Heart map advanced corrugation mode with graphical user interface

Abstract

The invention discloses a system. The system includes an input device and a processor. The processor is configured to: (i) receive and generate one of electrophysiology (EP) maps, the EP map visualizing a first EP parameter on the EP map using a graphical representation, a size of the graphical representation varying according to a value of the first EP parameter; (ii) receiving a second EP parameter using the input device; (iii) applying a visual indication of the second EP parameter on the graphical representation of the first EP parameter, wherein the visual indication varies according to a value of the second EP parameter; and (iv) displaying the EP map to a user on a display device.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit of U.S. Provisional Patent Application 63 / 645,336, filed May 10, 2024, which is incorporated herein by reference. Technical Field

[0003] This invention relates in general to electrophysiological mapping, and more specifically to the visualization of cardiac electrophysiological data points and mapping plots. Background Technology

[0004] Electrophysiological (EP) mapping of a patient's cardiac chambers is generated by placing electrodes in a region of the chamber tissue, acquiring the EP signal in that region, and then repeating the process for different regions. EP parameters are extracted from the EP signal of each measurement region and then displayed on a graphical representation of the tissue, such as a three-dimensional (3D) rendering of the cardiac chambers.

[0005] Previously proposed EP mapping visualization methods in patent literature aim to simplify the interpretation of EP mapping maps. For example, U.S. Patent 11,844,616 describes a method, apparatus, and system for a medical procedure, including sensing multiple tissue potentials at an organ region of an organ via one or more electrodes on a catheter. Multiple peak potentials are determined based on the multiple first tissue potentials, such that the peak potentials exceed a potential threshold. A first visual characteristic is determined based on the number of peak potentials. A rendering of the organ, including the organ region, is displayed such that the rendering of the first organ region includes the first visual characteristic.

[0006] This disclosure will be more fully understood through the following detailed description of embodiments thereof, taken in conjunction with the accompanying drawings, in which: Attached Figure Description

[0007] Figure 1 This is a schematic illustration of a catheter-based electrophysiological (EP) mapping and ablation system according to an example of this disclosure;

[0008] Figure 2 This is a schematic diagram of a graphical user interface (GUI) according to an example of this disclosure, which allows a user to select EP parameters and configure their bins for display in an EP mapping map;

[0009] Figure 3 This is based on the example of the use of this disclosure. Figure 2 A schematic volumetric rendering of a cardiac LAT mapping image generated by the GUI, featuring fragmented counts of bipolar amplitudes; and

[0010] Figure 4The examples provided in this disclosure are illustrative examples of generating overlays using a GUI and input devices. Figure 3 The method for EP mapping of ripples with fragmentation count shown in the figure. Detailed Implementation

[0011] Overview

[0012] During EP mapping, electrophysiological (EP) mapping maps, such as local activation time (LAT) mapping maps, are typically generated by the EP mapping system based on EP data captured at multiple locations within the cardiac chambers. These mapping maps are useful tools for diagnosing arrhythmias (e.g., atrial fibrillation) and guiding physicians (e.g., using ablation) to eliminate arrhythmias.

[0013] In this process, the mapping system uses conduits to sense the activation wave (reference signal) and the resulting activation (matrix signal). The processor annotates the reference signal and the corresponding matrix activation. Typically, hundreds of waveforms are acquired and annotated during the mapping process. Using these annotations, the processor calculates the corresponding EP values, such as the local activation time (LAT) value between the reference signal and the corresponding matrix signal.

[0014] In some cases, the processor of an EP mapping system superimposes discrete EP values ​​of one EP parameter onto a continuous (e.g., interpolated) EP mapping plot of another EP parameter. For example, a “wavy mapping plot” that includes a dynamic display of discrete bipolar electrophysiological data can be used in conjunction with LAT mapping visualization. As used herein, “wavy” refers to bars (or other graphic representations) protruding from the surface of an electrophysiological mapping plot, where the size of the bars (e.g., height or width) represents a specific EP value. A wavy mapping plot purchased from Biosense Webster, Inc. Within the module, the corrugation provides a dynamic display of bipolar electrogram data, where at each point, the corresponding bipolar electrogram amplitude is dynamically displayed as bars perpendicular to the LAT mapping surface. Existing corrugation implementations (such as in...) One limitation of this module is that the bars superimposed on the anatomical mapping convey only a measurement of the EP parameter: the bipolar amplitude at the bar's location. The bar representation can indicate abnormal conduction pathways leading to arrhythmias. However, because it provides only a single form of EP information, represented solely by the height of the ripples, this visualization may be too coarse or difficult to observe and rely on for diagnosis.

[0015] The examples of the invention described below provide novel ripple mapping systems and methods that enable ripples to simultaneously convey valuable EP parameter information in addition to bipolar amplitude. In one example, a system is provided that includes a display device, an input device (e.g., a touchscreen or computer mouse), and a processor. The processor is configured to receive or generate an electrophysiological (EP) mapping plot that visualizes a first EP parameter (e.g., bipolar amplitude) on the EP mapping plot using a graphical representation (e.g., bar height), the size of which varies according to the value of the first EP parameter. The processor is further configured to receive a second EP parameter (e.g., signal fragmentation count) and apply a visual indication (e.g., color) of the second EP parameter to the graphical representation of the first EP parameter, wherein the visual indication varies according to the value of the second EP parameter. The EP mapping plot is displayed to a user on the display device or stored in memory.

[0016] The processor can receive selections of a second EP parameter from the user via an input device. In other examples, the processor also receives bins (e.g., three bins for a count group ranging from 0 to 10) of the range of the second EP parameter from the user via an input device. The processor applies visual indications of the second EP parameter (e.g., bar color, transparency, intensity, hue, shading, etc.) to a given graphical representation of the first EP parameter.

[0017] In some examples, the processor is further configured to provide a graphical user interface (GUI) feature that allows a user to select a second EP parameter and configure its binning using a display device and an input device. The GUI feature allows the user to configure the binning of the second EP parameter via a GUI that includes, for example, a slider ruler with two or more user-movable separators representing the range of the second EP parameter.

[0018] In some examples, users can visualize all colors of a selected EP parameter or only a specific color (e.g., selected to represent one or more of the high / medium / low bins). The color set can be customized. In one example, to graphically represent the bins of an EP parameter range (e.g., providing different colors for the corrugated bars), the user moves the separator on a slider scale to visualize the deflection count of the first color bar as 0-3, the second color bar as 3-7, and the third color bar as a deflection count greater than 7, as shown below. As mentioned above, users can select to display only one bin on the GUI, such as displaying a high break count.

[0019] In some examples, the technique provides a ripple pattern with a graphical representation in the form of colored bars, where the dimensions (e.g., height or width) of the geometric representation (e.g., bars) represent the bipolar amplitude of the measured signal at that location. The ripple can be modified using visual indicators (e.g., color, transparency, intensity, hue, shading, etc.) that vary based on another EP parameter of interest measured or derived for the location of the ripple, such as, but not limited to, fragmentation count, activation duration, late potential sensitivity level, quality of electrode-tissue contact, etc.

[0020] In some examples, the processor can overlay a graphical representation (i.e., ripples) with the applied visual indications onto an existing EP mapping, such as a LAT or voltage mapping on a user's display.

[0021] Finally, the graphical representation can be arranged and combined across applications, for example, inverted. In the example of overlaying a corrugated map with a surface EP map, the second EP parameter can be a LAT value, where the bar height represents the LAT value. The bar color can represent the LAT value, and the bar height represents the second EP parameter value.

[0022] System Description

[0023] Figure 1 This is a schematic illustration of a catheter-based electrophysiological (EP) mapping and ablation system 10 according to an example of this disclosure.

[0024] System 10 includes multiple catheters that are percutaneously inserted by physician 24 through the patient's vascular system into the chambers or vascular structures of heart 12 (see illustration 45). Typically, a delivery sheath catheter is inserted into a cardiac chamber, such as a ventricle or atrium, near a desired location within heart 12. Subsequently, multiple catheters are inserted into the delivery sheath catheter to reach the desired location. These multiple catheters may include catheters dedicated to pacing, catheters for sensing intracardiac electrogram signals, catheters dedicated to ablation, and / or catheters dedicated to both EP mapping and ablation. The example catheter 14 shown herein is configured for sensing bipolar electrograms. Physician 24 contacts the distal end 28 of catheter 14 (hereinafter also referred to as distal end assembly 28) against the heart wall for sensing a target site within heart 12. For ablation, physician 24 similarly brings the distal end of the ablation catheter to the target site.

[0025] As shown in Figure 65, conduit 14 is an example conduit including a basket-shaped distal end 28, which includes one, preferably multiple, electrodes 26 optionally distributed on multiple splines 22 at the distal end 28 and configured to sense IEGM signals. Conduit 14 may additionally include a positioning sensor 29 embedded in or near the distal end 28 on or near the axis 46 of conduit 14, for tracking the positioning and orientation of the distal end 28. Optionally and preferably, the positioning sensor 29 is a magnetically based positioning sensor comprising three magnetic coils for sensing three-dimensional (3D) positioning and orientation. As shown, the distal end 28 also includes an expansion / collapse rod 42 of an expansion assembly 28 mechanically connected to the basket-shaped assembly 28 at the distal edge 41 of the assembly 28.

[0026] The magnetic-based positioning sensor 29 can operate in conjunction with a positioning pad 25, which includes a plurality of magnetic coils 32 configured to generate a magnetic field in a predefined workspace. Real-time positioning of the distal end 28 of the conduit 14 can be tracked based on the magnetic field generated by the positioning pad 25 and sensed by the magnetic-based positioning sensor 29. Details of the magnetic-based positioning sensing technology are described in U.S. Patents 5,5391,199, 5,443,489, 5,558,091, 6,172,499, 6,239,724, 6,332,089, 6,484,118, 6,618,612, 6,690,963, 6,788,967, and 6,892,091.

[0027] System 10 includes 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 toward electrodes 26 and sensed at the electrode skin patch 38, allowing triangulation of the position of each electrode via the electrode patch 38. Details of the impedance-based position tracking technique are described in U.S. Patents 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182.

[0028] Recorder 11 displays on display device 27 cardiac signals 21 acquired using surface ECG electrodes 18 (e.g., electrocardiograms acquired at separately tracked cardiac tissue locations) and intracardiac electrocardiograms acquired using electrodes 26 of catheter 14. Recorder 11 may include pacing capability for pacing rhythms and / or be electrically connectable to a separate pacemaker.

[0029] Workstation 55 includes memory 57, a processor 56 unit with a memory or storage device in which appropriate operating software is loaded, and user interface capabilities. Workstation 55 may provide multiple functions, optionally including: (i) three-dimensional (3D) modeling of endocardial anatomy and rendering the model or EP mapping 20 for display on display device 27; (ii) displaying, on display device 27, activation sequences (or other data) compiled from recorded cardiac signals 21, superimposed on representative visual markers or images overlaid on the rendered EP mapping 20; (iii) displaying the real-time position and orientation of multiple catheters within the cardiac chambers; and (iv) displaying relevant sites, such as where ablation energy has been applied, on display device 27. A commercial product embodying the elements of system 10 could be CARTO. TM The 3System was purchased from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA 92618.

[0030] In the example disclosed in this invention, according to the technology disclosed in this invention, physician 24 uses a GUI 111 including a signal type menu to select (e.g., using a computer mouse 112) which EP parameter will be visualized graphically. Input device 110 (e.g., an input device including a touchscreen 27 or a computer mouse 112) is configured to allow physician 24 to set or adjust the selected EP parameter on the GUI 111 and configure its sub-modules.

[0031] System 10 may include an ablation energy generator 50 adapted to conduct ablation energy to one or more electrodes at the distal end of a catheter configured for ablation. The energy generated by the ablation energy generator 50 may include, but is not limited to, radio frequency (RF) energy or pulsed field ablation (PFA) energy (including monopolar or bipolar high-voltage DC pulses to be used to achieve irreversible electroporation (IRE), or combinations thereof.

[0032] The patient interface unit (PIU) 30 is an interface configured to establish electrical communication between the catheter, electrophysiology equipment, power supply, and workstation 55 to control the operation of system 10 and to receive EA signals from the catheter. The electrophysiology equipment of system 10 may include, for example, multiple catheters, positioning pads 25, surface ECG electrodes 18, electrode patches 38, ablation energy generator 50, and recorder 11. Optionally and preferably, the PIU 30 further includes processing capabilities for real-time calculation of catheter position and for performing ECG calculations.

[0033] In some examples, processor 56 typically includes a general-purpose computer programmed in software to perform the functions described herein. This software may be downloaded to the computer electronically via a network, or alternatively or additionally located and / or stored on a non-transitory tangible medium, such as magnetic storage, optical storage, or electronic storage.

[0034] This configuration of system 10 is illustrated by way of example to illustrate certain problems solved by embodiments of the present disclosure and to demonstrate the application of these embodiments in enhancing the performance of such systems. However, embodiments of the present disclosure are by no means limited to this particular category of exemplary systems, and the principles described herein can be similarly applied to other types of medical systems. For example, other types of multi-electrode catheters, such as multi-arm OCTARAYs, can be used. TM Catheter or flat catheter.

[0035] GUI for EP mapping with advanced ripple patterns

[0036] Figure 2 This is a schematic diagram of an example GUI 111 according to the present disclosure, which allows the user to select EP parameters and configure their bins within the range of EP parameters for display in an EP mapping map.

[0037] In the example shown, the corrugated bars have different heights depending on the bipolar value (amplitude) they represent, which is the first visualized EP parameter. GUI 111 is configured to allow the user to select a second EP parameter using checkboxes, and its binning is configured to be graphically represented by bar colors.

[0038] In the example shown, GUI 111 includes a signal attribute menu 213 that allows the user to select a graphical visualization of a second EP parameter from fragmentation count, activity duration, and wavefront.

[0039] GUI 111 also includes a filter menu 223 that allows the user to configure the sliding scale scale 233. As shown, menu 223 allows the user to configure the visualization of a second EP parameter with up to three bin levels (low, medium, high). For example, the user can select only the high checkbox, which will only display areas with high fragmentation counts (e.g., Figure 3 The number of those colored red is 316).

[0040] Menu 223 also includes a checkbox 242 for displaying the bar only on the active area or on the entire mapping plot. The active area is defined elsewhere.

[0041] As shown in the figure, GUI 111 also includes a configured sliding scale 233. The scale 233 includes low (222), medium (224), and high (226) bins, colored green, yellow, and red, respectively. Users can configure the bin range using sliding separators 215 and 217.

[0042] EP map displaying advanced ripple mode

[0043] Figure 3 This is a schematic volumetric rendering of cardiac LAT mapping diagram 302 with a superimposed bipolar amplitude fragment count (222, 224, 226) of ripples according to an example of this disclosure. Using Figure 2 The GUI 111 generates a mapping map. In the LAT mapping map 302, the first EP parameter 304 (e.g., LAT value 304) is continuously represented and encoded using a color scale. The first EP parameter 324 with different bipolar amplitudes is graphically represented by bars 310 of different heights 320.

[0044] Different bar colors (312, 314, 316) represent the second EP parameter 334, which indicates the breakage level of the bins as set by the user. In the example shown, scale separators 215 and 217 are used to set the bins to show a low count 223 (green, 312) of up to three deflections, a count 224 (yellow, 224) of three to six deflections, and a count 226 (red, 316) of more than six deflections. Depending on the selection in the signal selection menu 213, the algorithm can view the duration or additional inputs besides the breakage count and set their levels.

[0045] LAT mapping 302 can characterize atrial flutter (AF), where the active region has a high deflection count (e.g., selected as greater than 6 as in scale 233) and a bipolar value ranging from 0.05 mV to 0.5 mV. LAT mapping 302 can characterize atrial fibrillation (Afib), where the active region has a high deflection count (e.g., selected as greater than 6 as in scale 233) and a bipolar value ranging from 0.05 mV to 2 mV.

[0046] Method for generating EP mapping maps using advanced ripple patterns

[0047] Figure 4 This is an illustrative example of an example according to the present disclosure for generating an overlay using a GUI 111 and an input device 110. Figure 3 The flowchart shows an example method for EP mapping diagram 302 of the fragmentation count ripples (312, 314, 316) shown.

[0048] The process executes an algorithm that begins at EP mapping receiving step 402 where processor 56 receives an EP mapping of another EP parameter (e.g., LAT) and a first EP parameter (e.g., bipolar amplitude), wherein the first EP parameter is graphically represented on the EP mapping according to the value of the first EP parameter in a given graphical representation (e.g., bars of different heights).

[0049] At the second EP parameter receiving step 404, the processor receives from the user via input device 110 the selection of the second EP parameter (e.g., signal fragmentation count) on GUI 111.

[0050] At the bin receiving step 404, the processor receives from the user via input device 110 the bin configuration of the range of the second EP parameters completed on GUI 111.

[0051] At visual indication step 408, the processor visually indicates the second EP parameter (e.g., coloring each bar) on the graphical representation (e.g., bars) of the first EP parameter based on the binning of the received second EP parameter.

[0052] At step 410 of the EP mapping display, the processor displays the EP mapping (e.g., mapping 302) to the user.

[0053] Example

[0054] Example 1

[0055] A system (10) includes an input device (110) and a processor (56). The processor (56) is configured to: (i) receive and generate one of an electrophysiological (EP) mapping (302), the EP mapping visualizing a first EP parameter (324) on the EP mapping (302) using a graphical representation (310), the size (320) of the graphical representation varying according to the value of the first EP parameter; (ii) receive a second EP parameter (334) using the input device (110); (iii) apply visual indications (312, 314, 316) of the second EP parameter (334) to the graphical representation (310) of the first EP parameter (324), wherein the visual indications (312, 314, 316) vary according to the value of the second EP parameter (334); and (iv) display the EP mapping (302) to the user.

[0056] Example 2

[0057] According to the system (10) of embodiment 1, wherein the processor (56) is further configured to receive bins (222, 224, 226) of the range of the second EP parameter (334) from the user via the input device (110), and to apply the visual indications (312, 314, 316) of the second EP parameter (334) according to the received bins (222, 224, 226).

[0058] Example 3

[0059] According to any one of Embodiments 1 and 2, the system (10) wherein the processor (56) is configured to use the display device (27) and the input device (110) to provide a graphical user interface (GUI) feature (111) that allows the user to perform at least one of the following: i) select the second EP parameter (334) and ii) configure its sub-bin.

[0060] Example 4

[0061] According to any one of Embodiments 1 to 3, the system (10) wherein the GUI feature (111) allows the user to configure the received bins (222, 224, 226) using a slider scale (233) of one or more user-movable separators (215, 217) having the range of the second EP parameter (334).

[0062] Example 5

[0063] According to any one of Embodiments 1 to 4, the system (10) wherein the first EP parameter (324) is a bipolar electrocardiogram amplitude.

[0064] Example 6

[0065] According to any one of embodiments 1 to 5, the system (10) wherein the second EP parameter (334) is one of fragmentation count, activity duration and wavefront candidate.

[0066] Example 7

[0067] According to any one of embodiments 1 to 6, the system (10) wherein the processor (56) is configured to configure the visual indication (320) of the first EP parameter as a bar (310) having a height (320) according to the value of the first EP parameter (324).

[0068] Example 8

[0069] According to any one of embodiments 1 to 7, the system (10) wherein the processor (56) is configured to color the strip (310) according to the received bins (222, 224, 226) (312, 314, 316).

[0070] Example 9

[0071] According to any one of embodiments 1 to 8, the system (10) wherein the processor (56) is configured to visualize the first EP parameter (324) on an EP mapping of other EP parameters (304).

[0072] Example 10

[0073] According to any one of embodiments 1 to 9, the system (10) wherein the other EP parameter (304) is the local activation time (LAT).

[0074] Example 11

[0075] According to any one of embodiments 1 to 10, the system (10) wherein the input device (110) includes one of a touch screen (27) and a computer mouse (112).

[0076] Example 12

[0077] A method comprising: receiving and generating one of an electrophysiological (EP) mapping (302), the EP mapping visualizing a first EP parameter (324) on the EP mapping (302) using a graphical representation (310), the size (320) of the graphical representation varying according to the value of the first EP parameter (324); receiving a second EP parameter (334); applying visual indications (312, 314, 316) of the second EP parameter (334) to the graphical representation (310) of the first EP parameter (324), wherein the visual indications (312, 314, 316) vary according to the value of the second EP parameter (334); and displaying the EP mapping (302) to a user.

[0078] Although the embodiments described herein are primarily for cardiac diagnostic applications, the methods and systems described herein can also be used in other medical applications.

[0079] It should be understood that the above embodiments are cited by way of example, and this disclosure is not limited to the content specifically shown and described above. Rather, the scope of this disclosure includes combinations and sub-combinations of the various features described above, as well as variations and modifications thereof, which will occur to those skilled in the art upon reading the above description and which are not disclosed in the prior art.

Claims

1. A system comprising: Input devices; and Processor, the processor being configured to: One of receiving and generating an electrophysiological (EP) mapping, wherein the EP mapping utilizes a graphical representation to visualize a first EP parameter on the EP mapping, the size of the graphical representation varying according to the value of the first EP parameter; Use the input device to receive the second EP parameter; Apply a visual indication of the second EP parameter to the graphical representation of the first EP parameter, wherein the visual indication varies according to the value of the second EP parameter; and The EP mapping map is displayed to the user.

2. The system according to claim 1, wherein, The processor is further configured to receive bins of the range of the second EP parameters from the user via the input device, and to apply the visual indication of the second EP parameters based on the received bins.

3. The system according to claim 2, wherein, The processor is configured to use the display device and the input device to provide graphical user interface (GUI) features that allow the user to perform at least one of the following: i) select the second EP parameter, and ii) configure its bin.

4. The system according to claim 3, wherein, The GUI feature allows the user to configure the received bins using a slider ruler with one or more user-movable separators within the range of the second EP parameter.

5. The system according to any one of claims 1-4, wherein, The first EP parameter is the bipolar electrocardiogram amplitude.

6. The system according to any one of claims 1-4, wherein, The second EP parameter is one of the fragmentation count, activity duration, and wavefront candidate.

7. The system according to any one of claims 1-4, wherein, The processor is configured to configure the visual indication of the first EP parameter as a bar with a height according to the value of the first EP parameter.

8. The system according to claim 7, wherein, The processor is configured to color the stripe according to the binning of the received second EP parameters.

9. The system according to any one of claims 1-4, wherein, The processor is configured to visualize the first EP parameter on an EP mapping map of other EP parameters.

10. The system according to claim 9, wherein, The other EP parameter is the Local Activation Time (LAT).

11. The system according to any one of claims 1-4, wherein, The input device includes either a touchscreen or a computer mouse.

12. A method comprising: One of receiving and generating an electrophysiological (EP) mapping, wherein the EP mapping utilizes a graphical representation to visualize a first EP parameter on the EP mapping, the size of the graphical representation varying according to the value of the first EP parameter; Receive the second EP parameter; Apply a visual indication of the second EP parameter to the graphical representation of the first EP parameter, wherein the visual indication varies according to the value of the second EP parameter; and The EP mapping map is displayed to the user.

13. The method of claim 12, further comprising receiving bins of the range of the second EP parameter from the user, and applying the visual indication of the second EP parameter based on the received bins.

14. The method of claim 13, further comprising providing a graphical user interface (GUI) feature that allows the user to perform at least one of the following: i) selecting the second EP parameter, and ii) configuring its bins.

15. The method according to claim 14, wherein, The GUI feature allows the user to configure the received bins using a slider ruler with one or more user-movable separators within the range of the second EP parameter.

16. The method according to any one of claims 12-15, wherein, The first EP parameter is the bipolar electrocardiogram amplitude.

17. The method according to any one of claims 12-15, wherein, The second EP parameter is one of the fragmentation count, activity duration, and wavefront candidate.

18. The method according to any one of claims 12-15, further comprising configuring the visual indication of the first EP parameter to have a bar with a height according to the value of the first EP parameter.

19. The method of claim 18, further comprising coloring the stripe according to the binning of the received second EP parameter.

20. The method according to any one of claims 12-15, wherein, The processor is configured to visualize the first EP parameter on an EP mapping map of other EP parameters.

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