Visual guidance for positioning the distal end of a medical probe

Abstract

The present invention is entitled "Visual Guidance for Locating the Distal End of a Medical Probe". The present invention discloses a method that includes receiving, from electrodes positioned within the heart, a first signal indicative of electrical activity in tissue that is in contact with at least three of the electrodes and a second signal indicative of the positions of the at least three electrodes. The second signal is processed to calculate the positions of the at least three electrodes and to determine a geometric center of the positions. Based on the signals, an electroanatomical map of a region of the tissue that includes the geometric center is generated, and an arrhythmia focus is determined in the map. A circle is presented, and a region of the map that includes the geometric center and the focus is presented within the circle such that the geometric center on the map is aligned with the center of the circle, and the region within the circle indicates a spatial relationship between the geometric center and the focus.

Description

[0001] Cross - Reference to Related Applications

[0002] This patent application claims the benefit of U.S. Provisional Patent Application 62 / 875,770, filed on Jul. 18, 2019, which is incorporated herein by reference. Technical Field

[0003] The present invention generally relates to medical imaging and, more particularly, to providing visual feedback to assist in guiding the distal end of a medical probe to a location within a body cavity in need of medical treatment. Background Art

[0004] Some medical procedures, such as mapping the cavities of a body organ (e.g., the heart), are performed by inserting a medical probe into the cavity. In some configurations, the medical probe includes a distal segment that includes a plurality of electrodes that can measure physiological properties such as the local surface potential at a location in the heart.

[0005] Examples of medical probes that include a plurality of electrodes include balloon catheters and basket catheters. In some configurations, these medical probes can deliver radiofrequency (RF) current to ablate tissue in contact with the distal end of the probe in order to provide a therapeutic result.

[0006] U.S. Patent 8,577,450, issued to Chmiel et al., describes a graphical interface for a multi-rib probe. The graphical interface includes a circle, the center of which represents the position of the distal end of the catheter body, and the radius of which represents the position and orientation of the ribs mounted at the distal end of the catheter.

[0007] U.S. Patent Application 2013 / 0274582, published to Afonso et al., describes a method for diagnosing cardiac arrhythmias and guiding catheter therapy. The method includes creating a representation of a catheter having a helical distal end that includes a plurality of electrodes that can be superimposed on a map, model, or image of tissue.

[0008] U.S. Patent 5,722,402, issued to Swanson et al., describes a method for guiding a movable electrode element within a multi-electrode structure. The method includes using different color hues to present a normalized distribution of voltages detected by the electrodes of a basket catheter.

[0009] U.S. Patent Application 2013 / 0184569, published to Strommer et al., describes a method for generating an electrophysiological map of the heart. The method includes generating a local activation time map of the heart by superimposing a representation of the position of the distal end of a catheter on a labeled image.

[0010] U.S. Patent No. 8,224,432 to MacAdam et al. describes a fast 3D mapping method using multi - electrode position data. The method includes applying color - coding to a mapping diagram that shows changes in activation time or any other parameter mapped according to a color scale.

[0011] U.S. Patent No. 8,326,419 to Rosenberg et al. describes a method for treatment optimization via multi - dimensional mapping. The method includes generating a mechanical - electrical delay mapping diagram by subtracting local electrical activation time from corresponding local mechanical activation time, and plotting at least the mechanical - electrical delay mapping diagram on a display. The method may also include plotting the mechanical - electrical delay mapping diagram using colors, where the color scale quantitatively identifies mechanical - electrical delay values (e.g., via blank or filled contours).

[0012] Documents incorporated by reference into this patent application are considered an integral part of this application, except that if any terms defined in these incorporated documents conflict with the definitions expressly or implicitly given in this specification, only the definitions in this specification shall be considered.

[0013] The above description gives an overview of the relevant art in the field and should not be construed as admitting that any of the information it contains constitutes prior art against this patent application. Summary of the Invention

[0014] According to an embodiment of the present invention, a method is provided that includes receiving, from an intracardiac catheter having a distal end including a plurality of electrodes, within a subject's heart, a first signal from at least three of the electrodes in response to electrical activity in myocardial tissue in contact with the at least three electrodes; receiving a second signal indicating the respective position coordinates of the at least three electrodes within the heart; processing the second signal to calculate the respective position coordinates of the at least three electrodes and determine the geometric center of the respective position coordinates; generating, based on the first signal and the second signal, an electroanatomical mapping diagram for a region of the myocardial tissue including the determined geometric center; determining a focus of arrhythmia in the region of the myocardial tissue in the mapping diagram; presenting a circle on a display; and presenting, within the circle, a region of the mapping diagram including the geometric center and the focus of the arrhythmia such that the geometric center on the mapping diagram is aligned with the center of the circle, wherein the region of the mapping diagram presented within the circle indicates the spatial relationship between the geometric center and the focus of the arrhythmia.

[0015] In some embodiments, the electrical activity includes local activation time values. In additional embodiments, presenting the region of the mapping diagram having the focus of the arrhythmia includes plotting a graphical representation of the local activation time values relative to their corresponding positions.

[0016] In one embodiment, the arrhythmia includes a rotor having at least one focus. In another embodiment, the arrhythmia includes a focus.

[0017] In additional embodiments, presenting the region of the mapping diagram having the geometric center includes presenting an icon at a position within the circle corresponding to the position of the focus of the arrhythmia relative to the geometric center. In other embodiments, presenting the circle and the region of the mapping diagram includes superimposing the circle on the electroanatomical mapping diagram. In complementary embodiments, the method further includes presenting within the circle a path of the arrhythmia from the focus of the arrhythmia.

[0018] In one embodiment, the intracardiac catheter includes a balloon catheter. In another embodiment, the intracardiac catheter includes a basket catheter.

[0019] In additional embodiments, generating the electroanatomical mapping diagram may include presenting the mapping diagram on the display at a first resolution. In this additional embodiment, presenting the region may include presenting the region at a second resolution greater than the first resolution.

[0020] According to an embodiment of the present invention, there is also provided a device, the device comprising: an intracardiac catheter configured to be inserted into a cardiac chamber; a plurality of electrodes attached to a distal end of the intracardiac catheter; a display; and a processor configured to: receive from the intracardiac catheter inserted into a given cardiac chamber a first signal from at least three of the electrodes in response to electrical activity in myocardial tissue in contact with the at least three of the electrodes; receive a second signal indicating corresponding position coordinates of the at least three electrodes within the heart; process the second signal to calculate the corresponding position coordinates of the at least three electrodes and determine a geometric center of the corresponding position coordinates; generate, based on the first signal and the second signal, an electroanatomical mapping diagram for a region of the myocardial tissue including the determined geometric center; determine a focus of an arrhythmia in the region of the myocardial tissue in the mapping diagram; present a circle on the display; and present within the circle a region of the mapping diagram including the geometric center and the focus of the arrhythmia such that the geometric center on the mapping diagram is aligned with the center of the circle, wherein the region of the mapping diagram presented within the circle indicates a spatial relationship between the geometric center and the focus of the arrhythmia.

[0021] According to an embodiment of the present invention, there is also provided a computer software product for operating in conjunction with an intracardiac catheter having a distal end including a plurality of electrodes. The product includes a non-transitory computer-readable medium storing program instructions which, when read by a computer, cause the computer to: receive, from the intracardiac catheter positioned within a subject's heart, a first signal from at least three of the electrodes in response to electrical activity in myocardial tissue in contact with the at least three electrodes; receive a second signal indicating respective position coordinates of the at least three electrodes within the heart; process the second signal to calculate the respective position coordinates of the at least three electrodes and determine a geometric center of the respective position coordinates; generate, based on the first signal and the second signal, an electroanatomical map of a region of the myocardial tissue including the determined geometric center; determine a focus of arrhythmia in the region of the myocardial tissue in the map; present a circle on a display; and present, within the circle, a region of the map including the geometric center and the focus of the arrhythmia such that the geometric center on the map is aligned with the center of the circle, wherein the region of the map presented within the circle indicates a spatial relationship between the geometric center and the focus of the arrhythmia. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] The present disclosure is described herein by way of example only with reference to the drawings, wherein:

[0023] Figure 1 FIG. is a schematic illustration of a medical system including a basket catheter having a distal end according to an embodiment of the present invention;

[0024] Figure 2 FIG. is a schematic illustration of a distal end of a basket catheter including electrodes of a strip attached to the catheter according to an embodiment of the present invention;

[0025] Figure 3 FIG. is a flow chart schematically showing a method of providing visual feedback to a medical professional for guiding a distal end of a balloon catheter according to an embodiment of the present invention;

[0026] Figure 4 FIG. is a schematic illustration of electrodes engaging myocardial tissue in a heart during a medical procedure according to an embodiment of the present invention;

[0027] Figure 5 FIG. is a schematic illustration of presenting an electroanatomical map on a display according to a first embodiment of the present invention;

[0028] Figure 6 FIG. is a schematic illustration of presenting an electroanatomical map on a display according to a second embodiment of the present invention; and

[0029] Figures 7A - 9B is a schematic illustration of a visual indicator according to an embodiment of the present invention, which can be presented on a display to assist a medical professional in positioning the distal end of a medical probe at a tissue area in need of treatment. Detailed Description

[0030] When using a medical probe having multiple electrodes (e.g., a basket catheter or a balloon catheter), it may be difficult to accurately position the electrodes relative to a desired location. For example, during a medical procedure, a medical professional may want to position a particular electrode of a catheter on or near a focal source of arrhythmia in myocardial tissue. However, there may be situations during the procedure where portions of the electrodes and / or tissue are not directly visible to the medical professional. In these cases, even if the electrode positions can be determined and a camera can be used to view the tissue, it may still be challenging for the medical professional to accurately position the electrodes at the desired location.

[0031] Embodiments of the present invention provide methods and systems for guiding the distal end of a medical probe toward a treatment location. As described below, a first signal and a second signal are received from an intracardiac catheter positioned within a subject's heart and having a distal end that includes a plurality of electrodes. In an embodiment of the present invention, the first signal is received from at least three of the electrodes in response to electrical activity in myocardial tissue in contact with the at least three electrodes, and the second signal indicates the respective position coordinates of the at least three electrodes within the heart.

[0032] The second signal is processed to calculate the respective position coordinates of the at least three electrodes and to determine the geometric center of the respective position coordinates. Based on the first signal and the second signal, an electroanatomical map is generated for a region of myocardial tissue that includes the determined geometric center, and a focal point of arrhythmia within the region of myocardial tissue is determined in the map.

[0033] To provide positioning guidance to the medical professional, a circle is presented on a display, and a region of the map that includes the geometric center and the focal point of arrhythmia is presented within the circle such that the geometric center (of the position coordinates of the electrodes) on the map is aligned with the center of the circle. In an embodiment of the present invention, the region of the map presented within the circle indicates the spatial relationship between the geometric center and the focal point of arrhythmia.

[0034] In some embodiments, a system implementing an embodiment of the present invention may present spatial relationships as a circular bull's-eye, where the bull's-eye indicates the location of the focus of arrhythmia relative to the electrode. The position of the bull's-eye within the circle can be used to verify whether the electrode is close to or in contact with the desired region. If the electrode is close to (but not in contact with) the desired region, a healthcare professional may use the image (e.g., the bull's-eye) as a visual guide for repositioning the distal end of the medical probe so as to move the electrode to the desired position.

[0035] System Description

[0036] Figure 1 FIG. is a schematic illustration of a medical system 20 including a medical probe 22 and a console 24 according to an embodiment of the present invention, and Figure 2 FIG. is a schematic illustration of the distal end 26 of a medical probe according to an embodiment of the present invention. The medical system 20 may be based on, for example, a system manufactured by Biosense Webster Inc. (33 Technology Drive, Irvine, CA 92618 USA). In the embodiments described below, the medical probe 22 can be used for diagnostic or therapeutic procedures, such as for mapping the electrical potential in the heart 28 of a patient 30 (also referred to herein as a subject). Alternatively, the medical probe 22 can be used for other therapeutic and / or diagnostic purposes in the heart or other body organs with the necessary modifications.

[0037] The probe 22 includes an insertion tube 32 and a handle 34 coupled to the proximal end of the insertion tube. During a medical procedure, a healthcare professional 36 may insert the probe 22 through the vascular system of the patient 30 such that the distal end of the medical probe enters a chamber of the heart 28. When the distal end 26 enters a chamber of the heart 28, the healthcare professional 36 may deploy an electrode assembly 38 attached to the distal end 26, and the healthcare professional may manipulate the handle 34 to position the strip of the electrode assembly such that the electrodes on the strip engage myocardial tissue at one or more desired positions. In an embodiment of the present invention, the electrode assembly 38 may include a basket electrode assembly attached to a basket catheter (as described below in the description with reference to Figure 2 or a balloon electrode assembly attached to a balloon catheter.

[0038] In Figure 1 the configuration shown, the console 24 is connected to body surface electrodes via a cable 40, which typically includes an adhesive skin patch 42 attached to the patient 30. The console 24 includes a processor 44, which in combination with a current tracking module 46, is based on the electrodes 48 on the strip attached to the electrode assembly 38 and the adhesive skin patch 42 ( Figure 2) to determine the position coordinates of the distal end 26 within the heart 28 based on the impedance and / or current measured therebetween. In addition to serving as a position sensor during a medical procedure, the electrode 48 can also perform other tasks, such as measuring the electrical activity of the heart 28.

[0039] As described above, the processor 44 can be combined with the current tracking module 46 to determine the position coordinates of the distal end 26 within the heart 28 based on the impedance and / or current measured between the adhesive skin patch 42 and the electrode 48. Such determination is typically made after a calibration process that has associated impedance or current with known positions of the distal end. In an embodiment of the present invention, the electrode 48 can also be configured to apply a signal to tissue within the heart 28 and / or measure some physiological property (e.g., local surface potential) at a location within the heart.

[0040] The processor 44 can include a real-time noise reduction circuit 50 that is typically configured as a field programmable gate array (FPGA), followed by an analog-to-digital (A / D) signal conversion integrated circuit 52. The processor can pass the signal from the A / D circuit 52 to another processor and / or can be programmed to determine the position coordinates mentioned above.

[0041] Although Figure 1 the illustrated medical system uses impedance- or current-based sensing to measure the position of the distal end 26, other position tracking techniques can be used (e.g., techniques using magnetic-based sensors). Impedance- and current-based position tracking techniques are described, for example, in U.S. Patents 5,983,126, 6,456,864, and 5,944,022. The methods of position sensing described above are implemented in the above system and are described in detail in the patents cited above.

[0042] The console 24 also includes an input / output (I / O) communication interface 54 that enables the console to pass signals from the electrodes 48 and the adhesive skin patch 42 and / or pass signals to the electrodes and the adhesive skin patch. Based on the signals received from the electrodes 48 and the adhesive skin patch 42, the processor 44 can generate an electroanatomical map 56 showing the position of the distal end 26 within the patient. During the procedure, the processor 44 can present the map 56 to the medical professional 36 on the display 58 and store the data representing the electroanatomical map in the memory 60. The memory 60 can include any suitable volatile and / or nonvolatile memory, such as random access memory or a hard disk drive. In some embodiments, the medical professional 36 can manipulate the map 56 using one or more input devices 62. In an alternative embodiment, the display 58 can include a touch screen that can be configured to accept input from the medical professional 36 in addition to presenting the map 56.

[0043] In Figure 2 In the example shown, the electrode assembly 38 is configured as a basket electrode assembly having a plurality of elongate strips 70 connected at its proximal and distal ends. The basket electrode assembly 38 has an expanded configuration in which the elongate strips 70 bend radially outward; and a collapsed configuration in which the strips are generally disposed along the axis of the insertion tube 32. In some embodiments, the distance between the proximal and distal ends of the basket electrode assembly 38 can be shortened, such as by moving the pull wire 72 proximally, causing the elongate strips 70 to bend outward into the expanded configuration. During a medical procedure, the basket electrode assembly 38 can assume the expanded configuration when unconstrained (such as by being pushed out of the lumen 74 at the distal end 26).

[0044] Each given elongate strip 7 includes one or more electrodes 48. In addition to using the electrodes 48 to determine the position of the basket electrode assembly 38, the electrodes can also be used to measure physiological characteristics, such as local surface potentials at corresponding positions on the myocardial tissue 110. In additional embodiments, the electrodes 48 can be configured to deliver ablation power (e.g., radiofrequency energy) to the myocardial tissue.

[0045] Figure 3 A flowchart schematically showing a method of providing visual feedback to a medical professional 36 for guiding a balloon 38 in a heart 28 according to an embodiment of the present invention, and Figure 4Schematic illustration of an electrode 48 for engaging myocardial tissue 110 in a heart during a medical procedure, according to an embodiment of the present invention. Although the steps of the flow chart are described using a medical probe 22 including an electrode 48 mounted on a basket electrode assembly 38, any other type of medical probe including multiple electrodes capable of simultaneously measuring physiological properties at corresponding locations on the myocardial tissue 110, such as a balloon catheter, is also considered to be within the spirit and scope of the present invention.

[0046] In an insertion step 80, a medical professional 36 inserts a distal end 26 of the medical probe 22 into a chamber of the heart 28. When inserting the distal end 26 into the chamber, the medical professional 36 may deploy the balloon 38 from the lumen 72 and inflate the balloon using the embodiment described above.

[0047] In a positioning step 82, the medical professional 36 manipulates the handle 34 such that the electrode 48 at the distal end 26 engages an area 112 of the myocardial tissue 110 having an arrhythmia.

[0048] In a first receiving step 84, the processor 44 receives a first signal from at least three electrodes 48 in response to electrical activity in the myocardial tissue engaged by the electrodes. In some embodiments, the electrical activity indicates the local activation time in the myocardial tissue.

[0049] In a second receiving step 86, the processor receives a second signal indicating the respective positions of the electrodes engaging the myocardial tissue. In Figure 1 the configuration shown, the processor 44 receives a second signal from the body surface electrodes in the adhesive skin patch 42 in response to the current transmitted by the processor to the electrodes 48.

[0050] In a calculating step 88, the processor 44 processes the received second signal to calculate the respective positions of the electrodes engaging the myocardial tissue 110, and in a determining step 90, the processor determines the geometric center 114 of the calculated positions on the myocardial tissue.

[0051] In a generating step 92, the processor 44 generates an electroanatomical map 56 for the area 112 based on the received first signal and second signal, and in an identifying step 94, the processor identifies the foci of arrhythmia in the electroanatomical map. The local activation time (LAT) of the myocardial tissue can be used to identify arrhythmias, and the processor can use the LAT of the tissue to identify specific foci of arrhythmia. For example, the processor can identify the foci of focal arrhythmias as the areas of arrhythmic tissue having the lowest LAT; and the foci of rotors can be identified as the areas of arrhythmic tissue around which the LAT values rotate. Implementing this embodiment using other methods available to the processor 44 to identify the foci of arrhythmia is also considered to be included within the scope of the present invention.

[0052] In a first rendering step 96, the processor 44 renders a circle on the display 58, and in a second rendering step 98, the processor renders within the circle a region of an electroanatomical map that includes a geometric center and a focus of arrhythmia such that the geometric center on the electroanatomical map is aligned with the center of the circle.

[0053] as described below Figure 5 As shown in FIGS. 6-9, the region of the electroanatomical map rendered within the circle indicates the spatial relationship between the geometric center and the focus of arrhythmia. In some embodiments, the processor 44 may render the spatial relationship by plotting local activation time values relative to their corresponding positions.

[0054] Figure 5 FIG. 10 is a schematic illustration of an electroanatomical map 56 rendered on the display 58 according to a first embodiment of the present invention. In the first embodiment of the present invention, the processor 44 renders the electroanatomical map 56 in a first window 120 on the display 58 and renders a circle 122 in a second window 124. The circle 122 corresponds to the region of the electroanatomical map 56 such that the center 126 of the circle 122 is aligned with the geometric center 128 of the arrhythmia 130. In some embodiments, the processor 44 may render a visual indicator 132 (e.g., an icon) that corresponds to the location of the focus 136 of the arrhythmia and indicates the spatial relationship between the geometric center 128 and the focus of the arrhythmia. In an embodiment of the present invention, the processor 44 may render the spatial relationship as a “bull's-eye” that indicates the distance 134 between the visual indicator 132 (which corresponds to the focus 136) and the center of the circle 126 (which corresponds to the geometric center 128).

[0055] In an embodiment of the present invention, the processor 44 may render the map 56 at a first resolution and render the circle 122 that includes the region of the myocardial tissue with arrhythmia at a second resolution that is greater than the first resolution. Rendering the region of the myocardial tissue with arrhythmia at a higher resolution (and thus rendering the region with arrhythmia in more detail) may assist the medical professional 36 in positioning the electrode 48 at an appropriate location for treating the arrhythmia 130.

[0056] Figure 6 FIG. 17 is a schematic illustration of an electroanatomical map 56 rendered on the display 58 according to a second embodiment of the present invention. In the second embodiment of the present invention, the processor 44 renders the electroanatomical map 56 on the display 58 and superimposes the circle 122 and the visual indicator 132 on the electroanatomical map 56 such that the circular center 126 is aligned with the geometric center 128 and the visual indicator 132 is aligned with the arrhythmia focus 136.

[0057] In a third embodiment, the processor 44 may combine the first and second embodiments described above by presenting the circle 122 and the visual indicator 132 in the window 124, presenting the electroanatomical map 56 in the window 120, and overlaying the circle and the visual indicator on the electroanatomical map.

[0058] In Figure 5 (and Figure 6 through FIG. 9) of the example presented, the geometric center 128 is adjacent to the focus 136, and the processor 44 may present the visual indicator 132 within the circle 122. However, if the geometric center 128 is not adjacent to the focus 136, the processor 44 may present the visual indicator 132 outside the circle 122.

[0059] Returning to the flowchart, in decision step 100, if the healthcare professional 36 observes that the ablated focus is not centered within the circle (e.g., as shown in Figure 5 , Figure 6 , Figure 7A , Figure 8A , and Figure 9A ), then the healthcare professional relocates the distal end 26 in relocation step 102, and the method continues to step 84. If the healthcare professional 36 observes that the ablated focus is centered within the circle (e.g., as shown in Figure 7B , Figure 8B , and Figure 9B ), then the method ends. In some cases, the healthcare professional may instruct the console 24 to deliver ablation power (e.g., radiofrequency energy) to the electrode 48 in order to ablate the region of myocardial tissue including the arrhythmia.

[0060] Figure 7A and Figure 7B (also collectively referred to herein as FIG. 7) are schematic diagrams of the circle 122 and the visual indicator 132 for an arrhythmia 130 including a focal arrhythmia according to an embodiment of the present invention. In Figure 7A , the visual indicator 132 is not aligned with the center of the circle 126, indicating that the geometric center 128 is not aligned with the focus 136. In Figure 7B , the visual indicator 132 is aligned with the center of the circle 126 (i.e., overlaps), indicating that the geometric center 128 is aligned with the focus 136.

[0061] Figure 8A and Figure 8B (also collectively referred to herein as FIG. 8) are schematic diagrams of the circle 122 and the visual indicator 132 for an arrhythmia 130 including a rotor arrhythmia having a single focus 136 according to an embodiment of the present invention. In Figure 8A and Figure 8BIn the example presented, arrow 140 indicates the path of the arrhythmia from focus 136 in myocardial tissue 110. In Figure 8A , visual indicator 132 is not aligned with the center point 126, thereby indicating that geometric center 128 is not aligned with focus 136. In Figure 8B , visual indicator 132 is aligned (i.e., overlaps) with the center point 126, thereby indicating that geometric center 128 is aligned with focus 136.

[0062] Figure 9A And Figure 9B (collectively referred to herein as FIG. 9 as well) are schematic diagrams of circle 122 and visual indicator 132 for arrhythmia 130 including a rotor arrhythmia having two foci 136 according to an embodiment of the present invention. In Figure 9A And Figure 9B In the example presented, arrows 150 and 152 indicate the paths of the arrhythmias from the respective foci 136 in myocardial tissue 110. In Figure 9A , visual indicator 132 is not aligned with the center point 126, thereby indicating that geometric center 128 is not aligned with focus 136. In Figure 9B , visual indicator 132 is aligned (i.e., overlaps) with the center point 126, thereby indicating that geometric center 128 is aligned with focus 136.

[0063] Although the description refers to Figure 5 , Figure 6 , FIG. 7, FIG. 8, and FIG. 9 for the processor 44 to present circle 122 on the display 58, any type of oval shape presenting the area corresponding to the mapping diagram 56 is also considered to be within the spirit and scope of the present invention.

[0064] It should be understood that the above embodiments are cited by way of example, and the present invention is not limited to what is specifically shown and described above. Instead, the scope of the present invention includes combinations and sub - combinations of the various features described above, as well as their variations and modifications, which would occur to those skilled in the art upon reading the above description and which are not disclosed in the prior art.

Claims

1. An apparatus for guiding the distal end of a medical probe, comprising: An intracardiac catheter configured to be inserted into a cardiac chamber; A plurality of electrodes attached to the distal end of the intracardiac catheter; A display; And A processor configured to: Receive, from the intracardiac catheter inserted into a given cardiac chamber, a first signal from at least three of the electrodes responsive to electrical activity in myocardial tissue in contact with the at least three electrodes; Receive a second signal indicative of respective position coordinates of the at least three electrodes within the heart; Process the second signal to calculate the respective position coordinates of the at least three electrodes and determine a geometric center of the position coordinates of the at least three electrodes; Generate an electroanatomical map of a region of the myocardial tissue including the determined geometric center based on the first signal and the second signal; Determine a focus of arrhythmia in the region of the myocardial tissue in the map; Present a circle on the display; And Present, within the circle, a region of the map including the geometric center and the focus of the arrhythmia such that the geometric center on the map is aligned with the center of the circle, wherein the region of the map presented within the circle indicates a spatial relationship between the geometric center and the focus of the arrhythmia.

2. The apparatus according to claim 1, wherein the electrical activity includes local activation time values.

3. The apparatus according to claim 2, wherein the processor is configured to present the region of the map through the focus of the arrhythmia includes plotting a graph of the local activation time values relative to their respective positions.

4. The apparatus according to claim 1, wherein the arrhythmia includes a rotor having at least one focus.

5. The apparatus according to claim 1, wherein the arrhythmia includes focal arrhythmia.

6. The apparatus according to claim 1, wherein the processor is configured to present the region of the map including the geometric center by presenting an icon at a position within the circle corresponding to the position of the focus of the arrhythmia relative to the geometric center.

7. The apparatus according to claim 1, wherein the processor is configured to present the circle and the region of the map by superimposing the circle on the electroanatomical map.

8. The apparatus according to claim 1, wherein the processor is further configured to present, within the circle, a path of the arrhythmia from the focus of the arrhythmia.

9. The apparatus according to claim 1, wherein the intracardiac catheter includes a balloon catheter.

10. The apparatus according to claim 1, wherein the intracardiac catheter includes a basket catheter.

11. The apparatus according to claim 1, wherein the processor is configured to generate the electroanatomical map by presenting the map on the display at a first resolution, and wherein the processor is configured to present the region by presenting the region at a second resolution greater than the first resolution.

12. A computer software product for operating in conjunction with an intracardiac catheter having a distal end including a plurality of electrodes, the product comprising a non-transitory computer-readable medium storing program instructions which, when read by a computer, cause the computer to: Receive, from the intracardiac catheter positioned within a subject's heart, a first signal from at least three of the electrodes responsive to electrical activity in myocardial tissue in contact with the at least three of the electrodes; Receive a second signal indicating respective position coordinates of the at least three electrodes within the heart; Process the second signal to calculate the respective position coordinates of the at least three electrodes and determine a geometric center of the position coordinates of the at least three electrodes; generate an electroanatomical map of a region of the myocardial tissue including the determined geometric center based on the first signal and the second signal; Determine a focus of arrhythmia in the region of the myocardial tissue in the map; Present a circle on a display; And Present, within the circle, a region of the map including the geometric center and the focus of the arrhythmia such that the geometric center on the map is aligned with the center of the circle, wherein the region of the map presented within the circle indicates a spatial relationship between the geometric center and the focus of the arrhythmia.

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