Enhanced ultrasound images

Abstract

In one exemplary mode, a medical system includes an ultrasound probe configured to capture an ultrasound image of at least a portion of a body part of a living subject; a display; and a processor configured to present to the display a respective representation of a respective subset of electroanatomical data superimposed over a respective one of the ultrasound images.

Description

Technical Field

[0001] The present disclosure relates to medical systems and, in particular, but not exclusively, to enhanced imaging. Background Art

[0002] Various devices and methods for intracardiac ultrasound imaging are known in the art. For example, Biosense Webster Inc. (Irvine, California) provides the CartoSound 2D ultrasound imaging system for real-time generation of 2D ultrasound images. TM Software Modules and SoundStar TM Catheter. The SoundStar catheter, which is inserted into the heart through the vascular system, contains a position sensor and a phased array ultrasound transducer. The CartoSound software module processes the signals from the position sensor and ultrasound transducer to generate a 3D image of the heart chambers.

[0003] Tal's U.S. Patent 8,075,486 describes the use of a specialized cardiac catheter for image acquisition whereby features of the heart can be readily identified on an ultrasound image based on a previously generated electrical activation map of the heart. The electrical activation map is automatically registered with the ultrasound image using information obtained from a position sensor in the catheter. Features identifiable on the electrical activation map, represented as dots, labels, design lines, and textual logos, are projected into the plane of an ultrasound fan and overlaid on the ultrasound image, thereby illustrating the features visible on the ultrasound fan. BRIEF DESCRIPTION OF THE DRAWINGS

[0004] The present disclosure will be understood from the following detailed description in conjunction with the accompanying drawings, in which:

[0005] Figure 1 is a schematic illustration of a catheter-based system including ultrasound imaging according to an exemplary mode of the present disclosure;

[0006] Figure 2 is Figure 1 A schematic side view of a distal end of a mapping catheter used in a system of FIG.

[0007] Figure 3 is Figure 1 A schematic side view of a distal end of an ultrasound probe used in a system of FIG.

[0008] Figure 4 Is Figure 1 A schematic representation of an ultrasound image captured by an ultrasound probe of the system;

[0009] Figure 5 Yes Figure 1 A flowchart of the steps in the method of operation of the system;

[0010] Figure 6 is a schematic diagram of a 3D anatomical map and a 2D ultrasound image having a representation of electroanatomical data disposed thereon; and

[0011] Figure 7 is a schematic diagram of a 3D anatomical map and a 2D ultrasound image on which different representations of electroanatomical data are disposed. DETAILED DESCRIPTION

[0012] Overview

[0013] Ultrasound scans (e.g., two-dimensional (2D) or three-dimensional (3D) ultrasound images) enable physicians to observe the movement of the chambers of the heart (or other body parts) in real time. Electroanatomical data (e.g., local activation time (LAT)) of the chambers (or other body parts) are typically presented as LAT values ​​overlaid on a 3D anatomical map of the chambers (e.g., using an appropriate color scheme). However, the 3D electroanatomical map may not represent an image of the chambers of the heart and may not provide a real-time representation showing the movement of the chambers of the heart. Currently, physicians often need to view the two presentations separately (i.e., the ultrasound map and the 3D electroanatomical map) and form a relationship in their minds between the two presentations. This process requires mental effort and can result in errors in judgment.

[0014] The exemplary mode of the present disclosure solves the above-mentioned problems by superimposing a representation of electroanatomical data on top of an ultrasound image captured by an ultrasound probe so that the electroanatomical data and the real-time ultrasound image can be evaluated in a single view. The electroanatomical data may include LAT values, bipolar data, and / or propagation data such as velocity vectors. The electroanatomical data may be represented using colored lines or areas or hatched lines or areas (e.g., to represent LAT values ​​or bipolar data) or arrows (e.g., to represent propagation data). The representation of the electroanatomical data may be superimposed on top of a 2D ultrasound image (e.g., a 2D ultrasound slice) or within (and / or on) a 3D ultrasound image.

[0015] The electroanatomical data to be included in the corresponding ultrasound image is selected based on the electroanatomical data being positioned within the corresponding ultrasound image or within a threshold proximity of the corresponding ultrasound image relative to the 3D coordinate space. For example, data from the 3D electroanatomical map may be selected to be superimposed on top of the corresponding ultrasound image based on where the corresponding ultrasound image intersects the 3D electroanatomical map in the 3D coordinate space. For example, if the 3D electroanatomical map includes a particular color distribution representing LAT values ​​(or bipolar data), the coloring used in the 3D electroanatomical map at the intersection of the 3D electroanatomical map and the 2D ultrasound image is superimposed on the 2D ultrasound image as one or more lines to show the LAT values ​​(or bipolar data) associated with the 2D ultrasound image.

[0016] The display is dynamic so that as the ultrasound probe moves and captures different ultrasound images of the chambers of the heart, the representation of the electroanatomical data superimposed above the different ultrasound images changes to reflect the new orientation of the different ultrasound images in the 3D coordinate space and that the new electroanatomical data is now included within the different ultrasound images or is included within a given threshold proximity of the different ultrasound images. For example, as the ultrasound probe moves, the LAT values ​​superimposed above the ultrasound images move and change to reflect the current LAT values ​​in the current region of the 3D coordinate space occupied by the corresponding ultrasound image.

[0017] The representation of electroanatomical data superimposed on top of the ultrasound image need not be limited to the electroanatomical data included in the 3D electroanatomical map. Other electroanatomical data not used in the 3D electroanatomical map may have been collected by the mapping catheter. For example, electroanatomical data (e.g., bipolar data) captured from tissue of internal structures such as papillary muscles may not be included in the 3D electroanatomical map. However, a representation of electroanatomical data captured from tissue of internal structures may be superimposed on top of the corresponding ultrasound image. In this way, electroanatomical data that is not normally visible to the physician (because the electroanatomical data is excluded from the 3D electroanatomical map) is now included in the corresponding ultrasound image.

[0018] In some exemplary modes, the position of a distal end of a catheter inserted into a chamber of the heart may be tracked, and a representation of the tracked distal end of the catheter may be superimposed over a corresponding ultrasound image.

[0019] System Description

[0020] Reference now Figure 1 , which is a schematic illustration of a catheter-based system 10 including ultrasound imaging according to an exemplary mode of the present disclosure. Figure 2 , the figure is in Figure 1 Schematic side view of the distal end of the mapping catheter 40 used in the system 10.

[0021] The system 10 is used to determine the position of the catheter 40, such as in Figure 1 In Figure 12 and in Figure 2 Catheter 40 is a probe that includes a shaft 14 and a plurality of flexible arms 16 (only some of which are labeled for simplicity) for insertion into a body part of a living subject (e.g., a chamber of a heart 18). The flexible arms 16 have respective proximal ends connected to the distal end of the shaft 14.

[0022] The catheter 40 includes a position sensor 20 disposed on the shaft 14 in a predefined spatial relationship relative to the proximal end of the flexible arm 16. The position sensor 20 may include a magnetic sensor 22 and / or at least one shaft electrode 24. The magnetic sensor 22 may include at least one coil, such as but not limited to a dual-axis or triple-axis coil arrangement, to provide position and orientation (including yaw) data. The catheter 40 includes a plurality of electrodes 26 disposed at different corresponding locations along each of the flexible arms 16 (for simplicity, only some are labeled in FIG. 1 ). Figure 2 In general, catheter 40 may be used to map electrical activity in the heart of a living subject using electrodes 26, or may be used to perform any other suitable function in a body part of a living subject, such as, but not limited to, reversible and / or irreversible electroporation and / or RF ablation.

[0023] The medical protocol system 20 can determine the position and orientation of the shaft 14 of the catheter 40 based on signals provided by the magnetic sensor 22 and / or shaft electrodes 24 (proximal electrode 24a and distal electrode 24b) mounted on the shaft 14 and located on either side of the magnetic sensor 22. At least some of the proximal electrode 24a, distal electrode 24b, magnetic sensor 22, and electrodes 26 are connected to various driver circuits in the console 28 via wires extending through the shaft 14. In some exemplary modes, the distal electrode 24b and / or the proximal electrode 24a may be omitted.

[0024] Figure 2 The illustrations shown are chosen solely for conceptual clarity. Other configurations of shaft electrodes 24 and electrodes 26 are possible. Additional functionality may be included in position sensor 20. Elements not relevant to the disclosed exemplary modes of the present disclosure, such as irrigation ports, are omitted for clarity.

[0025] The physician 30 navigates the catheter 40 to a target location in a body part (e.g., heart 18) of the patient 32 by manipulating the shaft 14 and / or the deflection from the sheath using a manipulator near the proximal end of the catheter 40. The catheter 40 is inserted through the sheath with the flexible arms 16 gathered together, and only after the catheter 40 is retracted from the sheath are the flexible arms 16 able to unfold and resume their intended functional shape. By housing the flexible arms 16 together, the sheath also serves to minimize vascular trauma on its way to the target location.

[0026] The console 28 includes processing circuitry 34 (typically a general purpose computer) and suitable front-end and interface circuitry for generating signals in and / or receiving signals from body surface electrodes 36 attached to the chest and back of the patient 32 or any other suitable skin surface by wires (not shown) extending through cables (not shown).

[0027] The console 28 also includes a magnetic sensing subsystem. The patient 32 is placed in a magnetic field generated by a pad including at least one magnetic field radiator 38, which is driven by a unit 42 disposed in the console 28. One or more magnetic field radiators 38 are configured to emit an alternating magnetic field into an area where a body part (e.g., heart 18) is located. The magnetic field generated by the magnetic field radiator 38 generates a direction signal in the magnetic sensor 22. The magnetic sensor 22 is configured to detect at least a portion of the emitted alternating magnetic field and provide the direction signal as a corresponding electrical input to the processing circuit 34.

[0028] In some exemplary modes, the processing circuit 34 uses the position signals received from the shaft electrode 24, the magnetic sensor 22, and the electrode 26 to estimate the position of the catheter 40 within an organ, such as a heart chamber. In some exemplary modes, the processing circuit 34 correlates the position signals received from the electrodes 24, 26 with the previously acquired magnetic position-calibrated position signals to estimate the position of the catheter 40 within the organ. The position coordinates of the shaft electrode 24 and the electrode 26 can be determined by the processing circuit 34 based on (among other inputs) the ratio of the current distribution between the electrodes 24, 26 and the body surface electrode 36 or the measured impedance. The console 28 drives the display 44, which can show the distal end of the catheter 40 within the heart 18.

[0029] Methods using current distribution measurements and / or position sensing of external magnetic fields are used in various medical applications (e.g., in the Magnetic Field Imaging Devices manufactured by Biosense Webster Inc. (Irvine, California) and 7,848,787, PCT Patent Publication No. WO 96 / 05768, and U.S. Patent Application Publications No. 2002 / 0065455A1, 2003 / 0120150A1, and 2004 / 0068178A1.

[0030] The system applies an active current location (ACL) impedance based position tracking method. In some exemplary modes, the processing circuit 34 is configured to use the ACL method to generate a mapping between an indication of electrical impedance and the position of the magnetic field radiator 38 in the magnetic coordinate system (e.g., a current-position matrix (CPM)). The processing circuit 34 estimates the position of the shaft electrode 24 and the electrode 26 by performing a lookup in the CPM.

[0031] Other methods of determining the position of the distal end of the catheter 40 may be used, for example, based on ultrasound transducers and receivers, using imaging techniques such as ultrasound or MRI or CT scanning (which may include placing radiopaque tags on the catheter 40).

[0032] The processing circuit 34 is typically programmed with software to perform the functions described herein. The software may be downloaded to the computer in electronic form over a network, for example, or it may alternatively or additionally be disposed and / or stored on a non-transitory tangible medium such as magnetic, optical or electronic memory.

[0033] For simplicity and clarity, Figure 1 Only elements related to the technology disclosed in the present invention are shown. System 10 generally includes additional modules and elements that are not directly related to the technology disclosed in the present invention and thus the additional modules and elements are not directly related to the technology disclosed in the present invention. Figure 1 and the corresponding descriptions are intentionally omitted.

[0034] The catheter 40 described above includes eight flexible arms 16, wherein each arm 16 has six electrodes 26. By way of example only, any suitable catheter may be used in place of the catheter 40, for example, a catheter having a different number of flexible arms and / or electrodes on each arm, or a different probe shape such as a balloon catheter, a basket catheter, or a lasso catheter.

[0035] The system 10 may also use any suitable catheter, such as catheter 40 or a different catheter, and any suitable ablation method to perform electroporation or RF ablation (or other ablation techniques) of cardiac tissue. The console 28 may include an RF signal generator configured to generate an electrical signal that is applied by one or more electrodes of a catheter connected to the console 28 (and optionally, one or more of the surface electrodes 36) to perform electroporation or RF ablation of the myocardium of the heart 18. The console 28 may include a pump (not shown) that pumps irrigation fluid to the distal end of the catheter performing RF ablation via an irrigation channel. The catheter performing RF ablation may also include a temperature sensor (not shown) for measuring the temperature of the myocardium during RF ablation and adjusting the ablation power and / or the irrigation rate of the pumping of the irrigation fluid based on the measured temperature.

[0036] Reference now Figure 3 , the figure is Figure 1 A schematic side view of the distal end of an ultrasound probe 46 used in the system 10. Figure 1 .

[0037] The system 10 and ultrasound probe 46 are shown here by way of example to aid understanding of the ultrasound-based imaging methods described further below. However, these methods are not limited to catheter-based ultrasound sensing and can be similarly applied using 2D or 3D ultrasound images acquired by other types of probes (in vivo and in vitro probes) with necessary modifications. In addition, these methods can be used not only in the heart, but also for mapping other anatomical cavities. The ultrasound probe 46 is configured to capture an ultrasound image of at least a portion of a body part (e.g., heart 18) of a living subject (e.g., patient 32).

[0038] like Figure 1 As shown, the doctor 30 inserts the ultrasound probe 46 into the body of the patient 32 so that the distal end of the ultrasound probe 46 passes through the vascular system and enters the patient's heart 18. The ultrasound probe 46 is connected to the console 28 at its proximal end. As described below, the processing circuit 34 receives and processes the signal from the ultrasound probe 46. The processing circuit 34 may include a general-purpose computer processor that is programmed with software to perform the functions described herein. The software may be downloaded to the processor in electronic form via (for example) a network. Alternatively or in addition, the software may be stored on a tangible computer-readable storage medium, such as an optical, magnetic or electronic memory medium. Additionally or alternatively, at least some of the functions of the processor may be performed by a digital signal processor (DSP) or by a dedicated or programmable hardware logic circuit.

[0039] Generally, console 28 also enables a user to observe and adjust the functions of processing circuitry 46 and to view and edit images formed using catheter 46. To these ends, console 28 includes display 44 and user interface 48.

[0040] like Figure 3 As shown, the distal end of the ultrasound probe 46 includes an ultrasound imaging device 50 for producing ultrasound images within the body. The device 50 generally includes a phased array transducer 52, which is operated as known in the art to capture a two-dimensional (2D) "sector" image in a scanning ultrasound beam plane (referred to herein as a "beam plane" or "image plane"), which contains the longitudinal axis of the ultrasound probe 46. The transducer 52 can receive ultrasound waves reflected from an object in the beam plane and output signals in response to the reflected ultrasound waves. Typically, these signals are transmitted to the console 28 by a wire 56 extending through the ultrasound probe 46, which processes these signals to form and display ultrasound images, as described below.

[0041] The distal end of the ultrasound probe 46 also includes a position sensor 54 that generates signals indicating the position (position and orientation, including yaw) of the catheter within the body. Based on these position signals, the console 28 determines the position and orientation of each sector image captured by the imaging device 50. Thus, the processing circuit 34 is able to determine the coordinates of objects appearing in the sector image and the boundaries of the sector image.

[0042] In the illustrated exemplary mode, the system 10 uses magnetic position sensing to determine the position coordinates of the distal end of the ultrasound probe 46 within the heart 18. In order to determine the position coordinates, the drive circuit in the console 28 drives the magnetic field radiator 38 to generate a magnetic field in the body of the patient 32. Typically, the magnetic field radiator 38 includes coils that are placed under the patient's torso at a known position outside the body. These coils generate a magnetic field in a predetermined working space that accommodates the heart 18. The sensor 54 generates electrical signals in response to these magnetic fields, and the sensor may include, for example, a magnetic position sensor that includes one or more coils in the distal end of the ultrasound probe 46. The processing circuit 34 processes these signals to determine the position (position and orientation) coordinates of the distal end of the ultrasound probe 46. The console 28 can use the coordinates in the drive display 44 to display the position and status of the ultrasound probe 46.

[0043] This position sensing and processing method is produced by Bernsens Webster Co., Ltd. 3 system. Such magnetic position sensing is described in detail in, for example, U.S. Patent 6,266,551. U.S. Patents 6,690,963, 6,716,166 and 6,773,402 describe other systems that combine ultrasound imaging with magnetic position sensing.

[0044] although Figure 1 A particular system configuration is shown, but other system configurations may be used in alternative exemplary modes of the present disclosure. For example, the methods described below may be applied using other types of position transducers, such as impedance-based sensors or ultrasonic position sensors. The term "position transducer" as used herein refers to an element mounted on or in the ultrasound probe 46 that causes the console 28 to receive a signal indicating the coordinates of the element. Thus, the position transducer may include a receiver in the ultrasound probe 46, such as a sensor 54, that generates a position signal to a control unit based on energy received by the transducer; or the position transducer may include a transmitter that transmits energy sensed by a receiver outside the probe. In addition, the methods described below may be similarly applied to mapping and imaging applications using not only catheter-type probes but also other types of probes (in the heart and in other body organs and regions), as well as ultrasound probes outside the body.

[0045] Reference now Figure 4 , the figure is from Figure 1 Schematic representation of an ultrasound image 60 captured by the ultrasound probe 46 of the system 10 .

[0046] The image has the form of a 2D sector with its vertex located at the imaging device 50. As described above, the console 28 can determine the vertex position and orientation of the sector in 3D space (including the boundaries of the sector) based on the signals received from the orientation sensor 54. The dark areas 62, 64 in the image correspond to areas filled with blood and therefore having low reflectivity, such as heart chambers. Brighter areas generally represent tissue, such as the inner and outer heart walls.

[0047] As previously described, the physician 30 can manipulate the ultrasound probe 46 within the heart 18 to capture images from different locations and different orientations. The reflections that make up the image can originate not only from the heart chamber in which the distal end of the ultrasound probe 46 is located, but also from other heart chambers and anatomical structures. Thus, for example, the ultrasound probe 46 can be inserted into the right atrium (which is relatively easy to access via the vena cava) and images of the left atrium and possibly the ventricles can be captured from the right atrium.

[0048] Reference now Figure 5 , the figure includes Figure 1 100 of the steps in a method of operating the system 10 .

[0049] The mapping catheter 40 is configured to be inserted into a body part. The mapping catheter 40 includes an electrode 26 configured to capture electrical activity of tissue of the body part (e.g., a chamber of the heart 18) at corresponding locations in the body part over time. In some exemplary modes, the mapping catheter 40 may include one or more electrodes to capture electrical activity from tissue of the body part. The mapping catheter 40 moves around the body part (e.g., around the chamber of the heart 18) to collect electrical activity at different corresponding locations.

[0050] The system 10 includes at least one position sensor (e.g., position sensor 20, electrode 26, magnetic sensor 22, shaft electrode 24, position sensor 54, and / or body surface electrode 36) configured to provide at least one signal indicating the position of the ultrasound probe 46 and the corresponding position of the electrode 26 of the mapping catheter 40 over time. These positions may be set on the ultrasound probe 46 and / or the mapping catheter 40, and / or on another probe set inside or outside the body. In some exemplary modes, the position sensor includes: the magnetic sensor 22 set on the mapping catheter 40 and the (magnetic) position sensor 54 set on the ultrasound probe 46. In some exemplary modes, the position sensor may include an ultrasonic transducer.

[0051] The processing circuit 34 is configured to calculate the corresponding position of the electrode 26 in the 3D coordinate system in response to the signal provided by the position sensor (e.g., the position sensor 20, the electrode 26, the magnetic sensor 22, the shaft electrode 24 and / or the body surface electrode 36) (block 102). The calculated corresponding position of the electrode 26 is the position where the electrical activity of the tissue is captured (e.g., for inclusion in a 3D anatomical map). The corresponding position may be calculated based on magnetic tracking, impedance-based tracking, a combination of magnetic tracking and impedance-based tracking, ultrasound tracking, or any suitable tracking modality, as described above with reference to Figure 1 Described in more detail.

[0052] The processing circuit 34 is configured to calculate electroanatomical data (included in an electroanatomical data set) in response to the captured electrical activity, and to calculate corresponding positions of the electroanatomical data (e.g., in a 3D coordinate system) in response to the calculated corresponding positions (block 104). The electroanatomical data may include any one or more of: local activation time data; bipolar data; propagation data; and velocity vectors.

[0053] The ultrasound probe 46 is inserted into the body part and manipulated around the body part as needed. The processing circuit 34 is configured to calculate the position of the ultrasound probe 46 in response to signals provided by the position sensor (e.g., the position sensor 54 and / or the body surface electrode 36 or any suitable sensor or transducer) (block 106), as described with reference to FIG. Figure 3 The processing circuit 34 is configured to calculate the position (eg, boundary) of the corresponding ultrasound image captured at the corresponding calculated position of the ultrasound probe 46, as shown in FIG. Figure 3 and Figure 4 Described in more detail.

[0054] The processing circuit 34 is configured to find a corresponding electroanatomical data subset from the electroanatomical data set (calculated in the step of box 104) that has electroanatomical data located in a three-dimensional (3D) coordinate space within a corresponding ultrasound image in the ultrasound image and / or within a given threshold of a corresponding ultrasound image in the ultrasound image (box 108) (e.g., based on the orientation of the electroanatomical data in the 3D coordinate space and the orientation (e.g., boundary) of the corresponding ultrasound image in the 3D coordinate space). In other words, for each ultrasound image, the processing circuit 34 is configured to find a subset of electroanatomical data from the electroanatomical data set that has electroanatomical data located within the ultrasound image in the 3D coordinate space or within a given threshold of the ultrasound image. The threshold may be set to any suitable default value (e.g., in the range of 0.5 mm to 2 mm) for optional adjustment by a physician. The electroanatomical data subset may include any one or more of the following: local activation time data; bipolar data; propagation data; and velocity vectors. In some exemplary modes, each ultrasound image is a two-dimensional (2D) slice. In some exemplary modes, each ultrasound image is a three-dimensional (3D) image.

[0055] Reference now Figure 6 , which is a schematic diagram of a 3D anatomical map 90 and a 2D ultrasound image 94 on which a representation 92 of electroanatomical data is disposed. Figure 5 .

[0056] Figure 6 The right hand side of the illustrated display 44 shows a 2D ultrasound image 94 captured by the ultrasound probe 46. The representation 92 of electroanatomical data may be colored and / or shaded and / or patterned to reflect different values ​​of electroanatomical data (eg, LAT values ​​or bipolar data values).

[0057] In some exemplary modes, data from the 3D electroanatomical map may be selected to be superimposed on the 2D ultrasound image 94 based on the location where the 2D ultrasound image 94 intersects the 3D electroanatomical map in 3D coordinate space. For example, if the 3D electroanatomical map includes a particular color distribution representing LAT values ​​(or bipolar data), the coloring used in the 3D electroanatomical map at the intersection of the 3D electroanatomical map and the 2D ultrasound image 94 (in the 3D coordinate space) is superimposed on the 2D ultrasound image 94 as one or more lines 92-1 to show the LAT values ​​(or bipolar data) associated with the 2D ultrasound image 94. These lines may be thicker than the corresponding coloring on the 3D electroanatomical map at the intersection of the 3D electroanatomical map and the 2D ultrasound image 94.

[0058] As the ultrasound probe 46 moves and captures different ultrasound images of the chambers of the heart 18, the representation of the electroanatomical data superimposed above the different ultrasound images changes to reflect the new orientation of the different ultrasound images being displayed and that the new electroanatomical data is now included within the different ultrasound images or is included within a given threshold proximity of the different ultrasound images. For example, as the ultrasound probe 46 moves, the LAT values ​​superimposed above the ultrasound images move and change to reflect the current LAT values ​​in the current region of the 3D coordinate space occupied by the corresponding ultrasound image.

[0059] The representation 92 of electroanatomical data superimposed on the ultrasound image 94 need not be limited to the electroanatomical data included in the 3D electroanatomical map. Other electroanatomical data not used in the 3D electroanatomical map may have been collected by the mapping catheter. For example, electroanatomical data (e.g., bipolar data) captured from tissue of the internal structure 98, such as the papillary muscles, may not be included in the 3D electroanatomical map. However, the representation 92-2 of electroanatomical data captured from tissue of the internal structure 98 may be superimposed on the 2D ultrasound image 94, such as Figure 6 In this way, electroanatomical data that is normally invisible to the physician (because it is excluded from the 3D electroanatomical map) is now included in the ultrasound image.

[0060] In some exemplary modes, the position of the distal end of a catheter inserted into a chamber of the heart 18 may be tracked (eg, reference Figure 1 ), and a representation 96 of the distal end of the tracked catheter can be superimposed on top of the 2D ultrasound image 94.

[0061] Thus, the processing circuit 34 is configured to present to the display 44 a respective representation 92 of the respective electroanatomical data subset superimposed on the respective ultrasound image 94 (block 110) (in other words, each ultrasound image 94 has its own representation 92 of its own respective electroanatomical data subset superimposed thereon). The respective position of the representation 92 in the respective ultrasound image 94 is calculated based on the respective position of the electroanatomical data represented by the representation 92. In some exemplary modes, the processing circuit 34 is configured to present to the display 44 a respective representation 92 of the respective electroanatomical data subset superimposed on the respective ultrasound image 94 and a representation 96 of the distal end of the catheter. The respective representation 92 may include a respective multi-colored line or multi-colored region. The multi-colored line or multi-colored region represents local activation time or bipolar data.

[0062] In some exemplary modes, the processing circuitry 34 is configured to present to the display 44 representations 92 of corresponding subsets of electroanatomical data superimposed over a 2D ultrasound image 94 of internal structures 98 of a chamber including the heart 18, wherein at least some of the representations 92 indicate electroanatomical data (e.g., bipolar data) of the internal structures 98 (e.g., papillary muscles).

[0063] The left hand side of the display 44 shows a 3D anatomical map 90 (e.g., generated from points captured by the mapping catheter 40 or from data captured by the ultrasound probe 46). The 3D anatomical map 90 may be calculated using any suitable map generation method, such as using Fast Anatomical Mapping (FAM) to form a smooth shell as described in U.S. Pat. No. 10,918,310 to Cohen et al. from points captured by the mapping catheter 40, or using ultrasound images as described in U.S. Pat. No. 10,835,207 to Altmann et al. to form a Fast Anatomical Map from data captured by the ultrasound probe 46. A 2D ultrasound image 94 is also shown intersecting the 3D anatomical map 90. Based on the respective positions of the 3D anatomical map 90 and the 2D ultrasound image 94 in the 3D coordinate space, the 2D ultrasound image 94 is positioned relative to the 3D anatomical map 90 according to the position provided by the position sensor 54 and the associated position tracking system. The 2D ultrasound image 94 is shown as partially transparent so that the orientation of the 2D ultrasound image 94 relative to the 3D anatomical map 90 can be clearly seen. In some exemplary modes, the 2D ultrasound image 94 is shown as being opaque above the 3D anatomical map 90. In some exemplary modes, the 3D anatomical map 90 is shown without the 2D ultrasound image 94 covering the 3D anatomical map 90.

[0064] Reference now Figure 7 , which is a schematic diagram of a 3D anatomical map 90 and a 2D ultrasound image 88 with different representations 86 of electroanatomical data disposed thereon (only some are labeled for simplicity). The respective representations 86 include respective pluralities of arrows. The respective pluralities of arrows represent velocity vectors or other propagation data.

[0065] As used herein, the term "about" or "approximately" for any numerical value or range indicates a suitable dimensional tolerance that allows a part or a collection of components to achieve its intended purpose as described herein. More specifically, "about" or "approximately" may refer to a range of ±20% of the value of the recited value, for example, "about 90%" may refer to a range of values ​​from 72% to 108%.

[0066] Example

[0067] Embodiment 1: A medical system comprising: an ultrasound probe configured to capture an ultrasound image of at least a portion of a body part of a living subject; a display; and a processor configured to present to the display a corresponding representation of a corresponding subset of electroanatomical data superimposed on a corresponding ultrasound image in the ultrasound image.

[0068] Embodiment 2: The system according to embodiment 1, wherein the corresponding representation comprises a corresponding multi-colored line or multi-colored area.

[0069] Embodiment 3: The system according to embodiment 2, wherein the multi-color line or multi-color area represents local activation time or bipolar data.

[0070] Embodiment 4: A system according to any one of embodiments 1 to 3, wherein the corresponding representation includes a corresponding plurality of arrows.

[0071] Embodiment 5: A system according to embodiment 4, wherein the corresponding multiple arrows represent velocity vectors.

[0072] Embodiment 6: A system according to any one of embodiments 1 to 5, wherein the corresponding electroanatomical data subset includes any one or more of the following: local activation time data; bipolar data; propagation data; and velocity vectors.

[0073] Embodiment 7: A system according to any one of embodiments 1 to 6, wherein the processor is configured to present to the display one of the corresponding representations of one of the electroanatomical data subsets superimposed on an ultrasound image of internal structures of a chamber of the heart in the ultrasound image, wherein the one of the corresponding representations indicates electroanatomical data of the internal structure.

[0074] Embodiment 8: A system according to embodiment 7, wherein the internal structure is a papillary muscle.

[0075] Embodiment 9: A system according to embodiment 7 or 8, wherein the electroanatomical data of the internal structure includes bipolar data.

[0076] Embodiment 10: A system according to any one of embodiments 1 to 9, wherein the processor is configured to present to the display the corresponding representation of the corresponding subset of electroanatomical data and the representation of the distal end of the catheter superimposed above the corresponding ultrasound image in the ultrasound image.

[0077] Embodiment 11: A system according to any one of embodiments 1 to 10, wherein the processor is configured to find the corresponding electroanatomical data subset from the electroanatomical dataset, the electroanatomical dataset having electroanatomical data located within the corresponding ultrasound image in the ultrasound image or within a given threshold of the corresponding ultrasound image in the ultrasound image in a three-dimensional (3D) coordinate space.

[0078] Example 12: According to the system described in Example 11, the system also includes: a mapping catheter, which is configured to be inserted into the body part and includes at least one electrode, which is configured to capture the electrical activity of the tissue of the body part at a corresponding position in the body part over time; and at least one position sensor, which is configured to provide at least one signal indicating the position of the ultrasound probe and the corresponding position of the at least one electrode of the mapping catheter, wherein the processor is configured to: calculate the corresponding position of the at least one electrode and the position of the ultrasound probe in response to the at least one signal provided by the at least one position sensor; and calculate the electroanatomical data of the electroanatomical data set and the corresponding position of the electroanatomical data in the 3D coordinate system in response to the captured electrical activity and the calculated corresponding position.

[0079] Example 13: A system according to Example 12, wherein the at least one orientation sensor includes: at least one first magnetic orientation sensor, which is disposed on the mapping catheter; and at least one second magnetic orientation sensor, which is disposed on the ultrasound probe.

[0080] Embodiment 14: A system according to any one of Embodiments 11 to 13, wherein each of the corresponding ones of the ultrasound images is a corresponding two-dimensional (2D) slice.

[0081] Embodiment 15: A system according to any one of Embodiments 11 to 13, wherein each of the corresponding ultrasound images in the ultrasound images is a corresponding three-dimensional (3D) image.

[0082] Embodiment 16: A medical method comprising: capturing an ultrasound image of at least a portion of a body part of a living subject; and presenting to a display a corresponding representation of a corresponding subset of electroanatomical data superimposed on a corresponding ultrasound image in the ultrasound image.

[0083] Embodiment 17: The method according to Embodiment 16, wherein the corresponding representation comprises a corresponding multi-color line or multi-color area.

[0084] Embodiment 18: The method according to Embodiment 17, wherein the multi-color line or multi-color area represents local activation time or bipolar data.

[0085] Embodiment 19: A method according to Embodiment 16 or 17, wherein the corresponding representation includes a corresponding plurality of arrows.

[0086] Embodiment 20: A method according to embodiment 19, wherein the corresponding multiple arrows represent velocity vectors.

[0087] Embodiment 21: A system according to any one of embodiments 16 to 20, wherein the corresponding electroanatomical data subset includes any one or more of the following: local activation time data; bipolar data; propagation data; and velocity vectors.

[0088] Embodiment 22: A method according to any one of embodiments 16 to 21, wherein the presentation includes presenting to the display one of the corresponding representations of one of the electroanatomical data subsets superimposed on an ultrasound image of internal structures of a chamber of the heart in the ultrasound image, wherein the one of the corresponding representations indicates electroanatomical data of the internal structure.

[0089] Embodiment 23: A method according to any one of Embodiments 16 to 22, wherein the presentation includes presenting to the display the corresponding representation of the corresponding electroanatomical data subset and the representation of the distal end of the catheter superimposed above the corresponding ultrasound image in the ultrasound image.

[0090] Embodiment 24: According to the method described in any one of Embodiments 16 to 23, the method further includes finding the corresponding electroanatomical data subset from the electroanatomical dataset, the electroanatomical dataset having electroanatomical data located within the corresponding ultrasound image in the ultrasound image or within a given threshold of the corresponding ultrasound image in the ultrasound image in a three-dimensional (3D) coordinate space.

[0091] For the sake of clarity, various features of the present disclosure described in the context of independent embodiments may also be provided in combination in a single embodiment. Conversely, for the sake of brevity, various features of the present disclosure are described in the context of a single embodiment and may also be provided separately or in any suitable sub-combination.

[0092] The above embodiments are cited by way of example, and the present disclosure is not limited by what is specifically shown and described above. On the contrary, the scope of the present disclosure includes combinations and sub-combinations of the various features described above, as well as variations and modifications thereof, which will occur to those skilled in the art upon reading the above description and which are not disclosed in the prior art.

Claims

1. A medical system, comprising: an ultrasound probe configured to capture an ultrasound image of at least a portion of a body part of a living subject; monitor; and A processor is configured to present to the display respective representations of respective subsets of electroanatomical data superimposed over respective ones of the ultrasound images.

2. The system according to claim 1, wherein: The corresponding representation comprises a corresponding multi-colored line or multi-colored area.

3. The system according to claim 2, wherein: The multi-colored lines or multi-colored areas represent local activation time or bipolar data.

4. The system according to claim 1, wherein: The respective representation comprises a respective plurality of arrows.

5. The system according to claim 4, wherein: The respective plurality of arrows represent velocity vectors.

6. The system according to claim 1, wherein: The corresponding electroanatomical data subset includes any one or more of: local activation time data; bipolar data; propagation data; and velocity vector.

7. The system according to claim 1, wherein: The processor is configured to present to the display one of the corresponding representations of one of the corresponding electroanatomical data subsets superimposed on an ultrasound image of internal structures of a chamber of the heart in the ultrasound image, wherein the one of the corresponding representations indicates electroanatomical data of the internal structure.

8. The system according to claim 7, wherein: The internal structure is the papillary muscle.

9. The system according to claim 8, wherein: The electroanatomical data of the internal structure includes bipolar data.

10. The system according to claim 1, wherein: The processor is configured to present to the display the respective representations of the respective subsets of electroanatomical data and a representation of a distal end of a catheter superimposed over the respective ones of the ultrasound images.

11. The system according to claim 1, wherein: The processor is configured to find the corresponding electroanatomical data subset from an electroanatomical dataset, the electroanatomical dataset having electroanatomical data located within the corresponding ultrasound image in the ultrasound image or within a given threshold of the corresponding ultrasound image in the ultrasound image in a three-dimensional (3D) coordinate space.

12. The system according to claim 11, further comprising: a mapping catheter configured to be inserted into the body part and comprising at least one electrode configured to capture electrical activity of tissue of the body part at a corresponding location in the body part over time; and at least one position sensor configured to provide at least one signal indicative of the position of the ultrasound probe and the corresponding position of the at least one electrode of the mapping catheter, wherein the processor is configured to: calculating the respective position of the at least one electrode and the position of the ultrasound probe in response to the at least one signal provided by the at least one position sensor; as well as The electroanatomical data of the electroanatomical data set and corresponding positions of the electroanatomical data in the 3D coordinate system are calculated in response to the captured electrical activity and the calculated corresponding positions.

13. The system according to claim 12, wherein: The at least one orientation sensor includes: at least one first magnetic orientation sensor, which is disposed on the mapping catheter; and at least one second magnetic orientation sensor, which is disposed on the ultrasound probe.

14. The system according to claim 11, wherein: Each of the corresponding ones of the ultrasound images is a corresponding two-dimensional (2D) slice.

15. The system according to claim 11, wherein: Each of the respective ones of the ultrasound images is a respective three-dimensional (3D) image.

16. A medical method, comprising: capturing an ultrasound image of at least a portion of a body part of a living subject; as well as Respective representations of respective subsets of electroanatomical data superimposed over respective ones of the ultrasound images are presented to a display.

17. The method according to claim 16, wherein: The corresponding representation comprises a corresponding multi-colored line or multi-colored area.

18. The method according to claim 17, wherein: The multi-colored lines or multi-colored areas represent local activation time or bipolar data.

19. The method according to claim 16, wherein: The respective representation comprises a respective plurality of arrows.

20. The method according to claim 19, wherein: The respective plurality of arrows represent velocity vectors.

21. The method according to claim 16, wherein: The corresponding electroanatomical data subset includes any one or more of: local activation time data; bipolar data; propagation data; and velocity vector.

22. The method according to claim 16, wherein: The presentation includes presenting to the display one of the corresponding representations of one of the corresponding electroanatomical data subsets superimposed on an ultrasound image of internal structures of a chamber of the heart in the ultrasound image, wherein the one of the corresponding representations indicates electroanatomical data of the internal structure.

23. The method according to claim 16, wherein: The presenting includes presenting to the display the respective representations of the respective subsets of electroanatomical data and a representation of a distal end of a catheter superimposed over the respective ones of the ultrasound images.

24. The method according to claim 16 also includes finding the corresponding electroanatomical data subset from an electroanatomical data set, wherein the electroanatomical data set has electroanatomical data located within the corresponding ultrasound image in the ultrasound image or within a given threshold of the corresponding ultrasound image in the ultrasound image in a three-dimensional (3D) coordinate space.

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