Visual route indication of excitement clusters

Abstract

The present invention is entitled "Visual Route Indication of Excitation Clusters." Disclosed herein are methods, devices, and systems for medical procedures, and the methods, devices, and systems include receiving first electrical activity at a first time at a plurality of points on a surface of an internal body. Identifying a first cluster of points from the plurality of points based on the first electrical activity, each of the first cluster of points exhibiting electrical activity above an activity threshold. Receive second electrical activity at a second time at a plurality of points on the surface of the internal body. Identifying a second cluster of points from the plurality of points based on the second electrical activity. Determining that the first cluster of points and the second cluster of points are related based on a propagation threshold. Providing a first visual indication of a first propagation route from the first cluster of points to the second cluster of points.

Description

Technical Field

[0001] The present application provides systems, devices, and methods for improving in vivo visualization. Background Art

[0002] Medical conditions such as cardiac arrhythmias, such as atrial fibrillation (AF), are often diagnosed and treated through in vivo procedures. For example, pulmonary vein isolation (PVI) from the body of the left atrium (LA) is performed using ablation to treat AF. Pulmonary vein isolation and many other minimally invasive catheterization procedures require real-time visualization and mapping of in vivo surfaces.

[0003] Visualization and mapping of in vivo signals and / or body parts can be performed by mapping the propagation of activation waves. Fluoroscopy, computerized tomography (CT), and magnetic resonance imaging (MRI), among other techniques, may require a greater than desired amount of time or resources to provide visualization and mapping.

[0004] Traditionally, medical professionals can manually identify electrical activity based on visually observing changes in electrical activity. However, such manual identification can be time-consuming and / or inefficient in other respects. Summary of the Invention

[0005] Disclosed herein are methods, devices, and systems for medical procedures, including receiving first electrical activity at a first time at a plurality of points on a surface within an internal body. Based on the first electrical activity, identifying a first cluster of points from the plurality of points, each of the first cluster of points exhibiting electrical activity above an activity threshold. Receive second electrical activity at a second time at a plurality of points on the surface within the internal body. Based on the second electrical activity, identifying a second cluster of points from the plurality of points. Determining, based on a propagation threshold, that the first cluster of points is related to the second cluster of points. Providing a first visual indication of a first propagation path from the first cluster of points to the second cluster of points. BRIEF DESCRIPTION OF THE DRAWINGS

[0006] A more detailed understanding may be obtained from the following description given by way of example with reference to the accompanying drawings, in which:

[0007] Figure 1 is an illustration of an exemplary system in which one or more features of the disclosed subject matter may be implemented;

[0008] Figure 2 It is a diagram of clusters of points used to identify organs in the body;

[0009] Figure 3 is a flow chart used to provide a visual indication of the route of transmission;

[0010] Figure 4A It is a diagram of the internal organs at the first moment;

[0011] Figure 4B yes Figure 4A Diagram of internal organs in the second time;

[0012] Figure 4C yes Figure 4A Diagram of the internal organs in the third time;

[0013] Figure 5A It is a diagram of another internal organ in the first place;

[0014] Figure 5B yes Figure 5A Diagram of internal organs in the second time;

[0015] Figure 5C yes Figure 5A Diagram of the internal organs in the third time;

[0016] Figure 5D yes Figure 5A A graphic representation of an internal organ at a second time with ripple electrical activity indication;

[0017] Figure 6A It is a diagram of another internal organ at the first time;

[0018] Figure 6B yes Figure 6A a diagram of the internal organs of the person at the second time; and

[0019] Figure 6C yes Figure 6A Illustration of internal organs in third time. DETAILED DESCRIPTION

[0020] According to an exemplary embodiment of the present invention, electrical propagation through an internal organ (e.g., the heart) can be sensed, and the propagation path based on the electrical activity can be visually displayed. Based on the technology disclosed herein, the electrical activity of clusters of points can be sensed at different times. The propagation path of the electrical activity based on one or more clusters of points can be determined based on properties such as elapsed time and the propagation speed of the electrical activity.

[0021] A cluster of points may be determined based on the electrical activity of a plurality of points being within a threshold proximity relative to one another. The threshold proximity may be, for example, 3 mm, or more generally, may be in the single digit millimeter range. For example, a first cluster of points may be determined based on a plurality of points exhibiting electrical activity above a threshold value of activity. The points in the first cluster of points may each be within a threshold proximity of at least one other electrically active point such that any outlier point that is greater than the threshold proximity to each of the other active points is not part of the first cluster of points. Notably, the threshold proximity as applied herein may not be a predetermined area of ​​an organ within the body, but rather may be a distance applied to each electrically active point on the organ within the body at a given time in order to determine the location of one or more clusters of points.

[0022] The electrical propagation of a cluster of points can be determined based on the movement of electrical activity within an internal organ after a given amount of elapsed time. The electrical propagation of a cluster of points can be visually provided, for example, by an arrow superimposed on a rendering of the internal organ, the arrow extending from a given cluster of points at a first time to a given cluster of points at a second time. A cluster of points can propagate along a route for a period of time, can split into two or more clusters of points, or can dissipate after a period of time.

[0023] The technology provided herein can allow for the visual representation of electrical propagation of clusters of points, allowing for the automatic clustering of electrical points on internal organs and for their electrical propagation to be automatically identified and visually represented for efficient medical analysis and use. Such visual representations can allow for a more efficient understanding of the electrical activity of internal organs and can speed up analysis and procedure times.

[0024] Figure 1 is an illustration of an exemplary mapping system 20 that may implement one or more features of the presently disclosed subject matter. The mapping system 20 may include a device, such as a catheter 40, configured to obtain electrical activity data according to exemplary embodiments of the present invention. Although the catheter 40 is shown as having a basket shape, it should be understood that any shape of catheter including one or more elements (e.g., electrodes) may be used to implement the exemplary embodiments disclosed herein. The mapping system 20 includes a probe 21 having an axis 22 that can be navigated by a medical professional 30 to a body part, such as a heart 26, of a patient 28 lying on a table 29. As shown in FIG. Figure 1 As shown, a medical professional 30 can insert the shaft 22 through the sheath 23 while manipulating the distal end of the shaft 22 using a manipulator 32 near the proximal end of the catheter and / or deflected from the sheath 23. As shown in inset 25, a catheter 40 can be mounted at the distal end of the shaft 22. The catheter 40 can be inserted through the sheath 23 in a collapsed state and can then be deployed within the heart 26.

[0025] According to an exemplary embodiment of the present invention, a catheter 40 can be configured to obtain electrical activity within a chamber of the heart 26. Illustration 45 shows the catheter 40 in a magnified view within a chamber of the heart 26. As shown, the catheter 40 can include an array of elements (e.g., electrodes 48) coupled to a key tooth that forms the shape of the catheter 40. The elements (e.g., electrodes 48) can be any elements configured to obtain biometric data and can be electrodes, transducers, or one or more other elements. It should be understood that although one catheter 40 is shown, multiple catheters can be used to collect electrical activity from organs within the body.

[0026] According to the exemplary embodiments disclosed herein, electrical activity can be any applicable electrical signal that can be measured based on one or more thresholds and can be sensed and / or enhanced based on signal-to-noise ratio and / or other filters. A catheter, such as catheter 40, can also be configured to sense additional biometric data in addition to electrical activity. This additional biometric data can include one or more of local activation time (LAT), topology, bipolar mapping, dominant frequency, impedance, and the like. Local activation time can be a time point corresponding to a threshold activity of local activation, calculated based on a normalized initial starting point. Topology can correspond to the physical structure of a body part or a portion of a body part, and can correspond to variations in the physical structure relative to different parts of the body part or relative to different body parts. Dominant frequency can be a frequency or frequency range that is prevalent in a portion of a body part and can vary in different parts of the same body part. For example, the dominant frequency of the pulmonary veins of a heart can be different from the dominant frequency of the right atrium of the same heart. Impedance can be a measurement of electrical resistance at a given region of a body part and can be calculated as an independent value based on frequency and / or incorporating additional considerations such as blood concentration.

[0027] like Figure 1 As shown, the probe 21 and the catheter 40 can be connected to the console 24. The console 24 can include a processor 41 (such as a general purpose computer) having a suitable front end and interface circuitry 38 for transmitting and receiving signals to and from the catheter 40, and for controlling other components of the mapping system 20. In some exemplary embodiments of the invention, the processor 41 can also be configured to receive electrical activity data, assign clusters of points at different times, and provide visual indications from a first cluster of points to an associated second cluster of points. According to an exemplary embodiment of the invention, the rendering data can be used to provide a rendering of one or more body parts (e.g., a body part rendering 35) to the medical professional 30 on the display 27. According to an exemplary embodiment of the invention, the processor can be located external to the console 24 and can be located, for example, in the catheter, in an external device, in a mobile device, in a cloud-based device, or can be a stand-alone processor.

[0028] As described above, the processor 41 may comprise a general purpose computer that may be programmed with software to perform the functions described herein. The software may be downloaded to the general purpose computer in electronic form, for example, over a network, or may alternatively or additionally be provided and / or stored on a non-transitory tangible medium, such as magnetic, optical, or electronic memory. Figure 1The exemplary configuration shown in FIG can be modified to implement the embodiments disclosed herein. The exemplary embodiments disclosed herein can similarly be applied using other system components and configurations. In addition, the mapping system 20 can include additional components, such as elements for sensing biometric patient data, wired or wireless connectors, processing and display devices, etc.

[0029] According to an exemplary embodiment of the present invention, the display connected to the processor (e.g., processor 41) can be located at a remote location, such as at a separate hospital or within a separate healthcare provider network. Additionally, the mapping system 20 can be part of a surgical system configured to obtain anatomical and electrical measurements of an organ (such as the heart) of a patient and to perform a cardiac ablation procedure. An example of such a surgical system is sold by Biosense Webster. system.

[0030] The mapping system 20 may also and optionally use ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), or other medical imaging techniques known in the art to obtain biometric data, such as anatomical measurements of the patient's heart. The mapping system 20 may use a catheter, electrocardiogram (EKG), or other sensor that measures electrical properties of the heart to obtain electrical measurements. Figure 1 As shown, the biometric data, including the anatomical and electrical measurements, can then be stored in a local memory 42 of the mapping system 20. It is noteworthy that the memory 42 can simultaneously store biometric data of multiple different modalities. The biometric data can be transmitted from the memory 42 to the processor 41. Alternatively or in addition, the biometric data can be transmitted to a server 60, which can be local or remote, using a network 62.

[0031] The network 62 can be any network or system known in the art, such as an intranet, a local area network (LAN), a wide area network (WAN), a metropolitan area network (MAN), a direct connection or a series of connections, a cellular telephone network, or any other network or medium capable of facilitating communication between the mapping system 20 and the server 60. The network 62 can be wired, wireless, or a combination thereof. A wired connection can be achieved using Ethernet, a universal serial bus (USB), RJ-11, or any other wired connection known in the art. A wireless connection can be achieved using Wi-Fi, WiMAX, and Bluetooth, infrared, cellular networks, satellite, or any other wireless connection method known in the art. In addition, several networks can work alone or communicate with each other to facilitate communication in the network 62.

[0032] In some cases, server 60 may be implemented as a physical server. In other cases, server 60 may be implemented as a server hosted by a public cloud computing provider (e.g., Amazon Web Services). virtual server.

[0033] Console 24 may be connected to body surface electrodes 43, which may include adhesive skin patches attached to patient 28, via cables 39. A processor, in conjunction with a current tracking module, may determine the position coordinates of catheter 40 within a body part of the patient, such as heart 26. The position coordinates may be based on impedance or electromagnetic fields measured between electrode 43 and electrode 48 or other electromagnetic components of catheter 40.

[0034] The processor 41 may include real-time noise reduction circuitry, typically configured as a field programmable gate array (FPGA), followed by an analog-to-digital (A / D) ECG (electrocardiogram) or EMG (electromyogram) signal conversion integrated circuit. The processor 41 may pass signals from the A / D ECG or EMG circuitry to another processor and / or may be programmed to perform one or more functions disclosed herein.

[0035] Console 24 may also include an input / output (I / O) communication interface that enables the console to transmit signals from and / or to electrodes 48 and 43. Based on the signals received from electrodes 48 and / or 43, processor 41 may generate rendering data that enables a display (such as display 27) to render a body part (such as body part rendering 35) and biometric data of multiple modalities as part of body part rendering 35.

[0036] During a procedure, the processor 41 can facilitate presentation of a body part rendering 35 including one or more clusters of points that are active at a given time. The processor 41 can identify one or more clusters at a given time and one or more other related or unrelated clusters at a subsequent time. The processor 41 can also determine a propagation route based on two or more related clusters of points and provide a visual indication of the propagation route accordingly. The electrical activity can be stored in the memory 42, and the processor 41 can access the electrical activity stored in the memory 42 to determine the point clusters and corresponding propagation routes. The propagation routes can be provided to the medical professional 30 on the display 27.

[0037] Memory 42 may include any suitable volatile and / or non-volatile memory, such as random access memory or a hard disk drive. In some exemplary embodiments of the present invention, healthcare professional 30 is able to manipulate body part rendering 35 using one or more input devices (such as a touchpad, mouse, keyboard, gesture recognition device, etc.). In an alternative exemplary embodiment of the present invention, display 27 may include a touchscreen that may be configured to accept input from healthcare professional 30 in addition to presenting body part rendering 35 (including propagation routes).

[0038] Figure 2 The surface of an intracorporeal chamber 200 (e.g., a ventricle) at a first time is shown, which includes a plurality of active points 201 and inactive points 202 as shown in legend 250. Each of the active points 201 and inactive points 202 may be a point on the surface of intracorporeal chamber 200 where an EGM signal is sensed. The EGM signal may be sensed by a catheter (such as Figure 1 catheter 40), and more specifically by an electrode on the catheter (such as Figure 1 electrode 48). Active points 201 correspond to points on intracorporeal chamber 200 where the EGM signal voltage is greater than an activity threshold. Inactive points 202 correspond to points on intracorporeal chamber 200 where the EGM signal voltage is lower than the activity threshold. The activity threshold may be, for example, 0.05 mV, such that an EGM signal voltage greater than or equal to 0.05 mV corresponds to an active point 201, and an EGM signal voltage less than 0.05 mV corresponds to an inactive point 202. The activity threshold may be pre-determined or may be determined dynamically based on an analysis of EGM signals from multiple points on intracorporeal chamber 200. After applying one or more applicable filters such as a signal-to-noise ratio-based filter, a high-pass filter, a low-pass filter, etc., the EGM signal voltage at points on intracorporeal chamber 200 may be compared with the activity threshold.

[0039] As Figure 2 shown, one or more point clusters may be determined based on the relative distances between active points 201. A first point cluster 210 may be determined based on each of the active points 201a to 201f that are within a threshold proximity D1 of each other (i.e., <D1). For example, D1 may be 3 mm. An example of an active point within a threshold proximity D1 of another point is shown between active points 201a and 201b, where the distance between active points 201a and 201b <D1. Another example of an active point within a threshold proximity D1 of another point is shown between active points 201b and 201c, where the distance between active points 201b and 201c <D1. It should be noted that although a point cluster (e.g., point cluster 210) is shown as a boundary (e.g., indicating point cluster 210 of Figure 2a dashed circle), but the point cluster is a set of points rather than a predefined shape. Thus, while the point cluster may be referred to herein as a plurality of active points within a certain shape (e.g., a circle), such reference is provided for simplicity only.

[0040] Outlier active points 201g and 201h may be at a distance greater than a threshold proximity D1 from each of the active points 201a to 201f, and thus may not be part of the first point cluster 210. Figure 2 An exemplary distance greater than D1 between outlier active point 201g and the nearest active point 201a within the first point cluster 210 is shown.

[0041] Similarly, as Figure 2 shown, a second point cluster 220 may be determined based on each of the active points 201i to 201m that are within a threshold proximity D1 of each other (i.e., < D1). Outlier active points 201n and 201p may be at a distance greater than the threshold proximity D1 from each of the active points 201i to 201m, and thus may not be part of the second point cluster 220.

[0042] According to an exemplary embodiment of the present invention, a density-based spatial clustering of applications with noise (DBSCAN) algorithm may be used to determine one or more point clusters. The DBSCAN algorithm is a density-based clustering non-parametric algorithm such that a set of points in a given space (e.g., a body cavity), i.e., points that are dense together (e.g., points having a plurality of nearby neighboring points within a threshold proximity) are grouped into point clusters. Outlier points that are located alone in a low-density region (i.e., whose nearest neighboring points are very far away) are not included in the point clusters.

[0043] According to an exemplary embodiment of the present invention, outlier points such as outlier active points 201g, 201h, 201n, and 201p may be grouped into a separate point cluster provided that they are within a threshold proximity D1 of each other.

[0044] Figure 3 A process flow diagram 300 for providing a visual indication of a second correlated point cluster at a second time from a first point cluster at a first time is shown.

[0045] In Figure 3 step 310 of the process shown, a first electrical activity of a plurality of points on a body surface may be received at a first time. The first electrical activity may be received by using an electrogram (EGM) signal collected by one or more catheters (e.g., Figure 1 catheter 40) including one or more electrodes (e.g., Figure 1 electrode 48). The electrical activity may be the magnitude of the voltage passing through a plurality of active points at the first time. The first electrical activity of the plurality of points at the first time may be stored in a memory (e.g., Figure 1's memory 42) and can be received by a processor (e.g., processor 41).

[0046] exist Figure 3 At step 320 of the process shown, the process may be performed according to the techniques described herein (including reference to Figure 2 A first cluster of points is identified from a plurality of points. The first cluster of points may each exhibit electrical activity above an activity threshold. For example, a first cluster of points may be identified such that each point within the first cluster that exhibits electrical activity above the activity threshold is within a proximity threshold (e.g., Figure 2 The distance is determined as the outlier point (e.g. Figure 2 The outlier points 201g, 201h, 201n and 201p) may not be included in the first point cluster. Figure 3 The process is shown to identify a first point cluster at a first time, but multiple point clusters may be identified at a first time, as further disclosed herein.

[0047] exist Figure 3 At step 330 of the process shown, second electrical activity at a plurality of points on the internal body surface may be received at a second time. The second electrical activity at the plurality of points at the second time may be specific to the second electrical activity at the internal body surface. Figure 3 The plurality of points that may be the same as those points exhibiting electrical activity at step 310 may be received, or may be different from (e.g., a subset of, overlapping with, or completely different from) the plurality of points at step 330. This may be accomplished by using a device comprising one or more electrodes (e.g., Figure 1 of electrodes 48) of one or more catheters (e.g. Figure 1 The second electrical activity is received by collecting the EGM signal of the catheter 40. The electrical activity may be the amplitude of the voltage passing through the plurality of points at the second time. The second electrical activity of the plurality of points at the second time may be stored in a memory (e.g. Figure 1 's memory 42) and can be received by a processor (e.g., processor 41).

[0048] exist Figure 3 At step 340 of the process shown, the process may be performed according to the techniques described herein (including reference to Figure 2 A second cluster of points is identified from the plurality of points based on the second electrical activity. The second cluster of points can each exhibit electrical activity above an activity threshold. For example, the second cluster of points can be identified such that each point within the second cluster of points exhibiting electrical activity above the activity threshold has a threshold proximity (e.g., Figure 2 The distance is determined to be an outlier point (e.g. Figure 2The outlier points 201g, 201h, 201n and 201p) may not be included in the second point cluster. Figure 3 The process is shown to identify a second cluster of points at a second time, but multiple clusters of points may be identified at the second time, as further disclosed herein.

[0049] exist Figure 3 At step 350 of the illustrated process, a determination can be made that the first cluster of points is related to the second cluster of points based on a propagation threshold. The propagation threshold can be a distance determined based on a propagation speed and a duration (i.e., subtracting the second time from the first time). Thus, the first cluster of points and the second cluster of points can be determined to be related based on whether the second cluster of points is within the propagation threshold distance from the first cluster of points. For example, if the propagation speed is 2 μm / millisecond and the difference between the second time and the first time is 3 milliseconds, then the propagation speed (i.e., 2 μm / millisecond) multiplied by the duration (i.e., 3 milliseconds) yields a propagation threshold of 6 μm.

[0050] According to an exemplary embodiment of the present invention, the propagation speed and, therefore, the corresponding propagation threshold may be predetermined. The predetermined propagation speed may be stored in, for example, a memory (e.g. Figure 1 42), and is a processor (e.g. Figure 1 A processor (eg, processor 41) may multiply the stored predetermined propagation speed by the time difference to determine a propagation threshold applicable to two or more point clusters at two or more times.

[0051] According to another exemplary embodiment of the present invention, the propagation velocity, and therefore the corresponding propagation threshold, may be determined dynamically. The dynamically determined propagation velocity may be based on any number of applicable factors, such as, but not limited to, tissue thickness, a particular internal organ (e.g., the heart), a particular portion of an internal organ (e.g., a ventricle or vein), a medical condition, patient characteristics, etc. For example, a processor (e.g., Figure 1 The processor 41 may receive and / or access one or more variables (eg, tissue thickness, specific internal organs, etc.) and may determine a propagation velocity based on the one or more variables.

[0052] According to other exemplary embodiments of the present invention, the propagation threshold may be determined based on factors other than propagation velocity or factors in combination with propagation velocity. Such factors may include, but are not limited to, surface topography, historical data (e.g., historical data stored in a memory), and the like.

[0053] exist Figure 3At step 350 of the illustrated process, a determination can be made that a first cluster of points at a first time is correlated with a second cluster of points at a second time based on determining whether a distance between the first cluster of points and the second cluster of points is within a propagation threshold. The distance between the first cluster of points and the second cluster of points can be measured from a first point within an area occupied by the first cluster of points and a second point within an area occupied by the second cluster of points.

[0054] According to an exemplary embodiment of the present invention, the first point and / or the second point may be the center of the first point cluster and the second point cluster, respectively. The center of the point cluster may be determined by averaging the physical position of each point within the point cluster. For example, the point cluster may have three points, and each of the three points may have corresponding X, Y, and Z coordinates. The coordinates of the first point may be X1, Y1, and Z1, the coordinates of the second point may be X2, Y2, and Z2, and the coordinates of the third point may be X3, Y3, and Z3. The center of the point cluster may be determined by (X1+X2+X3) / 3, (Y1+Y2+Y3) / 3, (Z1+Z2+Z3) / 3.

[0055] According to another exemplary embodiment of the present invention, the first point and / or the second point can be determined by assigning weights to one or more points within a point cluster. For example, one or more weights can be assigned to one or more points within a point cluster based on the voltage corresponding to each point. Points within a point cluster can have higher weights based on exhibiting higher relative voltages, and similarly, points within a point cluster can have lower weights based on exhibiting lower relative voltages. The voltage-based weights can be relative to a predetermined voltage or based on a dynamically determined voltage based on different voltage values ​​for each point within the point cluster.

[0056] The relationship between a first cluster of points at a first time and a second cluster of points at a second subsequent time may indicate that electrical activity within the internal organ is propagating from the first cluster of points to the second cluster of points.

[0057] exist Figure 3 At step 360 of the illustrated process, a visual indication of one or more propagation routes from a first cluster of points at a first time to a related second cluster of points at a second time may be provided. The visual indication may be any suitable visual indication, such as an arrow, highlighting of points within a cluster of points, a change in color or pattern, etc. The visual indication may identify the propagation routes of the electrical activity within the internal organ, such that the visual indication identifies the direction and distance of the change in electrical activity.

[0058] Figure 4A 、 Figure 4B and Figure 4C An internal organ 400 is shown, wherein there are a first point cluster 410a at a first time T1, a second related point cluster 410b at a second time T2, and a related third point cluster 410c at a third time T3. Each point cluster includes Figure 4A 、 Figure 4B and Figure 4C 4. It should be noted that for simplicity, inactive points on the surface of the internal organ 400 are not shown. The first point cluster 410a includes active points that are within a threshold proximity of at least one other active point within the first point cluster 410a. Similarly, the second point cluster 410b and the third point cluster 410c include active points that are within a threshold proximity of at least one other active point within the respective second point clusters 410b and third point clusters 410c.

[0059] like Figure 4A As shown, the center point 414 is the center of the first point cluster 410a. Figure 4B As shown, the center point 416 is the center of the second point cluster 410b. Figure 4C As shown, center point 418 is the center of third point cluster 410c. Figure 4A 、 Figure 4B and Figure 4C The three point clusters 410a, 410b, and 410c may be correlated such that the first point cluster 410a and the second point cluster 410b may be within a propagation threshold of each other, and such that the second point cluster 410b and the third point cluster 410c may be within a propagation threshold of each other. For example, the propagation threshold may be based on a propagation speed of 4 μm / millisecond, the duration between T1 and T2 may be 2 milliseconds, and the duration between T2 and T3 may be 3 milliseconds. Thus, the propagation threshold between the first point cluster 410a at time T1 and the second point cluster 410b at time T2 may be 8 μm (i.e., 2 milliseconds (T2-T1) multiplied by the propagation speed of 4 μm / millisecond), and the propagation threshold between the second point cluster 410b at time T1 and the third point cluster 410c at time T3 may be 12 μm (i.e., 3 milliseconds (T2-T1) multiplied by the propagation speed of 4 μm / millisecond). According to Figure 4A 、 Figure 4B and Figure 4C In the example shown, center 416 of second point cluster 410b may be within 8 μm of center 414 of first point cluster 410a, and therefore first point cluster 410a and second point cluster 410b may be related. Similarly, center 418 of third point cluster 410c may be within 12 μm of center 416 of second point cluster 410b, and therefore second point cluster 410b and third point cluster 410c may be related. According to an exemplary embodiment of the present invention, based on the common relationship between the first and third point clusters and the second point cluster, the third point cluster may also be related to the first point cluster.

[0060] like Figure 4BAs shown, a visual indication 430a is provided from the center 414 of the first point cluster 410a to the center 416 of the second point cluster 410b. It is worth noting that the visual indication 430a is provided based on determining that the first point cluster 410a and the second point cluster 410b are related. Similarly, as Figure 4C As shown, a visual indication 430b is provided from the center 416 of the second cluster 410b to the center 418 of the third cluster 410c. It is worth noting that the visual indication 430b is provided based on determining that the second cluster 410b and the third cluster 410c are related. According to one embodiment, Figure 4A 、 Figure 4B and Figure 4C The illustrated centers 414, 416, and 418 may not be rendered on a display, but may be used to determine the location of a visual indication, such as visual indication 430a and / or visual indication 430b.

[0061] According to an exemplary embodiment of the present invention, a point cluster may be determined to be unrelated to a previously identified point cluster. For example, a first point cluster may be identified at a first time, and a second point cluster may be identified at a second time. However, the second point cluster may have a center point located at a distance greater than a propagation threshold distance. Consequently, it may not be determined that the first point cluster and the second point cluster are related, resulting in no visual indication of the propagation path from the first point cluster to the second point cluster.

[0062] For clarity, two uncorrelated clusters of points at two different times may correspond to uncorrelated electrical activities. Figure 5A 、 Figure 5B and Figure 5C Examples of uncorrelated clusters of points are included so that uncorrelated electrical activity can exist within in vivo organs.

[0063] Figure 5A 、 Figure 5B and Figure 5C An internal organ 500 is shown, which includes a first point cluster 510a at a first time T4, a related second point cluster 510b (i.e., related to the first point cluster 510a) and an unrelated third point cluster 510d (i.e., unrelated to the first point cluster 510a) at a second time T5, and a related fourth point cluster 510c (i.e., related to the second point cluster 510b) and a related fifth point cluster 510e (i.e., related to the third point cluster 510d) at a third time T6. Each point cluster includes active points 512a, 512b, 512c, 512d, and / or 512e. It should be noted that for simplicity, inactive points on the surface of the internal organ 500 are not shown. Figure 5A 、 Figure 5B and Figure 5C Each point cluster shown in includes an active point within a threshold proximity of at least one other active point within the corresponding point cluster.

[0064] like Figure 5A As shown, the center point 514 is the center of the first point cluster 510a. Figure 5B As shown, center point 516 is the center of the second point cluster 510b, and center point 520 is the center of the third point cluster 510c. Figure 5C As shown, the center point 518 is the center of the fourth point cluster 510c and the center point 522. It is worth noting that the first point cluster 510a at the first time T4 and the third point cluster 510d at the second time T5 may be unrelated. For example, the distance between the third point cluster 510d and the first point cluster 510a may be greater than the propagation threshold, such as Figure 5B The distance in the PT1 is greater than that indicated by PT1. For example, the propagation threshold may be based on a propagation speed of 4 μm / millisecond, and the duration between T4 and T5 may be 2 milliseconds, resulting in a propagation threshold of 8 μm between T4 and T5. The center 520 of the third point cluster 510d may be greater than 8 μm (e.g., 9 μm) from the center 514 of the first point cluster 510a, so that the first point cluster 510a and the third point cluster 510d may be unrelated.

[0065] Figure 5A 、 Figure 5B and Figure 5C The point clusters 510a, 510b, and 510c may be correlated such that the first point cluster 510a and the second point cluster 510b are within a propagation threshold of each other, and such that the second point cluster 510b and the fourth point cluster 510c are within a propagation threshold of each other, as described with respect to FIG. Figure 4A 、 Figure 4B and Figure 4C As described above. In addition, the point clusters 510d and 510e can be correlated such that the third point cluster 510d and the fifth point cluster 510e can be within a propagation threshold of each other. For example, the propagation threshold can be based on a propagation speed of 4 μm / millisecond, and the duration between T5 and T6 can be 3 milliseconds (i.e., resulting in a propagation threshold of 12 μm from T5 to T6). Therefore, the center 520 of the third point cluster 510d at the second time T5 can be within 12 μm of the center 522 of the fifth point cluster 510e at the third time T6, resulting in the third point cluster 510d and the fifth point cluster 510e being correlated.

[0066] like Figure 5B As shown, a visual indication 530a is provided from the center 514 of the first point cluster 510a to the center 516 of the second point cluster 510b. Notably, no visual indication is provided between the first point cluster 510a and the third point cluster 510d because, as disclosed herein, the first point cluster 510a and the third point cluster 510d are not related (e.g., the distance between the two clusters exceeds a propagation threshold). Figure 5CAs shown, a visual indication 530b is provided from the center 516 of the second cluster 510b to the center 518 of the fourth cluster 510c. Additionally, based on the correlation between the third cluster 510d and the fifth cluster 510e, a visual indication 535a is provided from the center 520 of the third cluster 510d to the center 522 of the fifth cluster 510e. It should be noted that the direction of the visual indication 535a is in a different direction than the visual indications 530a and 530b because different areas of an organ in the body may experience electrical activity and propagation differently. Figure 5A 、 Figure 5B and Figure 5C In the example shown, visual indications 530a and 530b illustrate a first propagation route of electrical activity, and visual indication 535a illustrates a second, different propagation route of electrical activity.

[0067] Although Figure 5A 、 Figure 5B and Figure 5C Two unrelated first and third point clusters 510a and 510c are shown, but it should be noted that according to exemplary embodiments of the present invention, two or more propagation routes can originate from a common point cluster. For example, a first point cluster at a first time can be associated with two different point clusters at a second time. Thus, two different propagation routes can extend from the first point cluster (i.e., one propagation route extends to each of the two associated point clusters). Each separate propagation route can be identified by a corresponding visual indicator and can remain independent of the other propagation routes.

[0068] According to an exemplary embodiment of the present invention, Figure 5D As shown, a three-dimensional or pseudo-three-dimensional indication of electrical activity can be provided at clusters of points. Figure 5D is the same view of the internal organ 500 at a second time T5, which includes a related second point cluster 510b (i.e., related to the first point cluster 510a) and an unrelated third point cluster 510d (i.e., unrelated to the first point cluster 510a), as shown in FIG. Figure 5B shown. Figure 5D Also included are first and second bars 516a, 520a, which are indications of electrical activity at the second and third clusters 510b, 510d, respectively. Notably, an indication, such as a three-dimensional or pseudo-three-dimensional bar, can be provided via a display to indicate a cluster of points exceeding an activity threshold (e.g., the center of a cluster of points), as disclosed herein. Such indications can be provided at different times based on the corresponding clusters of points at that time. For example, over a span of three different times in which at least one cluster of points having electrical activity exceeding an activity threshold is provided, there may be at least three different indications (e.g., three-dimensional bars) originating from the center of each corresponding cluster of points. Such an indication may be present during the span of electrical activity exceeding the activity threshold for a given cluster of points, such that once electrical activity is no longer present at a given location, a given indication is no longer provided.

[0069] According to an exemplary embodiment of the present invention, one or more patterns may be identified from one or more propagation routes. Such patterns may be provided visually via visual indicators as disclosed herein. In addition, the identified patterns may be provided to medical professionals via alerts or may be stored in memory in other ways. For example, Figure 6A 、 Figure 6B and Figure 6C An internal organ 600 is shown with a first point cluster 610a at a first time T7, a related second point cluster 610b at a second time T8, and a related third point cluster 610c at a third time T9. Each point cluster includes active points 612a, 612b, and 612c. It should be noted that for simplicity, inactive points on the surface of the internal organ 600 are not shown. Figure 6A 、 Figure 6B and Figure 6C Each point cluster shown in includes active points that are each within a threshold proximity of at least one other active point within the corresponding point cluster.

[0070] like Figure 6A As shown, the center point 614 is the center of the first point cluster 610a. Figure 6B As shown, the center point 616 is the center of the second point cluster 610b. Figure 6C As shown, center point 618 is the center of third point cluster 610c. Figure 6A 、 Figure 6B and Figure 6C The three point clusters 610a, 610b, and 610c may be correlated such that the first point cluster 610a and the second point cluster 610b may be within a propagation threshold of each other, and such that the second point cluster 610b and the third point cluster 610c are within a propagation threshold of each other.

[0071] like Figure 6B As shown, a visual indication 630a may be provided from the center 614 of the first cluster 610a to the center 616 of the second cluster 610b. Figure 6C As shown, a visual indication 630b may be provided from the center 616 of the second cluster 610b to the center 618 of the third cluster 610c. Figure 6C As shown, the propagation paths indicated by the visual indications 630a and 630b create a rotor pattern, such that the propagation of the electrical activity changes direction back toward the first cluster of points 610a at the third time T9. The propagation path pattern (e.g., rotor pattern) can be identified based on one or more criteria such as shape, overlap, direction, etc. Alternatively, the propagation path pattern (e.g., rotor pattern) can be identified based on comparing the determined propagation paths (e.g., visual indications 630a and 630b) with stored propagation path patterns (e.g., stored in a memory such as Figure 1The identified propagation path pattern may be stored in a memory (e.g., memory 42) and / or provided to the medical professional via a visual alert (e.g., on a local or remote display, on a mobile device, etc.), an audible alert, a vibration, etc.

[0072] Any of the functions and methods described herein can be implemented in a general-purpose computer, a processor, or a processor core. By way of example, suitable processors include a general-purpose processor, a special-purpose processor, a conventional processor, a digital signal processor (DSP), a plurality of microprocessors, one or more microprocessors associated with a DSP core, a controller, a microcontroller, an application-specific integrated circuit (ASIC), a field-programmable gate array (FPGA) circuit, any other type of integrated circuit (IC), and / or a state machine. Such processors can be manufactured by configuring a manufacturing process using the results of a processed hardware description language (HDL) instruction and other intermediate data including a network table (such instructions can be stored on a computer-readable medium). The result of such a process can be a mask work that is subsequently used in a semiconductor manufacturing process to manufacture a processor that implements the features of the present disclosure.

[0073] Any functions and methods described herein may be implemented in a computer program, software, or firmware that is incorporated into a non-transitory computer-readable storage medium for execution by a general-purpose computer or processor. Examples of non-transitory computer-readable storage media include read-only memory (ROM), random access memory (RAM), registers, cache memory, semiconductor memory devices, magnetic media (such as internal hard disks and removable disks), magneto-optical media, and optical media (such as CD-ROMs and digital versatile disks (DVDs)).

[0074] It will be appreciated that many variations are possible based on the disclosure herein. Although features and elements have been described above in particular combinations, each feature or element can be used alone without the other features and elements, or in various combinations with or without the other features and elements.

Claims

1. A system for improving in vivo visualization, the system comprising: A probe configured to: sensing first electrical activity at a plurality of points on a surface of an internal body at a first time, and sensing second electrical activity at the plurality of points at a second time; A processor configured to: identifying a first cluster of points from the plurality of points based on the first electrical activity, the first clusters of points each exhibiting electrical activity above an activity threshold; identifying a second cluster of points from the plurality of points based on the second electrical activity, the second clusters of points each exhibiting electrical activity above the activity threshold; determining that the first cluster of points and the second cluster of points are related based on a propagation threshold, wherein the propagation threshold is based on a propagation speed multiplied by a difference between the first time and the second time; as well as Based on determining that the first cluster of points and the second cluster of points are correlated, a first visual indication of a first propagation path from the first cluster of points to the second cluster of points is provided. 2 . The system of claim 1 , wherein the first point cluster is identified based on proximity of the points in the first point cluster to each other. 3 . The system of claim 2 , wherein identifying the first point cluster is further based on identifying outliers that are more than a threshold distance from the first point cluster. 4 . The system of claim 1 , further comprising a display configured to render a first visual indication of the first propagation route. 5 . The system of claim 1 , wherein the first visual indication of the first propagation route is an arrow that originates at a center of the first cluster of points and ends at a center of the second cluster of points.

6. The system of claim 1 , wherein the probe is further configured to sense a third electrical activity at the plurality of points at a third time, and the processor is further configured to: identifying a third cluster of points from the plurality of points based on the third electrical activity, the third cluster of points each exhibiting electrical activity above the activity threshold; determining, based on the propagation threshold, that the second point cluster is related to the third point cluster; as well as Based on determining that the second point cluster and the third point cluster are correlated, a second visual indication of a second propagation route from the second point cluster to the third point cluster is provided. 7 . The system of claim 6 , wherein the processor is further configured to determine the rotor pattern based on identifying a circular pattern exhibited by the positions of the first cluster of dots, the second cluster of dots, and the third cluster of dots.

8. The system of claim 1 , wherein the probe is further configured to sense a third electrical activity at the plurality of points at a third time, and the processor is further configured to: identifying a third cluster of points from the plurality of points based on the third electrical activity, the third cluster of points each exhibiting electrical activity above the activity threshold; determining, based on the propagation threshold, that the first point cluster and the third point cluster are related; as well as Based on determining that the first point cluster and the third point cluster are correlated, a second visual indication of a second propagation route from the first point cluster to the third point cluster is provided.

9. The system of claim 8, further comprising a display configured to render a first visual indication of the first propagation route and a second visual indication of the second propagation route.

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