Method and system for shaving anatomical maps

Abstract

A system and method for shaving an anatomical map. The reference image is compared to the anatomical map using the accuracy parameter, and at least one region in the anatomical map that fails to meet the accuracy parameter is identified. An image of the electroanatomical map is displayed, wherein the image provides a visual indication of at least one region in the anatomical map that fails to meet at least one accuracy parameter. A modified map is generated by shaving the at least one region of the anatomical map that fails to meet the at least one accuracy parameter, and the modified map is displayed.

Description

Technical Field

[0001] The present disclosure relates generally to anatomical mapping systems. More particularly, the present disclosure relates to methods and systems for shaving anatomical maps, including, for example, electroanatomical maps of the heart. Background Art

[0002] The interior of a patient's organ (such as a heart chamber) can be mapped (electroanatomical mapping) using a mapping catheter having one or more suitable sensors mounted at its distal end for mapping within the organ. Using the position signals generated by the various sensors, the processor can calculate the sensor positions within the organ (e.g., heart chamber). Using the calculated positions, the processor can also obtain an anatomical map of the cavity surface. For example, in the fast anatomical mapping (FAM) of the heart chamber, the electroanatomical (EA) data collected is used to draw the point positions on the inner surface of the cavity. However, during FAM reconstruction, it is also possible to collect undesirable catheter positions and automatically add them to the cavity surface constructed by FAM. Examples of such undesirable data points include cavity wall positions that are distorted due to being pushed outward by the catheter, wrong wall positions caused by movement caused by breathing, positions that are incorrectly measured inside the cavity rather than on the surface, and irrelevant catheter positions, such as outside the mapping area of ​​interest.

[0003] The accumulation of such undesirable positions affects the accuracy of the reconstructed EA map. To address these inaccuracies, during or after acquisition, the physician or an expert assisting the physician may manually edit the surface generated by the acquired points to correct the errors. This editing typically involves erasing data points and / or removing ("shaving") portions from the calculated surface. When performed manually, such editing can be time consuming and lacks accuracy. Summary of the invention

[0004] A system and method for shaving an anatomical map. A reference image is compared to the anatomical map using an accuracy parameter, and at least one region of the anatomical map that fails to meet the accuracy parameter is identified. An image of the anatomical map is displayed, wherein the image provides a visual indication of the at least one region of the anatomical map that fails to meet the at least one accuracy parameter. A revised map is generated by shaving the at least one region of the anatomical map that fails to meet the at least one accuracy parameter, and the revised map is displayed.

[0005] In some embodiments, the anatomical map is a fast anatomical map (FAM) acquired during an electrophysiology study, and the reference image is a CT image, an ultrasound image (2D, 3D, or 4D), an MRI image, or an anatomical map shaved during a previous electrophysiology study. In one embodiment, the shaving is manually initiated by a user viewing a visual indication. Alternatively, the shaving is automatic and no user input is required to initiate shaving of areas that fail to meet accuracy parameters.

[0006] In one embodiment, the at least one accuracy parameter includes a maximum distance between the anatomical map and the reference image. In other embodiments, the accuracy is determined based on both the maximum distance and a point density value or a point quality value. In some examples, the accuracy parameter is configured by a user performing an electrophysiology study. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] A more detailed understanding may be obtained from the following detailed description provided by way of example in conjunction with the accompanying drawings, in which like reference numerals indicate like elements, and in which:

[0008] Figure 1 An example catheter-based electrophysiological mapping and ablation system is depicted in accordance with one or more embodiments;

[0009] Figure 2 is a block diagram of an example system for remotely monitoring and transmitting patient biometrics according to one or more embodiments;

[0010] Figure 3 is a system diagram of an example of a computing environment in communication with a network according to one or more embodiments;

[0011] Figure 4 An example of a linear catheter including a plurality of electrodes that can be used to map a cardiac region is shown;

[0012] Figure 5 An example of a balloon catheter is shown, which includes a plurality of splines (e.g., Figure 5 In a specific example, 12 splines) (including splines) and a plurality of electrodes (including electrodes) on each spline;

[0013] Figure 6 An example of a loop catheter (also known as a lasso catheter) including multiple electrodes that can be used to map a cardiac region is shown;

[0014] Figure 7 A technique for shaving FAM using a reference image is illustrated;

[0015] Figure 8A-8D It shows the combination Figure 7Exemplary maps of various aspects of the described shaving techniques;

[0016] Fig. 9 A method of shaving an electroanatomical map using a reference image is illustrated. DETAILED DESCRIPTION

[0017] A system and method for shaving an electroanatomical map. A reference image is compared to the electroanatomical map using at least one accuracy parameter, and at least one region of the anatomical map that fails to meet the at least one accuracy parameter is identified. An image of the electroanatomical map is displayed, wherein the image provides a visual indication of the at least one region of the electroanatomical map that fails to meet the at least one accuracy parameter. A revised map is generated by shaving the at least one region of the electroanatomical map that fails to meet the at least one accuracy parameter, and the revised map is displayed.

[0018] One or more advantages, technical effects, and / or benefits may include providing information to cardiologists and medical personnel to enhance organ mapping, such as cardiac mapping. Thus, the systems and methods and user interfaces particularly utilize and transform medical device equipment to enable / realize organ mapping that is not currently available or currently performed by cardiologists and medical personnel with increased efficiency and quality.

[0019] In one embodiment, a system for shaving an electroanatomical map includes a processor, a memory, a display, and a user interface. The processor receives at least one accuracy parameter via the user interface. In an example, the accuracy parameter represents the maximum distance between the electroanatomical map and a reference image. In other embodiments, more than one accuracy parameter is used. For example, a combination of a maximum distance and a point density value or a combination of a maximum distance and a point quality value is used. In some examples, when performing an electrophysiological study, a user configures at least one accuracy parameter via the user interface. The system identifies at least one region in the electroanatomical map that fails to meet the at least one accuracy parameter by comparing the electroanatomical map with a reference image. In some embodiments, the electroanatomical map is a fast anatomical map (FAM) acquired during an electrophysiological study, and the reference image is a CT image, an MRI image, an ultrasound image, or an electroanatomical map shaved during a previous electrophysiological investigation of the same patient, or another map that has been processed to make the map more accurate. An image of the electroanatomical map is displayed on a display, wherein the image provides a visual indication of the at least one region in the electroanatomical map that fails to meet the at least one accuracy parameter. A modified map is generated by shaving the at least one region of the electroanatomical map that fails to meet the at least one accuracy parameter, and the modified map is displayed on a display. In one embodiment, the shaving is manually initiated by a user viewing a visual indication. Alternatively, the shaving is automatic and the shaving of the region that fails to meet the at least one accuracy parameter can be initiated without user input.

[0020] refer to Figure 1 , which shows an example system (e.g., medical device equipment and / or catheter-based electrophysiological mapping and ablation) shown as system 10, in which one or more features of the subject matter of this article can be implemented according to one or more embodiments. As described herein, the whole or part of system 100 can be used to collect information (e.g., biometric data and / or training data sets) and / or for implementing machine learning and / or artificial intelligence algorithms. As shown, system 10 includes recorder 11, heart 12, catheter 14, model or anatomical map 20, electrogram 21, spline 22, patient 23, physician 24 (or medical professional or clinician), position pad 25, electrode 26, display device 27, distal end 28, sensor 29, coil 32, patient interface unit (PIU) 30, electrode skin patch 38, ablation energy generator 50 and workstation 55. It should also be noted that each element and / or item of system 10 represents one or more of the element and / or item. Figure 1The example of system 10 shown can be modified to implement the embodiments disclosed herein. The embodiments disclosed in the present invention can be applied similarly using other system components and settings. In addition, system 10 can include additional components, such as elements for sensing electrical activity, wired or wireless connectors, processing and display devices, etc. Although for completeness, the heart 12, patient 23 and physician 24 are described in conjunction with the example system, those skilled in the art will understand that the heart 12, patient 23 and physician 24 are not part of the system itself, but rather the system acts on or on behalf of these elements.

[0021] The system 10 includes a plurality of catheters 14 that are inserted percutaneously through the patient's vascular system into a chamber or vascular structure of the heart 12 by a physician 24. Typically, a delivery sheath catheter is inserted into the left atrium or right atrium near a desired location in the heart 12. Multiple catheters may then be inserted into the delivery sheath catheter in order to reach the desired location. The plurality of catheters 14 may include catheters dedicated to sensing intracardiac electrogram (IEGM) signals, catheters dedicated to ablation, and / or catheters dedicated to both sensing and ablation. An example catheter 14 configured for sensing IEGM is shown herein. The physician 24 brings the distal end 28 of the catheter 14 into contact with the heart wall for sensing a target site in the heart 12. For ablation, the physician 24 would similarly bring the distal end of the ablation catheter to the target site for ablation.

[0022] The catheter 14 is an exemplary catheter that includes one (preferably multiple) electrodes 26 that are optionally distributed on a plurality of splines 22 at a distal tip 28 and configured to sense IEGM signals. In addition, the catheter 14 may also include a sensor 29 that is embedded in or near the distal tip 28 for tracking the position and orientation of the distal tip 28. Optionally and preferably, the position sensor 29 is a magnetic-based position sensor that includes three magnetic coils for sensing three-dimensional (3D) position and orientation.

[0023] The sensor 29 (e.g., a position-based or magnetic sensor) can operate with the position pad 25, which includes a plurality of magnetic coils 32 configured to generate a magnetic field in a predefined working space. The real-time position of the distal tip 28 of the catheter 14 can be tracked based on the magnetic field generated by the position pad 25 and sensed by the sensor 29. Details of magnetic-based position sensing technology are described in U.S. Patents 5,5391,199, 5,443,489, 5,558,091, 6,172,499, 6,239,724, 6,332,089, 6,484,118, 6,618,612, 6,690,963, 6,788,967, and 6,892,091.

[0024] The system 10 includes one or more electrode patches 38 positioned in contact with the skin of the patient 23 to establish a position reference for impedance-based tracking of the location pad 25 and the electrodes 26. For impedance-based tracking, current is directed toward the electrodes 26 and sensed at the patches 38 (e.g., electrode skin patches) so that the position of each electrode can be triangulated via the patches 38. Details of impedance-based position tracking techniques are described in U.S. Patents 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182, which are incorporated herein by reference.

[0025] Recorder 11 displays electrograms 21 captured with electrodes 18 (e.g., surface electrocardiogram (ECG) electrodes) and intracardiac electrograms (IEGMs) captured with electrodes 26 of catheter 14. Recorder 11 may include pacing capabilities for pacing the cardiac rhythm and / or may be electrically connected to a separate pacemaker.

[0026] The system 10 may include an ablation energy generator 50 adapted to conduct ablation energy to one or more of the electrodes 26 at the distal tip 28 of the catheter 14 configured for ablation. The energy generated by the ablation energy generator 50 may include, but is not limited to, radio frequency (RF) energy or pulsed field ablation (PFA) energy (including monopolar or bipolar high voltage DC pulses that may be used to achieve irreversible electroporation (IRE)), or a combination thereof.

[0027] The PIU 30 is an interface configured to establish electrical connectivity between catheters, electrophysiology equipment, a power source, and a workstation 55 for controlling the operation of the system 10. The electrophysiology equipment of the system 10 may include, for example, a plurality of catheters 14, location pads 25, surface ECG electrodes 18, electrode patches 38, an ablation energy generator 50, and a recorder 11. Optionally and preferably, the PIU 30 additionally includes processing capabilities for enabling real-time calculation of the position of the catheters and for performing ECG calculations.

[0028] The workstation 55 includes a memory, a processor unit with memory or storage loaded with appropriate operating software, and user interface capabilities. The workstation 55 can provide multiple functions, optionally including: (1) three-dimensional (3D) modeling of the endocardial anatomy and rendering the model or anatomical map 20 for display on the display device 27; (2) displaying on the display device 27 an activation sequence (or other data) compiled from the recorded electrograms 21 as representative visual markers or images superimposed on the rendered anatomical map 20; (3) displaying the real-time position and orientation of multiple catheters within the heart chamber; and (5) displaying on the display device 27 sites of interest (such as where ablation energy has been applied). A commercial product embodying elements of the system 10 may be CARTO TM The 3 system was purchased from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA 92618.

[0029] For example, system 10 may be a surgical system (e.g., sold by Biosense Webster). The present invention is part of a surgical system that is configured to obtain biometric data (e.g., anatomical measurements and electrical measurements of a patient's organ such as the heart 12, and as described herein) and to perform cardiac ablation procedures. More specifically, treatment of cardiac conditions such as arrhythmias often requires obtaining detailed mapping of cardiac tissue, chambers, veins, arteries, and / or electrical pathways. For example, a prerequisite for successfully performing catheter ablation (as described herein) is that the cause of the arrhythmia is accurately located in a chamber of the heart 12. Such localization can be accomplished via an electrophysiological study during which electrical potentials are spatially resolved using a mapping catheter (e.g., catheter 14) introduced into a chamber of the heart 12. The electrophysiological study (so-called electroanatomical mapping) thus provides 3D mapping data that can be displayed on the display device 27. In many cases, the mapping function and the therapeutic function (e.g., ablation) are provided by a single catheter or a group of catheters, such that the mapping catheter also simultaneously operates as a therapeutic (e.g., ablation) catheter. In one example, the system 10 obtains rapid anatomical mapping (FAM) of a cardiac chamber, wherein acquired electroanatomical data is used to map the locations of points on the inner surface of the cavity.

[0030] Figure 2 is a block diagram of an example system 100 for remotely monitoring and transmitting patient biometrics (i.e., patient data). Figure 2In the example shown, system 100 includes a patient biometric monitoring and processing device 102 associated with a patient 104, a local computing device 106, a remote computing system 108, a first network 110, a patient biometric sensor 112, a processor 114, a user input (UI) sensor 116, a memory 118, a second network 120, and a transmitter-receiver (i.e., transceiver) 122.

[0031] According to one embodiment, the patient biometric monitoring and processing device 102 may be a device that is internal to the patient's body (e.g., subcutaneously implantable), such as Figure 1 The patient biometric monitoring and processing device 102 may be inserted into the patient's body via any suitable means, including oral injection, surgical insertion via a vein or artery, endoscopic procedure, or laparoscopic procedure.

[0032] According to one embodiment, the patient biometric monitoring and processing device 102 may be a device external to the patient's body, such as Figure 1 The patient biometric monitoring and processing device 102 may include an attachable patch (e.g., which attaches to the patient's skin) as described in more detail below. The monitoring and processing device 102 may also include a catheter with one or more electrodes, a probe, a blood pressure cuff, a weight scale, a bracelet or smart watch biometric tracker, a glucose monitor, a continuous positive airway pressure (CPAP) machine, or virtually any device that can provide input related to the patient's health or biometrics.

[0033] According to one embodiment, the patient biometric monitoring and processing device 102 may include both components internal to the patient and components external to the patient.

[0034] Figure 2 1 shows a single patient biometric monitoring and processing device 102. However, the example system may include multiple patient biometric monitoring and processing devices. The patient biometric monitoring and processing device may communicate with one or more other patient biometric monitoring and processing devices. Additionally or alternatively, the patient biometric monitoring and processing device may communicate with the network 110.

[0035] One or more patient biometric monitoring and processing devices 102 may collect patient biometric data (e.g., electrical signals, blood pressure, temperature, blood sugar level, or other biometric data) and receive at least a portion of the patient biometric data representing the collected patient biometric and additional information associated with the collected patient biometric from one or more other monitoring and processing devices 102. The additional information may be, for example, diagnostic information and / or additional information obtained from an additional device such as a wearable device. Each patient biometric monitoring and processing device 102 may process data including its own collected patient biometrics as well as data received from one or more other patient biometric monitoring and processing devices 102.

[0036] Biometric data (e.g., patient biometrics, patient data, or patient biometric data) may include one or more of local activation time (LAT), electrical activity, topology, bipolar mapping, reference activity, ventricular activity, dominant frequency, impedance, and the like. The LAT may be a time point corresponding to a threshold activity of local activation calculated based on a normalized initial starting point. The electrical activity may be any applicable electrical signal that may be measured based on one or more thresholds and may be sensed and / or enhanced based on a signal-to-noise ratio and / or other filters. The topology may correspond to a physical structure of a body part or a portion of a body part, and may correspond to changes in the physical structure relative to different portions of a body part or relative to different body parts. The dominant frequency may be a frequency or frequency range that is prevalent at a portion of a body part, and may be different in different portions of the same body part. For example, the dominant frequency of the PV of a heart may be different from the dominant frequency of the right atrium of the same heart. Impedance may be a resistance measurement at a given area of ​​a body part.

[0037] Examples of biometric data include, but are not limited to, patient identification data, intracardiac electrocardiogram (IC ECG) data, bipolar intracardiac reference signals, anatomical and electrical measurements, trajectory information, body surface (BS) ECG data, historical data, brain biometrics, blood pressure data, ultrasound signals, radio signals, audio signals, two-dimensional or three-dimensional image data, blood glucose data, and temperature data. Biometric data can generally be used to monitor, diagnose, and treat any number of various diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathy, and coronary artery disease) and autoimmune diseases (e.g., type I and type II diabetes). It should be noted that BS ECG data may include data and signals collected from electrodes on the surface of the patient, IC ECG data may include data and signals collected from electrodes inside the patient, and ablation data may include data and signals collected from tissue that has been ablated. In addition, BS ECG data, IC ECG data, and ablation data, along with catheter electrode positioning data, may be derived from one or more procedure records.

[0038] exist Figure 2 In the embodiment of the present invention, the network 110 is an example of a short-range network, such as a local area network (LAN) or a personal area network (PAN). Information can be sent between the patient biometric monitoring and processing device 102 and the local computing device 106 via the network 110 using any of a variety of short-range wireless communication protocols, such as Bluetooth, Wi-Fi, Zigbee, Z-Wave, near field communication (NFC), ultraband, Zigbee, or infrared (IR).

[0039] The network 120 may be a wired network, a wireless network, or include one or more wired and wireless networks. For example, the network 120 may be a long-range network (e.g., a wide area network (WAN), the Internet, or a cellular network). Information may be sent via the network 120 using any of a variety of long-range wireless communication protocols (e.g., TCP / IP, HTTP, 3G, 4G / LTE, or 5G / New Radio).

[0040] The patient biometric monitoring and processing device 102 may include a patient biometric sensor 112, a processor 114, a UI sensor 116, a memory 118, and a transceiver 122. The patient biometric monitoring and processing device 102 may continuously or periodically monitor, store, process, and transmit any number of various patient biometrics via the network 110. Examples of patient biometrics include electrical signals (e.g., ECG signals and brain biometrics), blood pressure data, blood glucose data, and temperature data. Patient biometrics may be monitored and transmitted to treat any number of various diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathy, and coronary artery disease) and autoimmune diseases (e.g., type I and type II diabetes).

[0041] The patient biometric sensor 112 may include, for example, one or more sensors configured to sense a type of biometric patient biometric. For example, the patient biometric sensor 112 may include electrodes configured to collect electrical signals (e.g., heart signals, brain signals, or other bioelectrical signals), a temperature sensor, a blood pressure sensor, a blood glucose sensor, a blood oxygen sensor, a pH sensor, an accelerometer, and a microphone.

[0042] As described in more detail below, the patient biometric monitoring and processing device 102 may be an ECG monitor for monitoring ECG signals of a heart (e.g., heart 12). The patient biometric sensor 112 of the ECG monitor may include one or more electrodes for collecting ECG signals. The ECG signals may be used to treat various cardiovascular diseases.

[0043] In another example, the patient biometric monitoring and processing device 102 can be a continuous glucose monitor (CGM) for continuously monitoring the patient's blood glucose level to treat various diseases, such as type I and type II diabetes. The CGM can include electrodes disposed subcutaneously that can monitor blood glucose levels from the patient's interstitial fluid. The CGM can be, for example, a component of a closed-loop system in which blood glucose data is sent to an insulin pump for calculating insulin delivery without user intervention.

[0044] The transceiver 122 may include a separate transmitter and receiver. Alternatively, the transceiver 122 may include a transmitter and receiver integrated into a single device.

[0045] The processor 114 may be configured to store patient data, such as patient biometric data collected by the patient biometric sensor 112, in the memory 118, and to transmit the patient data across the network 110 via the transmitter of the transceiver 122. Data from one or more other patient biometric monitoring and processing devices 102 may also be received by the receiver of the transceiver 122, as described in more detail below.

[0046] According to an embodiment, the patient biometric monitoring and processing device 102 includes a UI sensor 116, which can be, for example, a piezoelectric sensor or a capacitive sensor configured to receive user input (such as a tap or touch). For example, in response to the patient 104 tapping or contacting the surface of the patient biometric monitoring and processing device 102, the UI sensor 116 can be controlled to achieve capacitive coupling. Gesture recognition can be achieved via any of a variety of capacitance types, such as resistive capacitance, surface capacitance, projected capacitance, surface acoustic wave, piezoelectric, and infrared touch. The capacitive sensor can be set at a small area or over the length of the surface so that a tap or touch of the surface activates the monitoring device.

[0047] As described in more detail below, the processor 114 can be configured to selectively respond to different tap patterns (e.g., single or double taps) of the capacitive sensor (which can be the UI sensor 116) so that different tasks of the patch (e.g., acquisition, storage, or transmission of data) can be activated based on the detected pattern. In some embodiments, when a gesture is detected, audible feedback can be given to the user from the patient biometric monitoring and processing device 102.

[0048] The local computing device 106 of the system 100 communicates with the patient biometric monitoring and processing apparatus 102 and may be configured to act as a gateway to the remote computing system 108 via the second network 120. For example, the local computing device 106 may be, for example, a smart phone, a smart watch, a tablet, or other portable smart device configured to communicate with other devices via the network 120. Alternatively, the local computing device 106 may be a fixed or standalone device, such as a fixed base station including, for example, modem and / or router capabilities, a desktop or laptop computer using an executable program to transfer information between the patient biometric monitoring and processing apparatus 102 and the remote computing system 108 via a radio module of the PC, or a USB dongle. Patient biometrics may be transferred between the local computing device 106 and the patient biometric monitoring and processing apparatus 102 via a short-range wireless network 110, such as a local area network (LAN) (e.g., a personal area network (PAN)) using short-range wireless technology standards (e.g., Bluetooth, Wi-Fi, ZigBee, Z-wave, and other short-range wireless standards). In some embodiments, the local computing device 106 may also be configured to display the acquired patient electrical signals and information associated with the acquired patient electrical signals, as described in more detail below.

[0049] In some embodiments, the remote computing system 108 may be configured to receive at least one of the monitored patient biometric and information associated with the monitored patient via the network 120 as a remote network. For example, if the local computing device 106 is a mobile phone, the network 120 may be a wireless cellular network, and information may be transmitted between the local computing device 106 and the remote computing system 108 via a wireless technology standard such as any of the wireless technologies described above. As described in more detail below, the remote computing system 108 may be configured to provide (e.g., visually display and / or audibly provide) at least one of the patient biometric and the related information to a healthcare professional (e.g., a physician).

[0050] Figure 3 1 is a system diagram of an example of a computing environment 200 in communication with a network 120. In some cases, computing environment 200 is incorporated into a public cloud computing platform (such as Amazon Web Services or Microsoft Azure), a hybrid cloud computing platform (such as HP Enterprise OneSphere), or a private cloud computing platform.

[0051] like Figure 3 As shown, computing environment 200 includes a remote computing system 108 (hereinafter computer system), which is one example of a computing system on which embodiments described herein may be implemented.

[0052] The remote computing system 108 may perform various functions via the processor 220, which may include one or more processors. The functions may include analyzing monitored patient biometrics and associated information, and providing (e.g., via the display 266) alerts, additional information, or instructions based on physician-determined or algorithm-driven thresholds and parameters. As described in more detail below, the remote computing system 108 may be used to provide (e.g., via the display 266) a patient information dashboard to a healthcare provider (e.g., a physician) such that such information may enable the healthcare provider to identify and prioritize patients with more critical needs than others.

[0053] like Figure 3 As shown, the computer system 210 may include a communication mechanism such as a bus 221 or other communication mechanism for transmitting information within the computer system 210. The computer system 210 also includes one or more processors 220 coupled to the bus 221 for processing information. The processor 220 may include one or more CPUs, GPUs, or any other processors known in the art.

[0054] The computer system 210 also includes a system memory 230 coupled to the bus 221 for storing information and instructions to be executed by the processor 220. The system memory 230 may include computer-readable storage media in the form of volatile and / or non-volatile memory, such as a read-only system memory (ROM) 231 and / or a random access memory (RAM) 232. The system memory RAM 232 may include other dynamic storage devices (e.g., dynamic RAM, static RAM, and synchronous DRAM). The system memory ROM 231 may include other static storage devices (e.g., programmable ROM, erasable PROM, and electrically erasable PROM). In addition, the system memory 230 may be used to store temporary variables or other intermediate information during the execution of instructions by the processor 220. The basic input / output system 233 (BIOS) may include routines for transferring information between elements within the computer system 210 (such as during the boot process), which may be stored in the system memory ROM 231. The RAM 232 may contain data and / or program modules that are immediately accessible to and / or currently being operated by the processor 220. System memory 230 may additionally include, for example, operating system 234 , application programs 235 , other program modules 236 , and program data 237 .

[0055] The illustrated computer system 210 also includes a disk controller 240 that is coupled to the bus 221 to control one or more storage devices for storing information and instructions, such as a hard disk 241 and a removable media drive 242 (e.g., a floppy disk drive, an optical drive, a tape drive, and / or a solid-state drive). Storage devices may be added to the computer system 210 using an appropriate device interface (e.g., small computer system interface (SCSI), integrated device electronics (IDE), universal serial bus (USB), or FireWire).

[0056] The computer system 210 may also include a display controller 265 coupled to the bus 221 to control a monitor or display 266, such as a cathode ray tube (CRT) or a liquid crystal display (LCD), to display information to a computer user. The illustrated computer system 210 includes a user input interface 260 and one or more input devices, such as a keyboard 262 and a pointing device 261, for interacting with a computer user and providing information to the processor 220. The pointing device 261 may be, for example, a mouse, a trackball, or a pointing stick for communicating directional information and command selections to the processor 220 and for controlling cursor movement on the display 266. The display 266 may provide a touch screen interface that may allow input to supplement or replace the communication of directional information and command selections by the pointing device 261 and / or the keyboard 262.

[0057] In response to processor 220 executing one or more sequences of one or more instructions contained in a memory (such as system memory 230), computer system 210 may perform a portion or each of the functions and methods described herein. Such instructions may be read into system memory 230 from another computer-readable medium (such as hard disk 241 or removable media drive 242). Hard disk 241 may contain one or more data repositories and data files used by the embodiments described herein. Data repository contents and data files may be encrypted to increase security. Processor 220 may also be employed in a multi-processing arrangement to execute one or more sequences of instructions contained in system memory 230. In an alternative embodiment, hard-wired circuitry may be used in place of or in combination with software instructions. Therefore, embodiments are not limited to any particular combination of hardware circuitry and software.

[0058] As described above, the computer system 210 may include at least one computer-readable medium or memory for storing instructions programmed according to the embodiments described herein and for containing data structures, tables, records, or other data described herein. The term computer-readable medium as used herein refers to any non-transient tangible medium that participates in providing instructions to the processor 220 for execution. Computer-readable media can take many forms, including but not limited to non-volatile media, volatile media, and transmission media. Non-limiting examples of non-volatile media include optical disks, solid-state drives, magnetic disks, and magneto-optical disks, such as hard disks 241 or removable media drives 242. Non-limiting examples of volatile media include dynamic memory, such as system memory 230. Non-limiting examples of transmission media include coaxial cables, copper wires, and optical fibers, including wires that constitute bus 221. Transmission media can also take the form of sound waves or light waves, such as those generated during radio wave and infrared data communications.

[0059] The computing environment 200 may also include a computer system 210 that operates in a networked environment using logical connections to the local computing device 106 and one or more other devices, such as personal computers (laptops or desktops), mobile devices (e.g., patient mobile devices), servers, routers, network PCs, peer devices, or other public network nodes, and typically includes many or all of the elements described above with respect to the computer system 210. When used in a networked environment, the computer system 210 may include a modem 272 for establishing communications over a network 120 (such as the Internet). The modem 272 may be connected to the system bus 221 via a network interface 270 or via another appropriate mechanism.

[0060] like Figure 2 and Figure 3 As shown, network 120 can be any network or system known in the art, including the Internet, an intranet, a local area network (LAN), a wide area network (WAN), a metropolitan area network (MAN), a direct connection or a series of connections, a cellular telephone network, or any other network or medium capable of facilitating communications between computer system 610 and other computers (e.g., local computing device 106).

[0061] The treatment of cardiac disorders (such as arrhythmias) generally requires obtaining detailed mapping of cardiac tissue, chambers, veins, arteries and / or electrical pathways. For example, a prerequisite for the successful performance of catheter ablation is that the cause of the arrhythmia is accurately located in the heart chamber. Such localization can be accomplished via an electrophysiological study, during which electrical potentials are spatially resolved using a mapping catheter introduced into the heart chamber. This electrophysiological study (so-called electroanatomical mapping) therefore provides 3D mapping data that can be displayed on a monitor. In many cases, the mapping function and the therapeutic function (e.g., ablation) are provided by a single catheter or a group of catheters, so that the mapping catheter also operates simultaneously as a therapeutic (e.g., ablation) catheter.

[0062] Mapping of cardiac regions, such as cardiac regions, tissues, veins, arteries, and / or electrical pathways, can result in identification of problem areas, such as scar tissue, sources of arrhythmias (e.g., electrical rotors), healthy areas, and the like. The cardiac region can be mapped such that a visual rendering of the mapped cardiac region is provided using a display, as further disclosed herein. In addition, cardiac mapping can include mapping based on one or more modalities, such as, but not limited to, local activation time (LAT), electrical activity, topology, bipolar mapping, dominant frequency, or impedance. Data corresponding to multiple modalities can be captured using a catheter inserted into the patient, and data corresponding to multiple modalities can be provided for rendering simultaneously or non-simultaneously based on corresponding settings and / or preferences of a medical professional.

[0063] Cardiac mapping can be implemented using one or more techniques. As an example of a first technique, cardiac mapping can be implemented by sensing the electrical properties of cardiac tissue (e.g., local activation time) according to precise locations within the heart. The corresponding data can be collected using one or more catheters that are advanced into the heart using catheters having electrical sensors and position sensors in their distal ends. For example, the position and electrical activity can initially be measured at about 10 to about 20 points on the inner surface of the heart. These data points are generally sufficient to generate a preliminary reconstruction or mapping map of satisfactory quality of the heart surface. The preliminary map can be combined with data taken from additional points to produce a more comprehensive map of the heart's electrical activity. In a clinical setting, it is not uncommon to accumulate data at 100 or more sites to generate a detailed and comprehensive map of the electrical activity of the heart chambers. The generated detailed map can then be used as a basis for deciding on a course of therapeutic action, such as tissue ablation, to change the propagation of the heart's electrical activity and restore normal heart rhythm.

[0064] A catheter containing a position sensor can be used to determine the trajectory of points on the surface of the heart. These trajectories can be used to infer motion characteristics, such as the contractility of the tissue. When trajectory information is sampled at a sufficient number of points in the heart, a map depicting such motion characteristics can be constructed.

[0065] Electrical activity in the heart is typically measured by advancing a catheter containing an electrical sensor at or near its distal tip to a point in the heart, contacting the tissue with the sensor, and collecting data at that point. One disadvantage of mapping a cardiac chamber using a catheter containing only a single distal tip electrode is the time required to collect data point by point at the necessary number of points required for a detailed map of the chamber as a whole. Therefore, multi-electrode catheters have been developed to measure electrical activity at multiple points in a cardiac chamber simultaneously.

[0066] A multi-electrode catheter may be implemented using any suitable shape, such as a linear catheter having multiple electrodes, a balloon catheter including electrodes dispersed on multiple ridges that shape the balloon, a lasso or loop catheter having multiple electrodes, or any other suitable shape. Figure 4 An example of a linear catheter 402 including a plurality of electrodes 404, 405, and 406 that can be used to map a cardiac region is shown. The linear catheter 402 can be fully or partially elastic such that it can twist, bend, and / or otherwise change its shape based on received signals and / or based on the application of external forces (e.g., cardiac tissue) on the linear catheter 402.

[0067] Figure 5 An example of a balloon catheter 512 is shown, which includes a plurality of splines (e.g., Figure 5 ), including splines 514, 515, 516, and multiple electrodes on each spline, including electrodes 521, 522, 523, 524, 525 and 526 as shown. The balloon catheter 512 can be designed so that when it is deployed in the patient's body, its electrodes can remain in close contact with the endocardial surface. For example, the balloon catheter can be inserted into an inner cavity (such as a pulmonary vein (PV)). The balloon catheter can be inserted into the PV in a deflated state so that the balloon catheter does not occupy its maximum volume when inserted into the PV. The balloon catheter can be expanded inside the PV so that the electrodes on the balloon catheter are in contact with the entire circular segment of the PV. Such contact with the entire circular portion of the PV or any other inner cavity can achieve effective mapping and / or ablation.

[0068] Figure 6 An example of a loop catheter 630 (also known as a lasso catheter) is shown that includes a plurality of electrodes 632, 634, and 636 that can be used to map a cardiac region. The loop catheter 630 can be fully or partially elastic so that it can twist, bend, and / or otherwise change its shape based on received signals and / or based on the application of external forces (e.g., cardiac tissue) on the loop catheter 630.

[0069] According to one example, a multi-electrode catheter may be advanced into a chamber of the heart. An anteroposterior fluorogram (AP) and a lateral fluorogram may be obtained to establish the position and orientation of each electrode. An electrogram relative to a time reference (such as, starting from the P wave in the sinus rhythm from the surface ECG) may be recorded by each of the electrodes in contact with the surface of the heart. As further disclosed herein, the system may distinguish between those electrodes that record electrical activity and those electrodes that do not record electrical activity due to not being in close proximity to the endocardial wall. After recording the initial electrogram, the catheter may be repositioned, and the fluorogram and electrogram may be recorded again. The electrical mapping map may then be constructed according to iterations of the above process.

[0070] According to one example, cardiac mapping can be generated based on the detection of intracardiac potential fields. Non-contact technology that simultaneously collects a large amount of cardiac electrical information can be implemented. For example, a catheter having a distal end portion may be provided with a series of sensor electrodes distributed on its surface and connected to an insulated electrical conductor for connection to a signal sensing and processing device. The size and shape of the end portion may be such that the electrodes are substantially spaced apart from the wall of the heart chamber. The intracardiac potential field may be detected during a single heartbeat. According to one example, the sensor electrodes may be distributed on a series of circumferences located in planes spaced apart from each other. These planes may be perpendicular to the long axis of the end portion of the catheter. At least two additional electrodes may be provided adjacently at the end of the long axis of the end. As a more specific example, the catheter may include four circumferences, wherein eight electrodes are equiangularly spaced apart on each circumference. Therefore, in this specific implementation, the catheter may include at least 34 electrodes (32 circumferential electrodes and 2 end electrodes).

[0071] According to another example, an electrophysiological cardiac mapping system and technique based on a non-contact and non-expanding multi-electrode catheter can be implemented. An electrogram can be obtained using a catheter having a plurality of electrodes (e.g., between 42 and 122 electrodes). According to this specific implementation, knowledge of the relative geometry of the probe and the endocardium can be obtained, such as by an independent imaging modality (such as transesophageal echocardiography or 2D or 4D intracardiac echocardiography (ICE)). After independent imaging, the non-contact electrodes can be used to measure the cardiac surface potential and construct a map therefrom. The technique may include the following steps (after the independent imaging step): (a) measuring the potential using a plurality of electrodes disposed on a probe positioned in the heart; (b) determining the geometric relationship between the probe surface and the endocardial surface; (c) generating a coefficient matrix representing the geometric relationship between the probe surface and the endocardial surface; and (d) determining the endocardial potential based on the electrode potential and the coefficient matrix.

[0072] According to another example, techniques and apparatus for mapping the potential distribution of a cardiac chamber may be implemented. An intracardiac multi-electrode mapping catheter assembly may be inserted into the patient's heart. The mapping catheter assembly may include a multi-electrode array with an integral reference electrode, or preferably, a matching reference catheter. The electrodes may be deployed in a substantially spherical array. The electrode array may be spatially referenced to a point on the endocardial surface by a reference electrode or by a reference catheter in contact with the endocardial surface. A preferred electrode array catheter may carry a plurality of separate electrode sites (e.g., at least 24). In addition, the exemplary technique may be implemented by knowing the location of each of the electrode sites on the array and knowing the geometry of the heart. These locations are preferably determined by the technique of impedance plethysmography.

[0073] According to another example, a cardiac mapping catheter assembly may include an electrode array defining a plurality of electrode sites. The mapping catheter assembly may also include an inner cavity to receive a reference catheter having a distal end electrode assembly that can be used to detect a heart wall. The mapping catheter may include a braid of insulated wires (e.g., having 24 to 64 wires in the braid), and each wire may be used to form an electrode site. The catheter may be easily positioned in the heart for collecting electrical activity information from a first set of non-contact electrode sites and / or a second set of contact electrode sites.

[0074] According to another example, another catheter for mapping electrophysiological activity within the heart can be implemented. The catheter body may include a distal tip adapted to deliver stimulation pulses for cardiac pacing or an ablation electrode for ablating tissue in contact with the tip. The catheter may also include at least one pair of orthogonal electrodes to generate a difference signal indicative of local cardiac electrical activity adjacent to the orthogonal electrodes.

[0075] According to another example, a process for measuring electrophysiological data in a heart chamber may be implemented. The method may include, in part, positioning a set of active electrodes and passive electrodes into the heart, providing current to the active electrodes to generate an electric field in the heart chamber, and measuring the electric field at the passive electrode sites. The passive electrodes are contained in an array positioned on an inflatable balloon of a balloon catheter. In a preferred embodiment, the array is said to have from 60 to 64 electrodes.

[0076] According to another example, cardiac mapping can be implemented using one or more ultrasound transducers. The ultrasound transducer can be inserted into the patient's heart, and multiple ultrasound slices (e.g., two-dimensional or three-dimensional slices) can be collected at various positions and orientations within the heart. The position and orientation of a given ultrasound transducer can be known, and the collected ultrasound slices can be stored so that they can be displayed at a later time. One or more ultrasound slices corresponding to the position of a probe (e.g., a treatment catheter) can be displayed after a period of time, and the probe can be overlaid on one or more ultrasound slices.

[0077] According to other examples, the body patch and / or body surface electrodes may be positioned on or near the patient's body. A catheter having one or more electrodes may be positioned within the patient's body (e.g., within the patient's heart), and the position of the catheter may be determined by the system based on signals transmitted and received between the one or more electrodes of the catheter and the body patch and / or body surface electrodes. In addition, the catheter electrodes may sense biometric data (e.g., LAT values) from within the patient's body (e.g., within the heart). The biometric data may be associated with the determined position of the catheter so that a rendering of a body part (e.g., heart) of the patient may be displayed, and the biometric data overlaid on the shape of the body part may be displayed, as determined by the position of the catheter.

[0078] CT / MRI and / or ultrasound images can contain the most accurate anatomical references. Such images can include well-known anatomical landmarks used by doctors to achieve final registration. However, CT / MRI and ultrasound images lack the information captured by FAM, including, for example, information required for identifying the source of arrhythmias. As mentioned above, FAM often includes undesirable data points, including, for example, wrong wall positions caused by movement caused by breathing, excessive tension of the catheter to the heart wall during mapping, lack of stable / touch / arrhythmic pattern points, or various other reasons. In addition, FAM mapping is constructed from continuous catheter positions that capture the entire cardiac cycle, resulting in the shape of the heart being represented by its maximum volume at each point (which is inaccurate).

[0079] Reference now Figure 7 , shows a technique for shaving FAM to resolve undesirable data points. Figure 7, the calculation surface 701 represents a reference image, and the surface 702 represents the calculation surface of the FAM. The surface 701 corresponds to a reference image, such as a CT image, an MRI image, an ultrasound image, or an electroanatomical map shaved during a previous electrophysiological study of the same patient. The user interface associated with the workstation 55 is used to enter one or more accuracy parameters. In the example shown, accuracy parameters corresponding to a maximum distance of 2 mm and an 80% tissue proximity index (Tissue Proximity Index) (or "TPI", explained below) are used. The indication (in this example, the star 703) corresponds to an area that meets one or both of the accuracy parameters, that is, for each star 703, the distance between the surface 701 and the surface 702 is less than 2 mm, the TPI of the data point is greater than 80%, or both. The star 704 corresponds to an area where neither of these two accuracy parameters is met. The space between the dashed lines 705 corresponds to the area of ​​interest covered by the shaving tool. In some embodiments, the size of the area of ​​interest between the dashed lines can be configured by the user. The shaving tool includes a user interface that displays an ellipse 706. Oval 706 is a top view of the area between dashed lines 705. Oval 706 provides a visual indication on a user interface (e.g., display screen 20) of the area on the FAM map that fails to meet the specified accuracy parameters. Figure 7 In the illustrated technique, the map is modified by shaving the surface 702 (in the area between dashed lines 705) to remove all or part of the depth represented by stars 704. In other examples, one or more other accuracy parameters, including, for example, qualified points (e.g., defined by a Smart-index, or defined by signal quality), manually acquired points, presence of a VisiTag, and / or point density, may be used as an alternative or in addition to TPI or distance to the surface.

[0080] Still reference Figure 7In one embodiment, when the oval 706 is positioned on the display screen 20 over the area to be shaved, shaving of the surface 702 is started in response to a manual input from the user. In a more specific embodiment, the entire depth represented by the star 704 is removed in response to a single manual input from the user (e.g., a click of a mouse). Therefore, if 6 mm needs to be shaved from the surface 702 to remove the depth represented by the star 704, all 6 mm are shaved (in one step) in response to a single manual input from the user. This represents an improvement over more time-consuming manual shaving systems, in which only a limited depth (e.g., 2 mm) can be shaved at a time, because they require the user to perform multiple shaving iterations to shave to the desired depth. In an alternative embodiment, the shaving of the surface 702 is automatic and is performed without the user, for example, the user does not need to click a mouse to individually shave each area on the mapping that does not meet the accuracy parameters. In an example of this automatic mode, the system automatically erases all excess areas according to the criteria selected by the user prior to mapping. Alternatively, an automatic mode is implemented to shave a layer (eg, 5 mm) from the entire map without specifying the area to shave.

[0081] Figure 8A-8D It shows the combination Figure 7 Exemplary maps of various aspects of the shaving technique described. Fig. 8A In FIG. 8 , the (grey) surface 801 corresponds to the FAM map, and the brown (semi-transparent) corresponds to the reference surface 802. Figure 8B In FIG. 8 , the volume 803 to be shaved is shown (orange) on top of a reference map (grey) 804. Figure 8B It can be observed that different areas require different shaving layers, i.e. some areas require a greater shaving depth, while some areas require a lesser shaving depth. Figure 8C and Fig.8D , a shaved circle 805 (similar to Figure 7 oval 706 in FIG. Figure 8C In the embodiment, the shaving circle 805 is positioned on the area where several layers need to be shaved, and in Fig.8D In FIG. 8 , the shaving circle 805 is shown on the area where only one layer needs to be shaved. Figure 8C and Fig.8D In the figure, the relative difference between the FAM and the reference image is represented by the brown area beyond the gray reference area.

[0082] Fig. 9A method 900 of shaving an electroanatomical mapping image (such as a FAM) using a reference image is illustrated. In step 901, a reference image (e.g., a CT image or an MRI image or an ultrasound image) is selected. In step 902, one or more accuracy parameters are selected. In one example, a user interface associated with a workstation 55 is used to select the reference image and the accuracy parameters. In step 903, the FAM is compared to the reference image to identify areas that do not meet the accuracy parameters. In step 904, a visual indication (e.g., an ellipse 706) of one or more areas that do not meet the accuracy parameters is provided on the display screen 20. In step 905, the identified areas of the map are shaved, and the modified map is displayed (step 906).

[0083] In some embodiments, only a single accuracy parameter (e.g., maximum distance) is used to identify areas that need to be shaved. In other embodiments, more than one accuracy parameter is used. For example, a combination of maximum distance and point quality value (such as TPI, smart index) or a combination of maximum distance and point density value is used. Points in electroanatomical mapping can be rated according to their quality level, such as quality index, which can also be called smart (SMART) index. The quality score of a point is a weighted score of several parameters. The score can be calculated in real time while the acquisition of points is being performed. TPI stands for tissue proximity index (or contact pressure index), which indicates the proximity of the catheter to the tissue wall (e.g., whether the catheter contacts the tissue), estimating the contact force of the catheter electrode with the tissue wall during the acquisition of data points.

[0084] Although the features and elements are described in detail above, it will be known to those skilled in the art that each feature or element can be used alone or in any combination with other features and elements. In addition, 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-ROM disks and digital versatile disks (DVDs)).

[0085] The flow charts and block diagrams in the accompanying drawings illustrate the possible specific implementation architecture, functions and operations of the system, method and computer program product according to various embodiments of the present invention. In this regard, each box in the flow chart or block diagram may represent a module, fragment or part of an instruction, which includes one or more executable instructions for implementing a specified logical function. In some alternative implementations, the function indicated in the box may not occur in the order indicated in the accompanying drawings. For example, depending on the function involved, the two boxes shown in succession may actually be executed substantially simultaneously, or the box may sometimes be executed in the opposite order. It should also be noted that each box in the block diagram and / or the flow chart diagram and the combination of the boxes in the block diagram and / or the flow chart diagram can be implemented by a system based on dedicated hardware that performs a specified function or action or by a combination of dedicated hardware and computer instructions.

[0086] Although features and elements are described above in detail, it will be appreciated by those skilled in the art that each feature or element may be used alone or in any combination with other features and elements. In addition, the methods described herein may be implemented in a computer program, software, or firmware incorporated in a computer-readable medium for execution by a computer or processor. As used herein, a computer-readable medium should not be understood as a transient signal per se, such as a radio wave or other freely propagating electromagnetic wave, an electromagnetic wave propagating through a waveguide or other transmission medium (e.g., a light pulse passing through a fiber optic cable), or an electrical signal transmitted by wire.

[0087] 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, registers, cache memories, semiconductor memory devices, magnetic media such as internal hard disks and removable disks, magneto-optical media, optical media such as compact disks (CDs) and digital versatile disks (DVDs), random access memories (RAMs), read-only memories (ROMs), erasable programmable read-only memories (EPROMs or flash memories), static random access memories (SRAMs), and memory sticks. A processor associated with software can be used to implement a radio frequency transceiver used in a terminal, a base station, or any host computer.

[0088] The terms used herein are only for the purpose of describing specific embodiments and are not intended to be limiting. As used herein, unless the context clearly indicates otherwise, the singular forms "a", "a", and "the / said" include plural references. It should also be understood that the terms "comprise" and / or "comprising" when used in this specification specify the presence of the features, integers, steps, operations, elements and / or parts, but do not exclude the presence or addition of one or more other features, integers, steps, operations, elements and / or groups thereof.

[0089] The description of various embodiments herein is presented for the purpose of illustration, but is not intended to be exhaustive or limited to the disclosed embodiments. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and essence of the described embodiments. The terminology used herein is selected to best explain the principles of the embodiments, practical applications or technical improvements over technologies available on the market, or to enable other persons of ordinary skill in the art to understand the embodiments disclosed herein.

Claims

1. A computer-implemented method comprising: Provides anatomical maps and reference images; providing at least one accuracy parameter; identifying at least one region in the anatomical map that fails to meet the at least one accuracy parameter by comparing the anatomical map to the reference image; displaying an image of the anatomical map, wherein the image provides a visual indication of the at least one region of the anatomical map that fails to meet the at least one accuracy parameter; generating a revised map by shaving the at least one region of the anatomical map that fails to meet the at least one accuracy parameter; as well as The modified map is displayed.

2. The method according to claim 1, wherein: The anatomical map is a Fast Anatomical Map (FAM) acquired during an electrophysiological study.

3. The method according to claim 2, wherein: The reference image is one of a CT image and an MRI image.

4. The method according to claim 2, wherein: The reference image is an ultrasound image.

5. The method according to claim 2, wherein: The reference image is an anatomical map shaved during a previous electrophysiological study.

6. The method according to claim 1, wherein: The shaving step is initiated manually by a user viewing the visual indication.

7. The method according to claim 1, wherein: The identifying, displaying and shaving steps are performed using a workstation, and the shaving step is automatically initiated by the workstation.

8. The method according to claim 1, wherein: The at least one accuracy parameter comprises a maximum distance between the anatomical map and the reference image.

9. The method according to claim 8, wherein: The at least one accuracy parameter comprises a point density value.

10. The method according to claim 8, wherein: The at least one accuracy parameter comprises a point quality value.

11. The method according to claim 10, wherein: The point quality value corresponds to a smart index.

12. The method according to claim 1, wherein: The at least one accuracy parameter is configurable by a user performing the electrophysiological study.

13. The method according to claim 1, wherein: The anatomical map is an electroanatomical map.

14. A system for shaving an anatomical map, comprising: a processor communicatively coupled to the memory, a display communicatively coupled to the processor, User interface; The processor operates to: receiving, via the user interface, at least one accuracy parameter; identifying at least one region in the anatomical map that fails to meet the at least one accuracy parameter by comparing the anatomical map to a reference image; displaying an image of the anatomical map on the display, wherein the image provides a visual indication of the at least one region of the anatomical map that fails to meet the at least one accuracy parameter; generating a revised map by shaving the at least one region of the anatomical map that fails to meet the at least one accuracy parameter; as well as The modified map is displayed on the display.

15. The system of claim 14, further comprising at least one electrode catheter coupled to the processor, wherein the processor generates the anatomical map using data acquired by the at least one electrode catheter during an electrophysiological study, and wherein the anatomical map is a fast anatomical map (FAM).

16. The system of claim 15, wherein: The reference image is one of a CT image, an MRI image, an ultrasound image, or an anatomical map shaved during a previous electrophysiological study.

17. The system of claim 14, wherein: The shaving is initiated in response to input from a user to shave the at least one region of the electroanatomical map that fails to meet the at least one accuracy parameter.

18. The system of claim 14, wherein: The at least one accuracy parameter comprises a maximum distance between the anatomical map and the reference image.

19. The system of claim 14, wherein: The at least one accuracy parameter further comprises a point density value or a point quality value.

20. The system of claim 14, wherein: The anatomical map is an electroanatomical map.

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