biometric indicators and associated information to the physician 24.

[0049] 3 is a system diagram of an example computing environment 200 in communication with network 120. In some embodiments, computing environment 200 is incorporated into a public cloud computing platform, such as (Amazon Web Services or Microsoft Azure), a hybrid cloud computing platform (e.g., HP Enterprise OneSphere), or a private cloud computing platform.

[0050] As shown in Figure 3, computing environment 200 includes computer system 210, which is an example of workstation 55 of Figure 1, local computing device 106 of Figure 2, and / or remote computing system 108 of Figure 2, on which embodiments described herein may be implemented. By way of example, the tenting detection and correction techniques described herein are implemented as processor-executable code or software that may be stored on system memory 231 (as shown), executed by processor 220, and that may be mediated by processing operations by computing environment 200 and its hardware operations.

[0051] Computer system 210 may perform various functions via processor 220, which may include one or more processors. Functions may include analyzing monitored biometric measurements and associated information and providing alerts, additional information, or instructions (e.g., via display 266) according to physician-determined or algorithm-driven thresholds and parameters. This functionality may include operation of the tenting error and correction techniques described herein. As described in more detail herein, computer system 210 may be used to provide a dashboard of patient information to physician 24 of FIG. 1 (e.g., via display 266); such information may enable physician 24 to identify and prioritize patients with more significant needs than others.

[0052] 3, computer system 210 may include a communication mechanism, such as a bus 221 or other communication mechanism for communicating information within computer system 210. Computer system 210 further includes one or more processors 220 coupled with bus 221 for processing information. Processor 220 may include one or more CPUs, GPUs, or any other processors known in the art.

[0053] Computer system 210 also includes a system memory 230 coupled to bus 221 for storing information and instructions executed by processor 220. System memory 230 may include computer-readable storage media in the form of volatile and / or nonvolatile memory, such as read-only system memory (ROM) 231 and / or random access memory (RAM) 232. System memory RAM 232 may include other dynamic storage devices (e.g., dynamic RAM, static RAM, and synchronous DRAM). System memory ROM 231 may include other static storage devices (e.g., programmable ROM, erasable PROM, and electrically erasable PROM). Additionally, system memory 230 may be used to store temporary variables or other intermediate information during execution of instructions by processor 220. A basic input / output system (BIOS) 233 may include routines for transferring information between elements within computer system 210, such as during start-up, which may be stored in system memory ROM 231. RAM 232 may contain data and / or program modules that are immediately accessible to and / or presently being operated on by processor 220. System memory 230 may also include, for example, an operating system 234, application programs 235, other program modules 236, and program data 237.

[0054] The illustrated computer system 210 also includes a disk controller 240 coupled to bus 221 to control one or more storage devices, such as a magnetic hard disk 241 and a removable media drive 242 (e.g., a floppy disk drive, a compact disk drive, a tape drive, and / or a solid state drive), for storing information and instructions. Storage devices may be added to computer system 210 using an appropriate device interface (e.g., small computer system interface (SCSI), integrated device electronics (IDE), Universal Serial Bus (USB), or FireWire).

[0055] Computer system 210 may also include a display controller 265 coupled to bus 221 to control a monitor or display 266, such as a cathode ray tube (CRT) or liquid crystal display (LCD), for displaying information to a computer user. The illustrated computer system 210 includes a user input interface 260 and one or more input devices, such as a keyboard 262 and a pointing device 261, for interacting with a computer user and providing information to processor 220. Pointing device 261 may be, for example, a mouse, trackball, or pointing stick for communicating instructional information and command selections to processor 220 and for controlling cursor movement on display 266. Display 266 may provide a touchscreen interface that may enable input that supplements or replaces the communication of instructional information and command selections by pointing device 261 and / or keyboard 262.

[0056] Computer system 210 may perform some or each of the functions and methods described herein in response to processor 220 executing one or more sequences of one or more instructions contained in a memory, e.g., system memory 230. Such instructions may be read into system memory 230 from another computer-readable medium, e.g., hard disk 241 or removable media drive 242. Hard disk 241 may include one or more data stores and data files used by the embodiments described herein. Data store contents and data files may be encrypted for improved security. Processor 220 may also be employed in a multi-processing configuration to execute one or more sequences of instructions contained in system memory 230. In alternative embodiments, hardwired circuitry may be used in place of or in combination with software instructions. Thus, embodiments are not limited to any specific combination of hardware circuitry and software.

[0057] As mentioned above, computer system 210 may include at least one computer-readable medium or memory for retaining instructions programmed according to embodiments described herein (e.g., embodiments of the tenting error detection and correction techniques) and for containing data structures, tables, records, or other data described herein. As used herein, the term computer-readable medium refers to any non-transitory, tangible medium that participates in providing instructions to processor 220 for execution. Computer-readable media can take many forms, including, but not limited to, non-volatile media, volatile media, and transmission media. Non-limiting examples of non-volatile media include optical disks, solid-state drives, magnetic disks, and magneto-optical disks, such as hard disk 241 or removable media drive 242. Non-limiting examples of volatile media include dynamic memory, such as system memory 230. Non-limiting examples of transmission media include coaxial cables, copper wire, and fiber optics, including the wires that comprise bus 221. Transmission media can also take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications.

[0058] The computing environment 200 may further include a computer system 210 operating in a networked environment using logical connections to the local computing device 106 and one or more other devices, e.g., and to a personal computer (laptop or desktop), mobile device (e.g., patient mobile device), server, router, network PC, peer device, or other common network node, and typically includes many or all of the elements described above with respect to the computer system 210. When used in a networked environment, the computer system 210 may include a modem 272 for establishing communications over the network 120, e.g., the Internet. The modem 272 may be connected to the system bus 221 via a network interface 270 or another appropriate mechanism.

[0059] Network 120 as shown in FIGS. 2 and 3 may be any network or system generally known in the art, including the Internet, an intranet, a local area network (LAN), a wide area network (WAN), a metropolitan area network (MAN), a direct connection or series of connections, a cellular telephone network, or any other network or medium capable of facilitating communication between computer system 210 and other computers (e.g., local computing device 106).

[0060] 4 is a block diagram of an example device 400 capable of implementing one or more features of the present disclosure. Device 400 may be, for example, local computing device 106. Device 400 may include, for example, a computer, a gaming device, a handheld device, a set-top box, a television, a mobile phone, or a tablet computer. Device 400 includes a processor 402, a memory 404, a storage device 406, one or more input devices 408, and one or more output devices 410. Device 400 may also optionally include an input driver 412 and an output driver 414. It is understood that device 400 may include additional components not shown in FIG. 4, including an artificial intelligence accelerator.

[0061] In various alternative embodiments, processor 402 includes a central processing unit (CPU), a graphics processing unit (GPU), a CPU and a GPU located on the same die, or one or more processor cores, each of which may be a CPU or a GPU. In various alternative embodiments, memory 404 is located on the same die as processor 402 or is located separate from processor 402. Memory 404 includes volatile or non-volatile memory, such as random access memory (RAM), dynamic RAM, or cache. As an example, the tenting error detection and correction techniques described herein are implemented as processor-executable code or software that may be stored on memory 404 (as shown) and executed by processor 402, and that may be ingrained in the process operations by exemplary device 400 and its hardware operations.

[0062] The storage device 406 includes fixed or removable storage means, such as a hard disk drive, solid state drive, optical disk, or flash drive. The input device 408 includes, but is not limited to, a keyboard, keypad, touch screen, touchpad, detector, microphone, accelerometer, gyroscope, biometric scanner, or network connection (e.g., a wireless local area network card for transmitting and / or receiving wireless IEEE 802 signals). The output device 410 includes, but is not limited to, a display device, a speaker, a printer, a haptic feedback device, one or more lights, an antenna, or a network connection (e.g., a wireless local area network card for transmitting and / or receiving wireless IEEE 802 signals).

[0063] The input driver 412 communicates with the processor 402 and the input device 408, allowing the processor 402 to receive input from the input device 408. The output driver 414 communicates with the processor 402 and the output device 410, allowing the processor 402 to send output to the output device 410. Note that the input driver 412 and the output driver 414 are optional components; if the input driver 412 and the output driver 414 are not present, the device 400 operates in the same manner. The output driver 414 includes an accelerated processing device ("APD") 416 that communicates with the display device represented by the output device 410. The APD 416 accepts computational and graphic rendering commands from the processor 402, processes the computational and graphic rendering commands, and provides pixel output to the display device for display. As described in further detail below, APD 416 includes one or more parallel processing units that perform calculations according to the single-instruction-multiple-data ("SIMD") paradigm. Accordingly, while various functionalities are described herein as being performed by or in conjunction with APD 416, in various alternatives, functionality described as being performed by APD 416 may additionally or alternatively be performed by other computing devices with similar capabilities that are not driven by a host processor (e.g., processor 402) and that provide graphical output to a display device. For example, it is contemplated that any processing system that performs processing tasks according to the SIMD paradigm can perform the functions described herein. Alternatively, it is contemplated that computing systems that do not perform processing tasks according to the SIMD paradigm perform the functions described herein.

[0064] 5A and 5B depict posterior and lateral views of an electroanatomical map of the heart with a tenting error in accordance with one or more embodiments. In both the posterior and lateral views, a surface 501 of the heart is depicted. In this example, surface 501 has been determined by system 10 based (solely or in part) on position data points collected by catheter 14 during a cardiac procedure. As a physician moves catheter 14 during a procedure, catheter 14 may collide with a tissue wall, causing tenting. More specifically, during this collision, catheter 14 collects data points within a volume where the tissue wall has been deformed by catheter 14. Based on the collection of data points within the deformed volume, system 10 updates surface 501 to include surface 502 as part of the cardiac map. Surface 502 corresponds to the tenting error because it does not accurately reflect the heart surface but rather represents a deformed version of the heart surface caused by the collection of data points during the collision of catheter 14 against the tissue wall. In contrast, when catheter 14 is moved parallel to the tissue wall (as shown by path 503), a similar collision does not occur. When the catheter moves parallel to the tissue wall in this manner, the position data points collected using catheter 14 correspond to the actual volume of the heart and can therefore be used by system 10 to accurately update surface 501 based on the additional position data.

[0065] FIG. 6A depicts the collection of data points using catheter 14 during a medical procedure, according to one or more embodiments. Data point 601 corresponds to a position sensed by catheter 14 as it moves through the heart during the procedure. As shown in FIG. 6B, based on the collected data points 601, system 100 determines an initial map surface 602 of a volume of a portion of the heart. Continuing with the same example, FIG. 7A depicts the collection of subsequent data points 703 from catheter 14 as the catheter is moved to a new position during the procedure. As a result of these additional data points, the portion of calculated surface 602 corresponding to portion 702 is recalculated (or updated) based on points 703. FIG. 7B depicts the determination of the updated map surface. The updated map surface includes the portion of previous surface 602 that does not correspond to portion 702, along with surface portion 704.

[0066] The difference between the map surface shown in FIG. 7A and the map surface shown in FIG. 7B corresponds to a change in the map resulting from the collection of additional data points 703. As described below, system 100 then analyzes this change in the map to identify whether it corresponds to (or potentially corresponds to) a tenting error. Such an error would occur, for example, if catheter 14 were impacting a tissue wall at the time data points 703 were collected by catheter 14. The systems and methods for tenting detection disclosed herein apply one or more factors to analyze whether a change in the map is the result of a tenting error. Each of these factors is described below. It should be understood that each of these factors can be applied by itself to analyze whether a change in the map is the result of a tenting error. Alternatively, two, three, or four factors may be considered in combination to perform the analysis. FIG. 8 (discussed below) depicts several parameters used to evaluate one or more of these factors.

[0067] Referring now to FIG. 8, another view of the initial map surface 602 (from FIG. 6B) and the updated map surface 704 (from FIG. 7B) is shown. The FAM volume 703a generally corresponds to the additional data points 703 (shown in FIGS. 7A and 7B) used for surface reconstruction. In one example of FIG. 8, the FAM volume 703a corresponds to (or is defined relative to) the position data points collected by the catheter within the last X milliseconds (ms) of the procedure. In FIG. 8, the surface 801 corresponds to an offset surface that tracks the shape of the updated map surface 704, but is offset from 704 by a predetermined distance. In some embodiments, the surface 801 is determined by projecting a predetermined distance from the updated map surface 704 at an angle perpendicular thereto. Those skilled in the art will understand that the offset surface 801 is not limited to the illustrated embodiment and that the offset surface 801 can vary depending on the shape and / or distance from the updated map surface 704. As discussed below, the offset surface 801 is applied in connection with analyzing whether changes in the map (described above) correspond to one or more factors associated with tenting.

[0068] 8, volume 802 is also shown. In the illustrated embodiment, volume 802 corresponds to a sphere centered at vertex 803 of updated map surface 704. Volume 802 is also used in connection with analyzing whether changes in the map (discussed above) correspond to one or more factors associated with tenting. When volume 802 corresponds to a sphere, the sphere is not limited to the particular radius shown (e.g., the radius may be larger than the radius shown and may be large enough to intersect with initial map surface 602) or the midpoint shown (e.g., the midpoint may be located on another portion of updated map surface 704 or elsewhere in FIG. 8). Additionally, volume 802 may take other shapes, including, for example, an ellipsoid.

[0069] Factor #1: Do the first and second analysis volumes overlap (sufficiently)? Analysis factor #1 considers the overlap between two tenting analysis volumes, as described in connection with FIGS. 9A and 9B . Referring to FIG. 9A , for factor #1, the first tenting analysis volume corresponds to volume 802, which in the illustrated example corresponds to a sphere centered at vertex 803 of updated map surface 704. As described above, in some examples, FAM volume 703a corresponds to location data points collected by the catheter in the last X ms. In one embodiment, additional location data points are collected by the catheter in the next Y ms. The FAM volume associated with (or defined for) these additional data points (indicated by region 901 in FIGS. 9A and 9B ) corresponds to the second tenting analysis volume. In various embodiments of factor #1, the overlap between the first tenting analysis volume and the second tenting analysis volume is analyzed to determine whether factor #1 is satisfied. In some embodiments, factor #1 simply considers whether there is any overlap between the first tenting analysis volume and the second tenting analysis volume. In other embodiments, factors consider whether there is any overlap, and whether the amount of overlap exceeds a threshold. Various parameters can be used to determine such a threshold, including basing the threshold on the ratio of the sizes of the first and second tenting analysis volumes and / or the proximity of the additional data points to the volume 802, center 803, updated map surface 704, and / or offset surface 801.

[0070] In cases such as those shown in FIGS. 9A and 9B , where there is no overlap between the first tenting analysis volume and the second tenting analysis volume, factor #1 indicates a change in the map due to (or potentially due to) a tenting error. In other embodiments in which any overlap is compared against a threshold, factor #1 indicates a change in the map due to (or potentially due to) a tenting error when the overlap threshold is not exceeded. In the example of FIG. 9A , there is no overlap between the first tenting analysis volume (e.g., defined by volume 802) and the second tenting analysis volume (corresponding to a further data point acquired in the next Y ms, as indicated by region 901), and system 100 determines that data point 703 is associated with tenting based on this lack of overlap. As a result, as shown in FIG. 9B , updated map surface 704 is removed from the map, and map surface 602 is restored to the shape it had prior to the acquisition of data point 703. Further details regarding how the user interface of system 100 can operate to remove such tenting errors are provided below.

[0071] Factor #2: Were there any subsequent acquisitions within the offset volume? As described above, in some examples, FAM volume 703a corresponds to location data points collected by the catheter in the last X ms of the procedure, and additional location data points are collected by the catheter in the next Y ms. Factor #2 considers whether any of these additional location data points (or more than a threshold amount) fall within a volume (referred to as the “offset volume”) between updated map surface 704 and surface 801. In some embodiments, surface 801 (the offset surface) is determined by projecting a predetermined distance from updated map surface 704 at an angle perpendicular to it. In some examples, the magnitude and / or area associated with the offset used to determine offset surface 801 is adjusted based on the type of catheter being used. For example, the offset is adjusted based on whether the catheter is a focal “push” design or a fixed “push” design (such as an Optrell™ catheter). Additionally, the offset can be adjusted based on catheter mechanics, such as shaft-to-tip angle, since these mechanics can be correlated to the force applied to a tissue wall when the catheter impacts against the tissue wall. Additionally, in embodiments where information from a CT scan is integrated with map information, the offset may be adjusted to avoid overlapping with structures previously identified in the CT scan.

[0072] In the illustrated example, the volume corresponding to additional location data points collected by the catheter in the next Yms is indicated by region 1001 (in FIGS. 10A and 10B ) and also corresponds to the second tenting analysis volume. In some embodiments, factor #2 simply considers whether any data points within the second tenting analysis volume (corresponding to region 1001) are within the offset volume (between updated map surface 704 and surface 801). In other embodiments, factor #2 considers whether the number and / or location of these additional data points within the offset volume, if one or more of these additional data points are within the offset volume, exceeds a threshold. Again, various parameters may be used to determine such a threshold, including, for example, basing the threshold on the ratio of the sizes of the second tenting analysis volume and the offset volume and / or the proximity of the additional data points within the second tenting analysis volume to the updated map surface 704 and / or offset surface 801.

[0073] In cases such as those shown in FIG. 10A , where there is no overlap (or insufficient overlap) between volume 802 and the additional data point (1001), factor #2 indicates a change in the map that is due (or potentially due) to a tenting error. However, in the examples of FIGS. 10A and 10B , factor #1 and factor #2 are considered in combination when analyzing whether a change in the map is the result of tenting (or potentially the result of tenting). In relation to the example of FIG. 10A , analysis of factor #1 indicates an overlap between tenting analysis volume 802 and a second tenting analysis volume (corresponding to the additional data point indicated by region 1001), indicating that a change in the map associated with data point 703 is not associated with tenting. In the examples of FIGS. 10A and 10B , factor #1 and factor #2 are considered in combination, and a change in the map is determined to be the result (or potentially the result) of tenting only if both factors indicate a tenting error. 10A, because factor #1 indicates no tenting error and factor #2 indicates a tenting error, system 100 determines that data point 703 is not associated with tenting. As a result, updated map surface 704 is not removed (as in FIG. 9B). Instead, updated map surface 704 is used as a starting point for further updating the map to reflect additional data points within the second tenting analysis volume (1001). This further update of surface 704 is reflected in surface portion 704a, which now accommodates points associated with the second tenting analysis volume (1001).

[0074] In the examples of Figures 10A and 10B, Factor #1 and Factor #2 are considered together in assessing whether a change in the map corresponds to a tenting error, but it will be understood that the tenting error analysis can alternatively be based on Factor #2 by itself, or in combination with one or both of Factor #3 and Factor #4, as discussed below.

[0075] Factor #3: Has there been previous acquisition in the area of change? Factor #3 evaluates whether a change in the map (associated with data point 703) corresponds to tenting based on whether catheter 14 previously acquired a data point corresponding to FAM volume 703a. Application of factor #3 is illustrated in FIGS. 11A and 11B. In this example, data points defining volume 1101 were previously collected prior to the collection of data point 703 (which defines FAM volume 703a). In some embodiments, factor #3 simply considers whether there is any overlap between FAM volumes 703a and 1101. In other embodiments, the factor considers whether there is any overlap, and whether the amount of overlap exceeds a threshold. Various parameters can be used to determine such a threshold, including basing the threshold on the ratio of the sizes of volumes 703a and 1101.

[0076] In cases such as those shown in Figures 11A and 11B, where there is overlap between volume 703a and volume 1101, factor #3 indicates a change in the map that is not due to a tenting error. In other embodiments, where the amount of such overlap is compared against a threshold, factor #3 indicates a change in the map that is not due to a tenting error when the overlap threshold is not exceeded. In the example of Figure 11A, because there is high overlap between FAM volume 703a and volume 1101, the system determines that data point 703 is not associated with tenting based on this overlap. As a result, updated map surface 704 is not removed from the map (as in Figure 9B).

[0077] In the examples of Figures 11A and 11B, factor #3 is considered by itself in assessing whether a change in the map corresponds to a tenting error, but it will be understood that the tenting error analysis can alternatively be based on factor #3 in combination with one or more of the other factors discussed herein.

[0078] Factor #4: Total volume acquired < threshold In one embodiment, factor #4 considers whether the size of the total volume acquired (from the start of mapping) is less than a predetermined threshold. If the total volume acquired is less than the threshold, factor #4 tends to indicate that the changes in the map are not the result of tenting (or potentially the result of tenting). In another embodiment, factor #4 considers whether the ratio of volume 703a to the total volume acquired (from the start of mapping) is greater than a predetermined threshold. If this ratio is greater than the threshold, factor #4 tends to indicate that the changes in the map are not the result of tenting (or potentially the result of tenting).

[0079] The use of factor #4 is particularly advantageous in the early stages of constructing an electroanatomical map, when a relatively small number of location data points (e.g., of the heart) have been collected. Factor #4 may be considered by itself when assessing whether changes in the map correspond to tenting error. Alternatively, tenting error analysis may be based on factor #4 in combination with one or more of the other factors discussed herein.

[0080] 12, a user interface 1200 is shown that identifies a region 1203 on an electroanatomical map 1201 as potentially corresponding to a tenting error. If the analysis described above (applying one or more of factors #1-4) indicates that a change in the map (e.g., associated with an additional data point 703) is a potential result of a tenting error, the region 1203 of potential tenting error is flagged to the operator (e.g., using the illustrated thick arrow 1202). The user interface 1200 then provides the operator with the option to remove the updated map surface 704 associated with region 1203 from the map and restore the previous map surface 602 associated with region 1203 to the shape it had before the acquisition of data point 703.

[0081] Referring now to Figure 13, method 1300 is illustrated in accordance with one or more exemplary embodiments. Method 1300 is an exemplary series of operations resident in and performed by workstation 55 of Figure 1, local computing device 106 of Figure 2, remote computing system 108 of Figure 2, and / or exemplary device 400 of Figure 4. Method 1300 illustrates an example embodiment of how system 10 generates and presents a map of an anatomical structure (e.g., one or more 3D models) on a user interface, detects tenting errors, and provides functionality (through the user interface) to enable an operator to edit the map by, for example, removing tenting errors during an EP procedure (e.g., an ablation procedure).

[0082] Method 1300 begins at block 1301, where first position information defining an initial map surface of an electroanatomical map is acquired as a catheter moves within the body. In one example, the first position information corresponds to data point 601 (FIG. 6A). The first position information is used to determine an initial map surface (e.g., surface 602 (FIG. 6B)). The initial map surface is used to generate an electroanatomical map corresponding to an initial visualization presented on a display, as described herein.

[0083] The initial visualization is a map of the anatomy. For example, the initial visualization can be a 3D rendering of the heart chamber and can include a rendering of the catheter (in its actual location) within the heart chamber. The visualization can include various features, including one or more tags (e.g., VISITAGS®), one or more catheters, one or more internal surface points (e.g., CARTO® points), one or more ultrasound examination controls, and / or one or more points.

[0084] In block 1302, second position information is acquired using the catheter. In one example, the second position information corresponds to data point 703 (FIG. 7A). The second position information is used to determine an updated map surface, such as surface 704 (FIG. 7B). The updated map surface is used to generate an electroanatomical map corresponding to further visualization presented on a display.

[0085] In block 1303, the system 100 determines a difference between the initial map surface and the updated map surface corresponding to changes in the map resulting from the second position information. Also in block 1303, the system determines a first tenting analysis volume based at least in part on the updated map surface. In some embodiments, the first tenting analysis volume is a spherical volume centered around a point on the updated map surface. In some embodiments, an offset surface is determined by projecting a predetermined distance from the updated map surface, and the first tenting analysis volume corresponds to the volume between the updated map surface and the offset surface.

[0086] At block 1304, third position information representing an additional data point (e.g., shown as 901 (FIG. 9A) or 1001 (FIG. 10A)) is acquired using the catheter. The third position information is used to define a second tenting analysis volume relative to the second position information.

[0087] At block 1305, changes in the map are identified as potentially corresponding to tenting according to whether the first tenting analysis volume does not overlap the second tenting analysis volume by a predetermined amount.

[0088] In block 1306, a visual representation including the electroanatomical map is presented to the user on a user interface. The visual representation provides a visual indication (e.g., arrow 1202 in FIG. 12) that changes in the map potentially correspond to tenting. In this step, the user interface is operable by the user to remove changes in the map shape from the visual representation.

[0089] In some embodiments, a spherical volume centered around a point on the updated map surface is determined, and changes in the map are identified as potentially corresponding to tenting based on whether the third position information is within the spherical volume.

[0090] In some embodiments, changes in the map are identified as potentially corresponding to tenting based on whether previously acquired location information is within the first tenting analysis volume.

[0091] In some embodiments, a change in the map is identified as potentially corresponding to tenting based on whether the volume corresponding to the change in the map is less than a threshold value.

[0092] In some embodiments, the predetermined amount of overlap used to identify tenting corresponds to a ratio between the sizes of the first tenting analysis volume and the second tenting analysis volume.

[0093] In some embodiments, the electroanatomical map is a high-speed anatomical map generated during a cardiac ablation procedure.

[0094] The flowcharts and block diagrams in the figures illustrate the structure, functionality, and operation of possible implementations of systems, methods, and computer program products according to various embodiments of the present invention. In this regard, each block in a flowchart or block diagram may represent a module, segment, or portion of instructions, including one or more executable instructions for implementing the depicted logical function(s). In some alternative implementations, the functions shown in the blocks may occur out of the order shown in the figures. For example, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending on the functionality involved. It should also be noted that each block of the block diagrams and / or flow diagrams, and combinations of blocks in the block diagrams and / or flow diagrams, may be implemented by a dedicated hardware-based system that performs the specified function or operation, or may be operated or executed by a combination of dedicated hardware and computer instructions.

[0095] Although features and elements have been described above in particular combinations, those skilled in the art will understand that each feature or element can be used alone or in combination with other features and elements. In addition, the methods described herein can be implemented in a computer program, software, or firmware embodied in a computer-readable medium for execution on a computer or processor. A computer-readable medium, as used herein, should not be construed as being a transitory signal itself, such as an electric wave or other freely propagating electromagnetic wave, an electromagnetic wave propagating through a waveguide or other transmission medium (e.g., a light pulse passing through a fiber optic cable), or an electrical signal transmitted through a wire.

[0096] Examples of computer-readable media include electrical signals (transmitted via wired or wireless connections) and computer-readable storage media. Examples of computer-readable storage media include, but are not limited to, registers, cache memory, semiconductor memory devices, magnetic media (e.g., internal hard disks and removable disks), magneto-optical media, optical media (e.g., compact disks (CDs) and digital versatile disks (DVDs)), random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), static random access memory (SRAM), and memory sticks. A processor together with software can be used to implement a radio frequency transceiver for use in a terminal, a base station, or any host computer.

[0097] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms "a," "an," and "the" are intended to include the plural unless the context clearly dictates otherwise. It is further understood that the terms "comprise" and / or "comprising," when used herein, indicate the presence of stated features, integers, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or other features, integers, steps, operations, elements, components, and / or groups thereof.

[0098] The description of different embodiments herein is provided for illustrative purposes, but is not intended to be exhaustive or limited to the disclosed embodiments. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the described embodiments. The terms used herein are selected to best explain the principles, practical applications, or technical improvements of the embodiments compared to technologies found on the market, or to enable those skilled in the art to understand the embodiments disclosed herein.

[0099] [Embodiment] (1) A method for detecting and correcting errors in an electroanatomical map generated using a catheter positioned within a human body, the errors being the result of tenting in the electroanatomical map caused by impingement of the catheter against a tissue wall, the method comprising: acquiring first position information defining an initial map surface of the electroanatomical map as the catheter moves within the body; acquiring second position information using the catheter after acquiring the first position information, and determining an updated map surface based on the second position information, wherein a difference between the initial map surface and the updated map surface corresponds to a change in the map; determining a first tenting analysis volume based at least in part on the updated map surface; acquiring third position information using the catheter after acquiring the second position information, the third position information being used to define a second tenting analysis volume relative to the second position information; identifying the changes in the map as potentially corresponding to tenting according to whether the first tenting analysis volume does not overlap the second tenting analysis volume by a predetermined amount; presenting a visual representation including the electroanatomical map to a user on a user interface, the visual representation providing a visual indication that the change in the map potentially corresponds to tenting; The method, wherein the user interface is operable to remove the changes in the map from the visual representation. (2) the first tenting analysis volume is a spherical volume centered around a point on the updated boundary surface; 2. The method of claim 1, wherein the identifying step further includes identifying that the change in the map potentially corresponds to tenting according to whether the third position information is within the spherical volume. (3) determining an offset surface by projecting a predetermined distance from the updated map surface; 2. The method of claim 1, wherein the first tenting analysis volume is the volume between the updated map surface and the offset surface. (4) The method of embodiment 1, wherein the identifying step further includes identifying that the change in the map potentially corresponds to tenting according to whether previously acquired position information is within the first tenting analysis volume. (5) The method of embodiment 1, wherein the identifying step further includes identifying that the change in the map potentially corresponds to tenting according to whether a volume corresponding to the change in the map is smaller than a threshold.

[0100] (6) The method of claim 1, wherein the predetermined amount of overlap corresponds to a ratio between the sizes of the first tenting analysis volume and the second tenting analysis volume. (7) The method of embodiment 1, wherein the catheter is positioned within a human heart. (8) The method of embodiment 7, further comprising generating the electroanatomical map during a cardiac ablation procedure. (9) A system for detecting and correcting errors in an electroanatomical map generated using a catheter positioned within a human body, the errors being the result of tenting in the electroanatomical map caused by impaction of the catheter against a tissue wall, the system comprising: a memory for storing the electroanatomical map; a processor coupled to the memory; a user interface coupled to the processor; The processor: acquiring first position information defining an initial map surface of the electroanatomical map as the catheter moves within the body; acquiring second position information using the catheter after acquiring the first position information, and determining an updated map surface based on the second position information, wherein a difference between the initial map surface and the updated map surface corresponds to a change in the map; determining a first tenting analysis volume based at least in part on the updated map surface; acquiring third position information using the catheter after acquiring the second position information, the third position information being used to define a second tenting analysis volume relative to the second position information; identifying the changes in the map as potentially corresponding to tenting according to whether the first tenting analysis volume does not overlap the second tenting analysis volume by a predetermined amount; presenting a visual representation including the electroanatomical map to a user on the user interface, the visual representation providing a visual indication that the change in the map potentially corresponds to tenting; The system, wherein the user interface is operable to remove the changes in the map from the visual representation. (10) The processor: determining the first tenting analysis volume as a spherical volume centered around a point on the updated map surface; The system of embodiment 9, further configured to identify that the change in the map potentially corresponds to tenting depending on whether the third location information is within the spherical volume.

[0101] (11) The processor: determining an offset surface by projecting a predetermined distance from the updated map surface; 10. The system of claim 9, further configured to determine the first tenting analysis volume as the volume between the updated map surface and the offset surface. (12) The system of embodiment 9, wherein the processor is further configured to identify that the change in the map potentially corresponds to tenting according to whether previously acquired position information is within the first tenting analysis volume. (13) The system of embodiment 9, wherein the processor is further configured to identify that the change in the map potentially corresponds to tenting according to whether a volume corresponding to the change in the map is smaller than a threshold. (14) The system of embodiment 9, wherein the predetermined amount of overlap corresponds to a ratio between the sizes of the first tenting analysis volume and the second tenting analysis volume. (15) The system of embodiment 9, wherein the catheter is positioned within a human heart.

[0102] (16) The system of embodiment 15, wherein the processor is further configured to generate the electroanatomical map during a cardiac ablation procedure. (17) A non-transitory computer-readable medium storing instructions that, when executed by a processor, cause the processor to: acquiring first position information defining an initial map surface of the electroanatomical map as the catheter moves within the body; acquiring second position information using the catheter after acquiring the first position information, and determining an updated map surface based on the second position information, wherein a difference between the initial map surface and the updated map surface corresponds to a change in the map; determining a first tenting analysis volume based at least in part on the updated map surface; acquiring third position information using the catheter after acquiring the second position information, the third position information being used to define a second tenting analysis volume relative to the second position information; identifying the changes in the map as potentially corresponding to tenting according to whether the first tenting analysis volume does not overlap the second tenting analysis volume by a predetermined amount; presenting a visual representation including the electroanatomical map to a user on the user interface, the visual representation providing a visual indication that the change in the map potentially corresponds to tenting; The non-transitory computer-readable medium, wherein the user interface is operable to remove the changes in the map from the visual representation. (18) The instructions further include causing the processor to: determining the first tenting analysis volume as a spherical volume centered around a point on the updated map surface; A non-transitory computer-readable medium as described in embodiment 17, which identifies the change in the map as potentially corresponding to tenting depending on whether the third location information is within the spherical volume. (19) The non-transitory computer-readable medium of embodiment 17, wherein the instructions further cause the processor to identify that the change in the map potentially corresponds to tenting according to whether previously acquired position information is within the first tenting analysis volume. (20) The non-transitory computer-readable medium of claim 17, wherein the instructions further cause the processor to identify the change in the map as potentially corresponding to tenting according to whether a volume corresponding to the change in the map is less than a threshold.

Claims

1. 1. A system for detecting and correcting errors in an electroanatomical map generated using a catheter positioned within a human body, the errors being a result of tenting in the electroanatomical map caused by impaction of the catheter against a tissue wall, the system comprising: a memory for storing the electroanatomical map; a processor coupled to the memory; a user interface coupled to the processor; The processor: acquiring first position information defining an initial map surface of the electroanatomical map as the catheter moves within the body; acquiring second position information using the catheter after acquiring the first position information, and determining an updated map surface based on the second position information, wherein a difference between the initial map surface and the updated map surface corresponds to a change in the map; determining a first tenting analysis volume based at least in part on the updated map surface; acquiring third position information using the catheter after acquiring the second position information, the third position information being used to define a second tenting analysis volume for the second position information; and identifying the changes in the map as potentially corresponding to tenting according to whether the first tenting analysis volume does not overlap the second tenting analysis volume by a predetermined amount; presenting a visual representation including the electroanatomical map to a user on the user interface, the visual representation providing a visual indication that the change in the map potentially corresponds to tenting; The system, wherein the user interface is operable to remove the changes in the map from the visual representation.

2. The processor: determining the first tenting analysis volume as a spherical volume centered around a point on the updated map surface; The system of claim 1 , further configured to identify the change in the map as potentially corresponding to tenting according to whether the third location information is within the spherical volume.

3. The processor: determining an offset surface by projecting a predetermined distance from the updated map surface; The system of claim 1 , further configured to determine the first tenting analysis volume as a volume between the updated map surface and the offset surface.

4. 2. The system of claim 1, wherein the processor is further configured to identify that the change in the map potentially corresponds to tenting according to whether previously acquired position information is within the first tenting analysis volume.

5. 2. The system of claim 1, wherein the processor is further configured to identify the change in the map as potentially corresponding to tenting according to whether a volume corresponding to the change in the map is less than a threshold.

6. The system of claim 1 , wherein the predetermined amount of overlap corresponds to a ratio between the sizes of the first tenting analysis volume and the second tenting analysis volume.

7. The system of claim 1 , wherein the catheter is positioned within a human heart.

8. The system of claim 7 , wherein the processor is further configured to generate the electroanatomical map during a cardiac ablation procedure.

9. A non-transitory computer-readable medium storing instructions that, when executed by a processor, cause the processor to: acquiring first position information defining an initial map surface of the electroanatomical map as the catheter moves within the body; acquiring second position information using the catheter after acquiring the first position information, and determining an updated map surface based on the second position information, wherein a difference between the initial map surface and the updated map surface corresponds to a change in the map; determining a first tenting analysis volume based at least in part on the updated map surface; acquiring third position information using the catheter after acquiring the second position information, the third position information being used to define a second tenting analysis volume for the second position information; and identifying the changes in the map as potentially corresponding to tenting according to whether the first tenting analysis volume does not overlap the second tenting analysis volume by a predetermined amount; presenting a visual representation including the electroanatomical map to a user on the user interface, the visual representation providing a visual indication that the change in the map potentially corresponds to tenting; The non-transitory computer-readable medium, wherein the user interface is operable to remove the changes in the map from the visual representation.

10. The instructions further cause the processor to: determining the first tenting analysis volume as a spherical volume centered around a point on the updated map surface; 10. The non-transitory computer-readable medium of claim 9, further comprising: identifying the change in the map as potentially corresponding to tenting according to whether the third location information is within the spherical volume.

11. 10. The non-transitory computer-readable medium of claim 9, wherein the instructions further cause the processor to identify that the change in the map potentially corresponds to tenting according to whether previously acquired position information is within the first tenting analysis volume.

12. 10. The non-transitory computer-readable medium of claim 9, wherein the instructions further cause the processor to identify the change in the map as potentially corresponding to tenting according to whether a volume corresponding to the change in the map is less than a threshold.

13. 1. A method for detecting and correcting errors in an electroanatomical map generated using a catheter positioned within a human body, the errors being a result of tenting in the electroanatomical map caused by impaction of the catheter against a tissue wall, the method comprising: acquiring first position information defining an initial map surface of the electroanatomical map as the catheter moves within the body; acquiring second position information using the catheter after acquiring the first position information, and determining an updated map surface based on the second position information, wherein a difference between the initial map surface and the updated map surface corresponds to a change in the map; determining a first tenting analysis volume based at least in part on the updated map surface; acquiring third position information using the catheter after acquiring the second position information, the third position information being used to define a second tenting analysis volume for the second position information; and identifying the changes in the map as potentially corresponding to tenting according to whether the first tenting analysis volume does not overlap the second tenting analysis volume by a predetermined amount; presenting a visual representation including the electroanatomical map to a user on a user interface, the visual representation providing a visual indication that the change in the map potentially corresponds to tenting; The method, wherein the user interface is operable to remove the changes in the map from the visual representation.

14. the first tenting analysis volume is a spherical volume centered around a point on the updated boundary surface; 14. The method of claim 13, wherein the identifying step further comprises identifying that the change in the map potentially corresponds to tenting according to whether the third location information is within the spherical volume.

15. determining an offset surface by projecting a predetermined distance from the updated map surface; The method of claim 13 , wherein the first tenting analysis volume is the volume between the updated map surface and the offset surface.

16. 14. The method of claim 13, wherein the identifying step further comprises identifying that the change in the map potentially corresponds to tenting according to whether previously acquired position information is within the first tenting analysis volume.

17. 14. The method of claim 13, wherein the identifying step further comprises identifying the change in the map as potentially corresponding to tenting according to whether a volume corresponding to the change in the map is less than a threshold.

18. The method of claim 13 , wherein the predetermined amount of overlap corresponds to a ratio between the sizes of the first tenting analysis volume and the second tenting analysis volume.

19. The method of claim 13 , wherein the catheter is positioned within a human heart.

20. 20. The method of claim 19, further comprising generating the electroanatomical map during a cardiac ablation procedure.

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