Control the appearance of displayed markers to improve catheter and tissue visibility

Abstract

The present invention provides a method for improving visualization of at least a catheter in an organ of a patient, the method comprising displaying a map of the organ and at least a first visual marker superimposed on the map. A position within the map where the distal end of the catheter falls is received. Displayed on the map is (i) the distal end of the catheter consistent with the received position, and (ii) at least a second visual marker replacing the first visual marker, the second visual marker increasing the visibility of at least one of the map and the distal end relative to the first visual marker.

Description

Technical Field

[0001] The present invention relates generally to medical devices, and particularly to methods and systems for increasing visibility of medical devices and tissue during medical procedures. Background Art

[0002] Various medical systems, such as cardiac ablation systems, display visual indicia to the physician that indicate procedure-related medical parameters.

[0003] For example, U.S. Patent Application Publication 2016 / 0128770 describes a method and system for presenting information representing lesion formation. The system includes an electronic control unit (ECU). The ECU is configured to obtain a value of an ablation description parameter and / or a position signal metric, wherein the value corresponds to a position in the tissue. The ECU is further configured to evaluate the value, assign a visual indicator of a visualization scheme associated with the parameter / metric corresponding to the value, and generate a mark including the visual indicator so that the mark indicates the obtained value.

[0004] U.S. Patent Application Publication 2018 / 0064504 describes a visualization device for visualizing the quality of energy applied to an object. The quality of energy applied at a location on the object is visualized based on a) a provided image of the object and b) a provided mass value, wherein the mass value is a depth value indicating the depth to which the applied energy has changed the object, representing the quality of the energy applied to the object at the location on the object.

[0005] U.S. Patent Application Publication 2018 / 0020395 describes an image processing system that utilizes various methods and processing algorithms to enhance or facilitate visual detection and / or sensing modes of images captured in vivo via intravascular visualization and treatment catheters. Summary of the invention

[0006] Embodiments of the invention described herein provide a method for improving visualization of at least a catheter in an organ of a patient, the method comprising displaying a map of the organ and at least a first visual marker superimposed on the map. A position within the map where the distal end of the catheter falls is received. Displayed on the map is (i) the distal end of the catheter consistent with the received position, and (ii) at least a second visual marker replacing the first visual marker, the second visual marker increasing the visibility of at least one of the map and the distal end relative to the first visual marker.

[0007] In some embodiments, in response to identifying that the position of the distal end is within a predetermined vicinity of the first visual marker, displaying the second visual marker in place of the first visual marker is performed. In other embodiments, the method includes redisplaying the first visual marker in place of the second visual marker upon identifying that the position of the distal end is no longer within the predetermined vicinity. In other embodiments, displaying the second visual marker in place of the first visual marker includes modifying at least one attribute of the first visual marker to produce the second visual marker.

[0008] In one embodiment, the attribute is selected from the list consisting of size, shape, opacity, and color.In another embodiment, the organ comprises a heart, and the first visual indicia and the second visual indicia indicate one or more parameters of radio frequency (RF) ablation applied to tissue of the heart.

[0009] According to an embodiment of the present invention, there is further provided a system for improving visualization of at least a catheter in an organ of a patient, the system comprising an output device and a processor. The processor is configured to: (a) display a map of the organ and at least a first visual marker superimposed on the map on the output device, (b) receive a position where the distal end of the catheter falls within the map, and (c) display on the map (i) the distal end of the catheter consistent with the received position, and (ii) at least a second visual marker replacing the first visual marker, the second visual marker increasing the visibility of at least one of the map and the distal end relative to the first visual marker.

[0010] The present invention will be more fully understood through the following detailed description of embodiments of the present invention in conjunction with the accompanying drawings, in which: BRIEF DESCRIPTION OF THE DRAWINGS

[0011] Figure 1 is a schematic illustration of a catheter-based magnetic position tracking and ablation system according to an embodiment of the present invention;

[0012] Figure 2A , 2B and 2C is a schematic illustration of a catheter and visual markers superimposed on a map of an organ according to an embodiment of the present invention; and

[0013] Figure 3 is a flow chart schematically illustrating a method for increasing visibility of tissue and catheters in a map with visual markings according to an embodiment of the present invention. DETAILED DESCRIPTION

[0014] Overview

[0015] Some medical systems, such as cardiac ablation systems, may display auxiliary information on an operator display to assist with the workflow of the procedure.

[0016] Embodiments of the invention described below provide methods and systems for increasing visibility of medical catheters and tissue during medical invasive procedures such as ablation procedures. In some embodiments, a system for displaying an ablation catheter in a patient's heart includes a processor electrically coupled to the ablation catheter and an output device. In some embodiments, the processor is configured to display a map of at least a portion of the heart and one or more visual markers on the output device that are superimposed on the map and visualize ablation parameters applied to cardiac tissue, such as temperature, duration, and / or contact force. The markers are typically displayed as opaque objects.

[0017] In some cases, an opaque marker may visually obscure one or more sections of a medical catheter and / or some tissue that may be necessary to perform a procedure.

[0018] In some embodiments, the processor is configured to receive an electrical position signal indicating that the distal end of the catheter is at one or more locations within the heart, wherein at least one of these locations falls within the boundaries of the mapping map. In some embodiments, the processor is configured to recognize that the current position of the distal end is within a predetermined vicinity of at least one of the opaque visual markers, which means that the opaque visual marker may obstruct the visibility of at least a section of the distal end. In such embodiments, the processor is configured to modify the visual appearance of the opaque visual marker, for example by displaying a translucent (i.e., semi-clear) visual marker in place of the opaque visual marker. By replacing the opaque visual marker with a translucent visual marker, the user of the ablation system can see through the marker to see the previously obscured portion and be able to successfully perform the ablation procedure.

[0019] In some practical situations, the display of visual markers may be important for the workflow of an ablation procedure. For example, displaying an opaque visual marker may provide the user with information necessary to accurately perform an ablation procedure. In some embodiments, after the user moves the distal tip away from the aforementioned visual marker, the processor is configured to redisplay one or more opaque visual markers modified into translucent visual markers.

[0020] The disclosed technology improves patient safety and the quality of ablation procedures by providing physicians with clear visual information to assist in the procedure and by improving the visibility of tissue and catheters used in ablation procedures. In addition, the disclosed technology can be applied to any kind of annotations or other visual markers displayed on any anatomical map during any kind of medical procedure performed on a patient's organ.

[0021] System Description

[0022] Figure 1Schematic illustration of a catheter-based magnetic position tracking and ablation system 20 according to an embodiment of the present invention. The system 20 includes a catheter 21 having an axial distal end 22 that is navigated by a physician 30 through a vascular system into an organ of a patient 28, in this example, into a heart 26. In some embodiments, the physician 30 inserts the axial distal end 22 through a sheath 23 while manipulating the distal end 22 using a manipulator 32 located at the proximal end of the catheter 21.

[0023] Reference is now made to Illustration 25 . In some embodiments, system 20 includes a magnetic sensor 51 (also referred to herein as a magnetic position tracking sensor, or sensor 51 for simplicity) and an ablation catheter 50 coupled to distal end 22 .

[0024] In these embodiments, catheter 21 may be used for various procedures, such as electrophysiological (EP) mapping of heart 26 , and for ablating selected tissue of heart 26 .

[0025] In some embodiments, the proximal end of catheter 21 is electrically connected to console 24 via electrical leads and / or traces. In one embodiment, console 24 includes processor 39 and interface circuit 38 configured to exchange signals between processor 39 and various components and assemblies of system 20.

[0026] In some embodiments, interface circuit 38 is configured to receive electrical signals from catheter 21 and other sensors of system 20. Circuit 38 is further configured to send electrical signals from processor 38 to various components and assemblies of system 20, such as for applying power via catheter 21 to ablate tissue of heart 26, and for controlling other components and assemblies of system 20.

[0027] In some embodiments, system 20 includes a plurality (eg, three) of magnetic field generators 36 configured to generate an alternating magnetic field. Magnetic field generators 36 are placed at known locations outside of patient 28, for example, below patient bed 29.

[0028] In some embodiments, console 24 also includes a drive circuit 34 configured to drive a magnetic field generator 36 and an output device, shown in this example as a display 27 .

[0029] During the medical procedure, physician 30 navigates distal end 22 of catheter 21 in heart 26. In some embodiments, in response to the magnetic field radiated from magnetic field generator 36, magnetic sensor 51 is configured to generate a differential electrical signal (also referred to herein as a differential signal or a position signal) indicating the current position of distal end 22 in heart 26.

[0030] In some embodiments, based on the differential signal received from sensor 51 , processor 39 is configured to display the current position of distal end 22 in the coordinate system of system 20 , for example on display 27 .

[0031] This position sensing method is used, for example, in the CARTO TM The invention is implemented in a system and is described in detail in U.S. Patents 5,391,199, 6,690,963, 6,484,118, 6,239,724, 6,618,612 and 6,332,089, in PCT Patent Publication WO 96 / 05768, and in U.S. Patent Application Publications 2002 / 0065455A1, 2003 / 0120150A1 and 2004 / 0068178A1, the disclosures of which are incorporated herein by reference.

[0032] The processor 39 typically comprises a general purpose processor that is programmed by software to perform the functions described herein. The software may be downloaded to the computer in electronic form over a network, for example, or it may alternatively or additionally be disposed and / or stored on a non-transitory tangible medium such as magnetic, optical or electronic memory.

[0033] Displays visual markers superimposed on the cardiac map

[0034] Figure 2A is a schematic illustration of an anatomical map 55 of heart 26 according to an embodiment of the present invention. In some embodiments, processor 39 is configured to display one or more visual markers, such as visual markers 66A, 66B, and 66C, superimposed on anatomical map 55 (also referred to herein as map 55 for simplicity). In the context of the present invention and the claims, the term "visual marker" refers to any kind of annotation displayed on display 27 by processor 39, for example, to provide physician 30 with supplemental information that can help physician 30 navigate and locate distal end 22 in the tissue of heart 26, as described in detail below.

[0035] In some embodiments, the size and shape of visual markers 66A, 66B, and 66C may indicate the corresponding size and shape of a lesion formed by ablating tissue of heart 26. In such embodiments, the properties of visual markers 66A, 66B, and 66C, such as color, shape, and size, may be determined by ablation parameters applied to tissue of heart 26, such as, but not limited to, ablation energy, duration, contact force, and temperature.

[0036] In some embodiments, processor 39 is configured to display distal end 22 of catheter 21 in map 55. Figure 2A In the example of , visual markers 66A, 66B, and 66C are opaque and have a circular shape. Therefore, visual markers 66A and 66B may block visibility of at least some segments of distal end 22 and tissue of heart 26, but visual marker 66C is far enough from the tissue of interest and / or distal end 22 so as not to block them. It is noted that in order to perform electrophysiological (EP) mapping and / or tissue ablation procedures, it is important for physician 30 to have high visibility of both distal end 22 and ablated tissue of heart 26.

[0037] Increases visibility of the distal tip of the catheter and cardiac tissue during ablation procedures

[0038] Figure 2B 5 is a schematic illustration of an anatomical map 55 of heart 26 according to another embodiment of the present invention. In some embodiments, after catheter 21 is inserted into patient 28, processor 39 is configured to receive a position signal indicating the current position of distal end 22 (e.g., in heart 26). Processor 39 may receive a position signal from the above-described Figure 1 The position sensor 51 of the magnetic position tracking system described in or the position signal from any other suitable source.

[0039] In some embodiments, processor 39 is configured to estimate the distance between the position of distal end 22 and each of the visual markers displayed on map 55. The distance may be the minimum distance between the nearest edge of distal end 22 and the corresponding visual marker, or any other suitable calculated distance. Figure 2B In the example of , the processor 39 is configured to estimate distance 80A, which is the minimum distance between the distal end 22 and the visual marker 77A. Similarly, the processor 39 is configured to estimate distance 80B between the distal end 22 and the visual marker 77B and distance 80C between the distal end 22 and the visual marker 66C.

[0040] In some embodiments, processor 39 maintains a threshold distance indicating an allowable proximity between the visual marker and distal end 22. In response to identifying that the current position of distal end 22 is within a predetermined proximity of the visual marker, processor 39 is configured to modify at least one attribute of the visual marker to increase visibility of distal end 22. Attributes may include size, shape, opacity, color, position, or any other suitable attribute.

[0041] For example, in the following Figure 2CThe modification of the size shown in can be lateral, such as on the surface of the heart 26, and / or in the depth of the tissue of the heart 26. The shape can be modified from a circle to an elliptical shape or any other suitable shape. The change in position can be used in one or more visual markers to visualize specific tissues of the heart 26 (e.g., pulmonary vein ostia) or specific elements of the distal end 22 (e.g., ablation electrodes). The change in opacity will be detailed in the following examples and shown in Figure 2B middle.

[0042] For example, the distances 80A and 80B are less than the aforementioned threshold distances stored in the processor 39. In some embodiments, the processor 39 is configured to display translucent visual markers 77A and 77B in place of the opaque visual markers 66A and 66B to improve visibility of tissue of the distal tip 22 and the heart 26. In one embodiment, the visual markers 66A and 77A have substantially similar locations, sizes, and shapes, but have different degrees of transparency, thereby improving visibility of tissue of the distal tip 22 and the heart 26 within the vicinity of the visual marker 77A.

[0043] Note that distance 80C is greater than the threshold distance, in other words, distal end 22 is not within the predetermined proximity of visual marker 66C. In this embodiment, processor 39 is configured to continue to display opaque visual marker 66C in map 55.

[0044] In addition, during the ablation procedure, the physician 30 may move the distal end 22 away from the visual markers 77A and 77B. In some embodiments, upon identifying that the current position of the distal end 22 is no longer within the predetermined vicinity of the visual markers 77A and 77B, the processor 39 is configured to redisplay at least one of the opaque visual markers 66A and 66B in place of the translucent visual markers 77A and 77B.

[0045] Figure 2C 5 is a schematic illustration of an anatomical map 55 of a heart 26 according to an alternative embodiment of the present invention. In some embodiments, rather than displaying visual markers 66A and 66B that obscure visibility of the distal end 22, as described above Figure 1 As shown in , processor 39 is configured to display visual markers 88A and 88B at the same respective locations.

[0046] As above Figure 2A As described above with respect to visual markers 77A and 77B, in Figure 2C In the example of FIG. 8 , visual indicia 88A and 88B may be based on modified visual indicia 66A and 66B having one or more attributes.

[0047] In some embodiments, visual marker 88A may have a circular shape similar to visual marker 66A, but with a smaller diameter. By reducing the diameter of the visual marker, the minimum distance 90A between the distal end 22 and the edge of the visual marker 88A is greater than that described above. Figure 2B In this configuration, distal end 22 is not within a predetermined proximity of visual marker 88A, which increases visibility of at least one of a map of heart 26 and distal end 22 relative to visual marker 66A. In some embodiments, processor 39 is configured to estimate a distance between center of gravity (COG) 89A and a nearest edge of distal end 22, and adjust a diameter of visual marker 88A based on the estimated distance to have a distance 90A that is equal to or greater than a predetermined threshold distance stored in processor 39.

[0048] In some embodiments, the processor 39 is configured to display the visual marker 88B on the map 55 by setting the diameters of the COG 89B and the visual marker 88B such that a minimum distance 90B between the distal end 22 and the visual marker 88B is greater than a predetermined threshold distance stored in the processor 39 .

[0049] As above Figure 2B As described in , visual marker 66C is sufficiently far from distal end 22 that processor 39 may not display another visual marker in place of visual marker 66C.

[0050] exist Figure 2C In the exemplary configuration shown, visual markers 88A, 88B, and 66C have circular shapes but have different corresponding diameters to increase the visibility of at least one of the map 55 and the distal end 22 relative to the visual markers 66A and 66B. In other embodiments, the processor 39 is configured to modify the penetration depth of the displayed visual markers in the tissue of the heart 26. When the physician 30 can rotate the map 55 to observe the tissue of the heart 26 from different perspectives, the change in depth can improve the aforementioned visibility. In such embodiments, the processor 39 is configured to set a symmetrical circular shape of the visual marker, or an elliptical visual marker can be formed for visualizing a specific tissue of the heart 26 or a specific element of the distal end 22 in a selected dimension.

[0051] In other embodiments, processor 39 is configured to set similar diameters for all visual markers superimposed on map 55. For example, in Figure 2C In a configuration of , the processor may set the diameter of visual marker 88A to be the diameter of visual markers 88B and 66C.

[0052] Additionally or alternatively, processor 39 is configured to modify the shape and / or opacity and / or COG of one or more visual markers displayed in map 55. Furthermore, processor 39 is configured to temporarily remove one or more visual markers from map 55. Note that at least some of the visual markers are used in the workflow of the medical procedure, and thus, processor 39 may not remove or offset any visual markers that are necessary for the workflow of the medical procedure.

[0053] Additionally or alternatively, the processor 39 is configured to temporarily offset the COG of the visual marker that may inadvertently hit the direction of movement of the distal end 22 on the map 55. Note that in the case where the visual marker is necessary for the workflow of the medical procedure, the processor 39 may not offset or temporarily remove the corresponding visual marker from the map 55.

[0054] In other embodiments, Figures 2A to 2C The visual indicia shown in the diagram may indicate any parameters in addition to the ablation parameters described above. For example, the electrical potential sensed in the tissue of the heart 26 by the electrodes mounted on the distal tip 22, or the estimated lesion size based on the ablation parameters to be applied to the heart 26, or any other suitable parameter. In such embodiments, by modifying the display of the visual indicia, the processor 39 may assist the physician 30 in navigating and placing the distal tip 22 in the dense pre-ablation tissue of the heart 26.

[0055] In other embodiments, processor 39 or any other processor connected to system 20 may display the visual marker on any output device other than display 27. For example, physician 30 may use augmented reality (AR) goggles configured to display the visual marker and / or related information superimposed on map 55 and / or any suitable anatomical image of heart 26. Additionally or alternatively, any other suitable technique may be used to achieve the display of the visual marker.

[0056] This particular configuration of visual indicia is shown by way of example in Figures 2A to 2C 2 and 3 in order to illustrate certain problems solved by embodiments of the present invention and to demonstrate the application of these embodiments to enhancing visibility of selected tissue of distal tip 22 and heart 26. However, embodiments of the present invention are by no means limited to this particular class of exemplary configurations, and the principles described herein may be similarly applied to other classes of user interfaces and / or display systems.

[0057] Methods for improving visualization of the distal tip of a catheter during electrophysiology procedures

[0058] Figure 3 is a flow chart schematically illustrating a method for increasing visibility of the heart 26 and the distal end 55 of the catheter 21 during an electrophysiology procedure, according to an embodiment of the present invention.

[0059] The method begins at a first display step 100, in which processor 39 displays a map 55 of heart 26 or any other organ of patient 28 on an output device such as display 27. In some embodiments, processor 39 superimposes one or more visual markers, such as visual markers 66A-66C on map 55.

[0060] In a position receiving step 102, processor 39 receives signals from sensors 51 of the magnetic position tracking system indicating the current position of distal end 22, which is navigated by physician 30 or any other suitable operator of system 20. In some embodiments, at least some of the signals indicate one or more positions that fall within the boundaries of map 55.

[0061] In a proximity identification step 104, processor 39 may identify one or more visual markers, such as visual markers 66A and 66B, within a predetermined proximity of distal end 22. In some embodiments, processor 39 may maintain a threshold distance or a set of criteria and / or algorithms for determining the predetermined proximity.

[0062] In a visual marker modification step 106, processor 39 may modify the visual appearance of at least some of the visual markers identified in step 104. For example, processor 39 may display translucent visual markers 77A and 77B in place of opaque visual markers 66A and 66B that may otherwise obscure at least a section of distal tip 22 or tissue of heart 26 that is necessary for the workflow of the medical procedure.

[0063] Note that in the context of the present invention and the claims, the sentences “modify the visual appearance of at least some of the visual markers,” “display translucent visual markers 77A and 77B in place of opaque visual markers 66A and 66B,” and the claim language “display a second visual marker in place of the first visual marker,” refer to the same techniques applied by processor 39 to visual markers 66A and 66B to improve visualization of tissue of distal tip 22 or heart 26, such as in the above text. Figure 2B As described in.

[0064] In a second display step 108 that ends the method, after the distal end 22 moves away from the map 55 and is therefore no longer within the predetermined vicinity of the modified visual marker, the processor 39 may redisplay the visual marker as described above in step 100. In other words, when the distal end 55 is close to one or more given visual markers, the processor 39 may modify the visual appearance (e.g., opacity and size) of the one or more given visual markers, as described above in step 106, but after the distal end 22 is moved far enough away from the given visual markers, the processor 39 may redisplay the original visual appearance of the one or more given visual markers. For example, at least one of the visual markers may be

[0065] Although the embodiments described herein are primarily directed to electrophysiological (EP) mapping and cardiac ablation procedures, the methods and systems described herein may also be used in any other minimally invasive medical application where tissue and / or medical tools are located at a region of interest that is obscured by visual markers. In addition, the embodiments described herein may be used in any application where an operator navigates in any given space and attempts to perform surgery in a specific narrow region of interest. The techniques disclosed herein may be applied to any visual obstruction associated with a region of interest.

[0066] It should therefore be understood that the embodiments described above are cited by way of example, and that the present invention is not limited to the contents specifically shown and described above. On the contrary, the scope of the present invention includes combinations and sub-combinations of the various features described above, as well as variations and modifications thereof, which will occur to those skilled in the art when reading the above description, and which are not disclosed in the prior art. The documents incorporated by reference into this patent application are considered to be an integral part of this application, except that if any term defined in these incorporated documents conflicts with a definition explicitly or implicitly given in this specification, only the definition in this specification should be considered.

Claims

1. A system for improving visualization of at least a catheter in an organ of a patient, the organ including a heart, the system comprising: Output device; and A processor configured to: displaying on the output device a map of the organ and at least a first visual indicia superimposed on the map; receiving a position of a distal end of the catheter within the map; and displaying on the map (i) the distal end of the catheter consistent with the received position, and (ii) at least a second visual marker in place of the first visual marker, the second visual marker increasing visibility of at least one of the map and the distal end relative to the first visual marker, wherein the first visual marker and the second visual marker indicate one or more parameters of ablation applied to tissue of the heart, wherein the processor is further configured to: in response to identifying that the position of the distal end is within a predetermined vicinity of the first visual marker, display the second visual marker in place of the first visual marker; and upon identifying that the position of the distal end is no longer within the predetermined proximity, redisplaying the first visual marker in place of the second visual marker. 2 . The system of claim 1 , wherein the processor is configured to generate the second visual indicia by modifying at least one attribute of the first visual indicia.

3. The system of claim 2, wherein the processor is configured to select the attribute from a list consisting of size, shape, opacity, and color.

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