Application of ablation signals to both sides of tissue

Abstract

A system includes a display and a processor. The display is configured to display at least one map of an organ having tissue including a first surface and a second surface facing each other. The processor is configured to (i) receive a first location of a first lesion formed by ablating the first surface, (ii) calculate a second location on the second surface facing the first location, and (iii) display a marker on the map indicative of the second location for guiding a user to create a second lesion in tissue facing the first lesion.

Description

Technical Field

[0001] The present disclosure relates generally to medical devices, and in particular to methods and systems for facilitating application of ablative signals to both sides of tissue. Background Art

[0002] Various techniques have been disclosed for visualizing the ducts and tissues in question.

[0003] For example, U.S. Patent Application Publication No. 2021 / 0085387 describes a system that includes an interface and a processor. The interface is configured to receive data characterizing an initial ablation operation applied to a region of a patient's heart. If found necessary, the processor is configured to automatically specify a supplemental ablation operation to be applied to the region based on the received data. BRIEF DESCRIPTION OF THE DRAWINGS

[0004] The present disclosure will be more fully understood through the following detailed description of examples of the present disclosure in conjunction with the accompanying drawings, in which:

[0005] Figure 1 is a schematic illustration of a catheter-based tracking and ablation system according to an example of the present disclosure;

[0006] Figure 2 is a schematic illustration of markers indicating suggested ablation locations according to an example of the present disclosure, the markers being displayed on a tissue surface and based on lesions formed on opposite sides of the tissue; and

[0007] Figure 3 is a flow chart schematically illustrating a method for displaying markers of suggested ablation locations on a tissue surface according to an example of the present disclosure, the suggested ablation locations being calculated based on lesions formed on opposite sides of the tissue. DETAILED DESCRIPTION

[0008] Overview

[0009] Some tissue ablation procedures, such as ablation of the pericardium of the heart for the treatment of arrhythmias, require the formation of one or more lesions through the entire thickness of the pericardium. In some cases, applying an ablation signal to one side of the pericardium (e.g., to the endocardium or the epicardium) using an ablation catheter is sufficient to form a lesion through the entire thickness of the pericardium. However, in other cases, the lesion formed in response to applying an ablation signal to one side (e.g., to the endocardium) is incomplete and does not terminate the arrhythmia of the heart being treated. In such cases, the physician must guide the ablation catheter to apply additional ablation signals to the epicardium at a location facing the lesion formed on the endocardium, but determining such a location may be difficult due to the three-dimensional (3D) structure of the heart.

[0010] Examples of the present disclosure described below provide improved techniques for displaying to a user annotations of: (i) lesions formed on a first side of tissue, and (ii) suggested locations at a second, opposite side of the tissue that face the lesions formed on the first side.

[0011] In some examples, a system for treating a cardiac arrhythmia includes a suitable catheter having one or more ablation electrodes and one or more position sensors configured to generate a signal indicative of the catheter's position in a predefined XYZ coordinate system.

[0012] In some examples, the system includes a display configured to display at least one map of an organ (e.g., a patient's heart) having tissue including a first surface and a second surface facing each other and also facing a fluid of the organ. For example, in a heart, a first side and a second side of the pericardium include an endocardium and an epicardium, respectively. Given segments of the endocardium and epicardium face each other, wherein the endocardium also faces blood pumped through the heart, and the epicardium faces the fluid surrounding the heart.

[0013] In some examples, the system includes a processor configured to receive one or more first locations of one or more first corresponding lesions formed on the endocardium. The processor is configured to calculate one or more second locations on the surface of the epicardium, the one or more second locations facing the corresponding one or more first locations of the first lesions formed on the endocardium. In the present example, the processor is configured to calculate a projection of the one or more first locations on the surface of the epicardium. In the context of the present disclosure and in the claims, the term "projection" refers to the shortest distance between the corresponding first and second locations on the endocardium and the epicardium, respectively. It should be noted that the projection for each pair of the first and second locations can be performed in any suitable direction in the XYZ coordinates of the heart, as will be described below. Figure 2 Described in detail in .

[0014] The disclosed technology improves the quality of ablation procedures by assisting the physician in determining ablation locations at both sides of the tissue being ablated, thereby forming a lesion through the full thickness of the tissue and terminating the arrhythmia in the patient's heart.

[0015] System Description

[0016] Figure 1 is a schematic illustration of a catheter-based tracking and ablation system 20 according to an example of the present disclosure.

[0017] In some examples, the system 20 includes: a catheter 22 and a console 24, the catheter being configured to perform a cardiac procedure. In the examples described herein, the catheter 22 includes a focusing catheter that can be used for any suitable therapeutic and / or diagnostic purpose, such as for sensing electroanatomical signals and / or for ablating tissue in the heart 26, as will be described in detail below. In other examples, the catheter 22 may include any other suitable type of catheter, such as, but not limited to, a basket catheter, a lasso catheter, or a balloon catheter. In the context of the present disclosure and the claims, the term "ablation" refers to a radiofrequency (RF) ablation procedure or an irreversible electroporation (IRE) procedure. These procedures are intended to apply one or more high-voltage unipolar or bipolar electrical signals (e.g., pulses) to one or more electrodes in contact with the tissue to be ablated so as to form a lesion in one or more intended locations (also referred to herein as ablation sites) in the heart 26, thereby treating arrhythmias of the heart. The lesion is formed below Figure 2 Described in more detail in .

[0018] In some examples, console 24 includes a processor 33 (typically a general purpose computer) having suitable front-end and interface circuitry for receiving signals via catheter 22 and for controlling other components of system 20 described herein. Console 24 also includes a user display 35 that is configured to receive graphical and / or textual display items, such as a map 27 of heart 26, from processor 33, and is configured to display map 27, and optionally a number of annotations presented on map 27, for example, as shown below. Figure 2 as shown in .

[0019] In some examples, map 27 may include any suitable type of three-dimensional (3D) anatomical map generated using any suitable technology. For example, a 3D anatomical map may be generated using a suitable medical imaging system or using a CARTO TM The anatomical map may be generated using the Fast Anatomical Mapping (FAM) technique of the system or using anatomical images generated using any other suitable technique or using any suitable combination of the above.

[0020] In some examples, console 24 includes a recording unit 38 that is configured to record the TM The console 24 includes a patient interface unit (PIU) 44 configured to generate signals indicating positioning and collected and processed electrocardiogram (ECG) signals, and the patient interface unit is configured to exchange signals between the console 24 and multiple entities of the system 20 (e.g., the catheter 22).

[0021] See now illustration 23. In some examples, prior to performing an ablation procedure, a physician 30 inserts one or more catheters into the vasculature of a patient 28 lying on an operating table 29 in order to perform electroanatomical (EA) mapping of the tissue of interest of the heart 26. Based on the EA mapping, the physician 30 plans an ablation or IRE procedure, which is performed using the focusing catheter 22 or using any other suitable catheter.

[0022] Reference is now made to illustration 42. In some examples, catheter 22 includes a distal tip assembly (DEA) 40 having one or more ablation electrodes 55 configured to apply an ablation signal to tissue of heart 26. Catheter 22 further includes a position sensor 39, which is generally coupled to the distal tip of catheter 22 and is configured to generate a position signal indicative of a measured position of DEA 40 (and more specifically, ablation electrode 55) in an XYZ coordinate system, as will be described in detail below.

[0023] In some examples, DEA 40 includes a contact force sensor, referred to herein as force sensor 54, which is configured to measure the force applied by DEA 40 of catheter 22 to the endocardial tissue of heart 26. Force sensor 54 is configured to generate a force signal indicating the force applied by DEA 40 to the endocardial tissue of heart 26. In some examples, the force sensor can include a magnetic field transmitter and receiver connected by a spring in DEA 40, and can generate an indication of the force based on measuring the deflection of the spring. Further details of such catheters and force sensors are described in U.S. Patent Application Publications Nos. 2009 / 0093806 and 2009 / 0138007. In other examples, force sensor 54 can include any other suitable type of force sensor.

[0024] In the present example, ablation electrode 55 is positioned at the tip of DEA 40 and placed in contact with endocardial tissue of heart 26 such that the force signal is indicative of a force applied between ablation electrode 55 and the endocardial tissue of heart 26 .

[0025] Now return to see Figure 1 In some examples, PIU 44 is connected to a power source, such as a radio frequency (RF) generator 49 enclosed within the housing of PIU 44. In alternative examples, the RF generator may be external to the housing of PIU 44 and electrically connected to PIU 44 using a suitable cable. RF generator 49 is configured to apply a suitable RF ablation signal.

[0026] In some examples, the proximal end of catheter 22 is specifically connected to an interface circuit (not shown) of PIU 44 for transmitting ablation signals from PIU 44 to electrode 55 and applying the ablation signals to tissue of heart 26. The interface circuit is further configured to conduct position signals between position sensor 39 and processor 33.

[0027] In some examples, system 20 includes a neutral electrode 48, also referred to herein as a patch electrode, which is attached to the skin of patient 28 (e.g., on the back of the patient's torso) and electrically connected to PIU 44 via cable 21. In other examples, system 20 can include any suitable number of skin patches configured to adhere respective electrodes (e.g., about four or five electrodes) to the skin of patient 28.

[0028] In the context of the present disclosure and claims, the terms "about" or "approximately" for any numerical values ​​or ranges indicate a suitable dimensional tolerance that allows the part or collection of components to function for the intended purpose described herein.

[0029] In some examples, system 20 includes a handle 32 that is used by physician 30 to guide DEA 40 through the vasculature of patient 28 and into a target location for performing ablation in heart 26 .

[0030] In some examples, a position sensor 39 of a magnetic position tracking system is used to measure the position of the distal tip assembly 40 in the vasculature and heart 26 of the patient 28. In this example, the console 24 includes a drive circuit 41 configured to drive a magnetic field generator 36 placed at a known position external to the patient 28 lying on the operating table 29 (e.g., under the patient's torso). The position sensor is coupled to the distal tip and is configured to generate a position signal in response to an external magnetic field sensed from the field generator 36. The position signal (also referred to herein as a position measurement result) indicates the position of the DEA 40 in the XYZ coordinate system of the position tracking system.

[0031] This position sensing method is implemented in various medical applications, for example, in the CARTO™ system manufactured by Biosense Webster Inc. (Irvine, Calif), and is described in detail in U.S. Patents 5,391,199, 6,690,963, 6,484,118, 6,239,724, 6,618,612 and 6,332,089, PCT Patent Publication WO 96 / 05768, and U.S. Patent Application Publication Nos. 2002 / 0065455A1, 2003 / 0120150A1 and 2004 / 0068178A1.

[0032] In some examples, the coordinate system of the position tracking system is registered with the coordinate systems of system 20 and map 27 such that processor 33 is configured to display the position of distal tip assembly 40 on an anatomical or EA map (eg, map 27 ).

[0033] In some examples, processor 33 is programmed with software to implement 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 provided and / or stored on a non-transitory tangible medium such as magnetic, optical or electronic memory.

[0034] This particular configuration of system 20 is shown by way of example to illustrate certain problems solved by the examples of the present disclosure and to demonstrate the application of these examples in enhancing the performance of such systems. However, the examples of the present disclosure are by no means limited to this particular type of example system, and the principles described herein may be similarly applied to other types of catheters and / or medical systems configured for other types of tissue ablation procedures.

[0035] Landmarks of suggested ablation locations calculated based on lesions formed on opposite sides of the tissue are displayed on the tissue surface.

[0036] Figure 2 is a schematic illustration of markers 77 indicating suggested ablation locations, displayed on a map 27 about a surface 64 of tissue 50 and based on lesions formed on an opposing surface 62 of tissue 50 , according to an example of the present disclosure.

[0037] In some cases, physician 30 uses electrode 55 of catheter 22 to apply ablation signals to one side of tissue 50 and tissue 80 of heart 26. In this example, tissue 50 includes the septum between left ventricle (LV) 60 and right ventricle (RV) 70 of heart 26. Tissue 50 is defined between surface 62 and surface 64, which are the walls of LV 60 and RV 70, respectively. Similarly, tissue 80 includes the pericardium of heart 26, which is defined between surface 82 and surface 84, which are the endocardium and epicardium of the pericardium, respectively.

[0038] For example, an ablation signal is applied to surface 82 so as to kill cells of tissue 80 and thereby convert living cells located between surface 82 and surface 84 of segment 92 into a continuous lesion. It should be noted that the lesion is intended to be formed through the entire thickness of tissue 80 (between surface 82 and surface 84) so ​​as to prevent the propagation of one or more electrophysiological (EP) waves through segment 92 of tissue 80. In some cases, applying an ablation signal to one side of tissue 80 (e.g., to surface 82) is sufficient to form the desired continuous lesion along segment 92 through the thickness of tissue 80 (i.e., between surface 82 and surface 84).

[0039] However, in other cases, the lesion formed in response to applying the ablation signal to one side (e.g., to surface 82) is incomplete and may not completely block the propagation of the EP wave through the segment 92 of the tissue 80. In such cases, the physician 30 must guide the DEA 40 of the catheter 22 out of the heart 26 to apply an additional ablation signal to the surface 84 (i.e., epicardium) at a location facing the lesion formed on the surface 82 (i.e., endocardium). It should be noted that due to the three-dimensional (3D) structure of the tissue 80, it is difficult to accurately determine the location on the surface 84 to be ablated.

[0040] In some examples, processor 33 is configured to display markers 88 on map 27 that indicate corresponding locations where ablation signals have been applied to surface 82 and one or more lesions have been formed.

[0041] In some examples, the processor 33 is configured to calculate the corresponding position on the surface 84 facing the marker 88, usually by projecting the position of the marker 88 on the surface 84 facing the surface 82. Based on the projection, the processor 33 is configured to display a marker 99 indicating the calculated position on the map 27. In this example, the marker 99 is shown as a dashed circle as a suggested position, which is used to guide the physician 30 to apply an ablation pulse to the surface 84, and thereby form a corresponding lesion facing the lesion formed on the surface 82 and marked by the marker 88.

[0042] In some examples, the processor 33 is configured to calculate the distance 90 between each pair of the markers 88 and the markers 99. For example, the distance 90a between the marker 88a and the marker 99a and the distance 90b between the marker 88b and the marker 99b. In the case where the physician 30 accepts the suggested ablation positioning, and based on the calculated distances, the processor 33 and / or the physician 30 can determine one or more ablation parameters that will obtain the desired continuous lesion in the segment 92 in response to applying an ablation pulse at the location of the marker 99. It should be noted that in this example, the term "projection" refers to the shortest distance 90 between the corresponding markers 88 and the markers 99 on the surface 82 and the surface 84, respectively. In one example, the processor 33 is configured to calculate multiple distances between the marker 88a and multiple locations on the surface 84, and determine the position of the marker 99a based on the distance 90a, which is the shortest distance among the calculated distances.

[0043] In the example of segment 92 of tissue 80, surface 82 and surface 84 face each other and are also substantially parallel to each other, so distance 90a and distance 90b are approximately equal. In the example of tissue 50, surface 62 and surface 64 face each other, but are not parallel to each other due to the anatomical structure of LV 60 and RV 70. It should be noted that in Figure 2 In the example of , LV 60 has been mapped and one or more ablation signals have been applied to one or more tissues of the wall of LV 60 , but RV 70 may not have been mapped (eg, using one or more ECG sensing electrodes of catheter 22 or any other suitable catheter).

[0044] In some examples, processor 33 is configured to display markers 66 on map 27 indicating corresponding locations where ablation signals have been applied to surface 62. In the present example, the ablation signals applied at the locations of markers 66 have formed one or more lesions in tissue 50 that are incomplete between surface 62 and surface 64. In other words, at least a portion of the EP waves may propagate through tissue 50, which does not achieve the goal of the ablation procedure performed on tissue 50.

[0045] In some examples, processor 33 is configured to calculate a corresponding position on surface 64 facing marker 66, typically by projecting the position of marker 66 on surface 64 facing surface 62. Based on the projection, processor 33 is configured to display a marker 77 indicating the calculated position on map 27. In this example, marker 77 is shown as a dashed circle as a suggested position, which is used to guide physician 30 to apply ablation pulses to surface 64 and thereby form a corresponding lesion facing the lesion formed on surface 62.

[0046] In some examples, the processor 33 is configured to calculate the distance 68 between each pair of the markers 66 and 77. For example, the distance 68a between the marker 66a and the marker 77a and the distance 68b between the marker 66b and the marker 77b. As described above for the tissue 80, if the physician 30 accepts the suggested ablation location shown as the marker 77, and based on the calculated distance 68, the processor 33 and / or the physician 30 can determine one or more ablation parameters for each location marked by the corresponding marker 77. In response to applying an ablation signal including the determined ablation parameters at the location of the marker 99, the desired continuous lesion is generally formed in the ablated segment of the tissue 50.

[0047] In the example of tissue 50, the term projection refers to the shortest distance 68 between each pair of corresponding markers 66 and 77 displayed on surfaces 62 and 64, respectively. It should be noted that because surfaces 62 and 64 are not parallel to each other in the ablated segment, the orientation and calculated distance can change between each pair of markers 66 and 77.

[0048] For example, the size of distance 68a and the orientation of the arrow marking distance 68a are different from the size of distance 68b and the orientation of the arrow. Therefore, physician 30 may decide to: (i) use different ablation parameters in the ablation signal applied to surface 64 at the locations of markers 77a and 77b, and (ii) direct DEA 40 in a different direction (e.g., at the locations of markers 77a and 77b) so as to obtain a continuous lesion in the ablated segment between surface 62 and surface 64. As described above, the transformation of tissue 50 into a continuous lesion between surface 62 and surface 64 is intended to prevent the propagation of EP waves across the septum between LV 60 and RV 70, and thereby treat arrhythmias of heart 26.

[0049] In some examples, when the above techniques are implemented, at least one of the markers 77 and 99 is displayed on the map 27 and is used to assist the physician 30 in guiding the DEA 40 to the location marked by the displayed marker. Figure 1As described in , based on the position signal of the position sensor 39, the processor 33 is configured to continuously display a given marker (not shown) indicating the position of the DEA 40 in the heart 26 on the map 27. In such an example, the physician 30 moves the catheter 22 so as to position the DEA 40 at one or more of the suggested ablation locations, and then controls the catheter 22 to apply a predefined ablation signal to the tissue at the suggested location. For example, when the location of the given marker merges with the location of the marker 77a, the physician 30 can control the catheter 22 to apply the ablation signal so as to form a continuous lesion between the surface 62 and the surface 64, at least between the locations of the marker 66a and the marker 77a.

[0050] In other examples, catheter 22 includes a basket catheter (not shown) having a plurality of ablation electrodes 55 (not shown). In such examples, physician 30 moves catheter 22 so that the positions of the plurality of electrodes 55 of DEA 40 merge with the corresponding positions of marker 77, and then physician 30 can control catheter 22 to apply an ablation signal (using the corresponding ablation electrode 55) to surface 64 at the position marked by marker 77 so as to form a continuous lesion between surface 62 and surface 64.

[0051] For conceptual clarity, the configuration of markers 66, 77, 88, and 99 and distances 68 and 90 are shown by way of example, and in other examples, processor 33 is configured to use any other suitable calculations to determine: (i) the location and / or distance of one or more of these markers, and (ii) the size, shape, and other parameters associated with the appearance of any suitable type of marker to assist physician 30 in determining ablation of one or both of tissue 50 and tissue 80. For example, at least one of distances 68 and 90 may be presented as a text graphic, such as in a table presented on map 27.

[0052] It should be noted that in Figure 2 In the example of the embodiment of the present invention, the surfaces of tissue 50 and tissue 80 face each other and are in physical contact with the fluid within and surrounding the heart 26. For example, surface 62 and surface 64 face each other and are in physical contact with blood flowing through LV 60 and RV 70. Similarly, surface 82 and surface 84 face each other, and surface 82 is in physical contact with blood flowing through LV 60, and surface 84 is in physical contact with the fluid surrounding heart 26. In other examples, at least one of surface 62, surface 64, surface 82, and surface 84 may be accessible to DEA 40 through the vasculature of patient 28 and / or through other (soft or hard) tissue of the patient to apply the above-described techniques.

[0053] Figure 3is a flow chart schematically illustrating a method for displaying markers 77 indicating suggested ablation locations on the surface 64 of the tissue 50 , which are calculated based on lesions formed on the surface 62 of the tissue 50 , according to an example of the present disclosure.

[0054] The method begins with a catheter insertion step 100, in which a physician 30 inserts a DEA 40 of a catheter 22 into the body of a patient 28, as described above. Figure 1 and Figure 2 As described in.

[0055] In a cardiac map display step 102, processor 33 displays map 27 showing tissue 50 having surface 62 of left ventricle (LV) 60 and surface 64 of right ventricle (RV) 70, the two surfaces facing each other, as shown in FIG. Figure 2 As described in.

[0056] In a first ablation step 104, physician 30 moves catheter 22 into the LV, control system 20 applies an ablation signal to surface 62 to form a first lesion at one or more first locations on surface 62, and processor 33 stores the coordinates of the one or more first locations. Figure 2 In the example of , processor 33 displays the first location on surface 62 using marker 66 .

[0057] In the calculation step 106, the processor 33 calculates one or more second positions on the surface 64 facing the corresponding one or more first positions by projecting the one or more first positions on the surface 64, such as Figure 2 Described in detail in .

[0058] In a marker display step 108, processor 33 displays on map 27 one or more markers 77 indicating one or more second locations on surface 64, and distances 68 between each pair of corresponding first and second locations. Figure 2 In the example of FIG. 6 , distance 77 is shown between marker 66 and marker 77 located on surface 62 and surface 64 , respectively.

[0059] In a second ablation step 110 that terminates the method, the physician 30 moves the catheter 22 into the RV 70 to position the DEA 40 at the second position shown by the marker 77. In this example, the catheter 22 comprises a focusing catheter, and therefore, the physician 30 (i) sequentially moves the DEA 40 to each of the second positions so that the position of the ablation electrode 55 merges with the position of each marker 77, and (ii) creates a plurality of second lesions at the corresponding positions of the markers 77 (these second lesions face the first lesions shown as markers 66), as shown above. Figure 2 Described in detail in .

[0060] In some examples, physician 30 may perform testing to confirm the formation of a continuous lesion that blocks the propagation of EP waves through tissue 30 , which is the septum between LV 60 and RV 70 .

[0061] In some examples, Figure 3 The method of mutatis mutandis is applicable to the generation of a continuous lesion along the segment 92 between the surface 82 and the surface 84, as shown in the above Figure 2 Described in detail in .

[0062] In some examples, after obtaining and verifying the formation of one or more continuous lesions at the locations intended for ablation, physician 30 may remove catheter 22 from the body of patient 28 .

[0063] Although the examples described herein are primarily directed to electrophysiology procedures performed in a patient's heart 26 (such as, but not limited to, RF ablation and / or IRE procedures), the methods and systems described herein may also be used in other applications, such as in any catheterization procedure performed on both sides of tissue in any suitable organ of a patient.

[0064] Example 1

[0065] A system (20) includes a display (35) and a processor (33). The display (35) is configured to display at least one map (27) of an organ (26) having a tissue (50), the tissue including a first surface and a second surface (62, 64) facing each other. The processor (33) is configured to: (i) receive a first position (66) of a first lesion formed by ablating the first surface (62), (ii) calculate a second position facing the first position (66) on the second surface (64), and display a marker (77) indicating the second position on the map (27), the second position being used to guide a user (30) to generate a second lesion in the tissue (50) facing the first lesion.

[0066] Example 2

[0067] A system according to embodiment 1, wherein the processor is configured to calculate the second position by: (a) selecting two or more positions on the second surface, (b) respectively calculating two or more distances between (i) the first position and (ii) each of the two or more positions, and (iii) selecting the second position from the two or more positions based on the shortest distance selected from the two or more distances.

[0068] Example 3

[0069] A system as in embodiment 1, wherein the processor is configured to calculate the second position by calculating a projection of the first position on the second surface.

[0070] Example 4

[0071] A system according to Example 1, wherein the processor is configured to display an additional marker indicative of the first lesion on the map.

[0072] Example 5

[0073] A system according to embodiments 1 to 4, wherein the processor is configured to display a distance between the first location and the second location on the map.

[0074] Example 6

[0075] A system according to Example 5, wherein the processor is configured to set one or more ablation parameters based on the distance for generating the second lesion.

[0076] Example 7

[0077] A system according to Example 6, wherein the processor is configured to set the one or more ablation parameters to transform the tissue between the first position and the second position into a continuous lesion including the first lesion and the second lesion.

[0078] Example 8

[0079] A system as described in Examples 1 to 4, wherein the organ includes a heart, and wherein at least one of the first surface and the second surface includes the endocardium or the epicardium of the heart.

[0080] Example 9

[0081] A system as described in embodiments 1 to 4, wherein one or both of the first surface and the second surface faces a fluid located at one or both of the following locations: (i) within the organ, and (ii) surrounding the organ.

[0082] Example 10

[0083] A system according to Example 9, wherein the organ includes a heart, wherein the first surface and the second surface include first and second walls of a first chamber and a second chamber of the heart, respectively, and wherein the fluid includes blood pumped through the first chamber and the second chamber.

[0084] Embodiment 11

[0085] A method comprising:

[0086] showing at least one map (27) of an organ (26) having a tissue (50) including a first surface and a second surface (62, 64) facing each other;

[0087] receiving a first location (66) of a first lesion formed by ablating the first surface (62);

[0088] calculating a second position on the second surface (64) facing the first position; and

[0089] A marker (77) indicating the second position is displayed on the map (27), and the second position is used to guide the user (30) to create a second lesion in the tissue (50) facing the first lesion.

[0090] Example 12

[0091] A method according to embodiment 11, wherein calculating the second position includes: (a) selecting two or more locations on the second surface, (b) respectively calculating two or more distances between (i) the first position and (ii) each of the two or more locations, and (iii) selecting the second position from the two or more locations based on the shortest distance selected from the two or more distances.

[0092] Embodiment 13

[0093] The method of embodiment 11, wherein calculating the second position comprises calculating a projection of the first position on the second surface.

[0094] Embodiment 14

[0095] A method according to Example 11, and comprising displaying an additional marker indicative of the first lesion on the map.

[0096] Embodiment 15

[0097] A method according to any one of embodiments 11 to 14, and comprising displaying a distance between the first position and the second position on the map.

[0098] Example 16

[0099] A method according to embodiment 15, and comprising setting one or more ablation parameters based on the distance for producing the second lesion.

[0100] Embodiment 17

[0101] A method according to Example 16, wherein the one or more ablation parameters are set for transforming the tissue between the first position and the second position into a continuous lesion including the first lesion and the second lesion.

[0102] Embodiment 18

[0103] The method according to Examples 11 to 14, wherein the organ includes a heart, and wherein at least one of the first surface and the second surface includes the endocardium or the epicardium of the heart.

[0104] Embodiment 19

[0105] A method according to embodiments 11 to 14, wherein one or both of the first surface and the second surface faces a fluid located at one or both of the following locations: (i) within the organ, and (ii) surrounding the organ.

[0106] Embodiment 20

[0107] A method according to Example 19, wherein the organ includes a heart, wherein the first surface and the second surface include first and second walls of a first chamber and a second chamber of the heart, respectively, and wherein the fluid includes blood pumped through the first chamber and the second chamber.

[0108] It should be understood that the above embodiments are cited by way of example, and the present disclosure is not limited to 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 and their variations and modifications, which will occur to a person skilled in the art when reading the above description and which are not disclosed in the prior art. The documents incorporated by reference into this patent application are considered an integral part of this application, unless any term defined in these incorporated documents conflicts with the definition explicitly or implicitly given in this specification, in which case only the definition in this specification shall be considered.

Claims

1. A system comprising: a display configured to display at least one map of an organ having tissue, the tissue comprising a first surface and a second surface facing each other; and A processor, the processor being configured to: receiving a first location of a first lesion formed by ablating the first surface; calculating a second position on the second surface facing the first position; as well as A marker indicating the second position is displayed on the map, where the second position is used to guide a user to create a second lesion in the tissue facing the first lesion.

2. The system according to claim 1, wherein: The processor is configured to calculate the second position by: (a) selecting two or more locations on the second surface, (b) respectively calculating two or more distances between (i) the first position and (ii) each of the two or more locations, and (iii) selecting the second position from the two or more locations based on the shortest distance selected from the two or more distances.

3. The system according to claim 1, wherein: The processor is configured to calculate the second position by calculating a projection of the first position on the second surface.

4. The system according to claim 1, wherein: The processor is configured to display an additional marker on the map that is indicative of the first lesion.

5. The system according to claim 1, wherein: The processor is configured to display a distance between the first location and the second location on the map.

6. The system according to claim 5, wherein: The processor is configured to set one or more ablation parameters based on the distance for producing the second lesion.

7. The system according to claim 6, wherein: The processor is configured to set the one or more ablation parameters for transforming the tissue between the first location and the second location into a continuous lesion including the first lesion and the second lesion.

8. The system according to claim 1, wherein: The organ comprises a heart, and wherein at least one of the first surface and the second surface comprises an endocardium or an epicardium of the heart.

9. The system according to claim 1, wherein: One or both of the first surface and the second surface face a fluid located at one or both of the following locations: (i) within the organ, and (ii) surrounding the organ.

10. The system according to claim 9, wherein: The organ comprises a heart, wherein the first surface and the second surface comprise first and second walls of a first chamber and a second chamber of the heart, respectively, and wherein the fluid comprises blood pumped through the first chamber and the second chamber.

11. A method comprising: displaying at least a map of an organ having tissue including a first surface and a second surface facing each other; receiving a first location of a first lesion formed by ablating the first surface; calculating a second position on the second surface facing the first position; as well as A marker indicating the second position is displayed on the map, where the second position is used to guide a user to create a second lesion in the tissue facing the first lesion.

12. The method according to claim 11, wherein: Calculating the second position includes: (a) selecting two or more locations on the second surface, (b) respectively calculating two or more distances between (i) the first position and (ii) each of the two or more locations, and (iii) selecting the second position from the two or more locations based on the shortest distance selected from the two or more distances.

13. The method according to claim 11, wherein: Calculating the second position includes calculating a projection of the first position on the second surface.

14. The method of claim 11, and comprising displaying an additional marker on the map indicative of the first lesion.

15. The method of claim 11, and comprising displaying the distance between the first location and the second location on the map.

16. A method according to claim 15, and comprising setting one or more ablation parameters for producing the second lesion based on the distance.

17. The method according to claim 16, wherein: The one or more ablation parameters are set for transforming the tissue between the first location and the second location into a continuous lesion including the first lesion and the second lesion.

18. The method according to claim 11, wherein: The organ comprises a heart, and wherein at least one of the first surface and the second surface comprises an endocardium or an epicardium of the heart.

19. The method according to claim 11, wherein: One or both of the first surface and the second surface face a fluid located at one or both of the following locations: (i) within the organ, and (ii) surrounding the organ.

20. The method according to claim 19, wherein: The organ comprises a heart, wherein the first surface and the second surface comprise first and second walls of a first chamber and a second chamber of the heart, respectively, and wherein the fluid comprises blood pumped through the first chamber and the second chamber.

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