Ablation system with graphical user interface

Abstract

A graphical user interface (GUI) of a computer system is described herein. The graphical user interface (GUI) includes a display (e.g., a screen) that includes a first area and a second area that can be used to assist a user in performing a surgical intervention, such as a cardiac ablation procedure, using a catheter having a balloon disposed with electrodes. The first area can include menus that include dialog boxes. The second area can include an image of the balloon and representations of the electrodes. The GUI can also include a processor. The processor can be configured to, for example, receive input from the dialog boxes, change an appearance of the dialog boxes, receive input from the electrode representations, change an appearance of the electrode representations, control irrigation to the balloon, and control power to the electrodes.

Description

[0001] Cross-referencing of jointly pending applications

[0002] This patent application claims priority to U.S. Provisional Patent Application No. 62 / 869,516, filed July 1, 2019, pursuant to 35:119 of the United States Code. This application also relates to U.S. Patent Application No. 15 / 360,966, filed November 23, 2016; U.S. Patent Application No. 15 / 939,154, filed March 28, 2018; U.S. Design Patent Application No. 29 / 693,273, filed May 31, 2019; U.S. Design Patent Application No. 29 / 693,281, filed May 31, 2019; and U.S. Design Patent Application No. 29 / 693,296, filed May 31, 2019. The entire contents of these applications are incorporated herein by reference. Technical Field

[0003] The topics disclosed in this article relate to ablation systems, particularly those that include catheters capable of ablating cardiac tissue and graphical user interface systems for assisting in the execution of ablation. Background Technology

[0004] Ablation of cardiac tissue has been used to treat arrhythmias. Ablation energy is typically delivered to the cardiac tissue via a distal portion that travels along the tissue to be ablated. Some of these catheters apply ablation energy from various three-dimensional electrode structures. Ablation procedures using such catheters can be visualized using, for example, fluoroscopy. Summary of the Invention

[0005] This document describes a graphical user interface (GUI) for a computer system. The GUI includes a display (e.g., a screen) comprising a first area and a second area. The first area may include a menu comprising a first dialog box, a second dialog box, and a final dialog box. The second area includes an image of a balloon, comprising multiple electrode representations, including the first electrode representation. The GUI may also include a processor. The processor may be configured to receive first dialog box input from the first dialog box, change the appearance of the first dialog box in response to receiving the first dialog box input, change the appearance of the second dialog box, receive first electrode input from the first electrode representation, and change the first electrode representation upon receiving the first electrode input. The processor may also be configured to change the image of the balloon in response to receiving the first dialog box input.

[0006] The plurality of electrode representations may include indicators to help distinguish the plurality of electrode representations from one another. For example, at least one of the plurality of electrode representations may include a shape indicator, an alphanumeric indicator, or both.

[0007] The processor can also be configured to change the appearance of a second dialog box in response to receiving a first dialog box input. The processor can also be configured to change the appearance of a second dialog box in response to receiving a first second dialog box input. The processor can also be configured to change the appearance of a first dialog box in response to receiving a first second dialog box input. The processor can also be configured to prevent the appearance of the second dialog box from changing before receiving the first first dialog box input. The processor can also be configured to receive a second second dialog box input from the second dialog box and further change the appearance of the second dialog box in response to receiving the second second dialog box input. The processor can also be configured to change the appearance of the plurality of electrode representations in response to receiving a second second dialog box input. The processor can also be configured to activate at least one of a plurality of electrodes connected to the processor, including a first electrode, in response to receiving a final dialog box input. The processor can also be configured to display a progress metric (e.g., a timer) in response to receiving a final dialog box input. The processor can also be configured to cause the display to show a total power setting in response to receiving a final dialog box input. The processor can also be configured to receive a second first electrode input from the first electrode representation and change the first electrode representation upon receiving the second first electrode input. The processor can also be configured to receive a third first electrode input from the first electrode representation, and to change the first electrode representation upon receiving the third first electrode input. The processor can also be configured to change the appearance of the second dialog box in response to receiving at least one of the first, second, and third first electrode inputs.

[0008] As an example, a first dialog box input may include a command to activate a pump connected to the processor. As another example, a first electrode input may include a command specifying the position of a first electrode relative to at least one other electrode among a plurality of electrodes. As yet another example, a second first electrode input may include a command to prevent the first electrode from being activated.

[0009] In another embodiment, the plurality of electrodes may include second electrodes, and the plurality of electrode representations may include second electrode representations. Therefore, the processor may be configured to receive a first second electrode input from the second electrode representation and change the second electrode representation upon receiving the first second electrode input. Furthermore, the processor may be configured to receive a second second electrode input from the second electrode representation and change the second electrode representation upon receiving the second second electrode input. Additionally, the processor may be configured to receive a third second electrode input from the second electrode representation and change the second electrode representation upon receiving the third second electrode input.

[0010] In such embodiments, the first second electrode input may include a command specifying the position of the second electrode relative to at least one other electrode (e.g., the first electrode) among the plurality of electrodes. Additionally, the second second electrode input may include a command to prevent the second electrode from being activated, and the third second electrode input may include a command to change the power setting corresponding to the second electrode.

[0011] The aforementioned GUI of the computer system may form part of or a subsystem of the ablation system. In addition to the GUI of the computer system, the ablation system may also include a catheter, which includes an expandable balloon disposed on the catheter, the expandable balloon including a surface and a plurality of electrodes disposed on the surface, the plurality of electrodes including a first electrode and a second electrode.

[0012] Therefore, the GUI of the computer system can be used to facilitate the control of the catheter (including expanding the balloon and activating the electrodes) to perform an ablation procedure including at least the following steps: providing a menu including a first dialog box, a second dialog box, and a final dialog box in the first area of ​​the display; providing an image of the expandable balloon in the second area of ​​the display, the image including multiple electrode representations, the multiple electrode representations including the first electrode representation; receiving first first dialog box input from the first dialog box at the processor; changing the appearance of the first dialog box; changing the appearance of the second dialog box; receiving first first electrode input from the first electrode representation at the processor; and changing the first electrode representation.

[0013] The method may further include the following steps: changing the image of the balloon, changing the appearance of the second dialog box, simultaneously or sequentially changing the appearance of each of the plurality of electrode representations, activating at least one of the plurality of electrodes, displaying a measure of progress (e.g., a timer), displaying total power, changing the first electrode representation a second time, changing the first electrode representation a third time, activating the pump to expand the expandable balloon with flushing fluid, designating the first electrode to be positioned rearward compared to at least another electrode (e.g., the first electrode) among the plurality of electrodes, and changing the power setting corresponding to the first electrode.

[0014] In cases where the plurality of electrodes includes a second electrode and the plurality of electrode representations includes a second electrode representation, further variations of the method may include the steps of: receiving a first second electrode input at the processor, then changing the second electrode representation, followed by a second change and then a third change of the second electrode representation. In some further variations, the first second electrode input may include a command designating the second electrode as being set later than the at least one other electrode among the plurality of electrodes. Attached Figure Description

[0015] Although a claim that specifically points out and clearly claims protection for the subject matter described herein is provided after the specification, it is believed that the subject matter will be better understood through the description of certain examples below in conjunction with the accompanying drawings, in which similar reference numerals denote the same elements, and in the drawings:

[0016] Figure 1 This is a schematic diagram of an invasive medical procedure.

[0017] Figure 2 A top view of a catheter with an inflated balloon used in conjunction with a tether catheter;

[0018] Figure 3 for Figure 2 A perspective view of the balloon along with the trocar.

[0019] Figure 4 for Figure 2 A side view of the distal end of the catheter deployed in the region of the pulmonary vein and its orifice;

[0020] Figure 5 The first representation displayed for a graphical user interface (GUI);

[0021] Figure 6 A second representation for the GUI display;

[0022] Figure 7 A third representation for the GUI display;

[0023] Figure 8 The fourth representation for the GUI display;

[0024] Figure 9 The fifth representation for the GUI display;

[0025] Figure 10 The sixth representation for the GUI display;

[0026] Figure 11 The seventh representation for the GUI display;

[0027] Figure 12 The eighth representation for display in the GUI;

[0028] Figure 13 The ninth representation for the GUI display;

[0029] Figure 14 The tenth representation for the GUI display;

[0030] Figure 15 The eleventh representation displayed in the GUI;

[0031] Figure 16 The twelfth representation for the GUI display;

[0032] Figure 17 The thirteenth representation for the GUI display;

[0033] Figure 18 A flowchart for the method displayed using a GUI; and

[0034] Figure 19 This is a flowchart of a method for ablating tissue. Detailed Implementation

[0035] The following detailed description should be read in conjunction with the accompanying drawings, in which the same elements are numbered the same across different drawings. The drawings (not necessarily drawn to scale) illustrate selected embodiments and are not intended to limit the scope of the invention. The detailed description illustrates the principles of the invention by way of example rather than limitation. This description will clearly enable those skilled in the art to make and use the invention, and describes several embodiments, adaptations, variations, alternatives, and uses of the invention, including what is now believed to be the best mode for carrying out the invention.

[0036] As used herein, the term “about” or “approximately” for any numerical value or range indicates a suitable dimensional tolerance that allows a collection of parts or elements to achieve the intended purpose as described herein. More specifically, “about” or “approximately” may refer to a range of values ​​±10% of the listed values; for example, “about 90%” may refer to a range of values ​​from 81% to 99%. Additionally, as used herein, the terms “patient,” “host,” “user,” and “subject” refer to any human or animal subject and are not intended to limit the system or method to human use, but the use of the subject matter invention in human patients represents a preferred embodiment.

[0037] Figure 1 This is a schematic diagram of an invasive medical procedure using device 12 according to one embodiment. The procedure is performed by a medical professional 14, and by way of example, it is assumed that the procedure described below involves ablation of a portion of the myocardium 16 of the heart of a human patient 18. However, it should be understood that the embodiments disclosed herein are not limited to this particular procedure and may include substantially any procedure for biological or non-biological materials.

[0038] To perform ablation, a medical professional 14 inserts probe 20 into a sheath 21 that has been pre-positioned within the patient's body cavity. Sheath 21 is positioned such that the distal end of probe 20 enters the patient's heart. See below for further details. Figure 2 The detailed diagnostic / therapeutic catheter 24 (e.g., a balloon catheter) is deployed through the lumen of probe 20 and exits from the distal end of probe 20.

[0039] like Figure 1As shown, device 12 is controlled by system processor 46, which is located in the device's operating console 48, also schematically shown at reference numeral 15. Console 48 includes controls 49 and a screen 62, which can be used by a medical professional 14 to communicate with the processor. Thus, screen 62 may include a touchscreen, and controls 49 may include, for example, a mouse or trackball. During the procedure, processor 46 typically utilizes any method known in the art to track the position and orientation of the distal end of probe 20. For example, processor 46 may use a magnetic tracking method, in which magnetic transmitters 25X, 25Y, and 25Z, located outside the patient 18, generate signals in coils positioned in the distal end of probe 20. The system (purchased from Biosense Webster, Inc. of Irvine, California) uses this type of tracing method.

[0040] Software for processor 46 can be downloaded to the processor electronically, for example, via a network. Alternatively or otherwise, the software can be provided via a non-transitory tangible medium such as optical, magnetic, or electronic storage media. Tracking of the distal end 22 can be displayed on a three-dimensional representation 60 of the patient 18's heart on screen 62. However, it can be displayed in two dimensions, for example, via fluoroscopic examination or MRI.

[0041] To operate device 12, processor 46 communicates with memory 50, which has multiple modules used by the processor to operate the device. Therefore, memory 50 includes a temperature module 52, an ablation module 54, and an electrocardiogram (ECG) module 56. Memory 50 typically includes other modules such as a force module for measuring forces on the distal end 22, a tracking module for operating the tracking method used by processor 46, and a flushing module 53 connected to a pump, thereby allowing the processor to control the pump and thus control the flushing supplied to the catheter. For simplicity, Figure 1Other modules of this kind are not shown. This module may include hardware and software elements. For example, module 54 may include a radio frequency generator having at least one output or output channel (e.g., ten outputs or ten output channels). Each of the outputs can be individually and selectively activated or deactivated by a switch. That is, each switch may be positioned between the signal generator and the corresponding output. Thus, a generator with ten outputs would include ten switches. These outputs can each be individually coupled to electrodes on the ablation catheter, such as the ten electrodes 33 on balloon 80, as described in further detail below. This electrical connection can be achieved by establishing an electrical path between each output and each electrode. For example, each output can be connected to the corresponding electrode via one or more wires or suitable electrical connectors. Thus, in some embodiments, the electrical path may include at least one wire. In some embodiments, the electrical path may also include an electrical connector and at least a second wire. Thus, electrodes 33 can be selectively activated and deactivated by switches to receive radio frequency energy independently of each of the other electrodes.

[0042] Figure 2 This is a schematic perspective view of the diagnostic / therapeutic catheter 24, with the balloon 80 in an inflated configuration. The catheter 24 may include a handle 27, a plunger 28, and a flushing tube 29. The plunger 28 is used to open and close the flushing lumen, which passes through the catheter 24 and connects the tube 29 to the balloon 80, such that flushing fluid (e.g., saline) can be introduced or pumped through the tube 29 and ultimately into the balloon 80 by a pump connected to a flushing fluid source and flushing module 53. Specifically, the plunger 28 can be pulled proximally toward the handle 27 to open the flushing lumen, and pushed distally away from the handle 27 to close the flushing lumen. Further reference Figure 3 and Figure 4 In the case where the diagnostic / therapeutic catheter 24 is used to ablate the orifice 11 of a lumen (such as the pulmonary vein 13), the diagnostic / therapeutic catheter 24 may be supported by a tubular shaft 70 having a proximal axial portion 82 and a distal axial end 88. The shaft 70 includes a hollow central tube 74 that allows another catheter (such as a lasso catheter 72) to pass through it and across the distal axial end 88. The lasso catheter 72 can be inserted into the pulmonary vein to properly position the diagnostic / therapeutic catheter 24 relative to the orifice before orifice ablation. The distal lasso portion of the catheter 72 is typically formed of a shape memory retaining material such as nitinol. It should be understood that the diagnostic / therapeutic catheter 24 may also be used with linear or lesion catheters 99 (such as... Figure 3(As shown by the dashed line in the diagram) used together with other sites of the PV or heart. The lesion catheter 99 may include a force sensor located at its distal end. Suitable force-transmitting distal ends are disclosed in U.S. Patent 8,357,152 entitled “CATHETER WITH PRESSURE SENSING” by Govari et al., filed January 22, 2013, and in U.S. Patent Application 2011 / 0130648 entitled “CATHETER WITH PRESSURE MEASURING TIP” filed November 30, 2009, by Beeckler et al., the entire contents of which are incorporated herein by reference. Any catheter used with a diagnostic / therapeutic catheter may have features and functions including, for example, pressure sensing, ablation, and diagnostic (e.g., manipulation and pacing).

[0043] The balloon 80 of the diagnostic / therapeutic catheter 24 is made of a biocompatible material (e.g., made of polyethylene terephthalate (PET), polyurethane, or...). The outer wall, surface, or membrane 26 of the balloon 80 is made of a plastic material. A shaft 70 and a distal axial end 88 define the longitudinal axis 78 of the balloon 80. The balloon 80 is deployed in a collapsed configuration via the lumen 23 of the probe 20 and can expand after exiting the distal end. The membrane 26 of the balloon 80 may be formed with flushing orifices or flushing holes 35 through which fluid (e.g., saline) can be drained from the interior of the balloon 80 to the exterior for use at the tissue ablation site at the cooling port. Although Figure 2 and Figure 4 The fluid exiting the balloon 80 as a jet is shown, but the fluid can exit the balloon at any desired flow rate or pressure, including the rate at which fluid leaks from the balloon.

[0044] The membrane 26 supports and carries the combined electrodes and temperature sensing components, each configured as a multilayer flexible circuit electrode assembly 84. The "flexible circuit electrode assembly" 84 can have many different geometries. In an illustrated embodiment, the flexible circuit electrode assembly 84 has multiple radiating substrates or strips 30 on which electrodes 33 are disposed. The substrates 30 are uniformly distributed around the distal end 88 and the balloon 80. Each substrate has a wider proximal portion that tapers gradually to a narrower distal portion.

[0045] Screen 62 or its additional iterations may be used to display one or more displays of a graphical user interface (GUI) that assists medical professional 14 in communicating with and receiving information from processor 46 to perform ablation procedures using diagnostic / therapeutic catheter 24. An exemplary display of the GUI is shown in... Figures 5 to 18The medical professional 14 can provide certain inputs to the processor 46 via various GUI displays. These GUI displays can also be used to guide the medical professional 14 through the procedure by providing, for example, recommendations, notifications, and alerts. Therefore, each display may correspond to a different step or segment of the ablation procedure. Thus, the GUI displays can be configured to allow the medical professional 14 to provide inputs to the processor 46 related to the steps or segments of the ablation procedure corresponding to a given screen, while preventing the medical professional 14 from providing inputs unrelated to the steps or segments of the ablation procedure. Furthermore, based on a determination made by the processor 46, the processor 46 may modify the display to convey the information that the medical professional 14 may no longer provide certain inputs to the processor 46.

[0046] The GUI displays the first exemplary representation of 100 in Figure 5 The display 100 may include a first region 102 and a second region 104. The first region 102 and the second region 104 can be used to display different information corresponding to the procedure. For example, as shown, the first region 102 may include a menu containing multiple dialog boxes, such as dialog box 106, dialog box 108, dialog box 110, dialog box 112, and dialog box 114. Furthermore, dialog box 106 is shown in an expanded configuration, while dialog boxes 108, 110, 112, and 114 are shown in a collapsed configuration. These dialog boxes each correspond to different steps or sections of the ablation procedure. Figure 5 As seen in the diagram, for example, the first segment of the procedure is relevant in dialog box 106. Therefore, during the first segment of the procedure, dialog box 106 is expanded while the remainder is collapsed, thus preventing the professional 14 from providing input to the processor 46 unrelated to the expansion of balloon 80. In this segment of the procedure, flushing fluid (e.g., saline) can be provided to pass through catheter 24 and into balloon 80, which facilitates balloon 80 expansion. Therefore, dialog box 106 provides instructions regarding this segment of the procedure, such as text and graphics. As shown, dialog box 106 instructs, for example, “Pull the plunger toward the handle” and shows an image of the plunger, which may be a feature of catheter 24. Furthermore, dialog box 106 includes icons 140a and 140b, with which the medical professional 14 can interact to provide commands to the processor 46 related to this segment. For example, the professional 14 can initiate this segment of the procedure by conveying a start command to the processor 46 via touching or clicking icon 140, thereby causing the flow of flushing fluid to have a volumetric flow rate sufficient to expand balloon 80. In addition, since the specialist 14 may need to collapse the balloon 80, for example, to reposition it, icon 140b can be used to instruct the processor 46 to slow down the flow of flushing fluid, which helps to collapse the balloon.

[0047] The second region 104 may include a graphic representation 116 of the catheter 24, which may include a representation or icon of the balloon 80, such as the electrode 33 with or without the balloon 80. Figure 5 As seen, the catheter body of catheter 24 is represented as catheter body 118, and the electrodes 33 (numbered 1 to 10) are represented as icons 120, 122, 124, 126, 128, 130, 132, 134, 136, and 138. In representation 116 of balloon 80, the membrane 26 of balloon 80 is not shown because balloon 80 has not yet expanded. However, the representation of membrane 26 may be shown in subsequent views corresponding to the segment of the ablation process (where balloon 80 has expanded). For example, in Figure 6 In the diagram, membrane 26 is indicated by reference numeral 242. The central portion 144 can provide information about the ablation procedure, such as a timer indicating the elapsed time since the application of ablation energy to the electrode. Therefore, in the section corresponding to the ablation procedure prior to the application of ablation energy... Figure 5 In this context, the timer reflects "0:00". Furthermore, the balloon representation 116 may include icons corresponding to markers (e.g., markers described in U.S. Patent Application 15 / 939,154) that can be disposed on various electrodes 33, such as hollow rectangles 146, solid triangles 148, and hollow triangles 150. Therefore, these marker icons are positioned adjacent to or on the electrode representation having the corresponding marker. For example, if the first electrode 33 (electrode 1) of the balloon 80 includes a radiopaque marker in the form of a hollow rectangle, then icon 146 is positioned adjacent to the first electrode icon 120.

[0048] The GUI displays a second exemplary representation of 200 in Figure 6 The GUI display 200 is similar to GUI display 100, except for the differences described herein. Furthermore, in this example, GUI display 200 corresponds to a segment of the ablation process following the segment corresponding to GUI display 100. Specifically, GUI display 200 corresponds to a segment where the technician 14 identifies the pulmonary veins in which balloon 80 has been or will be placed, and then informs the processor 46 of this using information and icons in the now expanded dialog box 208. Dialog boxes 206, 210, 212, and 214 are collapsed to prevent instructions related to other segments of the process from being provided. As shown, dialog box 206 includes four icons 250a, 250b, 250c, and 250d, labeled LSpv, RSpv, LIpv, and Rlpv, abbreviations for left superior pulmonary vein, right superior pulmonary vein, left inferior pulmonary vein, and right inferior pulmonary vein. The technician 14 can communicate to the processor 46 the pulmonary veins in which balloon 80 will be placed.

[0049] The representation of balloon 80 in display 200 now includes representation 242 of membrane 26 because balloon 80 has been expanded in the version of the ablation procedure described herein. Furthermore, indications of physical or electrical quantities (e.g., current or impedance) associated with one or more electrodes 33 may be provided next to the corresponding electrode icon. Figure 6 As shown, the adjacent electrode icons provide impedance indications; for example, impedance indicators 150a, 150b, and 150c are next to icons 220, 222, and 224. For example, the impedance indications can inform a professional 14 that the processor 46 will allow each electrode 33 to have a maximum impedance, such that if the maximum impedance is exceeded, the processor 46 can deactivate the electrode.

[0050] The GUI displays a third exemplary representation of 300 in Figure 7 The GUI display 300 is similar to GUI display 200, except for the differences described herein. Furthermore, in this example, GUI display 300 corresponds to a step in the ablation procedure following the steps described for GUI display 200. After the professional 14 selects a pulmonary vein, dialog box 308 may provide a message to the professional 14, for example, via a confirmation icon or box 354. For example, it may be useful to remind the professional 14 to ensure that phrenic nerve pacing has been enabled, for example, via a pacing system, so that the patient will continue to breathe correctly during the ablation segment of the ablation procedure. Additionally, processor 46 may need to receive input corresponding to the professional 14 touching or clicking icon 354 before processor 46 advances GUI display 300 to a subsequent GUI display.

[0051] The GUI displays the fourth exemplary representation of 400 in Figure 8The GUI display 400 is similar to GUI display 300, except for the differences described herein. Furthermore, in this example, GUI display 400 corresponds to a segment of the ablation process following the steps described for GUI display 300. Specifically, GUI display 400 corresponds to a segment of the ablation process in which the practitioner 14 determines which electrodes 33 are positioned posteriorly to the patient relative to other electrodes 33. Based on this determination, the practitioner 14 may touch or click the corresponding electrode icon among electrode icons 420, 422, 424, 426, 428, 430, 432, 434, 436, and 438 to inform the processor 46 of the determination. This determination can be useful during those segments of the procedure where current is supplied to the electrodes 33, as the posterior aspect of the pulmonary veins and therefore the electrodes positioned adjacent to them are near the esophagus, making safety considerations arising from this anatomical structure necessary to consider. Therefore, in display 400, dialog box 408 may be presented as expanded, while dialog boxes 406, 408, 412, and 414 may be presented as collapsed. Furthermore, dialog box 408 can instruct the professional 14 to indicate the location of the electrode by clicking or touching the rear electrode 33. Accordingly, the electrode icons 420, 422, 424, 426, 428, 430, 432, 434, 436, and 438 can have different appearances on display 400 compared to displays 100, 200, and 300. For example, because the input to the processor 46 corresponding to electrode 33 is irrelevant to the steps or sections of the ablation procedure corresponding to displays 100, 200, and 300, the electrode icons can be shown in gray, while on display 400, these electrode icons can be shown in white, or flash between white and gray, thereby attracting the attention of the professional 14 as if requesting input from the professional 14.

[0052] The GUI displays the fifth example of 500 in Figure 9The GUI display 500 is similar to GUI display 400, except for the differences described herein. Furthermore, in this example, GUI display 500 corresponds to a step in the ablation process following the steps described for GUI display 400. Specifically, as shown, electrode icons 526, 528, and 530 are presented differently from icons 426, 428, and 430 in display 400, thus reflecting the processor 46's identification of the three electrodes 33 (electrodes 4 to 6) as posteriorly positioned towards the patient. As shown, electrode icons 526, 528, and 530 have a more prominent outline than other electrode icons. This more prominent outline can be provided by color or shading to easily distinguish these electrode icons from others. Additionally, the acronym "PE," representing the posterior electrode, can be provided on icons 526, 528, and 530. Furthermore, or alternatively, the overall color of icons 526, 528, and 530, not just the outline color, can be varied relative to other electrode icons. Additionally, dialog box 510 can be updated relative to dialog box 410 to indicate the selected electrode. These instructions can be used to make the professional 14 understand and remind the professional of the determination of the relative position of the electrode 33.

[0053] The sixth exemplary GUI displays 600 in Figure 10 The GUI display 600 is similar to the GUI display 400, except for the differences described herein. Furthermore, in this example, the GUI display 600 corresponds to a step in the ablation process following the steps described for the GUI display 400. The GUI display 600 reflects the decision made by the professional 14 not to allow the processor 46 to recognize any rear electrodes. Therefore, the GUI display 600 provides an alert that a rear electrode has not been selected, rather than reflecting a change in the appearance of the corresponding electrode icons (e.g., 526, 528, 530). For example, an asterisk 610a could be placed in the dialog box 610 instead of checkpoints (such as checkpoint 606a in dialog box 606 and checkpoint 608a in dialog box 608).

[0054] In addition, the GUI display 600 corresponds to a step in the ablation procedure, by which the specialist 14 determines whether any electrodes 33 should not be activated, i.e., receive any current for ablation of tissue, and then communicates this decision to the processor 46. Because the specialist 14 can determine that all electrodes should be activated, the step of disabling electrodes or informing the processor 46 of this decision via display 600 can be considered optional. This is reflected in the internal instruction dialog box 612, which is presented as an expanded instruction on display 600, while dialog boxes 606, 608, 610, and 614 are shown as collapsed.

[0055] The seventh exemplary GUI displays 700 in Figure 11The GUI display 700 is similar to the GUI display 600, except for the differences described herein. The GUI display 700 reflects that the professional 14 determines that the tenth electrode 33 should be disabled and conveys this decision to the processor 46 by touching or clicking the electrode icon 738. Therefore, the appearance of the electrode icon 738 has changed relative to the appearance of the other electrode icons. Additionally or alternatively, a note indicating that the tenth electrode has been disabled may be provided in the dialog box 712. Similar to the GUI display 500, the GUI display 700 also reflects that the processor 46 recognizes the various electrodes 33 (i.e., electrodes 4 to 6) corresponding to electrode icons 726, 728, and 730 as rear electrodes.

[0056] The eighth exemplary GUI displays 800 in Figure 12 The GUI display 800 is similar to GUI display 700, except for the differences described herein. Furthermore, in this example, GUI display 800 corresponds to a step in the ablation procedure following the steps described for GUI display 700. Specifically, GUI display 800 corresponds to a segment of the ablation procedure where tissue ablation can begin. Display 800 is configured to introduce instructions from professional 14 to processor 46 to begin tissue ablation, which will cause processor 46 to activate any electrodes 33 that were not previously disabled. Therefore, dialog box 814 is shown in an expanded configuration, while dialog boxes 806, 808, 810, and 812 are collapsed. Dialog box 814 includes a box 856 that the surgeon can touch or click to activate electrodes 33. To ensure that professional 14 is intentionally activating, processor 46 can be configured to require professional 14 to touch or click box 856 for a period of time, such as approximately one to five seconds, for example, approximately two seconds. Therefore, dialog box 814 can provide written instructions for any such requests.

[0057] The ninth exemplary GUI displays 900 in Figure 13 The GUI display 900 is similar to GUI display 800, except for the differences described herein. Furthermore, in this example, GUI display 900 corresponds to a step in the ablation process following the steps described for GUI display 800. Specifically, GUI display 900 corresponds to a segment of the ablation process during which at least some of the electrodes 33 have been activated. As seen in central section 944, it shows that twenty seconds have elapsed and power is being supplied to the active electrodes at 15 watts. Dialog box 914 remains in an extended configuration; however, box 956 is now configured to accept input from professional 14 to deactivate all active electrodes 33. Additionally, dialog box 914 provides instructions to deactivate any individual electrode 33 by tapping the corresponding electrode icon. As shown, display 900 reflects that this operation has been completed for the third electrode corresponding to electrode icon 924, as indicated by the shading.

[0058] Display 900 may also reflect certain electrodes 33 that can be disabled by processor 46, for example, when it is determined that the temperature of those electrodes may exceed the safe maximum value. As shown, the ninth electrode, corresponding to electrode icon 936, has been disabled by processor 46. This can be indicated in various ways, such as by thickening the outline of the electrode icon, changing its color, adding a mark (e.g., "x"), or removing the icon connection to the center portion 944—note the sub-icon number 836a on display 800. Figure 12 As shown in the figure, a corresponding warning can be provided on display 900 (for example, at its bottom).

[0059] Optionally, the color of all active electrodes 33 (e.g., electrodes corresponding to electrode icons 920, 922, 926, 928, 930, 932, and 934 on display 900) can also be changed, for example, to gold. Display 900 may also provide indications of physical properties (e.g., current and impedance) for each active electrode. As shown, a status bar 958 indicating the instantaneous impedance at each electrode is provided.

[0060] The tenth exemplary GUI displays 1000 in Figure 14 The GUI display 1000 is similar to GUI display 900, except for the differences described herein. Similar to GUI display 900, GUI display 1000 corresponds to a segment of the ablation process during which at least some of the electrodes 33 have been activated. Specifically, the GUI display corresponds to a mode in which the power supplied to each individual electrode can be modified. GUI display 1000 includes a control overlay that includes icons that a professional 14 can use to communicate to the processor 46 that the power supplied to individual electrodes should be modified. As shown, electrode icon 1020 corresponding to the first electrode includes an indication of the power supplied to that first electrode (e.g., 15 watts). Electrode icon 1020 also includes an increase power box 1020a and a decrease power box 1020b, which can be touched or clicked by the professional 14 to command the processor 46 to increase or decrease the power supplied to the electrode. After the desired power has been set, the professional 14 can touch or click the save box 1044a or the cancel box 1044b to return to display 900.

[0061] The eleventh exemplary GUI displays 1100 in Figure 15The GUI display 1100 is similar to GUI display 900, except for the differences described herein. GUI display 1100 corresponds to the segment of the ablation procedure after all previously activated electrodes 33 have been deactivated. Therefore, the central portion 1144 can indicate messages such as "Ablation complete". All dialog boxes 1106, 1108, 1110, 1112, and 1114 are shown in a collapsed configuration. An icon or box 1162 is provided that the surgeon can touch or click to instruct the processor 46 to perform a new ablation procedure.

[0062] The twelfth exemplary GUI displays 1200. Figure 16 The GUI display 1200 provides summary information or statistics on the ablation procedure for electrode 33, which may be useful for professionals 14 in determining further treatment. As shown, electrode icon 1220 is highlighted so that the information provided corresponds to the first electrode.

[0063] The thirteenth exemplary GUI displays 1300. Figure 17 The GUI display 1300 provides summary information or statistics on the ablation procedure for electrode 33, which may be useful for professionals 14 in determining further treatment. As shown, electrode icon 1320 is highlighted so that the information provided corresponds to the first electrode.

[0064] Processor 46 may be further configured to, for example, sequentially change the displays among displays 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1100, 1200, and 1300 to another display among these displays based on input received from the professional 14 via these displays or from sensors (e.g., temperature sensing elements) of conduit 24. Thus, processor 46 may be configured to receive various inputs from user interface devices such as screen 62 or console 49. Such inputs may include inputs sent to processor 46 when the professional 14 touches screen 62 displaying one of the aforementioned displays. For example, when the professional 14 touches screen 62 at the location of a display dialog box (e.g., dialog box 106), screen 62 may send dialog box inputs to processor 46. Similarly, when the professional 14 touches screen 62 at the location of a display electrode icon (e.g., icon 426), screen 62 may send electrode inputs to processor 46.

[0065] Dialog box input can be generated from any box in a dialog box, such as boxes 106, 108, 110, 112, and 114 on display 100 or their counterparts on other displays. For example, dialog box input could be a professional 14 touching a dialog box 106 in a closed configuration, which would cause input from screen 62 to be sent to processor 46, which would interpret the input as a command to change the appearance of dialog box 106 (e.g., expand dialog box 106). Dialog box input could also be a professional 14 touching a dialog box 108 in a collapsed configuration, for example, when dialog box 106 is in an expanded configuration. Processor 46 would receive input from screen 62 based on that screen, and would interpret the input as a command to change the appearance of dialog boxes 106 and 108. For example, dialog box 106 could be placed in a collapsed configuration, and dialog box 108 could be placed in an expanded configuration. This transition could correspond, for example, a transition from GUI display 100 to GUI display 200.

[0066] Dialog box input can also be considered as input received by processor 46 based on icons (e.g., icons 140a, 250b, 354, and 856) contained in the dialog box touched by professional 14. Thus, for example, when professional 14 touches icon 140a, screen 62 can send input to processor 46, which interprets the input as a command for display membrane representation 242, such as in display 200.

[0067] Electrode inputs can be generated from any of the electrode icons, such as icons 420, 422, 424, 426, 428, 430, 432, 434, 436, and 438 on display 400, or their counterparts on other displays. For example, electrode input could be a professional 14 touching electrode icon 426, which would cause input from screen 62 to be sent to processor 46, which would interpret the input as a command to designate the fourth electrode 33 as a rear electrode and change its appearance (e.g., change it to the appearance shown for electrode icon 526 on display 500).

[0068] Processor 46 may be further configured to prevent certain changes in the appearance of various displays (including dialog boxes and electrode icons) until the processor has received certain input. Thus, for example, processor 46 may prevent, for example, dialog box 108 from changing from a collapsed configuration to an expanded configuration until the processor has received input from, for example, dialog box 106 or icon 140a. Therefore, processor 46 may be configured to require the various displays described herein to be displayed in a predetermined order, such as sequentially. For example, dialog box 108 may only expand to dialog box 208 after processor 46 has received dialog box input from dialog box 106 or icon 140a, and dialog box 310 may only expand to dialog box 410 after processor 46 has received dialog box input from dialog box 308 or icon 354.

[0069] Additionally, the processor 46 can be configured to change the appearance of the electrode icons upon receiving dialog box input from the screen 62. For example, when the professional 14 touches the ablation icon 856 and the processor 46 receives corresponding dialog box input from the screen 62, the processor 46 interprets both as a command to both activate multiple electrodes 33 and change the appearance, such as the color, of the corresponding electrode icons. Thus, for example, icon 832 could be white and then change to a gold icon 932, corresponding to a transition from display 800 to display 900.

[0070] Similarly, processor 46 can be configured to change the appearance of a dialog box when it receives electrode input from screen 62. For example, when professional 14 touches electrode icon 426 and processor 46 receives the corresponding electrode input from screen 62, processor 46 interprets both as a command to change the appearance of dialog box 410 to indicate that the fourth electrode has been set as the rear electrode, as in dialog box 510.

[0071] Processor 46 can also be configured to display a measure of progress and change the appearance of that measure. For example, as shown on display 100, a timer is shown in the central portion 144 as indicating "0:00 in 60 seconds". As shown on display 900, a timer in the central portion 944 indicates "20 in 60 seconds". Processor 46 can be further configured to increment the timer upon receiving dialog box input from ablation icon 856. Alternatively or otherwise, the elapsed time after touching icon 856 can be reflected by, for example, a brush bar sometimes found at the bottom of a display showing digital video. In the embodiments disclosed herein, dialog box input provided to processor 46 when icon 856 is clicked can be considered the final dialog box input, as this is the last input received by processor 46 from the dialog box.

[0072] Dialog box inputs and electrode inputs can also be received by processor 46 as commands to make further changes to system 12. For example, in response to receiving a dialog box input from icon 140a, processor 46 can activate the pump.

[0073] Using the embodiments described herein, the applicant has devised a method and variations thereof for controlling a catheter using a GUI of a computer system, the GUI including a processor and a display (e.g., a screen), the catheter including an expandable balloon disposed on the catheter. Specifically, the method can be used to facilitate the performance of procedures such as ablation in the heart of a subject using a catheter such as catheter 24, which, among other things, has a balloon 80 with a surface (e.g., a membrane) and a plurality of electrodes 33 disposed on the surface, as described above. Figure 18 As reflected in the flowchart, exemplary method 1400 may begin at step 1401 and may include additional steps. At step 1402, a display may be provided as a menu including a dialog box, an image of the balloon with electrode representations, a measure of progress, and total power. For example, at step 1402, screen 62 may be provided to display, for example, display 100 ( Figure 5 ), display 200 ( Figure 6 ) or display 300 ( Figure 7Therefore, at step 1402, a menu including multiple dialog boxes (e.g., a first dialog box, a second dialog box, and a final dialog box) may be provided in the first area of ​​the display, and an image of the expandable balloon, including representations or icons of the electrodes (e.g., a first electrode icon or representation), may be provided in the second area of ​​the display. At step 1404, the processor may receive input from one of the dialog boxes, such as 106, 108, 208, 308, 310, 410, 412, 612, 712, and 814, in either a closed or expanded configuration. For example, the processor may receive first dialog box input from the first dialog box, second dialog box input from the second dialog box, and final dialog box input from the final dialog box. For the purpose of different variations of the reference method, it should be understood that the adjectives first, second, or final do not refer to the position of the dialog box on the display, such that the first dialog box is not limited to the topmost dialog box, and the final dialog box is not limited to the bottommost dialog box. Therefore, for example, the first dialog box may be, for example, dialog box 106, dialog box 108, dialog box 208, dialog box 310, or other dialog boxes. Therefore, the first dialog box input may vary accordingly. For example, if the first dialog box is dialog box 106, the input to the first dialog box can be a command received at processor 46, which is sent in response to the professional 14 touching the inflation box 140a. Furthermore, for example, if the first dialog box is dialog box 208, the input to the first dialog box can be a command received at processor 46, which is sent in response to the professional 14 touching such a box. Figure 5 The message is sent from the second dialog box 108, which is in a closed configuration.

[0074] Because the processor can be configured to receive multiple dialog box inputs, variations of the method may, in addition to or alternatively, include the following steps: receiving at the processor a first first dialog box input from a first dialog box, a second first dialog box input from a first dialog box, a first second dialog box input from a second dialog box, a second second dialog box input from a second dialog box, a first third dialog box input from a third dialog box, a second third dialog box input from a third dialog box, a first final dialog box input from a final dialog box, and a second final dialog box input from a final dialog box. In these variations, the processor may, in response to receiving any of the aforementioned dialog box inputs, change the appearance of any one of the first, second, third, and final dialog boxes, the electrode representation, or any combination thereof. Preferably, these changes reflect a transition from one GUI display to another.

[0075] In those variations where the first dialog box is dialog box 106 and a first dialog box input, which may be a first dialog box input, is received at processor 46 due to professional 14 touching inflator 140a, the method includes steps 1406 and 1408. That is, at step 1406, upon receiving a command in response to professional 14 touching inflator 140a, processor 46 may activate the pump, which causes balloon 80 to expand. Accordingly, at step 1408, the pump may be activated, for example, by means of a command received from display 100 (…). Figure 5 The transition causes the representation 242 of membrane 26 to appear in display 200. Figure 6 The image of the balloon is changed to show the representation of membrane 26 (not shown) 100.

[0076] At step 1410, regardless of which dialog box is the first dialog box mentioned in the methods and variations, the appearance of the first dialog box is changed upon receiving input to the first dialog box. For example, if the first dialog box input corresponds to a command whereby professional 14 touches the inflated frame 140a of dialog box 106, the color of frame 140a may be changed or its outline highlighted. Furthermore, for example, if the first dialog box input corresponds to a command whereby professional 14 touches the dialog box 108 in a collapsed configuration, the appearance of the first dialog box is changed upon receiving input from display 100 (…). Figure 5 ) to display 200 ( Figure 6 When the dialog box 108 is transformed into dialog box 208, dialog box 108 can be expanded into dialog box 208.

[0077] At step 1412, which may be optional and thus unnecessary to include in all variations of the method described herein, the appearance of another dialog box or a second dialog box may be changed in response to, for example, automatically receiving input to the first dialog box at processor 46. For example, if the first dialog box is dialog box 108, the second dialog box may be dialog box 106. Thus, in display 100 ( Figure 5 The first dialog box 106 shown in the extended configuration can be transformed into a display corresponding to 200. Figure 6 The collapsed configuration of dialog box 206 on the screen. In those variations where the change of appearance of the second dialog box is not automatic, the professional 14 can change the appearance of the second dialog box, for example, by touching the second dialog box in a closed configuration, or by touching another button or box contained in the second dialog box. For example, in the case where the first dialog box is dialog box 106 and the second dialog box is dialog box 108, the professional 14 can touch dialog box 108, thereby causing screen 62 to send the first and second dialog box inputs to processor 46, which can interpret the first and second dialog box inputs as an expanded dialog box 108 (transforming it into display 200). Figure 6The screen 62 will then display a second dialog box (208) to the processor 46, prompting the professional 14 to identify the pulmonary vein to be ablated during the procedure by touching the corresponding boxes 250a, 250b, 250c, or 250d. Touching one of these boxes will provide the processor 46 with a second dialog box input informing it of the pulmonary vein to be ablated.

[0078] At step 1414, which may be optional and thus unnecessary to include in all variations of the method described herein, the electrode representations may be changed individually, particularly after the balloon has been expanded (e.g., via frame 106) and the pulmonary vein has been positioned (e.g., via frame 208). For example, the color of each electrode representation in the electrode representation may be changed. In other variations, this change may be performed simultaneously. Changing each electrode representation in the electrode representation can be useful for instructing a professional 14 to send input from screen 62 to processor 46 using the electrode representation. That is, displaying 100 to 300 (… Figures 5 to 7 The device is configured to allow a professional (14) to input information regarding flushing and balloon position, but not regarding electrode orientation or power delivery of electrode 33. Therefore, the electrode indication (e.g., Figure 6 The numbers 126, 128, and 130 in the text can be displayed, for example, in gray. However, displaying 400 (...) Figure 8 This involves identifying those electrodes 33 that are positioned posteriorly relative to other electrodes (i.e., closer to the patient's esophagus compared to other electrodes). A professional 14 can have the processor 46 identify the posterior electrodes by touching the electrode representation corresponding to those posterior electrodes. Therefore, in displays such as display 300 corresponding to an earlier part of the method... Figure 7 ) changed to display 400 ( Figure 8 When this is done, the attention of the professional 14 can be focused on these electrode representations by changing the color of the electrode representations to white in the display 400.

[0079] At step 1416, the electrode representation can be used to provide the processor 46 with input regarding the orientation (e.g., relative position) of the electrode 33, the power to be delivered to the electrode 33, or both. For example, as described relative to step 1414, the processor can identify those electrodes 33 positioned rearward by touching the corresponding electrode representation. Thus, when the expert 14 touches the first electrode representation, such as 426, a first electrode input can be sent from screen 62 to the processor 46. Similarly, when the expert 14 touches other electrode representations, such as 428 and 430, a first other electrode input can be sent from screen 62 to the processor 46. In addition or alternatively, and referring to displays 600 and 700 (… Figure 10 and 11The professional 14 may touch at least one electrode to indicate to the processor 46 that the electrode should be disabled, that is, the electrode will not be activated together with other electrodes used to receive power for ablation.

[0080] At step 1418, the electrode indication can be changed to indicate that a professional 14 has touched them and the corresponding input is sent to the processor 46. For example, as shown in display 500 ( Figure 9 As seen above, electrodes 526, 528, and 530 have a higher accuracy than display 500. Figure 8 Electrode representations 426, 428, and 430 on the display have thicker contours. Furthermore, electrode representations 526, 528, and 530 include a "PE" label, while electrode representations 426, 428, and 430 do not. Therefore, display 500 reflects the instruction given by the expert 14 to the processor 46: that the fourth, fifth, and sixth electrodes 33, corresponding to electrode representations 426, 428, and 430, and electrode representations 526, 528, and 530, respectively, are oriented rearward compared to the remaining electrodes 33 (i.e., the first to third electrodes 33 and the seventh to tenth electrodes 33). Similarly, as in display 700 (… Figure 11 As seen above, electrode 738 has been shaded to indicate to the professional 14 that the tenth electrode 33 has been disabled.

[0081] At step 1420, at least one of the electrodes in electrode 33 can be activated to ablate tissue. (See Figure 800) Figure 12 A professional 14 may touch the ablation box 856 for approximately two seconds to activate at least one of the electrodes 33, i.e., all of these electrodes are not disabled during step 1416.

[0082] At step 1422, the electrode representations can be changed again. For example, at this point, these electrode representations can be changed to indicate to the professional 14 that these electrode representations are receiving power for ablation of tissue. Thus, for example, the color of these electrode representations can be changed to, for example, gold. For example, referring to display 900 corresponding to some sections of the electrodes 33 that are receiving power during the ablation procedure, the corresponding electrode representations 920, 922, 926, 928, 930, 932, 934, and 936 can be shown in gold.

[0083] At step 1424, the electrode representation can be changed again. For example, at this point, these electrode representations can be changed to indicate to the skilled worker 14 the adjustable power delivered to each electrode 33. For example, refer to... Figure 14 The electrode representation 1020 includes an indication of the power being received by the first electrode 33 (shown as “15w”, meaning “fifteen watts”) and also includes plus and minus icons or boxes 1020a and 1020b.

[0084] At step 1426, the skilled worker 14 can change the power setting of any electrode. For example, refer again... Figure 14 The professional 14 can increase the power received by the first electrode 33 by touching the plus frame 1020a, or decrease the power received by the first electrode 33 by touching the minus frame 1020b.

[0085] At step 1428, screen 62 (e.g., displaying 1200) can be used. Figure 16 ), display 1300 ( Figure 17 The procedure information is displayed on the ablation site (or both). The specialist 14 can review this information to determine whether a new round of ablation should be performed on the same pulmonary vein, a different pulmonary vein, or whether the catheter should be removed from the patient.

[0086] To assist medical professionals in performing ablation procedures using the aforementioned methods, a GUI display and processor can be used to prevent premature execution of steps of the method. For example, the processor can be configured to prevent changes to the appearance of dialog boxes, electrode representations, or any combination thereof. Thus, in another variation of the method, the processor can, for example, prevent changes to the appearance of a second dialog box until the processor has received input from a first dialog box, such as a first dialog box input, which could be a command for the extended balloon 80 associated with frame 140a.

[0087] Based on the foregoing, an ablation system including a catheter (e.g., 24), an operating console (e.g., 48) including a processor (e.g., 46), and a screen (62) can be used by a professional 14 to perform ablation procedures in, for example, the heart of a patient 18, the screen of which can display a GUI display (e.g., the GUI display described above). Figure 19 An exemplary method 1500 with variations is described. Method 1500 begins after a balloon 80 in a collapsed configuration has been placed in the heart of a patient 18.

[0088] At step 1502, balloon 80 can be expanded by initiating flushing of conduit 24 and balloon 80. That is, step 1502 may include any action taken by a professional 14 to pump flushing fluid at a sufficient flow rate through conduit 24 and into balloon 80 to expand balloon 80. (Display 100 is provided.) Figure 5The system assists professional 14 in performing step 1502 by prompting them to take two actions in dialog box 106. Specifically, dialog box 106 instructs: 1) “Pull the plunger toward the handle,” next to an image of the plunger on the handle of catheter 24; and 2) “Then, press to inflate.” Professional 14 can then follow these instructions to pull the plunger toward the handle, thereby opening the flushing lumen configured to pass through the catheter body to place balloon 80 in fluid communication with a source of flushing fluid (e.g., saline). Then, as instructed, professional 14 can touch display 100 (… Figure 5 The inflation box 140a in dialog box 106 causes screen 62 to send a corresponding dialog box input to processor 46, which interprets the corresponding dialog box input as a command to activate the pump so that flushing fluid from the source flows through the conduit body and into balloon 80. Therefore, step 1502 ends after the pump has been activated and balloon 80 has been inflated.

[0089] At step 1504, the professional 14 positions a pulmonary vein that will receive ablation therapy from electrodes 33 on balloon 80 during an upcoming round of ablation performed according to method 1500. That is, the professional 14 informs the processor 46 where the pulmonary vein of balloon 80 will be positioned—or more specifically, where the pulmonary vein orifice of balloon 80 will be positioned. Step 1504 may begin when dialog box 108 is expanded from a collapsed configuration to an open configuration. As described above, this may occur automatically when dialog box 106 collapses or when the professional 14 touches dialog box 108. In either variant, the processor 46 receives input from screen 62 to expand dialog box 108, such as via a display 200 including dialog box 208. Figure 6 The transformation of ).

[0090] Dialog box 208 may include the instruction "Set Pulmonary Vein" for professional 14, as well as pulmonary vein icons or boxes 250a, 250b, 250c, and 250d, which correspond to each of the four pulmonary veins described above. Therefore, professional 14 can touch one of the boxes 250a, 250b, 250c, and 250d to cause screen 62 to send the corresponding dialog box input to processor 46, thereby identifying the selected pulmonary vein.

[0091] In another variation of method 1500, at optional step 1506, upon receiving a dialog box input indicating the selected pulmonary vein, processor 46 may cause screen 62 to switch from display 200 (…). Figure 6 The display 300 includes dialog box 308. Figure 7The dialog box has a confirmation icon or box 354 that includes the instruction “Ensure phrenic nerve pacing”. Processor 46 may need to receive dialog box input sent by screen 62 in response to professional 14 touching box 354 before allowing method 1500 to proceed further. Therefore, box 354 serves as a reminder to the surgeon to check that phrenic nerve pacing has been activated, and as a safety feature to prevent any ablation from occurring before professional 14 indicates that she has activated the pacing.

[0092] At step 1508, the specialist 14 positions the posterior electrodes. That is, the specialist 14 communicates to the processor 46 those electrodes 33 located posteriorly within the patient's body, particularly relative to other electrodes. This instruction may help avoid accidental ablation of the patient's esophagus. Step 1508 may be displayed at 300 (…). Figure 7 The dialog box 310 in the dialog box is expanded to display 400. Figure 8 The transition begins when dialog box 410 is accessed. This transition may be triggered by processor 46 upon receiving dialog box input corresponding to a professional 14 having touched any of the boxes 250a-d and possibly box 354. Alternatively, the transition may be triggered by processor 46 upon receiving dialog box input corresponding to a professional 14 touching a box 310 in a closed configuration (e.g., after any of the boxes 250a-d have been touched and box 354 has been touched or not).

[0093] The transition from display 300 to display 400 may also include changing the electrode representation, for example, from gray to white. This change prompts a professional 14 to indicate to the processor 46, by touching the corresponding electrode representation on display 400, its determination of which electrodes are rear-positioned. Therefore, the processor 46 can accept electrode input from screen 62 displaying display 400 with white electrode representations, whereas in a preferred variant of the method, the processor will not accept input when screen 62 displays displays 100, 200, and 300 with gray electrode representations.

[0094] With display 400 on screen 62, the professional 14 can touch the electrode representations corresponding to the rear-mounted electrodes 33. For each electrode representation touched by the professional, the corresponding electrode input can be sent from screen 62 to processor 46, thus informing processor 46 of the selection. In response, processor 46 can, among other things, further change the appearance of the electrode representation to confirm the selection and, during subsequent steps of the method, remind the professional 14 of the selection. (In display 400...) Figure 8 ) and display 500 ( Figure 9In the example illustrated in [reference needed], the professional 14 identifies the fourth, fifth, and sixth electrodes 33 as rear electrodes and touches electrode representations 426, 428, and 430, causing screen 62 to send corresponding electrode inputs to processor 46. This further causes processor 46 to change the appearance of these electrode representations to that of electrode representations 526, 528, and 530. For example, as shown on display 500, the outlines of these electrode representations can be thickened, and these electrode representations can be labeled "PE" representing "rear electrodes." Furthermore, upon receiving these electrode inputs from screen 62, processor 46 can change the appearance of dialog box 410 to that of dialog box 510, for example, to provide text confirmation and reminders of selections. As shown, dialog box 510 indicates "You have set 4, 5, and 6."

[0095] At step 1510, the GUI provides the professional 14 with the option to disable any of the electrodes 33, such that the disabled electrode will not receive power, while the non-disabled electrodes will receive power during the upcoming steps 1512, 1514, and 1516. Step 1510 is performed in a manner similar to step 1508. That is, dialog box 412 can expand into dialog box 612 after the processor 46 receives dialog box input from screen 62 (e.g., the professional 14 touches dialog box 412). As shown, dialog box 12 includes a text prompt to the professional 14: "Tap any electrode on the balloon to turn off the electrode before ablation." Thus, the processor 46 can identify which electrodes to disable by the professional 14 touching the electrode representation corresponding to the electrode to be disabled. At display 600 ( Figure 10 ) and display 700 ( Figure 11 In the example shown, professional 14 determines that the tenth electrode 33 should be disabled and touches the corresponding electrode representation. This causes screen 62 to send the corresponding electrode input to processor 46 to disable the tenth electrode 33. In response, processor 46 changes the electrode representation, for example, by turning it gray, as seen at 738. Furthermore, upon receiving these electrode inputs from screen 62, processor 46 may change the appearance of dialog box 612 to that of dialog box 712, for example, to provide text confirmation or a reminder of the selection. As shown, dialog box 712 indicates "You have disabled 10".

[0096] The ablation segment of the method is then performed, starting from step 1512, which is the beginning of the ablation step. Step 1512 may include a professional 14 touching, for example, a display 600 ( Figure 10 The dialog box 614 is configured to cause the screen 62 to send dialog box input to the processor 46, which interprets the dialog box input as an instruction to expand the dialog box 614 to display 800. Figure 12The dialog box 814 contains commands. The dialog box 814 includes an ablation box 856 and the instruction "Hold for 2 seconds" below it. Therefore, the dialog box 814 prompts the professional 14 to activate the electrode 33 by pressing the box 856, but prevents unintentional activation by requiring the box to be in contact for at least a certain amount of time (e.g., at least about two seconds). When the processor 46 receives the dialog box input from the screen 62 corresponding to the "Hold for 2 seconds" box 856, the processor 46 activates all electrodes that were not disabled during step 1510.

[0097] Power is delivered to the non-disabled electrode 33 on the balloon 80 for a sustained period of time (e.g., sixty seconds). During this time, step 1514 may optionally be performed to adjust the power delivered to one or more of the active electrodes. Four exemplary adjustments are described here. All, some, or none may be performed. First, refer to display 900 ( Figure 13 Dialog box 914 includes a stop box 956. A technician 14 can touch the stop box 956 to stop all power delivery to all active electrodes. That is, when the stop box 956 is touched, screen 62 sends dialog box input to processor 46, which interprets the dialog box input as a command to stop power delivery to all electrodes. In some variations of this method, touching the stop box 956 terminates an ablation segment of the method, which is also one way to perform the termination ablation step 1516. In other variations of this method, touching the stop box 956 causes display 900 (… Figure 13 ) Switch back to displaying 800 ( Figure 12 This allows step 1512 to be re-executed.

[0098] Regarding the second adjustment, box 914 indicates "tap any electrode to stop one electrode at a time." Therefore, if the professional 14 determines that any of the electrodes 33 should be deactivated, the professional can touch the corresponding electrode indicator to disable that electrode. As seen on display 900, the professional has touched electrode indicator 924, thus indicating that the professional has determined that the third electrode 33 should be disabled. By touching electrode indicator 924, screen 62 sends the electrode input to processor 46, which interprets the electrode input as a command to stop further power delivery to the third electrode 33.

[0099] Regarding the third adjustment, the processor 46 can determine that certain electrodes 33 should be automatically disabled when it is determined that the temperature of those electrodes may have exceeded the safe maximum value. In such cases, the processor 46 can change the representation of the corresponding electrode. For example, display 900 reflects that the ninth electrode 33 has been disabled because it has exceeded the safe maximum value by showing an electrode representation 936 with a thickened outline and possibly a color change to, for example, red. Additionally, an X may be provided on the electrode representation 936. Furthermore, display 800 can be removed. Figure 12The connection is 836a. Text instructions may also be provided, for example, a warning indicating "Electrode 9 is off; temperature reaches 55°C" is displayed at the bottom of the display 900.

[0100] Regarding the fourth adjustment, a display 1000 can be provided when the professional 14 command processor 46 enters the "edit power" mode (e.g., by touching the center portion 944 represented by the balloon). Figure 14 In the "Edit Power" mode of display 1000, a control overlay can be provided above the electrode representations. Although only one such overlay is provided on display 1000 (i.e., above electrode representations 1020), it should be understood that a control overlay can be provided above some or all of the electrode representations corresponding to the active electrode 33. As described above, the control overlay includes boxes or icons 1020a and 1020b that the operator 14 can use to communicate to the processor 46 that the power supplied to individual electrodes should be modified. When these boxes are touched, electrode input is provided by screen 62 to the processor 46, which interprets the electrode input as a command to increase or decrease the power supplied to the electrode (e.g., the first electrode 33 as shown). After the desired power has been set, the operator 14 can touch or tap the save box 1044a or the cancel box 1044b to return to display 900.

[0101] After power has been supplied to electrode 33 for a period of time (e.g., approximately sixty seconds), the ablation segment automatically ends at step 1516, in which the processor 46 automatically deactivates electrode 33. (Refer to display 1100) Figure 15 The central portion 1144 can indicate "ablation complete". Additionally, a new ablation frame 1162 can be provided. A professional can touch frame 1162 to return to display 500. Figure 9 (and step 1502. For example, professional 14 may have determined that the same pulmonary vein should receive another round of ablation therapy as discussed below with reference to step 1518, or that different pulmonary veins should receive ablation therapy.)

[0102] At step 1518, the specialist 14 determines whether the same pulmonary vein should receive another round of ablation therapy. This step includes the specialist 14 reviewing information about the completed round of ablation. Such information may be displayed as a 1200 ( Figure 16 Text data in the form of ) or as displayed as 1300 ( Figure 17The graphical data provided can be the sum of any previous rounds of ablation. Thus, for example, both displays 1200 and 1300 reflect two rounds of ablation performed, as indicated by the boxes “First” and “Second” in the upper left corner. As shown, the “Second” box includes a thickened outline, indicating that the information reflected on the display corresponds to the second round of ablation. Furthermore, electrode representations 1220 and 1320 are highlighted, further indicating that the information reflected on the display during the second round of ablation corresponds to the first electrode 33. Therefore, a professional 14 can instruct the processor 46 to display information corresponding to one round of ablation and each electrode by making appropriate selections on displays 1220 and 1320.

[0103] Any examples or embodiments described herein may also include various other features in addition to or as alternatives to those described above. The teachings, expressions, embodiments, examples, etc., described herein should not be considered independent of each other. Various suitable ways in which the teachings herein can be combined will become apparent to those skilled in the art upon reference to the teachings herein.

[0104] Exemplary embodiments of the subject matter contained herein have been shown and described, and further improvements to the methods and systems described herein can be achieved through appropriate modifications without departing from the scope of the claims. Furthermore, while the methods and steps described above represent specific events occurring in a particular order, it is intended that certain specific steps need not necessarily be performed in the described order, but can be performed in any order, as long as the steps enable the embodiment to achieve its intended purpose. Therefore, if variations of the invention exist and such variations fall within the substantial scope of the disclosure or equivalents of the invention found in the claims, this patent is intended to cover those variations as well. Many such modifications will be apparent to those skilled in the art. For example, the examples, embodiments, geometries, materials, dimensions, ratios, steps, etc., described above are illustrative. Therefore, the claims should not be limited to the specific details of the structures and operations shown in this written description and the accompanying drawings.

Claims

1. A method for controlling a catheter using a graphical user interface (GUI) of a computer system, the GUI including a processor and a display, the catheter including an expandable balloon disposed on the catheter, the expandable balloon including a surface and a plurality of electrodes including a first electrode disposed on the surface, the method comprising: A menu including a first dialog box, a second dialog box, and a final dialog box is provided in the first area of ​​the display; An image of the expandable balloon is provided in the second area of ​​the display, the image including a plurality of electrode representations, the plurality of electrode representations including a first electrode representation; The processor receives a first dialog box input from the first dialog box. After receiving an operation from the first dialog box input at the processor, the processor receives a first dialog box input from the second dialog box. In response to receiving a first dialog box input from the second dialog box at the processor, the appearance of the first dialog box is changed; The appearance of the second dialog box is changed; wherein the appearance of the first dialog box is changed from an expanded configuration to a collapsed configuration, and wherein the appearance of the second dialog box is changed from a collapsed configuration to an expanded configuration. The processor receives a first electrode input represented by the first electrode. as well as Change the representation of the first electrode. The method includes preventing changes to the appearance of the second dialog box before receiving input from the first dialog box.

2. The method of claim 1, further comprising altering the image of the balloon.

3. The method according to claim 1, wherein, At least one of the plurality of electrode representations includes an alphanumeric indicator.

4. The method according to claim 1, wherein, At least one of the plurality of electrode representations includes a shape indicator.

5. The method of claim 1, further comprising changing the appearance of each of the plurality of electrode representations.

6. The method according to claim 5, wherein, Simultaneously change the appearance of each of the plurality of electrode representations.

7. The method of claim 1, further comprising activating at least one of the plurality of electrodes.

8. The method of claim 7, further comprising a metric for displaying progress.

9. The method according to claim 8, wherein, The progress metrics include timers.

10. The method of claim 8, further comprising displaying the total power.

11. The method of claim 7, further comprising a second change to the representation of the first electrode.

12. The method of claim 11, further comprising a third change to the representation of the first electrode.

13. The method of claim 12, further comprising activating a pump to cause flushing fluid to expand the expandable balloon.

14. The method according to claim 12, wherein, The first electrode input includes a command that designates the first electrode as being positioned rearward for at least one of the plurality of electrodes.

15. The method of claim 12, further comprising changing the power setting corresponding to the first electrode.

16. The method of claim 15, wherein: The plurality of electrodes further includes a second electrode; and The plurality of electrode representations also includes a second electrode representation.

17. The method of claim 16, further comprising: The processor receives the first and second electrode inputs. as well as Change the representation of the second electrode.

18. The method of claim 17, further comprising a second change in the representation of the second electrode.

19. The method of claim 18, further comprising a third change to the representation of the second electrode.

20. The method according to claim 19, wherein, The first and second electrode inputs include a command that designates the second electrode as positioned rearward for at least one of the plurality of electrodes.

21. The method according to claim 20, wherein, The at least one other electrode includes the first electrode.

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