Method and system for displaying information during cardiac surgery

Abstract

The present disclosure provides a method, apparatus and computer program product, the method comprising: obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into a chamber of a heart of a patient, where each electrical signal provides information about electrical activity in a location within the heart, and wherein each location is associated with a value from each attribute of the plurality of attributes; receiving, from a user via a user interface, a selection of filtering criteria for the at least one location, the filtering criteria associated with at least one attribute from the plurality of attributes; applying the filtering criteria to identify a subset of locations from the at least one location that meet the filtering criteria; updating a map of electrical activity within the heart based only on the subset of locations; and displaying the map of the electrical activity.

Description

Technical Field

[0001] The present disclosure relates to a method for selecting information to be displayed to a physician during a cardiac operation, using such information, and for updating a view of the electrical activity within the heart. Background Art

[0002] Arrhythmias can be caused by problems with the electrical conduction system of the heart and in particular by problems with the electrical activity at one or more points or regions on the walls of the heart chambers. Atrial fibrillation is an arrhythmia characterized by chaotic signals that cause the atria (left atrium and / or right atrium) to contract very rapidly and in an asynchronous rhythm.

[0003] To evaluate a patient's condition and decide on a treatment (such as applying one or more ablations), it may be necessary to evaluate the electrical activity at multiple locations on the heart wall. This activity can be obtained from multiple electrodes located on the distal end of an intracardiac catheter inserted into one or more chambers of the heart. The multiple signals obtained can be displayed to a user, such as a physician performing the operation. The signals obtained can also be used to generate a map of the electrical activity within the heart. Brief Description of the Drawings

[0004] In conjunction with the drawings, the present disclosure will be more fully understood from the following detailed description of embodiments of the present disclosure, in which:

[0005] Figure 1 is a schematic illustration of a catheter-based electrophysiology (EP) mapping and ablation system;

[0006] Figure 2 shows an exemplary user interface for defining or modifying attributes and presets according to some exemplary embodiments of the present disclosure;

[0007] Figure 3 shows a view of the display during a cardiac operation after applying a first preset according to some exemplary embodiments of the present disclosure;

[0008] Figure 4 shows a view of the display during a cardiac operation after applying a second preset according to some exemplary embodiments of the present disclosure;

[0009] Figure 5 is a flowchart of steps in a method for displaying information during a cardiac operation according to some exemplary embodiments of the present disclosure; and

[0010] Figure 6 is a schematic block diagram of a computing platform for displaying information during a cardiac operation according to some exemplary embodiments of the present disclosure. Detailed Description of the Embodiments

[0011] In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present invention. However, it will be apparent to those skilled in the art that the present invention may be practiced without these specific details. In other instances, details of well-known circuits, control logic components, and computer program instructions for conventional algorithms and processes are not shown in detail so as not to unnecessarily obscure the present invention.

[0012] The software programming code embodying aspects of the present invention is typically stored in a permanent storage device such as a computer-readable medium. In a client-server environment, such software programming code may be stored on the client or the server. The software programming code may be embodied in any of a variety of known media used with a data processing system. This includes but is not limited to magnetic and optical storage devices such as disk drives, magnetic tapes, compact discs (CDs), digital versatile discs (DVDs), and computer instruction signals contained in a transmission medium, with or without a carrier modulating the signal. For example, the transmission medium may include a communication network such as the Internet. Additionally, while the present invention may be embodied in computer software, the functions required to implement the present invention may alternatively be embodied in part or in whole using hardware components such as application specific integrated circuits or other hardware, or some combination of hardware components and software.

[0013] Overview

[0014] Arrhythmogenic tissue associated with atrial fibrillation can be identified by examining intracardiac electrograms (IEGMs) at one or more locations on the atrial wall (e.g., the inner wall) to detect local potentials caused by depolarization at each of the one or more locations.

[0015] IEGMs are typically detected using one or more electrodes on the distal end of an intracardiac catheter. In some example embodiments, the intracardiac catheter additionally includes a position sensor configured to track the position of the distal end.

[0016] Modern catheters have multiple electrodes distributed over multiple strips of the catheter, where at any given time, each electrode samples the electrical activity at a location. For example, some catheters may have dozens or even hundreds of electrodes and can thus collect information related to thousands of points within the heart, which amounts to a large amount of data. This data can be used to generate a mapping diagram showing an accurate geometric reconstruction of the heart and an overall view of the electrical activity within the heart. Based on the electrical activity at each location measured by the electrodes already present at that location, the electrical activity can be graphically represented by color coding, pattern coding, etc. of the regions of the mapping diagram.

[0017] However, this rich data also poses challenges as it may prevent users such as physicians or clinical assistants (CAS) from focusing on certain aspects of the procedure or certain regions of the heart. For example, a user may be interested in seeing electrical activity information only related to regions of the heart that are within the scar border zone located at the critical isthmus where arrhythmia exists. In another example, a user may be interested in seeing only regions where the late annotation time (LAT) has certain values, etc.

[0018] In currently available systems and methods, a list of positions that have been sampled by electrodes and have been used in the construction of a cardiac map can be presented to a user. A color-coded map can also be presented to the user based on all available positions and the electrical activity therein. The user can manually select individual positions to be included or excluded from consideration and included in the view when generating the map. However, due to the large number of electrodes and positions in advanced catheters, this method is difficult to implement effectively because a physician may spend a long time selecting positions and identifying each position in the list within the map. Besides being infeasible, such selection may also provide inaccurate results as a physician may make mistakes in identifying the desired positions.

[0019] Thus, according to some examples of the present disclosure, a user interface can be presented to a user for selecting a subset of available positions based on one or more attributes associated with each position. The user interface can include a list of attributes and one or more possible values applicable to each such attribute. Then, the user can select the attributes to be examined and the corresponding one or more desired values for each attribute. Then, the cardiac map can be updated to indicate electrical activity only based on positions that meet the applicable attribute values. Thus, if the selection eliminates positions in a particular region, that region will not have an indication of electrical activity, such as a color indication.

[0020] However, it should be understood that the geometric reconstruction of the cardiac map can be based on positions among all available positions such that the map structure and resolution are maintained while fewer positions are indicated and contribute to the display of electrical activity.

[0021] The reduction in the number of positions enables a physician to focus on the desired aspects, such as focusing on a particular region of the scar area, etc.

[0022] Some attributes can be binary, such as the tissue proximity index (TPI) indicating whether a position is on the heart wall, such that a user can select only positions on the heart wall and eliminate internal positions from the map and the list. Other attributes (such as voltage or impedance) can be associated with a numerical range such that a user can select only positions having values within the desired range (or belonging to the set of selected values in the case of discrete attributes).

[0023] It should be understood that for unselected attributes, all values are acceptable and no location is eliminated from the calculation and list due to the value of one of these attributes.

[0024] It should also be understood that the user interface may allow opt-in, such that the user can select which attributes to apply, or allow opt-out, where the user can select which attributes not to apply.

[0025] One or more sets of attributes and corresponding values can be defined, stored, and displayed as presets, such that the user can apply all the attributes associated with a preset in a single action without having to indicate each attribute and its corresponding value. The user can also apply multiple presets. Thus, one or more presets (whether globally defined as default or user-defined) can be stored and displayed for the user to select from.

[0026] The values of the attributes in a preset can be changed according to the values of the sampling locations. For example, if for the voltage attribute, the preset indicates a value range of 0.5 mV to 1.5 mV, and no sampling location has a value exceeding 1.2 mV, then the preset can be updated for display for the current operation and the user can be enabled to select a range of 0.5 mV to 1.2 mV.

[0027] The system and method provide advanced filtering of locations based on one or more specific attributes. Additionally, a physician who wishes to display only specific locations on a mapping diagram does not need to view all available locations and decide which ones to use. Since each mapping diagram can be based on tens of thousands of locations, it is clearly infeasible to select individual locations as in current available systems. Thus, the disclosed method and system provide for automatic selection of locations based on the selected combination of attributes. The selective and dynamic coloring of the cardiac mapping diagram provides an improved user experience and enables smooth workflow, thereby also reducing the operation time.

[0028] Additionally, the definition, storage, and customizable definition of standards and presets provide improved efficiency and flexibility of the system, as the user may not need to redefine presets each time but can make changes when needed.

[0029] System Description

[0030] Reference Figure 1, which shows an exemplary catheter-based electrophysiological mapping and ablation system 10. System 10 may include a plurality of catheters that may be inserted by physician 24 through the patient 23'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. Then, one or more catheters may be inserted into the delivery sheath catheter to reach the desired location in the heart 12. The plurality of catheters may include a catheter dedicated to sensing intracardiac electrogram (IEGM) signals, a catheter dedicated to ablation, and / or a catheter dedicated to both sensing and ablation. An exemplary catheter 14 configured for sensing IEGM is illustrated herein. Physician 24 may place the electrode assembly 28 of catheter 14 in contact with the heart wall for sensing a target site in the heart 12. For ablation, physician 24 may similarly place the distal end of the ablation catheter in contact with the target site for ablating tissue.

[0031] Catheter 14 is an exemplary catheter that is basket-shaped and includes one and preferably a plurality of electrodes 26 that are optionally distributed on a plurality of strips 22 at the electrode assembly 28 and are configured to sense IEGM signals. Each electrode 26 is connected via a wire (not shown) that passes through or is attached to the strip 22 towards a patient interface unit (PIU) 30 described in detail below. The strip 22 may be coupled to the shaft 19 of the electrode assembly 28. However, it should be understood that the present disclosure is not limited to the basket-shaped electrode assembly 28, but may be applicable to any type of catheter having any number of strips and electrodes.

[0032] Catheter 14 may additionally include a position sensor 29 embedded in or near the electrode assembly 28 for tracking the position and orientation of the electrode assembly 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.

[0033] The magnetic-based position sensor 29 may operate in conjunction with a positioning pad 25 that includes a plurality of magnetic coils 32 configured to generate a magnetic field in a predetermined workspace. The real-time position of the electrode assembly 28 of catheter 14 may be tracked based on the magnetic field generated by the positioning pad 25 and sensed by the magnetic-based position sensor 29. Details of magnetic-based position sensing techniques are described in U.S. Patents 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.

[0034] Additionally or alternatively, system 10 may include one or more electrode patches 38 positioned to contact the skin of patient 23 to establish a position reference for impedance-based tracking of positioning pad 25 and electrodes 26. For impedance-based tracking, current is directed to electrodes 26 and sensed at electrode skin patches 38 such that the position of each electrode can be triangulated via electrode 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.

[0035] System 10 displays on display device 27 a preset selection pane 35, a cardiac anatomical map 20 showing electrical activity within the heart using color coding, and a pane 21 of attributes of a plurality of positions captured by electrodes 26 of catheter 14, the plurality of positions being used to color code the map.

[0036] Recorder 11 may include pacing capabilities for pacing the heart rhythm and / or may be electrically connected to an independent pacemaker.

[0037] PIU 30 may be configured to establish electrical communication between the catheter, other electrophysiology equipment, a power source, and a workstation 55 for controlling the operation of system 10. The electrophysiology equipment of system 10 may include, for example, a plurality of catheters, positioning pad 25, body surface ECG electrodes 18, electrode patches 38, an ablation energy generator 50, and recorder 11. Optionally and preferably, PIU 30 additionally includes processing capabilities for performing real-time calculations of the position of electrodes 26 and for performing ECG calculations.

[0038] Workstation 55 includes a memory, a processor unit having a memory or storage device with appropriate operating software stored therein, and user interface capabilities. Workstation 55 may provide a variety of functions, optionally including: (1) modeling the endocardial anatomy in three dimensions (3D) based on signals received from electrodes 26 and rendering a model or anatomical map 20 for display; (2) selecting a subset of positions for which electrodes 26 provide information according to an activity preset; and (3) displaying on display device 27 the rendered anatomical map 20 color-coded or pattern-coded according to the selected positions, presets, and list of selected positions. An article of commerce embodying the elements of system 10 is the CARTO TM 3 system available from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA 92618.

[0039] Reference Figure 2, which shows an exemplary user interface for defining or modifying attributes and presets according to some exemplary embodiments of the present disclosure.

[0040] The user interface generally labeled 200 includes a number or another identifier 204 for the preset to be defined or modified.

[0041] The user interface 200 also includes a table 208 for defining the attributes to be applied and their corresponding values. One or more values can be defined for each such attribute, indicating, for example, a range, allowed values, or binary values. These values can be provided by the user typing text into a text box, using a slider, selecting from a list, etc. In some embodiments, for example for attributes with discrete values, a set of one or more values can be selected.

[0042] For example, for the attribute CL (cycle length), a first value (212) of 180 can be the minimum value, and a second value (216) of 250 can be the maximum value.

[0043] For a binary attribute, such as TPI (tissue proximity), only one value 224 can be selected from the possible values (such as true / false).

[0044] Once the attributes and values are defined, the user can save the set of attributes as a preset by pressing the "Save Preset" button 228. In some embodiments, the user can be prompted to provide a representative name for the preset.

[0045] In some embodiments, the user can apply the set of active attributes specifically to the current available location by pressing the Apply button 232 without saving the preset.

[0046] It should be understood that the values indicated, for example, as the first value 212 and the second value 216 or as the first value 224 can have default values suggested to the user. In some embodiments, the values that the user can input or select can be limited to the values available in a set of locations, such that during operation, the user cannot select a value lower than the minimum value present in any point, a value higher than the maximum value present in any point, a binary value not available in any point, etc.

[0047] An exemplary list of attributes whose values can be restricted includes, but is not limited to, any one or more of the following:

[0048] Impedance, for which a lower limit and / or an upper limit can be provided, and the impedance can provide an indication of scar tissue;

[0049] Voltage, for which a lower limit and / or an upper limit can be provided;

[0050] LAT (late activation time), for which a lower limit and / or an upper limit can be provided;

[0051] LAM (Late Annotation Mapping);

[0052] BI (average value obtained from bipolar electrodes), and a lower limit and / or an upper limit may be provided for the BI;

[0053] TPI (Tissue Proximity), and a true / false value may be provided for the TPI to indicate whether the location is on or inside the heart wall;

[0054] CL (Cycle Length), and a lower limit and / or an upper limit may be provided for the CL;

[0055] one or more stability parameters of the signal;

[0056] a fractionated signal, and a true / false value may be provided for the fractionated signal; and

[0057] a connected signal, and a true / false value may be provided for the connected signal.

[0058] Now refer to Figure 3 , which shows a view displayed during a cardiac operation after applying a first preset according to some exemplary embodiments of the present disclosure.

[0059] The view generally labeled 300 is substantially the same as the view displayed on the display 27 of Figure 1 .

[0060] View 300 shows a preset pane 35, where the user can see three presets numbered 1, 2, and 3. For each preset, the attributes associated with the preset are shown as being divided into groups, such as point filter 304, ECG filter 308, and ablation filter 312. For each preset, the user can use the corresponding entry in the "Active" column 316 to select whether it is to be activated. In the example of Figure 3 , only preset number 1 is activated.

[0061] It should be understood that multiple presets can be activated simultaneously, such that the selected locations are those whose attributes conform to all active presets. For example, if one active preset limits the CL attribute to 170 to 240, and another active preset limits the CL attribute to 200 to 270, the actual value used will be 200 to 240.

[0062] This range can be further reduced according to the attribute values of the available locations. For example, if the minimum available value is 210, the range will be reduced to 210 to 240.

[0063] In some embodiments, if the user points to or hovers over a particular attribute, such as CL, a pop-up window 320 may be displayed indicating the value associated with that attribute in the current scenario, such as the range from 210 to 240 described above. In other embodiments, the text may display the value determined by the active preset, such as 200 to 240 described above.

[0064] View 300 may also display, for example, the number of active locations in text box 324, i.e., the number of locations used to estimate electrical activity in the heart and to color the mapping diagram under the current preset.

[0065] View 300 may also include a two-dimensional (2D) or three-dimensional (3D) mapping diagram 20 of the heart, where the mapping diagram 20 may be manipulated by the user, such as rotated, scaled, zoomed, etc.

[0066] View 300 may also include a list 21 of locations that meet all active presets and are thus used to estimate electrical activity in the heart, as well as some attributes of these locations. In some embodiments, the displayed attributes may be those whose values are restricted by the active preset.

[0067] Now refer to Figure 4 , which shows a view of the display during a heart surgery after presets numbered 1 and 2 have been activated. This preset selection reduces the number of active locations shown in text box 325 from 1995 to 732. The reduction can also be observed by the size of scroll bar 328 relative to its size in Figure 3 .

[0068] It can be seen that Figure 4 the color coding of mapping diagram 20 in Figure 3 is different from that in

[0069] because it is based on a different set of locations. However, the anatomical reconstruction of the heart remains the same because it is based on position information obtained from electrodes at all points.

[0070] Now refer to Figure 5 , which shows a flowchart of steps in a method for displaying information during a heart surgery according to some exemplary embodiments of the present disclosure.

[0071] One or more filtering criteria may be defined in step 504, which may be a preparatory step. For example, the defining step 504 may be performed by the manufacturer when configuring the system, by a professional during system deployment, or by a user (such as a physician) during or before using the system.

[0072] Step 504 may include defining one or more criteria related to attributes of locations within a patient's heart or a preset related to one or more such attributes. Each attribute included in the criteria or preset may be associated with one or more values, such as a numerical range, a binary value, a selection of discrete values, etc.

[0073] In step 512, the criteria or preset may be stored at a storage device accessible by a computing platform (such as workstation 55) associated with the operation.

[0074] In step 516, during a cardiac procedure, a plurality of electrical signals may be obtained from electrodes of a catheter, where the electrical signals indicate electrical activity at a plurality of locations within or on the heart wall. It should be understood that each signal may provide information related to a plurality of locations as the electrodes are moved by the user. Each such location may be associated with a value of each of a plurality of attributes. These locations and electrical signals may be used to construct a map of the heart and encode the map according to the electrical activity in each region of the heart.

[0075] In step 520, a selection of one or more filtering criteria may be received, whether the criteria is part of a preset or not. The filtering criteria may be selected from predefined stored criteria or presets or may be specifically defined by a user of the system.

[0076] In step 524, the filtering criteria or preset may be applied to the plurality of locations to identify locations that meet the filtering criteria or preset. It should be understood that multiple criteria or presets may be applied such that only locations that meet all applied criteria or presets are identified.

[0077] In step 528, the map showing the electrical activity within the heart may be updated to indicate electrical activity based only on locations that meet the criteria or preset. Thus, the encoding of the map may be based on fewer locations than before the criteria or preset was applied, but the updated map may provide an indication more suitable to the needs of the user.

[0078] In step 532, the updated map may be displayed to the user.

[0079] In step 536, a list of locations that meet the criteria or preset may be displayed while avoiding displaying locations that do not meet. In some embodiments, the values associated with one or more attributes of each location may also be displayed.

[0080] This process may be repeated during a cardiac procedure, and the criteria or preset may be reapplied for newly received locations at each iteration. It should be understood that it is not necessary to repeat the selection of the criteria or preset for each iteration, but only when the user's selection changes.

[0081] Now refer to Figure 6, which shows a block diagram of a computing platform 600 for displaying information during a cardiac operation according to some exemplary embodiments of the present disclosure.

[0082] It should be understood that the computing platform 600 may be embedded within the workstation 55, but may also be a stand-alone computing platform or be embedded elsewhere and operatively communicate with the workstation 55.

[0083] The computing platform 600 may be implemented as one or more computing platforms operatively connected to each other. For example, one or more remote computing platforms that may be implemented on, for example, a cloud computer. Other computing platforms may be part of a computer network of an associated organization. In other embodiments, all functions may be provided by one or more computing platforms that are all part of an organizational network.

[0084] The computing platform 600 may include one or more processors 604, which may or may not be located on the same computing platform. The one or more processors may be one or more central processing units (CPUs), microprocessors, electronic circuits, integrated circuits (ICs), etc. The processor 604 may be configured to provide the required functions, for example, by loading into memory and activating software modules stored on a storage device 612 described in detail below.

[0085] The computing platform 600 may include a communication device 608 for communicating with other devices or other computing platforms as needed (e.g., obtaining information indicating position and electrical measurements from a catheter insertion controller, storing preset data, etc. on a remote storage device). The communication module 608 may be adapted to connect to any communication channel, such as a local area network (LAN), a wide area network (WAN), a cellular network, etc., and use any relevant communication protocol.

[0086] The computing platform 600 may include a storage device 612, such as a hard disk drive, a flash drive, a random access memory (RAM), a memory chip, etc. In some exemplary embodiments, the storage device 612 may store program code that is operable to cause the processor 604 to perform actions associated with any one of the modules listed below or the Figure 5 steps of the methods above. The program code may include one or more executable units, such as functions, libraries, stand-alone programs, etc., adapted to execute the instructions described in detail below.

[0087] Alternatively or additionally, the provided instructions may be stored on a non-transitory tangible computer-readable medium, such as magnetic, optical, or electronic memory.

[0088] The storage device 612 may include a display and a user interface module 616 for presenting to the user a display to be shown on the display device 27, such as a cardiac mapping diagram, a list of positions, etc. The display and the user interface module 616 may also be used to receive instructions and operating parameters from the user, such as selecting criteria or presets. The display and the user interface module 616 may include a criteria and preset definition module 620 for defining one or more criteria or presets, including selecting attributes and corresponding values, as for example above Figure 2 as shown.

[0089] The storage device 612 may include a communication module 624 for sending data to and receiving data from other parts of the system or other systems via the communication device 608, such as catheter positions, associated electrograms, user preferences, histograms, etc.

[0090] The storage device 612 may include a criteria and preset application module 628 for applying the selected criteria to the positions where information is received from the electrodes to identify positions that meet the criteria or presets. If multiple presets or criteria with common attributes are selected, the identified positions are those that meet the intersection of the defined values.

[0091] The storage device 612 may include an electrocardiogram generation module 632 for generating a geometric reconstruction of the heart and a mapping diagram of the electrical activity indicated thereon based on all available points.

[0092] The storage device 612 may include an electrocardiogram update module 636 for updating the mapping diagram of the electrical activity of the heart to reflect only the electrical information associated with positions that meet the applied criteria or presets.

[0093] It should be understood that the steps and modules disclosed above are in addition to the software, hardware, firmware or other modules required for operating the catheter, displaying the catheter insertion process, performing other calculations (such as signal analysis and specifically complex fractionated electrogram (CFE) analysis), generating cardiac mapping diagrams, etc. Further details of the method and system can be found in, for example, US8676305, US9629567, the entire contents of which are incorporated herein by reference for any purpose.

[0094] The present invention may be a system, a method, and / or a computer program product. The computer program product may include a computer-readable storage medium (or media) having computer-readable program instructions thereon for causing a processor to execute aspects of the present invention.

[0095] A computer-readable storage medium can be a tangible device that can store and hold instructions for use by an instruction execution device. A computer-readable storage medium can be, by way of example and not limitation, an electronic storage device, a magnetic storage device, an optical storage device, an electromagnetic storage device, a semiconductor storage device, or any suitable combination of the foregoing. A non-exhaustive list of more specific examples of computer-readable storage media includes the following: a portable computer diskette, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), a static random access memory (SRAM), a portable compact disc read-only memory (CD-ROM), a digital versatile disc (DVD), a memory stick, a floppy disk, a mechanically encoded device such as a punch card or raised structures in a groove having instructions recorded thereon, and any suitable combination of the foregoing. As used herein, a computer-readable storage 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., light pulses passing through an optical fiber cable) or an electrical signal transmitted through a wire.

[0096] The computer-readable program instructions described herein can be downloaded to a corresponding computing / processing device from a computer-readable storage medium or downloaded to an external computer or external storage device via a network, for example, the Internet, a local area network, a wide area network, and / or a wireless network. The network can include copper transmission cables, optical transmission fibers, wireless transmission, routers, firewalls, switches, gateway computers, and / or edge servers. A network adapter card or network interface in each computing / processing device receives the computer-readable program instructions from the network and forwards the computer-readable program instructions for storage in a computer-readable storage medium within the corresponding computing / processing device.

[0097] The computer-readable program instructions for performing the operations of the present invention may be assembly instructions, instruction set architecture instructions, machine instructions, machine-dependent instructions, microcode, firmware instructions, state-setting data, or source code or object code written in any combination of one or more programming languages, such as the programming languages Java, C, C++, Python, etc. The computer-readable program instructions may be executed entirely on the user's computer, partially on the user's computer, executed as a stand-alone software package, partially on the user's computer and partially on a remote computer, or entirely on the remote computer or server. In the latter case, the remote computer may be connected to the user's computer through any type of network, including a local area network (LAN) or a wide area network (WAN), or may be connected to an external computer (e.g., through the Internet using an Internet service provider). In some embodiments, in order to perform aspects of the present invention, an electronic circuit, including, for example, a programmable logic circuit, a field programmable gate array (FPGA), or a programmable logic array (PLA), may execute the computer-readable program instructions by utilizing the state information of the computer-readable program instructions to personalize the electronic circuit.

[0098] Aspects of the present invention are described herein with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of the invention. It should be understood that each block in the flowchart illustrations and / or block diagrams, and combinations of blocks in the flowchart illustrations and / or block diagrams, can be implemented by computer-readable program instructions.

[0099] These computer-readable program instructions can be provided to a processor of a general-purpose computer, a special-purpose computer, or other programmable data processing device to produce a machine, such that the instructions executed via the processor of the computer or other programmable data processing device create a means for implementing the functions / actions specified in the flowchart and / or block Figure 1 diagram(s). These computer-readable program instructions may also be stored in a computer-readable storage medium, which can direct a computer, a programmable data processing device, and / or other devices to operate in a particular manner, such that the computer-readable storage medium having instructions stored therein comprises an article of manufacture having instructions for implementing aspects of the functions / actions specified in the flowchart and / or block Figure 1 diagram(s).

[0100] The computer-readable program instructions may also be loaded onto a computer, other programmable data processing device, or other device to cause a series of operational steps to be performed on the computer, other programmable device, or other device to produce a computer-implemented process, such that the instructions executed on the computer, other programmable device, or other device implement the functions / actions specified in the flowchart and / or block Figure 1 diagram(s).

[0101] The flowcharts and block diagrams in the accompanying drawings 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, which includes 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 accompanying drawings. 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 actions, or by a combination of dedicated hardware and computer instructions.

[0102] Embodiment

[0103] Embodiment 1

[0104] A method, the method comprising: obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more chambers of a patient's heart, wherein each electrical signal from the plurality of electrical signals provides information about electrical activity at at least one location within the heart, and wherein each location of the at least one location is associated with a value of each of a plurality of attributes; receiving, via a user interface, a selection of a filtering criterion for the at least one location from a user, the filtering criterion being associated with at least one of the plurality of attributes; applying the filtering criterion to identify a subset of locations that meet the filtering criterion from the at least one location; updating a map of the electrical activity within the heart based only on the subset of locations; and displaying the map of the electrical activity.

[0105] Embodiment 2

[0106] The method according to embodiment 1, wherein the obtaining, the applying, the updating, and the displaying are repeatedly performed.

[0107] Embodiment 3

[0108] The method according to embodiment 1 or 2, the method further comprising displaying a representation of information related to the subset of locations to a user while avoiding displaying information of other locations that do not meet the filtering criterion.

[0109] Embodiment 4

[0110] The method according to any one of the preceding embodiments, wherein the plurality of electrical signals are electrocardiogram (ECG) signals.

[0111] Embodiment 5

[0112] The method according to any one of the preceding embodiments, wherein the at least one attribute is selected from the group consisting of: impedance; voltage; late annotation time (LAT) value at a location associated with the electrical signal; late annotation mapping (LAM); tissue proximity index (TPI); value obtained from bipolar measurement (BI); cycle length (CL) of the electrical signal; at least one stability parameter of the signal; fragmented or unfragmented signals; and connected or disconnected signals.

[0113] Embodiment 6

[0114] The method according to any one of the preceding embodiments, wherein the at least one filtering criterion is included in at least one preset, and wherein applying the filtering criterion is performed by applying the at least one preset for identifying the subset of locations.

[0115] Embodiment 7

[0116] The method according to any one of the preceding embodiments, the method further comprising defining the at least one filtering criterion.

[0117] Embodiment 8

[0118] The method according to embodiment 7, wherein defining the at least one filtering criterion includes defining at least one preset associated with the at least one attribute.

[0119] Embodiment 9

[0120] The method according to embodiment 8, the method further comprising storing the at least one preset.

[0121] Embodiment 10

[0122] The method according to embodiment 8, wherein defining the at least one filtering criterion includes selecting the at least one attribute and at least one corresponding value.

[0123] Embodiment 11

[0124] The method according to embodiment 10, wherein the at least one corresponding value includes a minimum or maximum value of a numerical range of the at least one attribute.

[0125] Embodiment 12

[0126] The method according to embodiment 10, wherein the at least one corresponding value includes a binary value of the at least one attribute.

[0127] Embodiment 13

[0128] The method according to embodiment 10, wherein the at least one corresponding value includes one or more discrete values of the at least one attribute.

[0129] Embodiment 14

[0130] The method according to embodiment 8, wherein the user interface enables a user to select one or more presets to be applied from the at least one preset.

[0131] Embodiment 15

[0132] The method according to embodiment 14, wherein if the same attribute is included in at least two activated presets, the at least one corresponding value of the same attribute complies with the limitations of the two presets.

[0133] Embodiment 16

[0134] The method according to embodiment 14, wherein the at least one corresponding value of the attribute in the preset complies with the available values of the at least one attribute within the at least one position.

[0135] Embodiment 17

[0136] A computerized device having a processor coupled to a memory unit, the processor being adapted to perform the following steps: obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more chambers of a patient's heart, wherein each electrical signal from the plurality of electrical signals provides information about electrical activity at at least one location within the heart, and wherein each location of the at least one location is associated with a value of each of a plurality of attributes; receiving, via a user interface, a selection of a filtering criterion for the at least one location from a user, the filtering criterion being associated with at least one of the plurality of attributes; applying the filtering criterion to identify a subset of locations that comply with the filtering criterion from the at least one location; updating a map of the electrical activity within the heart based only on the subset of locations; and displaying the map of the electrical activity.

[0137] Embodiment 18

[0138] The apparatus according to embodiment 17, wherein the at least one filtering criterion is included in at least one preset, and wherein applying the filtering criterion is performed by applying the at least one preset for identifying the subset of locations.

[0139] Embodiment 19

[0140] The apparatus according to embodiment 18, wherein the processor is further adapted to obtain a definition of the at least one preset, the at least one preset being associated with the at least one attribute.

[0141] Embodiment 20

[0142] A computer program product comprising a non-transitory computer-readable storage medium storing program instructions which, when read by a processor, cause the processor to perform: obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more chambers of a patient's heart, wherein each electrical signal from the plurality of electrical signals provides information about electrical activity at at least one location within the heart, and wherein each location of the at least one location is associated with a value of each of a plurality of attributes; receiving, via a user interface, a selection of a filtering criterion for the at least one location from a user, the filtering criterion being associated with at least one of the plurality of attributes; applying the filtering criterion to identify a subset of locations that meet the filtering criterion from the at least one location; updating a map of electrical activity within the heart based only on the subset of locations; and displaying the map of electrical activity.

[0143] Although the examples described herein are primarily directed to cardiac diagnostic applications, the methods and systems described herein can also be used in other medical applications.

[0144] It should be understood that the above embodiments are cited by way of example, and the present disclosure is not limited to what is specifically shown and described above. On the contrary, the scope of the present disclosure includes combinations and sub-combinations of the various features described above and their variations and modifications, which would occur to those skilled in the art upon reading the above description and which are not disclosed in the prior art.

Claims

1. A method, comprising: obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more chambers of a heart of a patient, wherein each electrical signal from the plurality of electrical signals provides information about electrical activity in at least one location within the heart, and wherein each location in the at least one location is associated with a value for each attribute from a plurality of attributes; receiving, via a user interface, a selection of a filter criterion for the at least one location from a user, the filter criterion being associated with at least one attribute from the plurality of attributes; applying the filtering criteria to identify a subset of locations from the at least one location that meet the filtering criteria; updating a map of electrical activity within the heart based only on the subset of locations; and The map of the electrical activity is displayed.

2. The method according to claim 1, wherein: The obtaining, the applying, the updating, and the displaying are repeatedly performed.

3. The method of claim 1, further comprising displaying to a user a representation of information related to the subset of locations while avoiding displaying information for other locations that do not meet the filtering criteria.

4. The method according to claim 1, wherein: The plurality of electrical signals are electrocardiographic (ECG) signals.

5. The method according to claim 1, wherein: The at least one property is selected from the group consisting of: impedance; voltage; a late annotation time (LAT) value at a location associated with the electrical signal; a late annotation map (LAM); a tissue proximity index (TPI); a value obtained from a bipolar measurement (BI); a cycle length (CL) of said electrical signal; at least one stability parameter of said signal; signals that are fragmented or not; and signals that are connected or disconnected.

6. The method according to claim 1, wherein: The at least one filtering criterion is comprised in at least one preset, and wherein applying the filtering criterion is performed by applying the at least one preset for identifying the subset of locations.

7. The method of claim 1, further comprising defining the at least one filtering criterion.

8. The method according to claim 7, wherein: Defining the at least one filtering criterion includes defining at least one preset associated with the at least one attribute.

9. The method of claim 8, further comprising storing the at least one preset.

10. The method according to claim 8, wherein: Defining the at least one filter criterion comprises selecting the at least one attribute and at least one corresponding value.

11. The method according to claim 10, wherein: At least one corresponding value comprises a minimum value or a maximum value of a numerical range of the at least one attribute.

12. The method according to claim 10, wherein: The at least one corresponding value comprises a binary value of the at least one attribute.

13. The method according to claim 10, wherein: The at least one corresponding value comprises one or more discrete values ​​of the at least one attribute.

14. The method according to claim 8, wherein: The user interface enables a user to select one or more presets to be applied from the at least one preset.

15. The method according to claim 14, wherein: If the same property is included in at least two activated presets, the at least one corresponding value of the same property complies with the limits of the two presets.

16. The method according to claim 14, wherein: The at least one corresponding value of the property in the preset complies with the available values ​​of the at least one property in the at least one location.

17. A computerized device having a processor coupled to a memory unit, the processor being adapted to perform the following steps: A plurality of electrical signals are obtained from a plurality of electrodes disposed on a catheter inserted into one or more chambers of a patient's heart, wherein each electrical signal from the plurality of electrical signals provides information about electrical activity in at least one location within the heart, and wherein each of the at least one location is associated with a value for each attribute from a plurality of attributes; receiving, via a user interface, a selection of a filter criterion for the at least one location from a user, the filter criterion being associated with at least one attribute from the plurality of attributes; applying the filtering criteria to identify a subset of locations from the at least one location that meet the filtering criteria; updating a map of electrical activity within the heart based only on the subset of locations; and The map of the electrical activity is displayed.

18. The apparatus according to claim 17, wherein: The at least one filtering criterion is comprised in at least one preset, and wherein applying the filtering criterion is performed by applying the at least one preset for identifying the subset of locations.

19. The apparatus according to claim 18, wherein: The processor is further adapted to obtain a definition of the at least one preset, the at least one preset being associated with the at least one attribute.

20. A computer program product, the computer program product comprising a non-transitory computer-readable storage medium storing program instructions configured to cause a processor to perform actions, the program instructions implementing: A plurality of electrical signals are obtained from a plurality of electrodes disposed on a catheter inserted into one or more chambers of a patient's heart, wherein each electrical signal from the plurality of electrical signals provides information about electrical activity in at least one location within the heart, and wherein each of the at least one location is associated with a value for each attribute from a plurality of attributes; receiving, via a user interface, a selection of a filter criterion for the at least one location from a user, the filter criterion being associated with at least one attribute from the plurality of attributes; applying the filtering criteria to identify a subset of locations from the at least one location that meet the filtering criteria; updating a map of electrical activity within the heart based only on the subset of locations; and The map of the electrical activity is displayed.

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