Post-ablation verification via visual signals

Abstract

The invention is entitled "Post-ablation verification via visual signals." A system and method are disclosed that are performed in association with a medical device in a medical procedure. The system and method include measuring at least one electrical signal in the medical procedure, rendering a depiction of the medical procedure on a display, representing the measured at least one electrical signal on the display in conjunction with the rendering of the medical procedure, recording a location of at least one medical device during the medical procedure, processing the recorded location of at least one medical device, depicting a value of a signal measured via the at least one medical device, and providing an output that correlates the processed recorded location of at least one medical device with the depicted signal measured via the at least one medical device at the processed recorded location by the at least one medical device.

Description

Technical Field

[0001] This invention relates to ablation associated with arrhythmias, and more specifically, to post-ablation verification via visual signals. Background Technology

[0002] Ablation catheters are commonly used to ablate cardiac tissue to prevent electrical signals from passing through the ablated tissue. This procedure is typically performed to prevent atrial fibrillation (AF), which is usually caused by erroneous signals and / or signal sources.

[0003] After the ablation procedure is completed, the effectiveness of the ablation is typically verified during a validation cycle. During the validation cycle, the catheter electrodes are placed over the ablation area and / or the surrounding area to confirm that the electrical signal does not penetrate the ablation zone. A positive result corresponds to a flat electrical signal read by the catheter electrodes.

[0004] During the validation period, a signal graph is provided, which includes signals from all catheter electrodes. When using a multi-electrode catheter, the signal graph shows the detected signal for each electrode. After effective ablation, the signal detected from the ablation area is considered flat or shows low electrical activity. However, it is often difficult to determine which electrode on the catheter corresponds to the detected signal on the signal graph. For example, the first electrode on a catheter with eight electrodes may detect the signal shown in the signal graph. However, the physician may not be able to easily identify which part of the organ the signal corresponds to and whether the signal originates from within or outside the ablation area. Summary of the Invention

[0005] The present invention provides a system and method for providing a user with a visual representation of an organ involved in a medical procedure to indicate the location where an electrical signal was detected during an operational cycle (such as a post-ablation verification cycle).

[0006] This invention discloses a system and method for execution in association with medical devices in a medical procedure. The system and method include measuring at least one electrical signal in the medical procedure, rendering a depiction of the medical procedure on a display, representing the measured at least one electrical signal on the display in conjunction with the rendering of the medical procedure, recording the position of at least one medical device during the medical procedure, processing the recorded position of the at least one medical device, depicting the value of the signal measured via the at least one medical device, and providing an output that correlates the processed recorded position of the at least one medical device with the depicted signal measured by the at least one medical device at the processed recorded position. Attached Figure Description

[0007] A more detailed understanding can be obtained through the following specific embodiments provided by way of example and in conjunction with the accompanying drawings, wherein similar reference numerals in the drawings indicate similar elements, and wherein:

[0008] Figure 1 A diagram of an exemplary system that can implement one or more features of the subject matter of this disclosure;

[0009] Figure 2A An example of a linear catheter including multiple electrodes that can be used to map regions of the heart is shown;

[0010] Figure 2B An exemplary balloon catheter comprising multiple strips and multiple electrodes on each strip is shown;

[0011] Figure 3 A display designed to provide feedback during the verification cycle of ablation is shown;

[0012] Figure 4A It shows Figure 3 A more detailed rendering of the image shows a display with heart chambers and four pulmonary veins that can be isolated via pulmonary isolation (PI).

[0013] Figure 4B It shows that it can be combined Figure 4A The rendering provides the signal curve; and

[0014] Figure 5 It shows the provision of relevant signals. Figure 3 The rendering method. Detailed Implementation

[0015] Cardiac arrhythmias, specifically atrial fibrillation, have long been a common and dangerous medical condition, particularly among the elderly. In patients with a normal sinus rhythm, the heart, composed of the atria, ventricles, and conduction tissues, beats synchronously and in a patterned manner under electrical stimulation. In patients with arrhythmias, abnormal areas of cardiac tissue do not follow the synchronous pulsating cycle associated with normal conduction tissues, unlike in patients with a normal sinus rhythm. Instead, these abnormal areas conduct abnormally to adjacent tissues, disrupting the cardiac cycle into an asynchronous rhythm. This abnormal conduction is known to occur in various regions of the heart, such as the sinoatrial (SA) node region, along the conduction pathways of the atrioventricular (AV) node and His bundle, or in the myocardial tissue that forms the walls of the ventricles and atria.

[0016] Cardiac arrhythmias, including atrial arrhythmias, can be multi-wave reentrant, characterized by multiple asynchronous loops of electrical impulses dispersed around the atrial chambers and typically self-propagating. Alternatively, or in addition to multi-wave reentrant arrhythmias, arrhythmias can also have a focal source, such as when isolated areas of tissue within the atria beat spontaneously in a rapid, repetitive manner. Ventricular tachycardia (V-tach or VT) is a tachycardia or rapid rhythm originating in a single ventricle. This is a potentially life-threatening arrhythmia because it can lead to ventricular fibrillation and sudden cardiac death.

[0017] Atrial fibrillation (AF) is a type of arrhythmia that occurs when the normal electrical impulses generated by the sinoatrial node are overwhelmed by disordered electrical impulses originating from the atria and pulmonary veins, causing irregular impulses to be transmitted to the ventricles. This results in an irregular heartbeat that can last from minutes to weeks, or even years. AF is typically a chronic condition that slightly increases the risk of death, usually caused by stroke. The risk increases with age. Approximately 8% of people over 80 years of age have some degree of AF. AF is usually asymptomatic and generally not life-threatening on its own, but it can cause palpitations, weakness, dizziness, chest pain, and congestive heart failure. The risk of stroke increases during AF because blood can pool and form clots in the poorly contracting atria and left atrial appendage. First-line treatment for AF is medication to slow the heart rate or restore a normal rhythm. Additionally, people with AF are often given anticoagulants to prevent them from having a stroke. The use of such anticoagulants carries the inherent risk of internal bleeding. For some patients, medication is insufficient; their atrial fibrillation (AF) is considered drug-resistant, meaning it cannot be treated with standard drug interventions. Synchronized cardioversion can also be used to restore AF to a normal rhythm. Alternatively, catheter ablation can be used to treat AF patients.

[0018] Catheter ablation-based treatments can include mapping the electrical properties of cardiac tissue (especially the endocardium and cardiac volume) and selectively ablating cardiac tissue by applying energy. Cardiac mapping, such as creating a potential mapping (voltage mapping) of the wave propagating along cardiac tissue or a mapping of the arrival time to various tissue locations (local time activation (LAT) mapping), can be used to detect localized cardiac tissue dysfunction. Cardiac mapping-based ablation, like those used in cardiac mapping, can stop or modify unwanted electrical signals propagating from one part of the heart to another.

[0019] The ablation process disrupts unwanted electrical pathways by creating a non-conductive ablation focus. Various energy delivery methods for creating ablation focuses have been disclosed, including the use of microwaves, lasers, and more commonly, radiofrequency energy to create conduction blocks along the heart tissue wall. In the two-step mapping-then-ablation procedure, electrical activity at various points in the heart is typically sensed and measured by inserting a catheter containing one or more electrical sensors (or electrodes) into the heart and acquiring data at multiple points. This data is then used to select the target endocardial region for ablation.

[0020] As clinicians treat increasingly challenging conditions such as atrial fibrillation and ventricular tachycardia, cardiac ablation and other cardiac electrophysiological procedures become increasingly complex. The treatment of complex arrhythmias now relies on the use of three-dimensional (3D) mapping systems to reconstruct the anatomy of the cardiac chambers of interest.

[0021] For example, cardiologists rely on software such as that produced by Biosense Webster, Inc. (Diamond Bar, Calif.). 3. The Complex Fragmented Atrial Electrocardiography (CFAE) module of the 3D mapping system is used to analyze intracardiac EGM signals and determine ablation points for the treatment of a wide range of heart conditions, including atypical atrial flutter and ventricular tachycardia.

[0022] 3D mapping can provide a wealth of information about the electrophysiological properties of tissues, representing the anatomical and functional matrix of these challenging arrhythmias.

[0023] Cardiomyopathy with different etiologies (hypoxia, dilated (DCM), hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular dysplasia (ARVD), left ventricular noncompaction (LVNC), etc.) has a recognizable matrix, characterized by a region of unhealthy tissue surrounded by normally functioning cardiomyocytes.

[0024] Electrode catheters have been widely used in medical practice for many years. They are used to stimulate and map electrical activity in the heart, as well as to ablate sites of abnormal electrical activity. In use, the electrode catheter is inserted into a major vein or artery, such as the femoral artery, and then guided to the cardiac chamber of interest. A typical ablation procedure involves inserting a catheter with at least one electrode at its distal end into the cardiac chamber. A reference electrode is provided, usually taped to the patient's skin, or a second catheter positioned in or near the heart may be used to provide the reference electrode. RF (radio frequency) current is applied to the tip electrode of the ablation catheter, and the current flows through the surrounding medium (i.e., blood and tissue) to the reference electrode. The current distribution depends on the amount of contact between the electrode surface and the tissue compared to blood, which has a higher conductivity. Heating of the tissue occurs due to its resistance. The tissue is sufficiently heated to destroy the cells in the cardiac tissue, resulting in the formation of a non-conductive ablation focus within the cardiac tissue. Heating of the electrode also occurs during this process due to conduction from the heated tissue to the electrode itself. If the electrode temperature becomes high enough, perhaps above 60°C, a thin, transparent coating of dehydrated hemoglobin can form on the electrode surface. If the temperature continues to rise, this dehydrated layer can become increasingly thick, causing blood to clot on the electrode surface. Because dehydrated biomaterials have a higher electrical resistance than endocardial tissue, the impedance to the flow of electrical energy into the tissue also increases. If the impedance increases sufficiently, an impedance rise occurs, and the catheter must be removed from the body and the tip electrode cleaned.

[0025] This invention discloses a system and method for execution in association with medical devices in a medical procedure. The system and method include measuring at least one electrical signal in the medical procedure, rendering a depiction of the medical procedure on a display, representing the measured at least one electrical signal on the display in conjunction with the rendering of the medical procedure, recording the position of at least one medical device during the medical procedure, processing the recorded position of the at least one medical device, depicting the value of the signal measured via the at least one medical device, and providing an output that correlates the processed recorded position of the at least one medical device with the depicted signal measured by the at least one medical device at the processed recorded position.

[0026] Figure 1This is an illustration of an exemplary system 102 that can implement one or more features of the subject matter of this disclosure. All or part of system 102 can be used to collect information for a training dataset, and / or all or part of system 102 can be used to implement a trained model. System 102 may include components, such as catheter 140, configured to damage tissue regions of organs within the body. Catheter 140 may also be further configured to obtain biometric data. While catheter 140 is shown as a pointed catheter, it should be understood that catheters of any shape, including one or more elements (e.g., electrodes), can be used to implement embodiments disclosed herein. System 102 includes a probe 121 having an axis that can be navigated by a physician 130 to a body part of a patient 128 lying on a bed 129, such as the heart 126. Multiple probes may be provided according to embodiments; however, for brevity, a single probe 121 is described herein, but it should be understood that probe 121 may represent multiple probes. Figure 1 As shown, a physician 130 can insert the shaft 122 through the sheath 123 while manipulating the distal end of the shaft 122 using a manipulator 132 near the proximal end of the catheter 140 and / or by deflection from the sheath 123. As shown in illustration 125, the catheter 140 can be fitted to the distal end of the shaft 122. The catheter 140 can be inserted through the sheath 123 in a collapsed state and can then be deployed within the heart 126. As further disclosed herein, the catheter 140 may include at least one ablation electrode 147 and a catheter needle 148.

[0027] According to an exemplary embodiment, catheter 140 may be configured to ablate a tissue region of the heart chamber of heart 126. Illustration 145 shows catheter 140 located within the heart chamber of heart 126 in an enlarged view. As shown, catheter 140 may include at least one ablation electrode 147 coupled to the body of the catheter. According to other exemplary embodiments, multiple elements may be connected via an elongation forming the shape of catheter 140. One or more other elements (not shown) may be provided, which may be any element configured to ablate or obtain biometric data, and may be an electrode, a transducer, or one or more other elements.

[0028] According to the embodiments disclosed herein, an ablation electrode, such as electrode 147, can be configured to deliver energy to a tissue region of an organ in the body, such as heart 126. The energy can be thermal and can cause damage to the tissue region by starting from the surface of the tissue region and extending into the thickness of the tissue region.

[0029] According to the exemplary embodiments disclosed herein, biometric data may include one or more of the following: LAT, electrical activity, topology, bipolar mapping, dominant frequency, impedance, etc. Local activation time can be a time point corresponding to a threshold activity of local activation, calculated based on a normalized initial start point. Electrical activity can be any applicable electrical signal that can be measured based on one or more thresholds and can be sensed and / or amplified based on signal-to-noise ratio and / or other filters. 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 part of a body part and can differ in different parts of the same body part. For example, the dominant frequency of the pulmonary veins of the heart can differ from the dominant frequency of the right atrium of the same heart. Impedance can be a resistance measurement at a given region of a body part.

[0030] like Figure 1 As shown, probe 121 and catheter 140 can be connected to console 124. Console 124 may include processor 141 (such as a general-purpose computer) having suitable front-end and interface circuitry 138 for transmitting and receiving signals to and from the catheter, as well as other components for controlling system 102. In some embodiments, processor 141 may be further configured to receive biometric data, such as electrical activity, and determine whether a given tissue region is conductive. According to one embodiment, the processor may be located external to console 124 and may be located, for example, in a catheter, an external device, a mobile device, a cloud-based device, or may be a stand-alone processor.

[0031] As noted above, processor 141 may include a general-purpose computer that can be software-programmed to perform the functions described herein. The software may be downloaded to the general-purpose computer electronically, for example, via a network, or alternatively or additionally set and / or stored on a non-transitory tangible medium, such as magnetic storage, optical storage, or electronic storage. Figure 1 The exemplary configuration shown can be modified to implement the embodiments disclosed herein. The embodiments disclosed herein can be applied similarly using other system components and settings. Additionally, system 102 may include additional components such as elements for sensing electrical activity, wired or wireless connectors, processing and display devices, etc.

[0032] According to one embodiment, the display 127 connected to the processor (e.g., processor 141) may be located in a remote location such as a separate hospital or within a separate healthcare provider network. Additionally, system 102 may be part of a surgical system configured to acquire anatomical and electrical measurements of a patient's organ (such as the heart) and perform cardiac ablation procedures. Examples of such surgical systems are sold by Biosense Webster. system.

[0033] System 102 can 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. System 102 can use catheters, electrocardiograms (EKG), or other sensors that measure the electrical properties of the heart to obtain electrical measurements. Figure 1 As shown, biometric data, including anatomical and electrophysiological measurements, can then be stored in memory 142 of the mapping system 102. The biometric data can be transferred from memory 142 to processor 141. Alternatively or otherwise, biometric data can be transferred to a server 160, which may be local or remote, using network 162.

[0034] Network 162 can be any network or system known in the art, such as an intranet, local area network (LAN), wide area network (WAN), metropolitan area network (MAN), direct connection or a series of connections, cellular telephone network, or any other network or medium capable of facilitating communication between the measurement system 102 and the server 160. Network 162 can be wired, wireless, or a combination thereof. Wired connections can be implemented using Ethernet, Universal Serial Bus (USB), RJ-11, or any other wired connection known in the art. Wireless connections can be implemented using Wi-Fi, WiMAX and Bluetooth, infrared, cellular networks, satellite, or any other wireless connection method known in the art. Additionally, several networks can operate independently or communicate with each other to facilitate communication within network 162.

[0035] In some cases, server 160 can be implemented as a physical server. In other cases, server 160 can be implemented as a public cloud computing provider (e.g., Amazon Web Services). () virtual server.

[0036] The console 124 can be connected to a surface electrode 143 via a cable 139, which may include an adhesive skin patch attached to the patient 128. A processor, in conjunction with a current tracking module, determines the orientation coordinates of the catheter 140 within a body part of the patient (e.g., the heart 126). The orientation coordinates may be based on impedance or electromagnetic field measured between the surface electrode 143 and other electromagnetic components of the electrode 147 or catheter 140. Additionally or alternatively, a positioning pad may be located on the surface of the bed 129 and may be detachable from the bed 129.

[0037] Processor 141 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 (electromyography) signal conversion integrated circuit. Processor 141 may pass signals from the A / D or EMG circuitry to another processor and / or may be programmed to perform one or more functions disclosed herein.

[0038] The console 124 may also include an input / output (I / O) communication interface that enables the console to transmit signals from the electrode 147 and / or transmit signals to the electrode.

[0039] During the procedure, processor 141 may facilitate the presentation of a body part rendering 135 to physician 130 on display 127 and store data representing the body part rendering 135 in memory 142. Memory 142 may include any suitable volatile and / or non-volatile memory, such as random access memory or hard disk drive. In some embodiments, healthcare professional 130 may be able to manipulate the body part rendering 135 using one or more input devices, such as a touchpad, mouse, keyboard, gesture recognition device, etc. For example, the input device may be used to change the position of catheter 140, causing the rendering 135 to be updated. In an alternative embodiment, display 127 may include a touchscreen that can be configured to accept input from healthcare professional 130 in addition to presenting the body part rendering 135.

[0040] Typically, a catheter containing an electrical sensor at or near its distal tip is advanced to a point in the heart. The sensor contacts the tissue and acquires data at that point, thus measuring the electrical activity at that point in the heart. A drawback of mapping cardiac chambers using catheters containing only a single distal electrode is the time-consuming process of acquiring data point-by-point at the necessary number of points required for a detailed map of the entire chamber. Therefore, multi-electrode catheters have been developed to simultaneously measure electrical activity at multiple points within the cardiac chambers.

[0041] Multi-electrode catheters can be implemented using any suitable shape, such as linear catheters with multiple electrodes, balloon catheters including electrodes distributed on multiple ridges that shape the balloon, sling or loop catheters with multiple electrodes, or any other suitable shape. Figure 2A An example of a linear catheter 202 including multiple electrodes 204, 205, and 206 for mapping regions of the heart is shown. The linear catheter 202 may be fully or partially elastic, such that it may be twisted, bent, and / or otherwise altered in shape based on received signals and / or based on external forces (e.g., cardiac tissue) applied to the linear catheter 202.

[0042] Figure 2B An exemplary balloon catheter 212 is shown, which includes multiple strips (e.g., Figure 2B The specific example includes 12 strips (strips 214, 216, 217), and multiple electrodes on each strip, including electrodes 221, 222, 223, 224, 225, and 226 as shown in the figure. The balloon catheter 212 can be designed such that its electrodes maintain close contact with the endocardial surface when deployed into the patient. For example, the balloon catheter can be inserted into an inner lumen, such as a pulmonary vein (PV). The balloon catheter can be inserted into the PV in a constricted state so that the balloon catheter does not occupy its maximum volume when inserted into the PV. The balloon catheter can inflate within the PV so that the electrodes on the balloon catheter contact the entire circular segment of the PV.

[0043] Figure 3 A display 300 designed to provide feedback during a validation cycle of ablation is shown. A rendering 310 of the ablated organ is available. The rendering 310 can be provided during both the ablation procedure and the validation cycle. The rendering 310 may show an ablation region 330, such that a catheter 320 can be guided to the ablation region 330 during the validation cycle. The ablation region 330 may include one or more ablations 340. As shown, ablations 340 may include vertical and horizontal ablations forming a plus sign. The catheter 320 may contact the ablation region 330 (and possibly the ablations 340) to collect any electrical signals present in the ablation region. A depiction of the catheter 320 may be provided in the organ rendering 310.

[0044] Figure 4A Showing from Figure 3 A more detailed rendering of 310 shows a display 300 having a cardiac chamber 450 and four pulmonary veins 4601, 4602, 4603, 4604 (commonly or generally referred to as pulmonary vein 460), which are segregated via pulmonary isolation (PI). As relative to Figure 3The catheter 320 is present in the ablation area 330 where one or more ablation zones 340 have been formed. As described, rendering 310 provides visual indications to allow physicians to identify organ regions where signals have been detected during a validation cycle to determine if additional ablation is required. Within the organ, the catheter is visualized, and on the catheter, electrodes are visualized.

[0045] If the catheter detects a signal with significant electrical activity (defined as a threshold by the physician), then... Figure 3 The electrodes of the catheter 320 in the display visually represent the location where the signal is detected, such as light, markings, flashes, emphasis, etc. Based on the visual representation and the location of the signal, it can be determined whether the detected signal is within region 330 where electrical activity should not occur, or whether the detected signal is outside such region but in regions such as regions 4701 and 4702, where good tissue exists and ablation is not intended to affect the signal. If the detected signal is within region 330 where electrical activity should not occur, additional ablation can be performed.

[0046] By way of example, all electrodes of catheter 320 that detect electrical activity may be presented as “green,” while those electrodes that measure low electrical activity compared to a threshold may be indicated as “red.” Alternatively or otherwise, electrodes of catheter 320 that detect electrical activity may be presented as “constant,” while those electrodes that measure zero electrical activity compared to a threshold may be indicated as “flickering.”

[0047] Figure 4B A signal graph 400, which can be combined with rendering 300, is shown. The signal graph 400 can show the electrical activity of all electrodes corresponding to the conduit 320. This can include any number of signals, such as 40 signals. Figure 4B Signal plot 400 illustrates four such signals to aid in understanding the invention. These four signals include signal 1 410, signal 2 420, signal 3 430, and signal 4 440. Each of these signals 1-4 410-440 corresponds to a signal measured in the electrodes of catheter 320. As shown, signals 1 410 and 2 430 include electrical activity, while signals 3 430 and 4 440 do not include electrical activity or include low electrical activity. This can be determined by signal plot 400.

[0048] When the signals in display 300 (signals 3 430, 4 440) are below a threshold that can be defined by the user or by BWI as an inactive signal / flat line, the signal associated with a specific electrode on catheter 320 can have a visual indication, allowing the physician to potentially locate the area within rendering 310 and determine whether the absence of signal is appropriate. When the signals in display 300 (signals 1 410, 2 420) are above the threshold, they can be indicated as active signals exhibiting electrical activity. The signal associated with a specific electrode on catheter 320 can have a visual indication on the electrode, allowing the physician to potentially locate the area within rendering 310 and determine whether the presence of electrical activity is appropriate. Figure 4A Rendering 310 and Figure 4B The signal curves of the catheter electrodes are synchronized, allowing the position and signal visualization of the catheter electrodes to be correlated. This correlation can be achieved through visual representations such as light, markings, flashes, and emphasis. That is, the signal curves of the electrodes can flash, and the electrodes in the rendering also flash.

[0049] This correlation provides detail as the catheter is moved and when interacting with the display. When catheter 320 moves within the chamber, the electrodes within rendering 310 are visualized as described. For example, if catheter 320 detects a signal, the electrodes detecting such a signal can be marked in rendering 310 using one of the specified methods. As the catheter moves to other locations where catheter 320 detects a signal, the electrodes detecting such a signal can be further marked in rendering 310 using one of the specified methods. As catheter 320 moves and reaches a location where the electrodes detect no signal, the marking of the electrodes may cease, or the electrodes without a signal may be distinguishably marked in rendering 310 from those marked as having a signal.

[0050] Specifically, as the cathode is positioned to measure electrical signals using electrodes, the measured signals can be plotted. For example, an electrode positioned at location 4101 can provide signal pattern 410, an electrode positioned at location 4201 can provide signal pattern 420, an electrode positioned at location 4301 can provide signal pattern 430, and an electrode positioned at location 4401 can provide signal pattern 440.

[0051] As described above, when the electrode is located at position 4101 as shown in Figure 410, the electrode at position 4101 and Figure 410 can be marked to provide the user with a visual indication that Figure 410 corresponds to electrode 4101. When the electrode is located at position 4201 as shown in Figure 420, the electrode at position 4201 and Figure 420 can be marked to provide the user with a visual indication that Figure 420 corresponds to electrode 4201. When the electrode is located at position 4301 as shown in Figure 430, the electrode at position 4301 and Figure 430 can be marked to provide the user with a visual indication that Figure 430 corresponds to electrode 4301. When the electrode is located at position 4401 as shown in Figure 440, the electrode at position 4401 and Figure 440 can be marked to provide the user with a visual indication that Figure 440 corresponds to electrode 4401.

[0052] Alternatively or otherwise, the system may operate in the opposite manner to that described above, as it may respond to a user interacting with the display rather than a user interacting with the conduit. In this configuration, the user may interact with the signal graph 400 via an input device on the display. For example, the graph of the signal in the signal graph 400 may be hovered over with a cursor, and the corresponding electrode of the conduit may blink in the rendering 310, or vice versa, such as by hovering over the rendering 310 and the corresponding electrical signal blinking. While blinking is provided as one method of providing visual indication to the user, other techniques may be used additionally or alternatively. These other techniques may include the use of coloring, the use of hashing, blinking, pointers or indicators, or other methods of providing emphasis or highlighting of the depiction on the display.

[0053] Alternatively, for example, a single signal on the signal curve 400 or an electrode on the catheter 320 can be selected via user input. That is, the depiction can highlight or present only a single electrode and its corresponding graphic depiction for viewing. The corresponding electrode on the catheter 320 that has the signal on the signal curve 400 can be presented. When a single signal on the signal curve 400 or an electrode on the catheter 320 is selected, other signals on the signal curve 400 or electrodes on the catheter 320 can be hidden and not seen. Similarly, only the corresponding electrode on the catheter 320 or the signal on the signal curve 400 is presented, while other electrodes on the catheter 320 or signals on the signal curve 400 can be hidden and not seen.

[0054] By using the electrodes of catheter 320 to assess whether there is a lack of signal or electrical activity in various regions of rendering 310, the physician can determine whether additional ablation is needed. Essentially, the physician may be able to determine, for example, whether unwanted electrical activity exists within ablation region 330, or whether unwanted electrical activity is absent outside ablation region 330 but in regions 4701, 4702. If unwanted electrical activity is present within ablation region 330, additional ablation can be performed to control the pathway of such electrical signals. If unwanted electrical activity is absent, this absence may indicate, for example, the presence of scarring in a chamber. Such scarring may originate from prior procedures, or at least may not originate from the procedures of this invention. Such scarring may be the cause of another arrhythmia and / or is not important to this procedure.

[0055] Figure 5 It shows the provision of relevant signals. Figure 3 Method 500 for rendering. Method 500 includes measuring electrical signals in a medical protocol at step 510. At step 520, method 500 includes rendering the medical protocol on a display. At step 530, method 500 includes representing the measured electrical signals on the display. At step 540, method 500 includes recording the location of a medical device, such as catheter location. Additionally, other data of the medical protocol may be recorded, including ECG data, force data, etc. At step 550, method 500 may include processing that includes analyzing data, such as catheter location and associated electrical signals. This processing may include identifying annotations on the ECG data. As will be understood by those skilled in the art, reference annotations may be included within the data when the protocol occurs. The processing in step 550 may include detecting or determining specific channels for these mapping annotations and mapping the annotations to the catheter channels. At step 560, the signal value of each channel in the channels is visualized or depicted.

[0056] If no signal is measured at the electrode, the absence of signal information can be provided through a visual depiction of the electrode, and the graph of the signal at that electrode can be plotted as a flat line signal. As mentioned above, the absence of signal or flat line can be presented in a variety of ways. In short, the electrode and the graph of the signal for the electrode can be colored, or otherwise provided with visual indications that allow the user to notice the absence of a signal. Visual indications include flashing, marking, etc.

[0057] If an ECG signal is measured on another electrode, signal information, including amplitude and other commonly understood ECG data, can be provided to a visualization of that other electrode and a graph of the signal at that other electrode. As mentioned above, the signal for the electrode can be presented in several ways. In short, the electrode and the graph of the signal for the electrode can be colored green to indicate the presence of a signal.

[0058] At step 570, the method may include providing an output that correlates a given electrode and its position within the illustrated medical protocol with a signal measured by the electrode at that position.

[0059] Method 500 can be executed in real time. Data can be generated and rendered in real time, so signal visualization / no-signal visualization can be simultaneously depicted on a 3D conduit electrode model when measuring flat lines or signals.

[0060] Generally, the system captures ongoing timeline data and correlates it with other sensed data. The sensed data can include data sensed by the system, such as ECG, location, etc. ECG data can be processed, and a threshold can be used to identify one or more electrodes as "not sensing ECG data." This identification can then be combined with the catheter's location when no information is permitted to be displayed. Similar methods can be used for signals above a threshold detected based on catheter location.

[0061] While features and elements have been specifically described above, those skilled in the art will recognize that each feature or element can be used alone or in any combination with other features and elements. Furthermore, the methods described herein can be implemented in a computer program, software, or firmware incorporated in a computer-readable medium for execution by a computer or processor. Examples of computer-readable media include electronic signals (transmitted via a wired or wireless connection) and computer-readable storage media. Examples of computer-readable storage media include, but are not limited to, 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 discs (DVDs)).

Claims

1. A computer-implemented method performed in association with a medical device in a medical procedure, the method comprising: Acquire at least one electrical signal measured during the post-ablation verification period; A depiction of the medical procedure is rendered on a display, the depiction including a rendering of the patient's heart and the ablation area, the ablation area being marked as not containing electrical activity as a result of the ablation; The rendered depiction on the display represents at least one measured electrical signal; Process the location of at least one medical device recorded during the post-ablation verification period; A signal curve is plotted on the display for the at least one electrical signal measured via the at least one medical device; as well as A visual output is provided on the display that correlates the recorded location processed by at least one medical device with a plotted signal graph, the visual output indicating whether the recorded location contains electrical activity and whether the recorded location is within the ablation area.

2. The method according to claim 1, wherein, The at least one electrical signal is an electrical signal from the heart.

3. The method according to claim 1, wherein, The rendering of the medical protocol includes the rendering of the patient's heart and catheters.

4. The method according to claim 1, wherein, During the post-ablation verification period, the location of at least one medical device is recorded using a medical system.

5. The method according to claim 4, wherein, The medical system in question is the CARTO® system.

6. The method according to claim 1, wherein, The relevant outputs include visual representations.

7. The method according to claim 6, wherein, The visual representation is a marker.

8. The method according to claim 6, wherein, The visual representation includes blinking.

9. The method according to claim 1, wherein, The medical device is a catheter used in ablation, and the at least one electrical signal includes a detected cardiac electrical signal.

10. The method according to claim 1, wherein, Measuring at least one electrical signal includes at least one zero-signal measurement indicating successful ablation to block the electrical pathways of signals in the heart.

11. The method according to claim 1, wherein, Measuring at least one electrical signal includes at least one real-time signal measurement result indicating an electrical pathway in the heart.

12. A non-transitory computer-readable medium including code stored thereon, said code, when executed by a processor, causing a system to perform a method for associating with a medical device in a medical protocol, said method comprising: At least one electrical signal was measured during the post-ablation verification period; A depiction of the medical procedure is rendered on a display, the depiction including a rendering of the patient's heart and the ablation area, the ablation area being marked as containing no electrical activity as a result of the ablation; The rendered depiction on the display represents at least one measured electrical signal; The location of at least one medical device is recorded during the post-ablation verification period; The recorded location of at least one medical device was processed; A signal curve is plotted on the display for the at least one electrical signal measured via the at least one medical device; as well as A visual output is provided on the display that correlates the recorded location processed by at least one medical device with a plotted signal graph, the visual output indicating whether the recorded location contains electrical activity and whether the recorded location is within the ablation area.

13. The computer-readable medium according to claim 12, wherein, The at least one electrical signal is an electrical signal from the heart.

14. The computer-readable medium of claim 12, wherein, The rendering of the medical protocol includes the rendering of the patient's heart and catheters.

15. The computer-readable medium according to claim 12, wherein, During the post-ablation verification period, the location of at least one medical device is recorded using a medical system.

16. The computer-readable medium of claim 15, wherein, The medical system in question is the CARTO® system.

17. The computer-readable medium according to claim 12, wherein, The relevant outputs include visual representations.

18. The computer-readable medium according to claim 12, wherein, Measuring at least one electrical signal includes at least one zero-signal measurement indicating successful ablation to block the electrical pathways of signals in the heart.

19. The computer-readable medium according to claim 12, wherein, Measuring at least one electrical signal includes at least one real-time signal measurement result indicating an electrical pathway in the heart.

20. A system for performing a method associated with a medical device in a medical protocol, the system comprising: A medical system for measuring at least one electrical signal during a post-ablation validation period and rendering a depiction of the medical procedure on a display, the depiction including renderings of the patient's heart and the ablation area, the ablation area being marked as containing no electrical activity as a result of the ablation, the medical system comprising: A processor that operates in conjunction with a display to combine a rendered depiction on the display representing at least one measured electrical signal. A memory module for recording the location of at least one medical device during the post-ablation verification period; The processor processes the location recorded by at least one medical device; The processor and the display operate to plot signal curves of the at least one electrical signal measured via the at least one medical device; and A display for providing visual output that correlates a recorded location processed by at least one medical device with a plotted signal graph, the visual output indicating whether the recorded location contains electrical activity and whether the recorded location is within the ablation area.

Images