Multi-plane suggested orientation

Abstract

The invention relates to a multi-plane suggested orientation. Systems and methods for providing a multi-plane suggested orientation by tracking a target are described. The systems and methods include a catheter for performing medical electrophysiology and a graphical user interface (GUI) for monitoring the catheter. The GUI is used to maintain the target in the display during medical electrophysiology. The catheter and GUI operate in combination to display a tilt angle in the display for following the target, receive a rotation angle of a current plane of the device view, receive a point of interest associated with the target, calculate a new plane using a vector in the rotated axis and a vector from a center point of the device to the target, and display the new plane in the display. And calculating an angle between the rotation angle and an angle of the new plane to maintain the target included in the display.

Description

Technical Field

[0001] The present invention relates to medical systems and the imaging capabilities and use of devices during procedures. More specifically, the present invention relates to in-vivo medical probes and ultrasound imaging that provide multi-planar (e.g., at least two-dimensional) recommended orientations. Background Art

[0002] Three-dimensional (3D) ultrasound is a medical ultrasound technique commonly used, for example, in fetal, cardiac, transrectal, and endovascular applications. 3D ultrasound specifically refers to the volumetric presentation of ultrasound data. When referring to a series of 3D volumes collected over time, it is commonly referred to as 4D ultrasound (three spatial dimensions plus one time dimension).

[0003] Ultrasound imaging can be used to image body tissues, and medical probes inserted into the tissues are used to perform diagnostic or therapeutic procedures on the tissues. Manipulating the tilt and rotation of a catheter is commonly referred to as mechanical manipulation. It is also possible to perform tilt and rotation manipulations on the ultrasound imaging plane from the catheter, which is referred to as electronic manipulation. Summary of the Invention

[0004] The present invention describes systems and methods for providing multi-planar recommended orientations by tracking a target. The systems and methods include a catheter for performing medical electrophysiology and a graphical user interface (GUI) for monitoring the catheter, the GUI being configured to maintain the target within a display for the catheter user during medical electrophysiology. The catheter and the GUI operate in combination to display, during a procedure, a tilt angle for causing the device to follow the target in the display, receive as input a rotation angle of the current plane of the view of the device, receive as input an interest point associated with the target, calculate a new plane of the view of the device using a vector sum in the rotated axis and a vector from the center point of the device to the target, and calculate an angle between the rotation angle of the current plane and the angle of the new plane to provide movement of the device to maintain the target within the display. Description of the Drawings

[0005] A more detailed understanding can be obtained from the following detailed description provided by way of example in conjunction with the drawings, in which like reference numerals in the drawings indicate like elements, and in which:

[0006] Figure 1 An example catheter-based electrophysiology mapping and ablation system according to one or more embodiments is depicted;

[0007] Figure 2 is a block diagram of an example system for remotely monitoring and transmitting patient biometrics according to one or more embodiments;

[0008] Figure 3System diagram of an example of a computing environment communicating with a network according to one or more embodiments;

[0009] Figure 4A Shows an example of a linear catheter including multiple electrodes that can be used to map a cardiac region;

[0010] Figure 4B Shows an example of a balloon catheter including multiple splines and multiple electrodes on each spline;

[0011] Figure 4C Shows an example of a collar catheter including multiple electrodes that can be used to map a cardiac region;

[0012] Figure 4D Shows an example of an intracardiac echocardiogram (ICE) catheter capable of providing real-time, three-dimensional visualization inside the heart;

[0013] Figure 5 Illustrates a graphical user interface (GUI) configured to provide the tilt and rotation required to track an object of interest;

[0014] Figure 6A Illustrates a graphical user interface (GUI) configured to provide tilt suggestions to a user for tracking the tip of an ablation catheter;

[0015] Figure 6B Illustrates a graphical user interface (GUI) configured to provide tilt suggestions to a user for tracking the tip of an ablation catheter;

[0016] Figure 7A Illustrates a graphical user interface (GUI) configured to provide tilt and rotation suggestions to a user for tracking the tip of an ablation catheter and the direction of the tip of the ablation catheter;

[0017] Figure 7B Illustrates a graphical user interface (GUI) configured to provide tilt and rotation suggestions to a user for tracking the tip of an ablation catheter and the direction of the tip of the ablation catheter;

[0018] Figure 8 Illustrates a method of tracking a point of interest according to the examples described herein; and

[0019] Figure 9 Illustrates a method of tracking a point of interest and the direction of the point of interest according to the examples described herein. DETAILED DESCRIPTION

[0020] The present invention describes systems and methods for providing multi-plane suggested orientations by tracking a target. The systems and methods include a catheter for performing medical electrophysiology and a graphical user interface (GUI) for monitoring the catheter, the GUI being configured to maintain the target within a display for a user of the catheter during medical electrophysiology. The catheter and the GUI operate in combination to display, during a procedure, an inclination angle for moving the device to follow the target in the display, receive as input a rotation angle of a current plane of the device view, receive as input a point of interest associated with the target, calculate a new plane of the device view using a vector in the rotated axis and a vector from a center point of the device to the target, and calculate an angle between the rotation angle of the current plane and the angle of the new plane to provide movement of the device to maintain the target within the display.

[0021] Also included is a method for tracking a target during a procedure to maintain the target within a display for a user of a device. The systems and methods include: displaying, during a procedure, an inclination angle for moving the device to follow the target in the display, receiving as input a rotation angle of a current plane of the device view, receiving as input a point of interest associated with the target, calculating a new plane of the device view using a vector in the rotated axis and a vector from a center point of the device to the target, and calculating an angle between the rotation angle of the current plane and the angle of the new plane to provide movement of the device to maintain the target within the display.

[0022] Also included is a system and method for tracking a target and the orientation of the target during a procedure to maintain the target within a display for a user of a device. The systems and methods include: displaying, during a procedure, an inclination angle and a rotation angle for moving the device to follow the target in the display, receiving as input a device position, a point of interest associated with the target, and an orientation of the point of interest, calculating a normal of a plane represented by the orientation of the point of interest and the device position, calculating a new plane of the device view using a vector calculated by a cross product between the calculated normal of the plane and a vector of the device and the vector of the device, and calculating an angle between the current plane of the device represented by the normal of the plane and the calculated new plane of the device view to maintain the target within the display.

[0023] The systems and methods may use the calculated angles that are multi-plane, and the multi-plane represents the inclination and rotation of the device.

[0024] The system and method can further adjust the device to account for the calculated angle, thereby presenting a new plane. The new plane can track a target in a display for a user of the device. The device can be a medical probe. The target can be a part of a patient's body. The device can be a catheter, and the target can be a pulmonary vein. The device can be a four-dimensional catheter with views including biplane mode, multiplane mode, and 4D.

[0025] In one example, a graphical user interface (GUI) can be provided. The GUI can provide a visual display to a user for interacting with an imaging system, such as the CARTO system described herein. Specifically, the GUI can provide information to the user to guide the user on how to manipulate the catheter, such as the catheter described below with respect to Figures 4A to 4D the catheter. The guidance information can be based on the known position and orientation of the catheter or another object of interest. The GUI can provide tilt and / or tilt and rotation values with associated directions to guide the user in manipulating the catheter to track the object of interest. Additionally, the system can receive the guidance information and manipulate the catheter to track the object of interest based on the guidance information. For example, in one example, arrows can be used to indicate the direction of tilt and / or tilt and rotation of the catheter to provide an increasing or decreasing direction. The required tilt and rotation can be updated in real time to accommodate movement of the object of interest and / or advancement of the catheter within a part of the object of interest. In this way, the user can capture slices showing the object of interest at a high resolution.

[0026] Referring to Figure 1 , which shows an example system shown as system 10 (e.g., a medical device rig and / or a catheter-based electrophysiology mapping and ablation system), in which one or more features of the subject matter herein can be implemented according to one or more embodiments. As described herein, all or part of system 100 can be used to collect information (e.g., biometric data and / or training datasets) and / or for implementing machine learning and / or artificial intelligence algorithms. As shown, system 10 includes a recorder 11, a catheter 14, a model or anatomical map 20, an electrogram 21, a spline 22, a position pad 25, one or more electrodes 26, a display device 27, a distal tip 28, a sensor 29, coils 32, a patient interface unit (PIU) 30, an electrode skin patch 38, an ablation energy generator 50, and a workstation 55. As will be understood, and as provided for a complete description, the heart 12, the patient 23, and the physician 24 (which represents any medical professional, technician, or clinician) are depicted with system 10. Each element and / or item of system 10 represents one or more of that element and / or that item. Figure 1An example of the system 10 shown can be modified to implement the embodiments disclosed herein. The embodiments disclosed in the present invention can be similarly applied using other system components and settings. Additionally, the system 10 can include additional components, such as elements for sensing electrical activity, wired or wireless connectors, processing and display devices, and the like.

[0027] The system 10 includes a plurality of catheters 14 that are inserted by a physician 24 through the patient's vascular system via the skin into the chambers or vascular structures of the heart 12. Generally, a delivery sheath catheter is inserted into the left atrium or right atrium near the desired location in the heart 12. Thereafter, a plurality of catheters can be inserted into the delivery sheath catheter to reach the desired location. The plurality of catheters 14 can 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 can similarly bring the distal end of the ablation catheter to the target site for ablation.

[0028] The catheter 14 is an exemplary catheter that includes at least one (preferably a plurality of) electrodes 26 that are optionally distributed on a plurality of splines 22 at the distal end 28 and are configured to sense IEGM signals. Additionally, the catheter 14 can further include a sensor 29 that is embedded in or near the distal end 28 for tracking the positioning and orientation of the distal end 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.

[0029] The sensor 29 (e.g., a positioning or magnetic-based sensor) can operate in conjunction with a position pad 25 that includes a plurality of magnetic coils 32 configured to generate a magnetic field in a predefined workspace. The real-time positioning of the distal end 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 techniques are described in U.S. Pat. Nos. 5,539,199, 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.

[0030] System 10 includes one or more electrode patches 38 that are positioned to contact the skin of patient 23 to establish a position reference for position pad 25 and impedance-based tracking of electrodes 26. For impedance-based tracking, current is directed toward electrodes 26 and sensed at patches 38 (e.g., electrode skin patches) such that the position of each electrode can be triangulated via patches 38. Details of impedance-based position tracking techniques are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182, which are incorporated herein by reference.

[0031] Recorder 11 displays electrogram 21 captured with electrodes 18 (e.g., body surface electrocardiogram (ECG) electrodes) and intracardiac electrogram (IEGM) captured with electrodes 26 of catheter 14. Recorder 11 may include pacing capabilities for pacing the heart rhythm and / or may be electrically connected to an independent pacemaker.

[0032] System 10 may include an ablation energy generator 50 that is adapted to conduct ablation energy to one or more of electrodes 26 at the distal end 28 of catheter 14 that is configured for ablation. The energy generated by ablation energy generator 50 may include, but is not limited to, radiofrequency (RF) energy or pulsed field ablation (PFA) energy (including monopolar or bipolar high voltage DC pulses that can be used to effect irreversible electroporation (IRE)), or combinations thereof.

[0033] PIU 30 is an interface configured to establish electrical connectivity between the catheter, electrophysiology equipment, power supply, and workstation 55 for controlling the operation of System 10. The electrophysiology equipment of System 10 may include, for example, multiple catheters 14, position pads 25, body surface ECG electrodes 18, electrode patches 38, ablation energy generator 50, and recorder 11. Optionally, PIU 30 additionally includes processing capabilities for performing real-time calculations of the position of the catheter and for performing ECG calculations.

[0034] The workstation 55 includes a memory, a processor unit with a memory or storage device loaded with appropriate operating software, and user interface capabilities. The workstation 55 can provide multiple functions, optionally including: (1) performing three-dimensional (3D) modeling of the endocardial anatomy and rendering a model or anatomical map 20 for display on a 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 positions and orientations of multiple catheters within the heart chambers; and (5) displaying, on the display device 27, a site of interest (such as where ablation energy has been applied). A commercial product embodying the elements of the system 10 may be the CARTO TM 3 system, which is available from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA 92618.

[0035] For example, the system 10 may be part of a cardiac mapping system (e.g., a system sold by Biosense Webster ), which is configured to obtain biometric data (e.g., anatomical and electrical measurements of a patient's organ such as the heart 12, as described herein) and perform a cardiac ablation procedure. More specifically, the treatment of cardiac disorders such as arrhythmias typically requires obtaining a detailed map of the 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 within the chambers of the heart 12. Such localization can be accomplished via an electrophysiological study during which the electrical potential is spatially resolved using a mapping catheter (e.g., catheter 14) introduced into the chambers of the heart 12. This 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 treatment function (e.g., ablation) are provided by a single catheter or a group of catheters, such that the mapping catheter also operates as a treatment (e.g., ablation) catheter simultaneously.

[0036] Figure 2 is a block diagram of an example system 100 for remotely monitoring and transmitting patient biometrics (i.e., patient data). In Figure 2 the example shown, the 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, patient biometric sensors 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.

[0037] According to one example, the patient biometric monitoring and processing device 102 can be a device that is inside the patient's body (e.g., subcutaneously implantable), such as Figure 1 the catheter 14. The patient biometric monitoring and processing device 102 can be inserted into the patient's body via any suitable means, including oral injection, surgical insertion via a vein or artery, endoscopic procedures, or laparoscopic procedures.

[0038] According to one example, the patient biometric monitoring and processing device 102 can be a device that is outside the patient's body, such as Figure 1 the electrode patch 38. For example, as described in more detail below, the patient biometric monitoring and processing device 102 can include an attachable patch (e.g., which attaches to the patient's skin). The monitoring and processing device 102 can also include a catheter, a probe, a blood pressure cuff, a scale, a bracelet or a smartwatch biometric tracker, a glucose monitor, a continuous positive airway pressure (CPAP) machine, or almost any device that can provide input related to the patient's health or biometrics.

[0039] According to one example, the patient biometric monitoring and processing device 102 can include both components inside the patient and components outside the patient.

[0040] Figure 2 A single patient biometric monitoring and processing device 102 is shown in

[0041] . However, an exemplary system can include multiple patient biometric monitoring and processing devices. The patient biometric monitoring and processing devices can communicate with one or more other patient biometric monitoring and processing devices. Additionally or alternatively, the patient biometric monitoring and processing device can communicate with the network 110.

[0042] Biometric data (e.g., patient biometrics, patient data, or patient biometric data) can include one or more of local activation time (LAT), electrical activity, topology, bipolar mapping, reference activity, ventricular activity, dominant frequency, impedance, etc. The LAT can be a time point corresponding to the threshold activity of local activation calculated based on a normalized initial starting point. The electrical activity can be any applicable electrical signal that can be measured based on one or more thresholds and can be sensed and / or enhanced based on signal-to-noise ratio and / or other filters. The topology can correspond to the physical structure of a body part or a part of a body part and can correspond to the variation of the physical structure with respect to different parts of the body part or with respect to different body parts. The dominant frequency can be a frequency or frequency range prevalent at a part of a body part and can be different in different parts of the same body part. For example, the dominant frequency of the PV of the heart can be different from that of the right atrium of the same heart. The impedance can be a resistance measurement result at a given area of a body part.

[0043] 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, cardiomyopathies, and coronary artery diseases) and autoimmune diseases (e.g., type I and type II diabetes). Note that BS ECG data can include data and signals collected from electrodes on the patient's surface, IC ECG data can include data and signals collected from electrodes within the patient's body, and ablation data can include data and signals collected from ablated tissue. Additionally, BS ECG data, IC ECG data, and ablation data, along with catheter electrode positioning data, can be derived from one or more procedural records.

[0044] In Figure 2 , network 110 is an example of a short-range network (e.g., 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 network 110 using any one of various short-range wireless communication protocols, such as Bluetooth, Wi-Fi, Zigbee, Z-Wave, near field communication (NFC), ultraband, Zigbee, or infrared (IR).

[0045] Network 120 can be a wired network, a wireless network, or include one or more wired and wireless networks. For example, network 120 can be a remote network (e.g., a wide area network (WAN), the Internet, or a cellular network). Information can be sent via network 120 using any one of a variety of remote wireless communication protocols (e.g., TCP / IP, HTTP, 3G, 4G / LTE, or 5G / New Radio).

[0046] The patient biometric monitoring and processing device 102 can 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 can continuously or periodically monitor, store, process, and transmit any number of various patient biometrics via 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 can be monitored and transmitted for the treatment of any number of various diseases, such as cardiovascular diseases (e.g., arrhythmia, cardiomyopathy, and coronary artery disease) and autoimmune diseases (e.g., type I and type II diabetes).

[0047] The patient biometric sensor 112 can include, for example, one or more sensors configured to sense the type of biometric patient biometric. For example, the patient biometric sensor 112 can include electrodes configured to acquire 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.

[0048] As described in more detail below, the patient biometric monitoring and processing device 102 can be an ECG monitor for monitoring the ECG signal of the heart (e.g., heart 12). The patient biometric sensor 112 of the ECG monitor can include one or more electrodes for acquiring the ECG signal. The ECG signal can be used to treat various cardiovascular diseases.

[0049] In another example, the patient biometric monitoring and processing device 102 can be a continuous glucose monitor (CGM) for continuously monitoring the blood glucose level of a patient to treat various diseases, such as type I and type II diabetes. The CGM can include a subcutaneously disposed electrode that can monitor the blood glucose level from the interstitial fluid of the patient. The CGM can be, for example, a component of a closed-loop system, where blood glucose data is sent to an insulin pump for calculating the delivery of insulin without user intervention.

[0050] The transceiver 122 can include a separate transmitter and receiver. Alternatively, the transceiver 122 can include a transmitter and receiver integrated into a single device.

[0051] The processor 114 may be configured to store patient data in the memory 118, such as patient biometric data collected by the patient biometric sensor 112, 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.

[0052] According to one example, 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 a touch. For example, in response to the patient 104 tapping or touching 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 various capacitive types, such as resistive capacitive, surface capacitive, projected capacitive, surface acoustic wave, piezoelectric, and infrared touch. The capacitive sensor can be provided at a small area or along the length of the surface such that a tap or a touch on the surface activates the monitoring device.

[0053] As described in more detail below, the processor 114 may be configured to selectively respond to different tap patterns (e.g., single tap or double tap) of the capacitive sensor, which can be the UI sensor 116, such that different tasks of the patch (e.g., data acquisition, storage, or transmission) can be activated based on the detected pattern. In some embodiments, an audible feedback may be given to the user from the patient biometric monitoring and processing device 102 when a gesture is detected.

[0054] The local computing device 106 of system 100 communicates with the patient biometric monitoring and processing device 102 and can 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 can be, for example, a smart phone, a smart watch, a tablet computer, or other portable smart device configured to communicate with other devices via the network 120. Alternatively, the local computing device 106 can be a fixed or stand-alone device, such as a fixed base station including, for example, modem and / or router capabilities, a desktop computer or laptop computer using an executable program to transfer information between the patient biometric monitoring and processing device 102 and the remote computing system 108 via the radio module of the PC, or a USB dongle. Patient biometrics can be transferred between the local computing device 106 and the patient biometric monitoring and processing device 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 can also be configured to display the collected patient electrical signals and information associated with the collected patient electrical signals, as described in more detail below.

[0055] In some embodiments, the remote computing system 108 can be configured to receive at least one of the monitored patient biometrics 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 can be a wireless cellular network, and information can be transferred between the local computing device 106 and the remote computing system 108 via wireless technology standards such as any of the wireless technologies described above. As described in more detail below, the remote computing system 108 can be configured to provide (e.g., visually display and / or auditorily provide) at least one of the patient biometrics and related information to a healthcare professional (e.g., a physician).

[0056] Figure 3 is a system diagram of an example of the computing environment 200 that communicates with the network 120. In some cases, the 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.

[0057] As Figure 3 shown, the computing environment 200 includes a remote computing system 108 (hereinafter referred to as a computer system), which is an example of a computing system on which the embodiments described herein can be implemented.

[0058] The remote computing system 108 can perform various functions via a processor 220 that can include one or more processors. The functions can include analyzing monitored patient biometrics and associated information and providing (e.g., via a display 266) alerts, additional information, or instructions based on thresholds and parameters determined by a doctor or algorithm-driven. As described in more detail below, the remote computing system 108 can be used to provide (e.g., via a display 266) a patient information dashboard to healthcare personnel (e.g., doctors) such that such information can enable the healthcare personnel to identify and prioritize patients with more critical needs than others.

[0059] As Figure 3 shown, the computer system 210 can include a communication mechanism (such as a bus 221) or other communication mechanisms for transferring 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 can include one or more CPUs, GPUs, or any other processors known in the art.

[0060] 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 can include computer-readable storage media in the form of volatile and / or non-volatile memory, such as read-only system memory (ROM) 231 and / or random access memory (RAM) 232. The system memory RAM 232 can include other dynamic storage devices (e.g., dynamic RAM, static RAM, and synchronous DRAM). The system memory ROM 231 can include other static storage devices (e.g., programmable ROM, erasable PROM, and electrically erasable PROM). In addition, the system memory 230 can 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) can contain routines for transferring information between elements within the computer system 210 (such as during the startup process), and the routines can be stored in the system memory ROM 231. The RAM 232 can contain data and / or program modules that can be immediately accessed by the processor 220 and / or are currently being operated on by the processor. The system memory 230 can additionally include, for example, an operating system 234, application programs 235, other program modules 236, and program data 237.

[0061] The computer system 210 shown 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 disk drive, a tape drive, and / or a solid state drive). Storage devices can 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).

[0062] 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 computer system 210 shown 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 can be, for example, a mouse, a trackball, or a pointing stick, for transmitting direction information and command selections to the processor 220 and for controlling the movement of a cursor on the display 266. The display 266 may provide a touchscreen interface that may allow input to supplement or replace the communication of direction information and command selections by the pointing device 261 and / or the keyboard 262.

[0063] In response to one or more sequences of one or more instructions contained in a memory, such as the system memory 230, being executed by the processor 220, the computer system 210 may perform part or each of the functions and methods described herein. Such instructions can be read into the system memory 230 from another computer-readable medium, such as the hard disk 241 or the removable media drive 242. The hard disk 241 may contain one or more data repositories and data files used by the embodiments described herein. The data repository contents and data files can be encrypted to enhance security. The processor 220 may also be employed in a multiprocessing arrangement to execute one or more sequences of instructions contained in the system memory 230. In alternative embodiments, hardwired circuitry may be used in place of or in combination with software instructions. Accordingly, the embodiments are not limited to any specific combination of hardware circuitry and software.

[0064] As described above, 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 the data structures, tables, records, or other data described herein. As used herein, the term computer-readable medium refers to any non-transitory tangible medium that participates in providing instructions to 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 discs, solid state drives, magnetic disks, and magneto-optical discs, such as hard disk 241 or removable media drive 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 wire, and fiber optics, including the wires that make up bus 221. Transmission media can also take the form of acoustic or light waves, such as acoustic or light waves generated during radio wave and infrared data communications.

[0065] Computing environment 200 may also include computer system 210, which operates in a networked environment using logical connections to local computing device 106 and one or more other devices, the one or more other devices being such as a personal computer (laptop or desktop computer), a mobile device (e.g., a patient mobile device), a server, a router, a network PC, a peer device, or other common network nodes, and generally including many or all of the elements described above with respect to computer system 210. When used in a networked environment, computer system 210 may include a modem 272 for establishing communications over a network 120, such as the Internet. Modem 272 may be connected to system bus 221 via network interface 270 or via another suitable mechanism.

[0066] As Figure 2 and Figure 3 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 series of connections, a cellular telephone network, or any other network or medium capable of facilitating communication between computer system 610 and other computers (e.g., local computing device 106).

[0067] The treatment of cardiac conditions such as cardiac arrhythmias typically requires obtaining a detailed mapping of cardiac tissue, chambers, veins, arteries, and / or electrical pathways. For example, a prerequisite for successfully performing catheter ablation is that the cause of the arrhythmia is accurately located within the cardiac chamber. Such localization can be accomplished via an electrophysiological study during which electrical potentials are detected with a mapping catheter introduced into the cardiac chamber and spatially resolved. This electrophysiological study (so-called electroanatomical mapping) thus provides 3D mapping data that can be displayed on a monitor. In many cases, the mapping function and the treatment function (e.g., ablation) are provided by a single catheter or a group of catheters, such that the mapping catheter also operates as a treatment (e.g., ablation) catheter simultaneously.

[0068] Mapping of cardiac regions such as cardiac regions, tissues, veins, arteries, and / or electrical pathways can lead to the identification of problem areas such as scar tissue, arrhythmia sources (e.g., electrical rotors), healthy regions, etc. 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. Additionally, 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 catheters inserted into the patient's body, and the data corresponding to multiple modalities can be provided simultaneously or non-simultaneously for rendering based on the corresponding settings and / or preferences of the medical professional.

[0069] Cardiac mapping can be achieved using one or more techniques. As an example of a technique, cardiac mapping can be achieved by sensing the electrical properties (e.g., local activation time) of cardiac tissue according to the precise location within the heart. Corresponding data can be acquired using one or more catheters that are advanced into the heart using catheters having electrical sensors and position sensors at their distal ends. Specifically, for example, position and electrical activity can initially be measured at approximately 10 to approximately 20 points on the inner surface of the heart. These data points are generally sufficient to generate a preliminary reconstruction or mapping of the heart surface with satisfactory quality. The preliminary map can be combined with data taken at additional points in order to produce a more comprehensive map of cardiac electrical activity. In a clinical setting, it is not uncommon to accumulate data at 100 or more sites to generate a detailed and comprehensive mapping of cardiac chamber electrical activity. The generated detailed mapping can then be used as a basis for deciding, for example, a course of treatment action such as tissue ablation to alter the propagation of cardiac electrical activity and restore normal heart rhythm.

[0070] Catheters containing position sensors can be used to determine the trajectories of points on the cardiac surface. 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 within the heart, a mapping depicting such motion characteristics can be constructed.

[0071] A catheter that includes an electrical sensor at or near its distal end can typically be advanced to a specific point in the heart, the sensor is used to contact tissue and acquire data at that point, and in this way, the electrical activity at that point in the heart is measured. One drawback of using a catheter with only a single distal end electrode to map a cardiac chamber is that it takes a relatively long time to acquire data point by point at the necessary number of points required for a detailed map of the overall chamber. Thus, multi-electrode and high-density mapping catheters have been developed to measure electrical activity at multiple points in a cardiac chamber simultaneously.

[0072] The multi-electrode catheter can be implemented using any suitable shape, such as a linear catheter with multiple electrodes, a balloon catheter including electrodes dispersed on multiple ridges that form a balloon, a loop or collar catheter with multiple electrodes, or any other suitable shape. Figure 4A An example of a linear catheter 402 including multiple 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 the received signal and / or based on an external force (e.g., cardiac tissue) applied to the linear catheter 402.

[0073] Figure 4B An example of a balloon catheter 412 is shown, the balloon catheter includes multiple splines (e.g., Figure 4B 12 splines in a specific example), including splines 414, 416, 417, and multiple electrodes on each spline, including electrodes 421, 422, 423, 424, 425, and 426 as shown. The balloon catheter 412 can be designed such that when it is deployed into a patient's body, its electrodes can remain in close contact with the endocardial surface. For example, the balloon catheter can be inserted into a lumen (such as a pulmonary vein (PV)). The balloon catheter can be inserted into the PV in a contracted state such that the balloon catheter does not occupy its maximum volume when inserted into the PV. The balloon catheter can be inflated inside the PV such that the electrodes on the balloon catheter contact the entire circular segment of the PV. Such contact with the entire circular portion of the PV or any other lumen can enable effective mapping and / or ablation.

[0074] Figure 4C An example of a collar catheter 430 (also referred to as a loop catheter) including multiple electrodes 432, 434, and 436 that can be used to map a cardiac region is shown. The collar catheter 430 can be fully or partially elastic such that it can twist, bend, and / or otherwise change its shape based on the received signal and / or based on an external force (e.g., cardiac tissue) applied to the collar catheter 430.

[0075] Figure 4DAn example of an intracardiac echocardiogram (ICE) catheter 450 that can provide real-time, three-dimensional visualization inside the heart is shown. The ICE catheter 450 includes a twistable and deflectable shaft 452 that provides extension and rotation of the transducer. The ICE catheter 450 includes a transducer orienter 454 and a shaft deflector 456, as well as a connector cable 458. The ICE catheter 450 is capable of providing 4D intracardiac echocardiogram with a 90°×90° field of view. The ICE catheter 450 may include independent rotation and extension via the shaft 452 and the orienter 454.

[0076] According to one example, a multi-electrode catheter can be advanced into a chamber of the heart. Anteroposterior fluorograms (AP) and lateral fluorograms can be obtained to establish the position and orientation of each electrode. Electrograms can be recorded by each of the electrodes in contact with the heart surface relative to a time reference (such as starting from the P wave in the sinus rhythm from a body surface ECG). As further disclosed herein, the system can distinguish 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 an initial electrogram, the catheter can be repositioned, and fluorograms and electrograms can be recorded again. Then an electrical mapping can be constructed based on iterations of the above process.

[0077] According to one example, cardiac mapping can be generated based on the detection of an intracardiac potential field. A non-contact technique for simultaneously acquiring a large amount of cardiac electrical information can be implemented. For example, a catheter having a distal end portion can be provided with a series of sensor electrodes distributed on its surface and connected to insulated electrical conductors for connection to a signal sensing and processing device. The size and shape of the end portion can be such that the electrodes are substantially spaced apart from the wall of the cardiac chamber. The intracardiac potential field can be detected during a single heartbeat. According to one example, the sensor electrodes can be distributed on a series of circumferences located in planes spaced apart from each other. These planes can be perpendicular to the long axis of the end portion of the catheter. At least two additional electrodes can be provided adjacent to each other at the ends of the long axis of the end. As a more specific example, the catheter can include four circumferences, with eight electrodes equally angularly spaced on each circumference. Thus, in this specific implementation, the catheter can include at least 34 electrodes (32 circumferential electrodes and 2 end electrodes).

[0078] According to another example, electrophysiological cardiac mapping systems and techniques based on non-contact and non-expanding multi-electrode catheters can be implemented. Electrograms can be obtained using a catheter having a plurality of electrodes (e.g., between 42 and 122 electrodes). According to one example, knowledge of the relative geometry of the probe and the endocardium can be obtained, such as through an independent imaging modality (such as transesophageal echocardiography). After independent imaging, non-contact electrodes can be used to measure the cardiac surface potential and construct a mapping diagram therefrom. The technique can 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.

[0079] According to one example, techniques and devices for mapping the potential distribution of a cardiac chamber can be implemented. An intracardiac multi-electrode mapping catheter assembly can be inserted into a patient's heart. The mapping catheter assembly can include a multi-electrode array having an integral reference electrode, or preferably, include a companion reference catheter. The electrodes can be deployed in the form of a substantially spherical array. The electrode array can be spatially referenced to a point on the endocardial surface by the reference electrode or by the reference catheter in contact with the endocardial surface. A preferred electrode array catheter can carry a plurality of individual electrode sites (e.g., at least 24). Additionally, the exemplary technique can be implemented by knowing the position of each electrode site in the electrode array on the array and knowing the cardiac geometry. These positions are preferably determined by techniques of impedance plethysmography.

[0080] According to one example, a cardiac mapping catheter assembly can include an electrode array defining a plurality of electrode sites. The mapping catheter assembly can further include a lumen to receive a reference catheter having a distal end electrode assembly that can be used to probe the cardiac wall. The mapping catheter can include a braid of insulating wire (e.g., having 24 to 64 wires in the braid), and each wire can be used to form an electrode site. The catheter can be easily positioned in the heart for acquiring electroactivity information from a first set of non-contact electrode sites and / or a second set of contact electrode sites.

[0081] According to one example, another catheter for mapping electrophysiological activity within the heart can be implemented. The catheter body can include a distal end adapted to deliver a stimulation pulse for cardiac pacing or an ablation electrode for ablating tissue in contact with the end. The catheter can further include at least a pair of orthogonal electrodes to generate a differential signal indicative of local cardiac electrical activity adjacent to the orthogonal electrodes.

[0082] According to one example, a process for measuring electrophysiological data in a heart chamber can be implemented. The method can partially include positioning a set of active and passive electrodes into the heart, providing a 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 included 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.

[0083] According to one example, cardiac imaging can be achieved using one or more ultrasound transducers. The ultrasound transducers can be inserted into a patient's heart and can collect multiple ultrasound slices (e.g., two-dimensional or three-dimensional slices, sometimes referred to as wedges or volumes) 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 such that they can be displayed at a later time. One or more ultrasound slices corresponding to the position of a probe (e.g., a therapy catheter) after a period of time can be displayed, and the probe can be overlaid on the one or more ultrasound slices.

[0084] According to other examples, body patches and / or surface electrodes can be positioned on or near a patient's body. A catheter having one or more electrodes can be positioned within a patient's body (e.g., within the patient's heart), and the position of the catheter can be determined by the system based on signals transmitted and received between one or more electrodes of the catheter and the body patches and / or surface electrodes. Additionally, the catheter electrodes can sense biometric data (e.g., LAT values) from within the patient's body (e.g., within the heart). The biometric data can be associated with the determined position of the catheter such that a rendering of a patient's body part (e.g., the heart) can be displayed, and the biometric data overlaid on the shape of the body part, as determined by the position of the catheter, can be displayed. A 4D ICE system can include viewing modes that include a biplane mode, a multiplane mode, and 4D. The biplane / multiplane mode generally provides higher resolution 2D images compared to 2D images extracted from the 4D mode.

[0085] In one example, a graphical user interface (GUI) can be provided. The GUI can provide a visual display to a user for interacting with a cardiac mapping system such as the example systems described above. Specifically, the GUI can provide information to the user to guide the user on how to manipulate the catheter, such as with respect to Figures 4A to 4DThe catheter described. This information can be based on the known position and orientation of the catheter or another object of interest. The GUI can provide tilt and / or tilt and rotation values with associated directions to guide the user in manipulating the catheter to change and adjust the tilt and rotation angles of the field of view or sector displayed from the catheter. Additionally, the system can receive this information and manipulate the catheter based on this information. For example, in one example, arrows can be used to indicate the direction of tilt and / or tilt and rotation of the sector displayed from the catheter to provide a direction of increase or decrease. The required tilt and rotation can be updated in real time to accommodate the movement of the object of interest. In this way, the user can capture slices showing the object of interest with high resolution.

[0086] Figure 5 Illustrates a graphical user interface (GUI) 500 configured to provide the tilt and rotation required to track an object of interest. As shown, the GUI 500 can include a first view window 510 and a second view window 520. When tracking the point of interest, the GUI 500 can provide guidance on the tilt and rotation angles for adjustment to view the point of interest. Guidance on the tilt and rotation angles can be provided within window 530. Window 530 can be displayed as an overlay window that overlays one or both of the first view window 510 and the second view window 520. Additionally, information associated with the measurement being performed can be included. As Figure 5 shown, the heart rate 540 can be provided in the form of a signal. The average heart can be additionally displayed. As shown herein, the position of any element can be tracked. This example only relates to an ablation catheter by way of example.

[0087] In one example, the system can know or define the position of the ablation catheter and provide a depiction of the ablation catheter within the first view window 510 from a first favorable position and within the second view window 520 from a second favorable position. The first favorable position and the second favorable position can be orthogonal to each other to provide an optimal view for the user of the ablation catheter. As the ablation catheter moves, it can move within the first view window 510 and / or the second view window 520. In this example, the tilt and rotation angles can be displayed in window 530. The tilt and rotation angles can each be calculated as described below and can be configured to maintain the view of the ablation catheter within the first view window 510 and / or the second view window.

[0088] Figure 6A Illustrates a graphical user interface (GUI) 600 configured to provide tilt recommendations to the user for tracking the tip of an ablation catheter. Similarly, Figure 6BIllustrates a graphical user interface (GUI) 650 that is configured to provide a user with tilt suggestions for tracking the tip of an ablation catheter. Collectively, GUI 600 and GUI 650 illustrate a depiction of example tilt suggestions for tracking the tip of an ablation catheter. Each of GUI 600 and GUI 650 represents changing the tilt to 39 degrees to track the catheter tip (displayed in window 530). As described above with respect to Figure 5 As described, a first view window 510, a second view window 520, and a window 530 for displaying tilt suggestions are included in each of GUI 600 and GUI 650.

[0089] In Figure 6A and Figure 6B both illustrate a graphical user interface of Figure 5 . Specifically, a first view window 510 and a second view window 520 are illustrated. Additionally, the tilt angle can be displayed in a window 530 that is illustrated as part of the second view window 520. As illustrated in the example windows of Figure 6A and Figure 6B , a tilt angle of 39 degrees will enable tracking of the catheter tip (illustrated in window 530). Figure 6A represents the view before applying the suggested tilt angle, and Figure 6B represents the view after applying the suggested tilt angle.

[0090] Specifically referring to Figure 6A , a depiction of the suggested tilt angle in the biplane mode is shown. In the left portion of Figure 6A , there is an illustration of the plane of the viewing sector (depicted in windows 510, 520) and a specific object (in this case, the catheter). Two viewing planes representing the plane or axis of observation are provided - in one case, the axis depicted in window 510, and in another case, the axis depicted in window 520. As illustrated in the two windows 510, 520 of Figure 6A , the viewing sector does not track the catheter. The offset angle required to track the catheter is calculated to be 39 degrees.

[0091] Specifically referring to Figure 6B , an illustration of the suggested tilt angle in the biplane mode compared to Figure 6A is shown, where Figure 6B depicts a posterior tilt adjustment. In the left portion of Figure 6B , there is an illustration of the plane of the viewing sector (depicted in windows 510, 520) and a specific object (in this case, the catheter). Similar to Figure 6A , two planes representing the plane or axis of observation are provided - in one case, the axis depicted in window 510, and in another case, the axis depicted in window 520. AsFigure 6B As illustrated in the two windows 510, 520, after taking into account the Figure 6A offset in

[0092] Figure 7A Illustrated is a graphical user interface (GUI) 700 configured to provide a user with tilt and rotation suggestions for tracking the tip and orientation of an ablation catheter. Similarly, Figure 7B Illustrated is a graphical user interface (GUI) 750 configured to provide a user with tilt and rotation suggestions for tracking the tip and orientation of an ablation catheter. Collectively, GUI 700 and GUI 750 illustrate a depiction of exemplary tilt and rotation suggestions for tracking the tip of an ablation catheter and its orientation. Each of GUI 700 and GUI 750 represents changing the tilt to -14 degrees and the rotation to 34 degrees to track the tip of the catheter (shown in window 530). As described above with respect to Figure 5 Each of the first view window 510, the second view window 520, and window 530 for displaying tilt suggestions is included in each of GUI 600 and GUI 650.

[0093] In Figure 7A and Figure 7B both illustrate Figure 5 a graphical user interface. Specifically, the first view window 510 and the second view window 520 are illustrated. Additionally, the tilt angle and the rotation angle may be displayed in window 530, which is illustrated as part of the second view window 520. As illustrated in the exemplary windows of Figure 7A and Figure 7B a tilt angle of -14 degrees and a rotation angle of 34 degrees will enable tracking of the tip of the catheter (illustrated in window 530). Figure 7A represents the view before applying the suggested tilt and rotation angles, and Figure 7B represents the view after applying the suggested tilt and rotation angles.

[0094] Specifically referring to Figure 7A , a depiction of the suggested tilt angle and rotation angle in the biplane mode is illustrated. In the left portion of Figure 7A , there is an illustration of the plane of the observation sector (depicted in windows 510, 520) and the plane of a specific object (in this case, the catheter). Two observation planes representing the plane or axis of observation are provided - in one case, the axis depicted in window 510, and in the other case, the axis depicted in window 520. As illustrated in the two windows 510, 520 of Figure 7A , the observation sector does not track the catheter. The offset angles of tilt and rotation required to track the catheter are calculated as a tilt angle of -14 degrees and a rotation angle of 34 degrees.

[0095] Specific reference is made to Figure 7B , which illustrates the depicted recommended tilt and rotation angles in a biplane mode as compared to Figure 7A , where Figure 7B posterior tilt and rotation adjustments are depicted. In the left portion of Figure 7B , an example of the plane of the viewing sector (depicted in windows 510, 520) and a specific object (in this case a catheter) is provided. Similar to Figure 7A , two planes representing the plane or axis of view are provided - in one case the axis depicted in window 510 and in another case the axis depicted in window 520. As exemplified in the two windows 510, 520 of Figure 7B , after taking into account the offset angles of tilt and rotation in Figure 6A , the viewing sector now tracks the catheter.

[0096] Figure 8 Method 800 for tracking a point of interest according to an example described herein is illustrated. For example, examples of points of interest may include the tip of an ablation catheter. Method 800 includes, at 810, displaying to a user on a graphical user interface (GUI) a tilt angle for following a point of interest (e.g., generally referred to as an object). At 820, method 800 includes inputting a rotation angle of a current slice of a view in a mapping into a processor associated with the GUI. The rotation angle is calculated by obtaining an orientation axis provided by the system and computing the angle between the current axis and the axis required to track the object. At 830, method 800 includes inputting the point of interest into a processor associated with the GUI, which may include (e.g.) transducer position. For example, these inputs may be system measurements. For example, transducer position and transducer rotation values may be used to create a matrix for converting real-world coordinates to ULS coordinates when tracking a point of interest. The matrix may be used to convert coordinates of an object of interest in real-world coordinates to ULS coordinates.

[0097] At 840, to calculate a recommended tilt for tracking the tip of an ablation catheter, a calculation of a new plane of the sector is performed. The plane is represented by: (a) a vector in the rotated x-axis, the rotation being according to the rotation angle of the current slice, and (b) a vector from the tip center point to the point of interest. At 850, method 800 includes, such as calculating the angle between the original plane and the new plane based on Euler angles and recommending a new tilt angle, and providing the recommended tilt angle either in absolute terms or as a δ angle relative to the current angle.

[0098] Figure 9Illustrates method 900 for tracking a point of interest and the orientation of the point of interest according to an example described herein. For example, an example of a point of interest may include the tip of an ablation catheter. Method 900 includes, at 910, displaying to a user an inclination angle and a rotation angle on a graphical user interface (GUI). At 920, method 900 includes inputting a transducer position into a processor associated with the GUI. At 930, method 900 includes inputting a point of interest into a processor associated with the GUI. At 940, the method includes inputting the orientation of the point of interest into a processor associated with the GUI. For example, these inputs may be system measurements.

[0099] At 950, method 900 includes calculating a normal (plane normal) of a plane represented by the orientation of the point of interest (object) and the vector tip of the transducer. At 960, method 900 includes calculating a new plane of a sector using (a) a vector calculated from the cross product between the plane normal and the tip transducer and (b) the tip transducer vector (the position and orientation of the ablation catheter tip are shown on an ultrasound image). The calculation may include calculating a vector between the point of interest and the transducer position (scan origin). This vector is referred to as tip2transducer. Perform the calculation of the normal of the plane represented by the orientation of the object and the vector tip2transducer. This vector is referred to as the plane normal. Perform a calculation on the normal between the plane normal and the tip transducer vector. This normal is referred to as vector X. The new plane of the sector is calculated and represented by a vector calculated from the cross product between vector X and the tip transducer vector.

[0100] At 960, method 900 includes calculating the angle between the original plane and the new plane based on Euler angles and providing the inclination and rotation angles in absolute terms or as a δ angle relative to the current angle.

[0101] In some examples, the point of interest of the tracked element and the orientation of the point of interest, such as the position of the catheter at the 3 system position pad coordinates, i.e., the tip of the ablation catheter and its orientation, may be based on existing CARTO system magnetic positioning technology. For example, in some configurations, the ultrasound catheter may not actually be moved by the system but is manually controlled by a physician. Tracking in this case involves that when the catheter is parked, the ultrasonic beam that is continuously transmitted and received as described above to form a volume wedge can be cropped, or have its beam gain / depth changed such that the relevant anatomy remains in view.

[0102] While the features and elements have been described specifically above, those of ordinary skill in the art will appreciate that each feature or element can be used separately or in any combination with other features and elements. Additionally, 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 wired or wireless connections) 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)). A processor associated with software can be used to implement a radio frequency transceiver used in a WTRU, UE, terminal, base station, RNC, or any host computer.

[0103] The flowcharts and block diagrams in the figures illustrate the architecture, functionality, and operation of possible implementations of systems, methods, and computer program products according to various embodiments of the present invention. In this regard, each block in the flowchart or block diagram may represent a module, segment, or portion of instructions that include one or more executable instructions for implementing the specified logical function. In some alternative implementations, the functions noted in the blocks may occur out of the order noted in the figures. For example, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending upon the functionality involved. It should also be noted that each block of the block diagrams and / or flowchart illustrations, and combinations of blocks in the block diagrams and / or flowchart illustrations, can be implemented by a system based on dedicated hardware for performing the specified functions or acts, or by a combination of dedicated hardware and computer instructions.

[0104] While the features and elements have been described specifically above, those of ordinary skill in the art will appreciate that each feature or element can be used separately or in any combination with other features and elements. Additionally, 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. As used herein, a computer-readable medium should not be construed to be 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., an optical pulse passing through an optical fiber cable), or an electrical signal transmitted through a wire.

[0105] Examples of computer-readable media include electronic signals (transmitted via wired or wireless connections) 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 discs (CDs) and digital versatile discs (DVDs), random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), static random access memory (SRAM), and memory sticks. Processors associated with software can be used to implement radio frequency transceivers used in terminals, base stations, or any host computer.

[0106] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, unless the context clearly dictates otherwise, the singular forms "a", "an", and "the" include plural referents. It should also be understood that the terms "comprises" and / or "comprising", when used in this specification, specify the presence of the stated features, integers, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and / or groups thereof.

[0107] The description of the various embodiments herein has been presented for purposes 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 spirit of the described embodiments. The terms used herein were chosen to best explain the principles of the embodiments, the practical application or technical improvement over technologies found in the marketplace, or to enable others of ordinary skill in the art to understand the embodiments disclosed herein.

Claims

1. A system for providing multi-plane suggested orientations by visually tracking a target anatomical structure for display, the system being configured to interface with a 4D intracardiac echocardiography (4D-ICE) catheter that provides information to a processor via an I / O device; wherein, The system comprises: processor; an input / output (I / O) device configured to provide input to and output from the processor; a graphical user interface (GUI) displayed on a display communicatively coupled to the processor, the GUI for monitoring the catheter and configured to maintain a vein contained within a field of view of the catheter during medical electrophysiology, The system operates to: displaying a tilt angle that causes the catheter to track the target anatomical structure; receiving as a first input an angle of a current plane of view of the catheter; receiving a point of interest associated with the target anatomical structure as a second input; calculating a new plane of view of the catheter using the vector in the rotated axis and the vector from the catheter to the point of interest; calculating a tilt angle as a difference between the angle of the current plane and the angle of the new plane to provide angular movement of the catheter to maintain the target anatomy contained within the display; and The catheter is adjusted according to the tilt angle of the new plane to maintain the point of interest in the display.

2. The system according to claim 1, wherein: The calculated tilt angles are multiplanar.

3. The system according to claim 2, wherein: Multiple planes represent the inclination and rotation of the catheter.

4. The system according to claim 1, wherein: The system is configured to produce bi-planar modes, multi-planar modes, and 4D modes.

5. The system according to claim 1, wherein: The target anatomical structure is a vein.

6. A method for tracking a target during a procedure to maintain the target contained in a display of a device, the method comprising: displaying a tilt angle for causing the device to track the target of the protocol; receiving as a first input an angle of a current plane of view of the apparatus; receiving a point of interest associated with the target as a second input; calculating a new plane of the view of the device using a vector in the rotated axis and a vector from the device to the point of interest; calculating a tilt angle as a difference between the angle of the current plane and the angle of the new plane to provide movement of the device to maintain the object contained within the display; as well as The apparatus is adjusted according to the tilt angle of the new plane of view so as to maintain the point of interest in the display.

7. The method according to claim 6, wherein: The calculated tilt angles are multiplanar.

8. The method according to claim 7, wherein: Multiple planes represent tilt and rotation of the device.

9. The method according to claim 6, wherein: The new plane tracks the point of interest in the display.

10. The method according to claim 6, wherein: The device is a catheter and the target is a pulmonary vein.

11. A method for tracking a target and the direction of the target during a procedure to maintain the target contained in a display of a device, the method comprising: during the procedure, displaying in the display a tilt angle and a rotation angle used to cause the device to track the target; receiving device location, a point of interest associated with the target, and a direction of the point of interest; calculating a normal to a plane represented by the direction of the point of interest and the device position; calculating a new plane of view for the device using a vector calculated from a cross product between the calculated normal to the plane and a vector of the device and the vector of the device; as well as An angle between a current plane of the device represented by the calculated normal to the plane and the calculated new plane of view of the device is calculated.

12. The method according to claim 11, wherein: The angles are multi-planar.

13. The method according to claim 12, wherein: The multiple planes represent the tilt and rotation of the device.

14. The method of claim 11, further comprising changing an angle of the device relative to the new plane of view of the device.

15. The method according to claim 14, wherein: The new plane tracks the target.

16. The method according to claim 11, wherein: The device is a medical probe.

17. The method according to claim 16, wherein: The target is a part of the patient's body.

18. The method according to claim 11, wherein: The device is a catheter and the target is a pulmonary vein.

19. The method according to claim 11, wherein: The device is a four-dimensional catheter with views including bi-plane mode, multi-plane mode and 4D.

20. The method according to claim 11, wherein: The device includes a transducer of the catheter.

Images