Methods and systems for shaving anatomical map

Abstract

To provide a system and method for shaving an anatomical map including an electroanatomical map of a heart.SOLUTION: The invention provides a system and method for shaving an anatomical map. A reference image is compared to the anatomical map using an accuracy parameter, and at least one area in the anatomical map that fails to meet the accuracy parameter is identified. An image of the electro-anatomical map is displayed, where the image provides a visual indication of the at least one area in the anatomical map that fails to meet the at least one accuracy parameter. A revised map is generated by shaving the at least one area in the anatomical map that fails to meet the at least one accuracy parameter, and the revised map is displayed.SELECTED DRAWING: Figure 9

Description

[Technical field]

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

[0002] The interior of a patient's organ, such as a heart chamber, may be mapped (e.g., electroanatomically mapped) using a mapping catheter having one or more suitable sensors attached to its distal end for mapping within the organ. Using position signals generated by the various sensors, a processor may calculate sensor locations within the organ (e.g., heart chamber). Using the calculated locations, the processor may further derive an anatomical map of the cavity surface. For example, in fast anatomical mapping (FAM) of a cardiac chamber, point locations on the interior surface of the cavity are delineated using acquired electroanatomical (EA) data. However, undesired catheter locations may also be acquired and automatically added to the FAM-constructed cavity surface during FAM reconstruction. Examples of such undesired data points include distorted cavity wall locations due to being pushed outward by the catheter, incorrect wall locations due to respiratory-induced motion, locations erroneously measured inside the cavity instead of on the surface, and irrelevant catheter locations, e.g., locations outside the mapping area of ​​interest.

[0003] The accumulation of such undesired locations affects the accuracy of the reconstructed EA map. To address these inaccuracies, during or after acquisition, the physician, or a specialist assisting the physician, may manually edit the surface generated from the acquired points to correct the errors. This editing typically involves erasing data points and / or removing ("shaving") portions from the computed surface. If performed manually, such editing can be time consuming and inaccurate. Summary of the Invention [Means for solving the problem]

[0004] A system and method for shaving an anatomical map. A reference image is compared to the anatomical map using an accuracy parameter to identify at least one region in the anatomical map that does not meet the accuracy parameter. An image of the anatomical map is displayed, the image providing a visual indication of the at least one region in the anatomical map that does not meet the at least one accuracy parameter. A modified map is generated by shaving the at least one region in the anatomical map that does not meet the at least one accuracy parameter, and the modified map is displayed.

[0005] In some embodiments, the anatomical map is a fast anatomical map (FAM) acquired during an electrophysiological study, and the reference image is a CT image, an ultrasound image (2D, 3D, or 4D), an MRI image, or an anatomical map shaved during a previous electrophysiological study. In one embodiment, the shaving is manually initiated by the user viewing a visual instruction. Alternatively, the shaving is automated and performed without input from the user to initiate shaving of areas that do not meet the accuracy parameters.

[0006] In one embodiment, the at least one accuracy parameter includes a maximum distance between the anatomical map and the reference image. In other embodiments, the accuracy is determined based on both the maximum distance and a point density value or a point quality value. In some examples, the accuracy parameter is configured by a user performing the electrophysiological study. [Brief description of the drawings]

[0007] A more detailed understanding may be had from the following description, given by way of example in conjunction with the accompanying drawings, in which like reference numbers indicate similar elements and in which: [Figure 1] 1 illustrates an exemplary catheter-based electrophysiology mapping and ablation system in accordance with one or more embodiments. [Diagram 2] FIG. 1 is a block diagram of an exemplary system for remotely monitoring and communicating a patient's biometric indicators, in accordance with one or more embodiments. [Diagram 3] FIG. 1 is a system diagram of an example computing environment in communication with a network in accordance with one or more embodiments. [Figure 4] 1 shows an example of a linear catheter containing multiple electrodes that may be used to map a cardiac region. [Diagram 5] An example of a balloon catheter is shown that includes a plurality of splines (eg, 12 splines in the particular example of FIG. 5) and a plurality of electrodes on each spline that includes an electrode. [Figure 6] 1 shows an example of a loop catheter (also called a lasso catheter) containing multiple electrodes that can be used to map a region of the heart. [Figure 7] We present a technique for shaving the FAM using a reference image. [Figure 8A] 8 is an exemplary map illustrating aspects of the shaving technique described in connection with FIG. 7. [Figure 8B] 8 is an exemplary map illustrating aspects of the shaving technique described in connection with FIG. 7. [Figure 8C] 8 is an exemplary map illustrating aspects of the shaving technique described in connection with FIG. 7. [Figure 8D] 8 is an exemplary map illustrating aspects of the shaving technique described in connection with FIG. 7. [Figure 9] We show how to shave an electroanatomical map using a reference image. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0008] A system and method for shaving an electro-anatomical map. A reference image is compared to the electro-anatomical map using at least one accuracy parameter to identify at least one region in the anatomical map that does not meet the at least one accuracy parameter. An image of the electro-anatomical map is displayed, the image providing a visual indication of the at least one region in the electro-anatomical map that does not meet the at least one accuracy parameter. A corrected map is generated by shaving the at least one region in the electro-anatomical map that does not meet the at least one accuracy parameter, and the corrected map is displayed.

[0009] One or more advantages, technical effects, and / or benefits may include providing information to cardiac physicians and medical personnel to enhance organ mapping, such as cardiac mapping. Thus, the systems and methods and user interfaces specifically utilize and transform medical device equipment to enable / implement improved efficiency and quality organ mapping that is otherwise not currently available or currently performed by cardiac physicians and medical personnel.

[0010] In one embodiment, a system for shaving an electroanatomical map includes a processor, a memory, a display, and a user interface. The processor receives at least one accuracy parameter via the user interface. In one example, the accuracy parameter represents a maximum distance between the electroanatomical map and a reference image. In other embodiments, more than one accuracy parameter is used. For example, both the maximum distance combined with either a point density value or a point quality value are used. In some examples, a user configures the at least one accuracy parameter via the user interface when performing an electrophysiological study. The system identifies at least one region in the electroanatomical map that does not meet the at least one accuracy parameter by comparing the electroanatomical map to the reference image. In some embodiments, the electroanatomical map is a fast anatomical map (FAM) acquired during the electrophysiological study, and the reference image is a CT image, an MRI image, an ultrasound image, or an electroanatomical map shaved during a previous electrophysiological study of the same patient, or another map that has been processed to make the map more accurate. An image of the electroanatomical map is shown on the display, the image providing a visual indication of at least one region in the electroanatomical map that does not meet at least one accuracy parameter. A correction map is generated by shaving at least one region in the electroanatomical map that does not meet at least one accuracy parameter, and the correction map is shown on the display. In one embodiment, the shaving is manually initiated by a user viewing the visual indication. Alternatively, the shaving is automated and performed without input from a user to initiate shaving of the region that does not meet at least one accuracy parameter.

[0011] Reference is made to FIG. 1, which illustrates an exemplary system (e.g., medical device instrumentation and / or catheter-based electrophysiological mapping and ablation) shown as system 10 in which one or more features of the subject matter herein may be implemented according to one or more embodiments. All or a portion of system 100 may be used to collect information (e.g., biometric data and / or training data sets) and / or implement machine learning and / or artificial intelligence algorithms as described herein. System 10 includes a recorder 11, a heart 12, a catheter 14, a model or anatomical map 20, an electrogram 21, a spline 22, a patient 23, a physician 24 (or medical professional or clinician), a location pad 25, an electrode 26, a display device 27, a distal tip 28, a sensor 29, a coil 32, a patient interface unit (PIU) 30, an electrode skin patch 38, an ablation energy generator 50, and a workstation 55, as shown. It is further noted that each element and / or item of the system 10 represents one or more of that element and / or item. The example system 10 shown in FIG. 1 can be modified to implement the embodiments disclosed herein. The embodiments of the present disclosure can be similarly applied using other system components and configurations. Furthermore, the system 10 may include additional components, such as elements for sensing electrical activity, wired or wireless connectors, processing units and display devices. Although the heart 12, the patient 23, and the physician 24 are described in relation to an exemplary system for completeness, those skilled in the art will understand that the heart 12, the patient 23, and the physician 24 are not part of the system itself, but instead the system functions relative to or on behalf of these elements.

[0012] The system 10 includes multiple catheters 14 that are percutaneously inserted by a physician 24 through the patient's vascular system into a heart chamber or vasculature of the heart 12. Typically, a delivery sheath catheter is inserted into the left or right atrium near a desired location in the heart 12. The multiple catheters can then be inserted into the delivery sheath catheter to reach the desired location. The multiple catheters 14 may include catheters dedicated to sensing intracardiac electrogram (IEGM) signals, catheters dedicated to ablation, and / or catheters dedicated to both sensing and ablation. An exemplary catheter 14 configured to sense IEGMs is shown herein. The physician 24 brings a distal tip 28 of the catheter 14 into contact with the heart wall to sense a target site in the heart 12. For ablation, the physician 24 similarly brings a distal end of an ablation catheter to a target site for ablation.

[0013] Catheter 14 is an exemplary catheter that includes one, and preferably multiple, electrodes 26, optionally distributed across multiple splines 22 at distal tip 28, and configured to sense IEGM signals. Catheter 14 may further include a sensor 29 embedded in or near distal tip 28 for tracking the position and orientation of distal tip 28. Optionally and preferably, position sensor 29 is a magnetic-based position sensor including three magnetic coils for sensing three-dimensional (3D) position and orientation.

[0014] The sensor 29 (e.g., a position-based or magnetic-based position sensor) may operate in conjunction with a location pad 25 that includes a plurality of magnetic coils 32 configured to generate a magnetic field within a predetermined working volume. The real-time position of the distal end 28 of the catheter 14 may be tracked based on the magnetic field generated by the location pad 25 and sensed by the sensor 29. Details of magnetic-based position sensing technology are described in U.S. Patent Nos. 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.

[0015] The system 10 includes one or more electrode patches 38 placed on the patient 23 for skin contact to establish a position reference for the location pads 25 and impedance-based tracking of the electrodes 26. For impedance-based tracking, a current is directed to the electrodes 26 and sensed at the patch 38, so that the location of each electrode can be triangulated via the patch 38. Details of impedance-based position tracking technology are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182, each of which is incorporated herein by reference.

[0016] Recorder 11 displays electrograms 21 captured by electrodes 18 (e.g., surface electrocardiogram (ECG) electrodes) and intracardiac electrograms (IEGMs) captured by electrodes 26 of catheter 14. Recorder 11 may include pacing capability for pacing the cardiac rhythm and / or may be electrically connected to a stand-alone pacer.

[0017] The system 10 may include an ablation energy generator 50 adapted to deliver ablation energy to one or more electrodes 26 at the distal tip 28 of the catheter 14 configured for ablation. The energy generated by the ablation energy generator 50 may include, but is not limited to, radio frequency (RF) energy or pulsed field ablation (PFA) energy, including monopolar or bipolar high voltage DC pulses such as may be used to effect irreversible electroporation (IRE), or combinations thereof.

[0018] The patient interface unit (PIU) 30 is an interface configured to establish electrical communication between the catheters, the electrophysiological equipment, a power source, and a workstation 55 that controls the operation of the system 10. The electrophysiological equipment of the system 10 may include, for example, a number of catheters 14, location pads 25, body surface ECG electrodes 18, electrode patches 38, an ablation energy generator 50, and a recorder 11. Optionally and preferably, the PIU 30 additionally includes processing capabilities for implementing real-time calculations of the catheter positions and performing ECG calculations.

[0019] The workstation 55 includes a processor unit having a memory, a memory or storage device loaded with appropriate operating software, and a user interface function. The workstation 55 may optionally provide multiple functions including: (1) modeling the endocardial anatomical structures in three dimensions (3D) and rendering a model or anatomical map 20 for display on the display device 27; (2) displaying activation sequences (or other data) compiled from recorded electrograms 21 with representative visual indicators or images superimposed on the rendered anatomical map 20 on the display device 27; (3) displaying real-time positions and orientations of multiple catheters within the cardiac chambers; and (5) displaying sites of interest, such as locations where ablation energy has been applied, on the display device 27. One commercially available product embodying elements of the system 10 is available as the CARTO™ 3 system, commercially available from Biosense Webster, Inc., 31A Technology Drive, Irvine, Calif., 92618.

[0020] For example, the system 10 can be part of a surgical system (e.g., the CARTO® system sold by Biosense Webster) configured to obtain biometric data (e.g., anatomical and electrical measurements of a patient's organs as described herein, such as the heart 12) and to perform cardiac ablation procedures. More particularly, in the treatment of cardiac diseases, such as cardiac arrhythmias, it is often required to obtain detailed mapping of cardiac tissue, chambers, veins, arteries, and / or electrical pathways. For example, as a prerequisite for successful catheter ablation (as described herein), the cause of the cardiac arrhythmia may be precisely localized in the chambers of the heart 12. Such localization may be performed by electrophysiological studies, during which spatially resolved electrical potentials may be detected by a mapping catheter (e.g., catheter 14) introduced into the chambers of the heart 12. This electrophysiological study, so-called electroanatomical mapping, provides 3D mapping data, which may be displayed on a display device 27. Often, mapping and therapy functions (e.g., ablation) are provided by a single catheter or group of catheters, with the mapping catheter also simultaneously acting as the therapy (e.g., ablation) catheter. In one example, system 10 obtains fast anatomical mapping (FAM) of the cardiac chamber, where the locations of points on the interior surface of the chamber are delineated using acquired electroanatomical (EA) data.

[0021] Figure 2 is a block diagram of an exemplary system 100 for remote monitoring and communication of patient biometric indicators (i.e., patient data). In the example shown in Figure 2, the system 100 includes a patient biometric monitoring and processing unit 102 associated with a patient 104, a local computing device 106, a remote computing system 108, a first network 110, a patient biometric sensor 112, a processor 114, a user input (UI) sensor 116, a memory 118, a second network 120, and a transmitter-receiver (i.e., transceiver) 122.

[0022] According to one embodiment, the patient biometric monitoring and processing device 102 may be a device internal to the patient's body (e.g., subcutaneously implantable), such as the catheter 14 of Figure 1. The patient biometric monitoring and processing device 102 may be inserted into the patient via any applicable method, including oral injection, surgical insertion via a vein or artery, an endoscopic procedure, or a laparoscopic procedure.

[0023] According to one embodiment, the patient biometric monitoring and processing device 102 may be a device external to the patient, such as the electrode patch 38 of Figure 1. For example, as described in more detail below, the patient biometric monitoring and processing device 102 may include an attachable patch (e.g., attached to the patient's skin). The monitoring and processing device 102 may also include a catheter having one or more electrodes, a probe, a blood pressure cuff, a weight scale, a bracelet or smart watch biometric tracker, a glucose monitor, a continuous positive airway pressure (CPAP) machine, or virtually any device that may provide input regarding the patient's health or biometrics.

[0024] According to one embodiment, the patient biometric monitoring and processing device 102 may include both patient internal and patient external components.

[0025] A single patient biometric monitoring and processing device 102 is shown in FIG. 2. However, an exemplary system may include multiple patient biometric monitoring and processing devices. A patient biometric monitoring and processing device may be in communication with one or more other patient biometric monitoring and processing devices. Additionally or alternatively, a patient biometric monitoring and processing device may be in communication with a network 110.

[0026] One or more patient biometric monitoring and processing devices 102 may acquire patient biometric data (e.g., electrical signals, blood pressure, temperature, blood glucose levels, or other biometric data) and may receive at least a portion of the patient biometric data representative of the acquired patient biometric indicators, as well as additional information associated with the acquired patient biometric indicators from one or more other patient biometric monitoring and processing devices 102. The additional information may be, for example, diagnostic information and / or additional information obtained from additional devices, such as wearable devices. Each patient biometric monitoring and processing device 102 may process data including its own acquired patient biometric indicators as well as data received from one or more other patient biometric monitoring and processing devices 102.

[0027] The biometric data (e.g., patient biometrics, patient data, or patient biometric data) may include one or more of local activation time (LAT), electrical activity, topology, bipolar mapping, baseline activity, ventricular activity, dominant frequency, impedance, and the like. LAT may be a time point of threshold activity corresponding to local activation calculated based on a normalized initial starting point. Electrical activity may be any applicable electrical signal that may be measured based on one or more thresholds and may be sensed and / or enhanced based on signal-to-noise ratio and / or other filters. Topology may correspond to the physical structure of the body part or a portion of the body part, and may correspond to changes in the physical structure for different parts of the body part or for different body parts. The dominant frequency may be a frequency or range of frequencies commonly found in a portion of the body part and may be different in different parts of the same body part. For example, the dominant frequency of the PVs of the heart may be different from the dominant frequency of the right atrium of the same heart. Impedance may be a resistance measurement in a particular region of the body part.

[0028] 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 biomarkers, blood pressure data, ultrasound signals, radio signals, audio signals, two-dimensional or three-dimensional image data, blood glucose data, and temperature data. Biometric data may generally be used to monitor, diagnose, and treat any number of different diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathies, and coronary artery disease), and autoimmune diseases (e.g., diabetes mellitus type I and type II). Note that BS ECG data may include data and signals collected from electrodes on the patient's surface, IC ECG data may include data and signals collected from electrodes inside the patient's body, and ablation data may include data and signals collected from ablated tissue. Additionally, BS ECG data, IC ECG data, and ablation data may be derived from one or more procedure records along with catheter electrode position data.

[0029] 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 may be transmitted between the patient biometric monitoring and processing device 102 and the local computing device 106 over network 110 using any one of a variety of short-range wireless communication protocols, such as Bluetooth, Wi-Fi, ZigBee, Z-Wave, near field communication (NFC), ultra-wideband, Zigbee, or infrared (IR).

[0030] Network 120 may be a wired network, a wireless network, or may include one or more wired and wireless networks. For example, network 120 may be a long-range network (e.g., a wide area network (WAN), the Internet, or a cellular network). Information may be transmitted over network 120 using any one of a variety of long-range wireless communication protocols (e.g., TCP / IP, HTTP, 3G, 4G / LTE, or 5G / New Radio).

[0031] The patient biometric monitoring and processing device 102 may include a patient biometric sensor 112, a processor 114, a UI sensor 116, a memory 118, and a transceiver 122. The patient biometric monitoring and processing device 102 may continuously or periodically monitor, store, process, and communicate any number of different patient biometrics over the network 110. Examples of patient biometrics include electrical signals (e.g., ECG signals and brain biometrics), blood pressure data, blood glucose data, and temperature data. The patient biometrics may be monitored and communicated to treat across any number of different diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathies, and coronary artery disease), and autoimmune diseases (e.g., type I and type II diabetes).

[0032] The patient biometric sensor 112 may include, for example, one or more sensors configured to sense a type of biometric patient biometric indicator. For example, the patient biometric sensor 112 may include electrodes configured to acquire electrical signals (e.g., cardiac 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.

[0033] As described in more detail below, the patient biometric monitoring and processing device 102 may be an ECG monitor for monitoring an ECG signal of a heart (e.g., heart 12). The patient biometric sensor 112 of the ECG monitor may include one or more electrodes for acquiring the ECG signal. The ECG signal may be used in the treatment of various cardiovascular diseases.

[0034] In another example, the patient biometric monitoring and processing device 102 may be a continuous glucose monitor (CGM) for continuously monitoring a patient's blood glucose levels on a continuous basis to treat various diseases such as type I and type II diabetes. The CGM may include electrodes placed subcutaneously that can monitor blood glucose levels from the patient's interstitial fluid. The CGM may be a component of a closed loop system in which blood glucose data is sent to an insulin pump, for example, for delivery of calculated insulin without user intervention.

[0035] The transceiver 122 may include a separate transmitter and receiver, or may include a transmitter and receiver integrated into a single device.

[0036] The processor 114 may be configured to store patient data, such as patient biometric data acquired by the patient biometric sensor 112, in the memory 118 and to communicate the patient data over the network 110 via a transmitter of the transceiver 122. Data from one or more other patient biometric monitoring and processing devices 102 may also be received by a receiver of the transceiver 122, as described in more detail below.

[0037] According to one embodiment, the patient biometric monitoring and processing device 102 includes a UI sensor 116, which may be a piezoelectric or capacitive sensor configured to receive user input, such as a tap or touch. For example, the UI sensor 116 may be controlled to perform capacitive coupling in response to the patient 104 tapping or touching the surface of the patient biometric monitoring and processing device 102. Gesture recognition may be performed by any one of a variety of capacitive types, such as resistive capacitive, surface capacitive, projected capacitive, surface ultrasonic, piezoelectric, and infrared touch. The capacitive sensor may be placed over a small area or length of the surface such that a tap or touch on the surface activates the monitoring device.

[0038] As described in more detail below, the processor 114 may be configured to selectively respond to different tapping patterns (e.g., single tap or double tap) of a capacitive sensor, which may be the UI sensor 116, such that different tasks of the patch (e.g., acquiring, storing, or transmitting data) may be initiated based on the detected pattern. In some embodiments, when a gesture is detected, audible feedback may be provided to the user from the patient biometric monitoring and processing device 102.

[0039] The local computing device 106 of the system 100 may be configured to communicate with the patient biometric monitoring and processing device 102 and act as a gateway to the remote computing system 108 via the second network 120. The local computing device 106 may be, for example, a smartphone, smartwatch, tablet, or other portable smart device configured to communicate with other devices via the network 120. Alternatively, the local computing device 106 may be a fixed or stand-alone device, such as, for example, a fixed base station including modem and / or router capabilities, a desktop or laptop computer using an executable program to communicate information between the patient biometric monitoring and processing device 102 and the remote computing system 108 via a wireless module of the PC, or a USB dongle. Patient biometric indicators may be communicated 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, local computing device 106 may also be configured to display the acquired patient electrical signals and information associated with the acquired patient electrical signals, as described in more detail below.

[0040] In some embodiments, the remote computing system 108 may be configured to receive at least one of the monitored patient's biometric indicators and information associated with the monitored patient via the network 120, which is a long-range network. For example, if the local computing device 106 is a cellular phone, the network 120 may be a wireless cellular network and information may be communicated between the local computing device 106 and the remote computing system 108 via a wireless technology standard, such as any of the wireless technologies listed above. As described in more detail below, the remote computing system 108 may be configured to provide (e.g., visually display and / or audibly provide) at least one of the patient's biometric indicators and associated information to a medical professional (e.g., a physician).

[0041] 3 is a system diagram of an example computing environment 200 in communication with network 120. In some examples, 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.

[0042] As shown in FIG. 3, computing environment 200 includes a remote computing system 108 (hereinafter computer system), which is one example of a computing system on which embodiments described herein may be implemented.

[0043] The remote computing system 108 can perform various functions via the processor 220, which may include one or more processors. Functions may include analyzing monitored patient biometrics and associated information and providing alerts, additional information, or instructions (e.g., via the display 266) according to physician-determined or algorithm-driven thresholds and parameters. As described in more detail below, the remote computing system 108 can be used to provide a patient information dashboard (e.g., via the display 266) to medical personnel (e.g., physicians), which may enable medical personnel to identify and prioritize patients with greater needs than others.

[0044] 3, computer system 210 may include a communication mechanism, such as a bus 221, or other communication mechanism for communicating information within computer system 210. Computer system 210 further includes one or more processors 220 coupled with bus 221 for processing information. Processor 220 may include one or more CPUs, GPUs, or any other processors known in the art.

[0045] The computer system 210 also includes a system memory 230 coupled to the bus 221 for storing information and instructions executed by the processor 220. The system memory 230 may include computer-readable storage media in the form of volatile and / or non-volatile memory, such as a read only system memory (ROM) 231 and / or a random access memory (RAM) 232. The system memory RAM 232 may include other dynamic storage devices (e.g., dynamic RAM, static RAM, and synchronous DRAM). The system memory ROM 231 may include other static storage devices (e.g., programmable ROM, erasable PROM, and electrically erasable PROM). In addition, the system memory 230 may be used to store temporary variables or other intermediate information during execution of instructions by the processor 220. A basic input / output system (BIOS) 233 may include routines to transfer information that may be stored in the system memory ROM 231 between elements within the computer system 210, such as during start-up. RAM 232 may contain data and / or program modules that are immediately accessible to and / or presently being operated on by processor 220. System memory 230 may further include, for example, an operating system 234, application programs 235, other program modules 236, and program data 237.

[0046] The illustrated computer system 210 also includes a disk controller 240 coupled to bus 221 for controlling one or more storage devices for storing information and instructions, such as a magnetic hard disk 241 and a removable media drive 242 (e.g., a floppy disk drive, a compact disk drive, a tape drive, and / or a solid state drive). Storage devices may be added to 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).

[0047] 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 liquid crystal display (LCD), for displaying information to a computer user. The illustrated computer system 210 includes a user input interface 260 and one or more input devices, such as a keyboard 262 and a pointing device 261, for interacting with a computer user and providing information to the processor 220. The pointing device 261 may be, for example, a mouse, trackball, or pointing stick for communicating instructional information and command selections to the processor 220 and for controlling cursor movement on the display 266. The display 266 may provide a touch screen interface that may enable input that complements or replaces the communication of instructional information and command selections by the pointing device 261 and / or the keyboard 262.

[0048] The computer system 210 may perform some or each of the functions and methods described herein in response to the processor 220 executing one or more sequences of one or more instructions contained in a memory, such as the system memory 230. Such instructions may 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 include one or more data stores and data files used by the embodiments described herein. The data store contents and data files may be encrypted to improve security. The processor 220 may also be employed in a multi-processing configuration 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. Thus, the embodiments are not limited to any specific combination of hardware circuitry and software.

[0049] As mentioned above, computer system 210 may include at least one computer-readable medium or memory for holding instructions programmed according to the embodiments described herein and for containing data structures, tables, records, or other data described herein. As used herein, the term computer-readable medium refers to any non-transitory tangible medium involved 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 disks, solid-state drives, magnetic disks, and magneto-optical disks, 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 comprise bus 221. Transmission media can also take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications.

[0050] The computing environment 200 may further include a computer system 210 operating in a networked environment using logical connections to the local computing device 106 and to one or more other devices, such as a personal computer (laptop or desktop), a mobile device (e.g., a patient mobile device), a server, a router, a network PC, a peer device, or other common network node, and typically includes many or all of the elements described above with respect to the computer system 210. When used in a networked environment, the computer system 210 may include a modem 272 for establishing communications over a network 120, such as the Internet. The modem 272 may be connected to the system bus 221 via a network interface 270 or another appropriate mechanism.

[0051] Network 120 as shown in FIGS. 2 and 3 may be any network or system commonly 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 communications between computer system 610 and other computers (e.g., local computing device 106).

[0052] The treatment of cardiac diseases such as cardiac arrhythmias often requires obtaining detailed mapping of cardiac tissue, heart chambers, veins, arteries, and / or electrical pathways. For example, a prerequisite for the successful performance of catheter ablation is the precise localization of the cause of cardiac arrhythmia in the heart chamber. Such localization can be performed by electrophysiological studies, during which electrical potentials are detected spatially resolved by a mapping catheter introduced into the heart chamber. This electrophysiological study, so-called electroanatomical mapping, thus provides 3D mapping data, which can be displayed on a monitor. In many cases, the mapping function and the therapeutic function (e.g., ablation) are provided by a single catheter or a group of catheters, the mapping catheter also simultaneously operating as a therapeutic (e.g., ablation) catheter.

[0053] Mapping of cardiac regions, such as cardiac sites, tissues, veins, arteries, and / or cardiac electrical pathways, can lead to identifying problem areas, such as scar tissue, arrhythmia sources (e.g., electrical rotors), healthy regions, etc. The cardiac regions can be mapped such that a visual rendering of the mapped cardiac regions 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 within the patient's body and provided for rendering simultaneously or at different times based on corresponding settings and / or medical professional preferences.

[0054] Cardiac mapping can be performed using one or more techniques. As an example of a first technique, cardiac mapping may be performed by sensing electrical properties of cardiac tissue, e.g., local activation time, as a function of precise location within the heart. The corresponding data can be acquired using one or more catheters that are advanced into the heart using catheters having electrical and location sensors at their distal tips. As a specific example, location and electrical activity can be initially measured at about 10 to about 20 points on the inner surface of the heart. These data points may generally be sufficient to generate a preliminary reconstruction or map of the cardiac surface with satisfactory quality. This preliminary map may be combined with data acquired at additional points to generate a more comprehensive map of the cardiac electrical activity. In a clinical situation, it is not uncommon to accumulate data at 100 or more sites to generate a detailed and comprehensive map of the electrical activity of the cardiac chambers. The detailed map generated may then serve as a basis for making decisions regarding therapeutic action guidelines, e.g., tissue ablation, to modify the propagation of the cardiac electrical activity and restore normal cardiac rhythm.

[0055] A catheter containing a position sensor may be used to determine the trajectory of each point on the surface of the heart. These trajectories can be used to infer motion properties, such as the contractile force of the tissue. A map indicative of such motion properties may be constructed when trajectory information is sampled at a sufficient number of points within the heart.

[0056] Electrical activity at a point in the heart can typically be measured by advancing a catheter containing an electrical sensor at or near its distal tip to the point in the heart, contacting tissue with the sensor, and acquiring data at the point. One drawback with mapping the chambers of the heart using a catheter containing only a single distal tip electrode is the long time required to collect data for each point, relative to the necessary number of points required for a detailed map of the heart chamber as a whole. Therefore, multi-electrode catheters have been developed to simultaneously measure electrical activity at multiple points in the heart chambers.

[0057] The multi-electrode catheter can be implemented using any applicable shape, such as a linear catheter with multiple electrodes, a balloon catheter including electrodes disposed on multiple bones forming a balloon, a lasso or loop catheter with multiple electrodes, or any other applicable shape. Figure 4 shows an example of a linear catheter 402 including multiple electrodes 404, 405, and 406 that can be used to map a cardiac area. The linear catheter 402 can be fully or partially elastic such that it can twist, bend, and / or otherwise change its shape based on received signals and / or based on the application of an external force (e.g., cardiac tissue) to the linear catheter 402.

[0058] FIG. 5 illustrates an example of a balloon catheter 512 including multiple splines (e.g., 12 splines in the example of FIG. 5), including splines 514, 515, 516, and multiple electrodes on each spline, including electrodes 521, 522, 523, 524, 525, and 526 as shown. The balloon catheter 512 may be designed such that its electrodes may be held in intimate contact against the endocardial surface when deployed in a patient's body. As an example, the balloon catheter may be inserted into a lumen such as a pulmonary vein (PV). The balloon catheter may be inserted into the PV in a deflated state, such that the balloon catheter does not occupy the full volume of the PV while inserted into the PV. The balloon catheter may be expanded while inside the PV, such that the electrodes on the balloon catheter contact the entire circular portion of the PV. Such contact with the entire circular portion of the PV, or any other lumen, may enable efficient mapping and / or ablation.

[0059] 6 shows an example of a loop catheter 630 (also called a lasso catheter) that includes multiple electrodes 632, 634, and 636 that may be used to map a cardiac region. The loop catheter 630 may be fully or partially elastic such that it can twist, bend, and / or otherwise change its shape based on received signals and / or based on the application of an external force (e.g., cardiac tissue) on the loop catheter 630.

[0060] According to one example, a multi-electrode catheter may be advanced into a heart chamber. Anteroposterior (AP) and lateral fluorograms may be acquired to establish the location and orientation of each of the electrodes. Electrograms may be recorded from each of the electrodes in contact with the heart surface relative to a time reference, such as the onset of the P wave in sinus rhythm from a surface ECG. The system further disclosed herein may distinguish between electrodes that record electrical activity and those that do not record electrical activity due to not being in close proximity to the endocardial wall. After an initial electrogram has been recorded, the catheter may be repositioned and fluorograms and electrograms may be recorded again. An electrical map may then be constructed from a repetition of the above process.

[0061] According to an example, cardiac mapping may be generated based on detection of intracardiac potential fields. Non-contact methods may be implemented to simultaneously obtain a large amount of cardiac electrical information. For example, a catheter having a distal end portion may include a series of sensor electrodes distributed over its surface and connected to insulated conductors for connection to signal sensing and processing means. The size and shape of the end portion may be such that the electrodes are spaced apart from the wall of the cardiac chamber. The intracardiac potential fields may be detected during one cardiac beat. According to an example, the sensor electrodes may be distributed on a series of circumferences located in planes spaced apart from one another. These planes may be perpendicular to the long axis of the end portion of the catheter. At least two additional electrodes may be disposed adjacent to each end of the long axis of the end portion. As a more specific example, the catheter may include four circumferences with eight electrodes equiangularly spaced apart on each circumference. Thus, in this particular implementation, the catheter may include at least 34 electrodes (32 circumferential electrodes and two end electrodes).

[0062] According to another example, electrophysiological cardiac mapping systems and techniques based on non-contact and non-expandable multi-electrode catheters can be implemented. Electrograms can be acquired using a catheter with multiple electrodes (e.g., 42-122 electrodes). According to this implementation, knowledge of the relative geometry of the probe and endocardium can be obtained, such as by an independent imaging modality such as transesophageal echocardiography or 2D or 4D intracardiac echogram (ICE). After independent imaging, non-contact electrodes can be used to measure cardiac surface potentials from which a map can be constructed. This technique can include the following steps (after the independent imaging step): (a) measuring potentials by multiple electrodes placed on a probe positioned within the heart; (b) determining the geometric relationship between the probe surface and the endocardium surface; (c) generating a matrix of coefficients representing the geometric relationship between the probe surface and the endocardium surface; and (d) determining the endocardium potentials based on the electrode potentials and the matrix of coefficients.

[0063] According to another example, a technique and apparatus can be implemented for mapping the electrical potential distribution of a heart chamber. An intracardiac multi-electrode mapping catheter assembly can be inserted into the patient's heart. The mapping catheter assembly can include a multi-electrode array with an integral reference electrode, or preferably, a companion reference catheter. These 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 a reference electrode or by a reference catheter that contacts the endocardial surface. A preferred electrode array catheter can have a large number of individual electrode sites (e.g., at least 24). Additionally, this exemplary technique can be implemented with knowledge of the location of each of the electrode sites on the array, as well as knowledge of the cardiac geometry. These locations are preferably determined by impedance plethysmography.

[0064] According to another example, a cardiac mapping catheter assembly can include an electrode array that defines multiple electrode sites. The mapping catheter assembly can also include a lumen for receiving a reference catheter having a distal tip electrode assembly that can be used to probe the heart wall. The mapping catheter can include a braid of insulated wires (e.g., having 24-64 wires in the braid), each of which can be used to form an electrode site. The catheter can be easily positionable within the heart to be used to collect electrical activity information from a first set of non-contact electrode sites and / or a second set of contact electrode sites.

[0065] According to another example, another catheter for mapping electrophysiological activity in the heart can be implemented. The catheter body can include a distal tip adapted to deliver stimulation pulses for pacing the heart, or an ablation electrode for ablating tissue in contact with the tip. The catheter can further include at least a pair of orthogonal electrodes that generate a difference signal indicative of local cardiac electrical activity adjacent the orthogonal electrodes.

[0066] According to another embodiment, a process may be implemented for measuring electrophysiological data within a heart chamber. The method may include, in part, positioning a set of active and passive electrodes on the heart, supplying a current to the active electrodes thereby generating an electric field within the heart chamber, and measuring the electric field at the passive electrode sites. The passive electrodes are included in an array disposed on an inflatable balloon of a balloon catheter. In a preferred embodiment, the array is said to have 60-64 electrodes.

[0067] According to another example, cardiac mapping can be performed using one or more ultrasound transducers. The ultrasound transducers can be inserted into the patient's heart and can collect multiple ultrasound slices (e.g., two-dimensional or three-dimensional slices) at various positions and orientations within the heart. The position and orientation of a particular ultrasound transducer may be known, and the collected ultrasound slices can be stored so that they can be displayed later. One or more ultrasound slices corresponding to the position of a probe (e.g., a treatment catheter) can be displayed later, and the probe can be overlaid on the one or more ultrasound slices.

[0068] According to another example, the body patch and / or body surface electrodes may be positioned on or adjacent to the patient's body. A catheter having one or more electrodes may be positioned within the patient's body (e.g., within the patient's heart), and the position of the catheter may be determined by the system based on signals transmitted and received between the one or more electrodes of the catheter and the body patch and / or body surface electrodes. Additionally, the catheter electrodes may sense biometric data (e.g., LAT values) from within the patient's body (e.g., within the heart). The biometric data may be associated with the determined catheter position, such that a rendering of the patient's body part (e.g., heart) may be displayed showing the biometric data as measured for each catheter position superimposed on the shape of the body part.

[0069] CT / MRI and / or ultrasound images can contain the most accurate anatomical references. Such images can contain known anatomical landmarks used by the physician to achieve the final registration. However, CT / MRI and ultrasound images lack the information captured by FAM, including, for example, the information necessary to identify the source of arrhythmia. As mentioned above, FAM often contains undesirable data points, including, for example, incorrect wall positions due to respiratory induced motion, overtraction of the catheter against the heart wall during mapping, points lacking stable / contact / arrhythmic patterns, or various other reasons. Also, FAM maps are constructed from successive catheter positions capturing the entire cardiac cycle, and as a result, the shape of the heart is represented (not exactly) by its maximum volume at any point.

[0070] Referring now to FIG. 7, a technique for shaving the FAM to account for undesired data points is shown. In FIG. 7, calculated surface 701 represents a reference image and surface 702 represents a calculated surface of the FAM. Surface 701 corresponds to a reference image, such as a CT image, an MRI image, an ultrasound image, or an electroanatomical map shaved during a previous electrophysiological study of the same patient. A user interface associated with workstation 55 is used to input one or more accuracy parameters. In the example shown, accuracy parameters corresponding to a maximum distance of 2 mm and a tissue proximity index (or "TPI" described below) of 80% are used. The indications (in this example, stars 703) correspond to areas where one or both of the accuracy parameters are met, i.e., for each star 703, the distance between surfaces 701 and 702 is less than 2 mm, or the TPI of the data points is greater than 80%, or both. Stars 704 correspond to areas where both of the accuracy parameters are not met. The space between the dotted lines 705 corresponds to the area of ​​interest covered by the shaving tool. In some embodiments, the size of the region of interest between the dotted lines is configurable by the user. The shaving tool includes a user interface that displays an ellipse 706. The ellipse 706 is a top view of the area between the dotted lines 705. The ellipse 706 provides a visual indication on the user interface (e.g., display screen 20) of the area on the FAM map that does not meet the specified accuracy parameters. In the technique shown in FIG. 7, the map is modified by the shaving surface 702 (the area between the dotted lines 705) to remove all or part of the depth represented by the star 704. In other examples, one or more other accuracy parameters can be used as an alternative to or in addition to the TPI or distance from the surface, including, for example, qualified points (e.g., defined by smart index or by signal quality), manually acquired points, presence of visitag, and / or point density.

[0071] 7, in one embodiment, shaving of surface 702 is initiated in response to manual input from a user when ellipse 706 is positioned over the area to be shaved on display screen 20. In a more specific embodiment, the entire depth represented by star 704 is removed in response to a single manual input from the user (e.g., clicking a mouse). Thus, if 6 mm needs to be shaved from surface 702 to remove the depth represented by star 704, all 6 mm is shaved (in one step) in response to a single manual input from the user. This represents an improvement over more time-consuming manual shaving systems that can only shave a limited depth (e.g., 2 mm) at a time because these systems require the user to perform multiple shaving iterations to shave to the desired depth. In an alternative embodiment, shaving of surface 702 is automated and performed without the user, e.g., without the user having to click a mouse to individually shave each area of ​​the map where the accuracy parameters are not met. In such an example of an automatic mode, all excess areas are automatically erased by the system according to criteria selected by the user prior to mapping. Alternatively, the automatic mode may be implemented to shave a layer (e.g., 5 mm) from the entire map without specifying the area to be shaved.

[0072] 8A-8D are exemplary maps illustrating aspects of the shaving technique described in relation to FIG. 7. In FIG. 8A, the (gray) surface 801 corresponds to the FAM map, and the brown (semi-transparent) corresponds to the reference surface 802. In FIG. 8B, the volume 803 that needs to be shaved is displayed (orange) on top of the reference map (gray) 804. From FIG. 8B, it can be observed that different regions require shaving of different layers, i.e., some regions need to be shaved at a greater depth and some regions need to be shaved at a lesser depth. In FIG. 8C and FIG. 8D, a shaving circle 805 (similar to the ellipse 706 in FIG. 7) is shown. In FIG. 8C, the shaving circle 805 is located in an area where several layers need to be shaved, while in FIG. 8D, the shaving circle 805 is displayed in an area where only one layer needs to be shaved. In FIG. 8C and FIG. 8D, the relative difference between the FAM image and the reference image is represented by the brown area that exceeds the gray reference area.

[0073] FIG. 9 illustrates a method 900 for shaving an electroanatomical image (such as a FAM) using a reference image. In step 901, a reference image (e.g., a CT image or an MRI image or an ultrasound image) is selected. In step 902, one or more accuracy parameters are selected. In one example, a user interface associated with the workstation 55 is used to select the reference image and the accuracy parameters. In step 903, the FAM is compared to the reference image to identify regions where the accuracy parameters are not met. In step 904, a visual indication (e.g., oval 706) is provided on the display screen 20 of one or more regions where the accuracy parameters are not met. In step 905, the identified regions of the map are shaved and a modified map is displayed (step 906).

[0074] In some embodiments, only a single accuracy parameter (e.g., maximum distance) is used to identify areas that require shaving. In other embodiments, more than one accuracy parameter is used. For example, both maximum distance combined with either a point quality value (TPI, SMART index, etc.) or a point density value are used. Points in the electroanatomical mapping can be evaluated according to their quality level, such as a quality index, which may also be called SMART index. The quality score of a point is a weighted score of several parameters. The score can be calculated in real time while the acquisition of the point is taking place. TPI stands for tissue proximity index (or contact pressure index), which indicates how close the catheter is to the tissue wall (e.g., whether the catheter is touching the tissue or not) and estimates the contact force of the catheter electrode with the tissue wall during the acquisition of the data point.

[0075] Although the features and elements have been described above in a particular combination, those skilled in the art will understand that each of the features or elements can be used alone or in combination with other features and elements. In addition, the methods described herein can be implemented in a computer program, software, or firmware that is embedded in a computer-readable medium for execution on 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).

[0076] The flowcharts and block diagrams in the figures illustrate the structure, 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 flowcharts or block diagrams may represent a module, segment, or portion of instructions that includes one or more executable instructions for implementing the illustrated logical function. In some alternative implementations, the functions shown in the blocks may occur in an order other than that shown in the figures. For example, two blocks shown in succession may in fact be executed substantially simultaneously, or the blocks may sometimes be executed in the reverse order, depending on the functionality involved. It should also be noted that each block of the block diagrams and / or flow diagrams, and combinations of blocks in the block diagrams and / or flow diagrams, may be implemented by a dedicated hardware-based system that performs the specified function or operation, or may operate or execute a combination of dedicated hardware and computer instructions.

[0077] Although the features and elements have been described above in a particular combination, those skilled in the art will understand that each of the features or elements can be used alone or in combination with other features and elements. In addition, the methods described herein can be implemented in a computer program, software, or firmware that is embodied in a computer-readable medium for execution on a computer or processor. As used herein, a computer-readable medium should not be construed as being a signal that is itself ephemeral, such as an electric wave or other freely propagating electromagnetic wave, an electromagnetic wave propagating through a wave guide or other transmission medium (e.g., a light pulse passing through a fiber optic cable), or an electric signal transmitted through a flow line.

[0078] Examples of computer-readable media include electrical 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 memory, semiconductor memory devices, magnetic media such as internal hard disks and removable disks, magneto-optical media, optical media such as compact disks (CDs) and digital versatile disks (DVDs), random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), static random access memory (SRAM), and memory sticks. The processor may be used with software to implement a radio frequency transceiver for use in a terminal, a base station, or any host computer.

[0079] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms "a," "an," and "the" are intended to include the plural unless the context clearly indicates otherwise. It is further to be understood that the terms "comprise" and / or "comprising," as used herein, indicate the presence of stated features, integers, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or other features, integers, steps, operations, elements, components, and / or groups thereof.

[0080] The description of different embodiments herein is presented for illustrative purposes, but is not intended to be exhaustive or limited to the disclosed embodiments. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the described embodiments. The terms used in this specification are selected to best explain the principles, practical applications, or technical improvements of the embodiments compared to the art found in the market, or to enable those skilled in the art to understand the embodiments disclosed herein.

[0081] [Embodiment] (1) A computer-implemented method, comprising: Providing an anatomical map and a reference image; Providing at least one accuracy parameter; comparing the anatomical map to the reference image to identify at least one region in the anatomical map that does not meet the at least one accuracy parameter; displaying an image of the anatomical map, the image providing a visual indication of the at least one region within the anatomical map that does not meet the at least one accuracy parameter; and generating a corrected map by shaving the at least one region in the anatomical map that does not meet the at least one accuracy parameter; and displaying the correction map. (2) The method of embodiment 1, wherein the anatomical map is a fast anatomical map (FAM) obtained during an electrophysiological study. (3) The method of embodiment 2, wherein the reference image is one of a CT image or an MRI image. (4) The method of embodiment 2, wherein the reference image is an ultrasound image. (5) The method of embodiment 2, wherein the reference image is an anatomical map shaved during a previous electrophysiological study.

[0082] (6) The method of claim 1, wherein the shaving step is manually initiated by a user viewing the visual instructions. (7) The method of embodiment 1, wherein the identifying, displaying, and shaving steps are performed using a workstation, and the shaving step is initiated automatically by the workstation. (8) The method of embodiment 1, wherein the at least one accuracy parameter includes a maximum distance between the anatomical map and the reference image. (9) The method of embodiment 8, wherein the at least one accuracy parameter includes a point density value. (10) The method of embodiment 8, wherein the at least one accuracy parameter includes a point quality value.

[0083] (11) The method of embodiment 10, wherein the point quality value corresponds to a smart index. (12) The method of embodiment 1, wherein the at least one accuracy parameter is configurable by a user performing the electrophysiological study. (13) The method of embodiment 1, wherein the anatomical map is an electroanatomical map. (14) A system for shaving an anatomical map, comprising: a processor communicatively coupled to the memory; a display communicatively coupled to the processor; a user interface; The processor, receiving at least one accuracy parameter via the user interface; comparing the anatomical map to a reference image to identify at least one region in the anatomical map that does not meet the at least one accuracy parameter; displaying an image of the anatomical map on the display, the image providing a visual indication of the at least one region within the anatomical map that does not meet the at least one accuracy parameter; and generating a corrected map by shaving the at least one region in the anatomical map that does not meet the at least one accuracy parameter; displaying the correction map on the display. (15) The system of embodiment 14, further comprising at least one electrode catheter coupled to the processor, wherein the processor generates the anatomical map using data acquired by the at least one electrode catheter during an electrophysiological study, and wherein the anatomical map is a fast anatomical map (FAM).

[0084] (16) The system of embodiment 15, wherein the reference image is one of a CT image, an MRI image, an ultrasound image, or an anatomical map shaved during a previous electrophysiological study. (17) The system of embodiment 14, wherein the shaving is initiated in response to an input from a user to shave the at least one region in the electro-anatomical map that does not meet the at least one accuracy parameter. (18) The system of embodiment 14, wherein the at least one accuracy parameter includes a maximum distance between the anatomical map and the reference image. (19) The system of embodiment 14, wherein the at least one accuracy parameter further includes a point density value or a point quality value. (20) The system of embodiment 14, wherein the anatomical map is an electroanatomical map.

Claims

1. 1. A computer-implemented method, comprising: Providing an anatomical map and a reference image; Providing at least one accuracy parameter; comparing the anatomical map to the reference image to identify at least one region in the anatomical map that does not meet the at least one accuracy parameter; displaying an image of the anatomical map, the image providing a visual indication of the at least one region within the anatomical map that does not meet the at least one accuracy parameter; and generating a correction map by shaving the at least one region in the anatomical map that does not meet the at least one accuracy parameter; and displaying the correction map.

2. The method of claim 1 , wherein the anatomical map is a fast anatomical map (FAM) acquired during an electrophysiological study.

3. The method of claim 2 , wherein the reference image is one of a CT image or an MRI image.

4. The method of claim 2 , wherein the reference image is an ultrasound image.

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

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

7. 2. The method of claim 1, wherein the steps of identifying, indicating, and shaving are performed using a workstation, and the shaving step is automatically initiated by the workstation.

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

9. The method of claim 8 , wherein the at least one accuracy parameter comprises a point density value.

10. The method of claim 8 , wherein the at least one accuracy parameter comprises a point quality value.

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

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

13. The method of claim 1 , wherein the anatomical map is an electroanatomical map.

14. 1. A system for shaving an anatomical map, comprising: a processor communicatively coupled to the memory; a display communicatively coupled to the processor; a user interface; The processor, receiving at least one accuracy parameter via the user interface; comparing the anatomical map to a reference image to identify at least one region in the anatomical map that does not meet the at least one accuracy parameter; displaying an image of the anatomical map on the display, the image providing a visual indication of the at least one region within the anatomical map that does not meet the at least one accuracy parameter; and generating a correction map by shaving the at least one region in the anatomical map that does not meet the at least one accuracy parameter; displaying the correction map on the display.

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

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

17. 15. The system of claim 14, wherein the shaving is initiated in response to an input from a user to shave the at least one region in the electro-anatomical map that does not meet the at least one accuracy parameter.

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

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

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

Images