Multiplane suggested orientation

Abstract

To provide multiplanar (e.g., at least two dimensional) suggested orientation.SOLUTION: Systems and methods for providing a multiplane suggested orientation by tracking a target are described. These include a catheter for performing medical electrophysiology, and a graphical user interface (GUI) for monitoring the catheter. The GUI is used to maintain the target in a display during medical electrophysiology. The catheter and GUI operate in combination to display a tilt angle to follow the target in the display, receiving a rotation angle of a current plane of a view of the device, receiving a point of interest related to the target, calculating a new plane using a vector in an axis after rotation and a vector from a center point of the device to the target, and calculating the angles between the rotation angle and an angle of the new plane to maintain inclusion of the target in the display.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present invention relates to medical systems and the imaging function and use of devices during procedures. More particularly, the present invention relates to an in-vivo medical probe and ultrasound imaging that provide a proposed orientation in multiple planes (e.g., at least two dimensions).

Background Art

[0002] Three-dimensional (3D) ultrasound is a medical ultrasound technology often used, for example, in fetal, cardiac, transrectal, and intravascular applications. Specifically, 3D ultrasound refers to the volume rendering of ultrasound data. When accompanied by a series of 3D volumes collected over time, it is generally referred to as 4D ultrasound (one time dimension in addition to three spatial dimensions).

[0003] Ultrasound imaging can be used to image body tissues while a medical probe inserted into the tissue is being used to perform a diagnostic or therapeutic procedure on the tissue. Manipulating the tilt and rotation of a catheter is generally referred to as mechanical manipulation. The tilt and rotation operations may also be performed with respect to the ultrasound imaging plane from the catheter, which is referred to as electronic steering.

Summary of the Invention

Means for Solving the Problems

[0004] A system and method are described for providing multi-planar proposed orientations by tracking a target. The system and method include a catheter for performing a medical electrophysiology procedure and a graphical user interface (GUI) for monitoring the catheter, the GUI being used to maintain inclusion of the target in a display for a user of the catheter during the medical electrophysiology procedure. The catheter and the GUI cooperate to display on the display an inclination angle for causing the device to follow the target during the procedure, receive as input a rotation angle of the current plane of the view of the device, receive as input a point of interest related to the target, calculate a new plane of the view of the device using a vector on the rotated axis and a vector from the center point of the device to the target, and calculate an angle between the rotation angle of the current plane and the angle of the new plane to provide movement of the device to maintain inclusion of the target in the display.

Brief Description of the Drawings

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

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DETAILED DESCRIPTION OF THE INVENTION

[0006] A system and method are described for providing a proposed orientation in multiple planes by tracking a target. The system and method include a catheter for performing a medical electrophysiology procedure and a graphical user interface (GUI) for monitoring the catheter, and the GUI is used to maintain the inclusion of the target in the display to the user of the catheter during the medical electrophysiology procedure. The catheter and the GUI cooperate to display on the display an inclination angle for moving the device to follow the target during the procedure, receive as input a rotation angle of the current plane of the view of the device, receive as input a point of interest related to the target, calculate a new plane of the view of the device using a vector within the rotated axis and a vector from the center point of the device to the target, and calculate an angle between the rotation angle of the current plane and the angle of the new plane to provide movement of the device to maintain the inclusion of the target in the display.

[0007] Also included are a system and method for tracking a target to maintain inclusion of the target in the display for the user of the device during the procedure. The system and method include displaying on the display an inclination angle for moving the device to follow the target during the procedure, receiving as input a rotation angle of the current plane of the view of the device, receiving as input a point of interest related to the target, calculating a new plane of the view of the device using a vector within the rotated axis and a vector from the center point of the device to the target, and calculating an angle between the rotation angle of the current plane and the angle of the new plane to provide movement of the device to maintain the inclusion of the target in the display.

[0008] Also included are systems and methods for tracking a target and the target's orientation to maintain inclusion of the target in the display for a user of the device during a procedure. The system and method include displaying on the display, during the procedure, an inclination angle and a rotation angle for moving the device to follow the target; receiving, as input, a device position, a point of interest associated with the target, and a direction of the point of interest; calculating a normal of a plane represented by the direction of the point of interest and the device position; calculating a vector calculated from the cross product of the calculated normal of the plane and the device vector and using the device vector to calculate a new view plane of the device; and calculating an angle between the current plane of the device represented by the normal of the plane and the new plane of the calculated view of the device to maintain inclusion of the target in the display.

[0009] The system and method may use the calculated angles, which are multi-planar, and the multi-planes represent the inclination and rotation of the device.

[0010] The system and method may further adjust the device to render a new plane in view of the calculated angles. The new plane may track a target within the display for a user of the device. The device may be a medical probe. The target may be a part of a patient's body. The device may be a catheter and the target may be a pulmonary vein. The device may be a four-dimensional catheter having views including dual-plane mode, multi-plane mode, and 4D.

[0011] In one example, a graphical user interface (GUI) may be provided. The GUI may provide a visual display to the user for interacting with an imaging system such as the CARTO system described herein. Specifically, the GUI may provide information to the user to guide the user on how to operate a catheter, such as the catheter described with respect to FIGS. 4A-4D below. This guidance information can be based on the known position and orientation of the catheter or another object of interest. The GUI can provide inclinations and / or inclination and rotation values with associated directions to guide the user regarding the operation of the catheter to track the object of interest. Further, the system can receive this guidance information and operate the catheter to track the object of interest based on the guidance information. In one example, arrows can be used to indicate the direction of inclination and / or inclination and rotation of the catheter and, for example, provide a direction to increase or decrease. The required inclinations and rotations may be updated in real time to adapt to the movement of the object of interest and / or the advancement of the catheter within a portion of the object of interest. In this way, the user can capture slices that show the object of interest at high resolution.

[0012] Refer to FIG. 1, which shows an exemplary system 10 (e.g., a medical device apparatus and / or a catheter-based electrophysiology mapping and ablation system) that can implement one or more features of the subject matter of this specification according to one or more embodiments. The whole or part of system 100 can be used to collect the information described in this specification (e.g., biometric measurement data and / or training data sets), and / or implement machine learning and / or artificial intelligence algorithms. As shown, system 10 includes a recorder 11, a catheter 14, a model or anatomical map 20, an electrogram 21, a spline 22, a location pad 25, one or more electrodes 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 understood and provided for a complete description, the heart 12, the patient 23, and the physician 24 (representing any medical professional, technician, or clinician) are depicted together with system 10. Each element and / or item of system 10 represents one or more of that element and / or that item. The example of system 10 shown in FIG. 1 can be modified to implement the embodiments disclosed in this specification. The embodiments of the present disclosure can also be similarly applied using other system components and settings. Further, system 10 may include additional components such as elements for sensing electrical activity, wired connectors or wireless connectors, processing devices, and display devices.

[0013] System 10 includes a plurality of catheters 14 that are percutaneously inserted by a physician 24 into a cardiac chamber or vascular structure of a patient's vasculature. Typically, a delivery sheath catheter is inserted into the left atrium or right atrium near a desired location within the heart 12. Thereafter, the plurality of catheters can be inserted into the delivery sheath catheter to reach a desired location. The plurality of catheters 14 can include catheters dedicated to sensing intracardiac electrogram (IEGM) signals, catheters dedicated to ablation, and / or catheters dedicated to both sensing and ablation. Exemplary catheters 14 configured to sense IEGM are shown herein. The physician 24 contacts the distal tip 28 of the catheter 14 with the heart wall to sense a target site of the heart 12. For ablation, the physician 24 can similarly move the distal end of the ablation catheter to a target site for ablation.

[0014] Catheter 14 is an exemplary catheter that optionally distributes over a plurality of splines 22 at the distal tip 28 and includes at least one, preferably a plurality of electrodes 26 configured to sense IEGM signals. Catheter 14 may additionally include a sensor 29 embedded within or near the distal tip 28 to track the position and orientation of the distal tip 28. Optionally and preferably, the position sensor 29 is a magnetic-based position sensor that includes three magnetic coils for sensing three-dimensional (3D) position and orientation.

[0015] Sensor 29 (e.g., a position-based or magnetic-based position sensor) may operate 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 tip 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 techniques are described in U.S. Patent Nos. 5,539,199, 5,443,489, 5,558,091, 6,172,499, 6,239,724, 6,332,089, 6,484,118, 6,618,612, 6,690,963, 6,788,967, 6,892,091.

[0016] System 10 includes one or more electrode patches 38 positioned on the patient 23 for skin contact to establish location referencing of the location pad 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 patches 38 (e.g., electrode-skin patches), whereby the location of each electrode can be triangulated via the patches 38. Details of impedance-based position tracking techniques are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182, which are hereby incorporated by reference.

[0017] Recorder 11 displays an electrogram 21 captured by the electrodes 18 (e.g., body surface electrocardiogram (ECG) electrodes) and an intracardiac electrogram (IEGM) captured by the electrodes 26 of the catheter 14. Recorder 11 may include pacing capabilities for pacing the heartbeat rhythm and / or may be electrically connected to an independent pacer.

[0018] System 10 may include an ablation energy generator 50 adapted to transmit ablation energy to one or more electrodes 26 at the distal tip 28 of a catheter 14 configured to ablate. The energy produced by ablation energy generator 50 may include radiofrequency (RF) energy, pulsed-field ablation (PFA) energy, or a combination thereof, including unipolar or bipolar high voltage DC pulses that can be used to effect irreversible electroporation (IRE), but is not limited thereto.

[0019] PIU30 is an interface configured to establish electrical communication between a catheter, electrophysiology equipment, a power source, and a workstation 55 that controls the operation of system 10. The electrophysiology equipment of system 10 may include, for example, a plurality of catheters 14, location pads 25, body surface ECG electrodes 18, electrode patches 38, ablation energy generator 50, and recorder 11. Optionally, PIU30 further includes processing capabilities to implement real-time calculation of catheter location and perform ECG calculations.

[0020] The workstation 55 includes a memory, a processor unit having a memory or storage device loaded with appropriate operating software, and a user interface function. The workstation 55 optionally provides a plurality of functions including: (1) modeling the endocardial anatomical structure in three dimensions (3D) and rendering it to display a model or anatomical map 20 on a display device 27; (2) displaying on the display device 27, in a representative visual indicator or image superimposed on the rendered anatomical map 20, an activation sequence (or other data) compiled from the recorded electrogram 21; (3) displaying the real-time locations and orientations of a plurality of catheters within the heart chamber; and (5) displaying on the display device 27 a site of interest such as a location where ablation energy has been applied. One commercially available product embodying the elements of the system (10) is available as the CARTO (trademark) 3 system, commercially available from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA, 92618.

[0021] For example, system 10 can be part of a cardiac mapping system (e.g., the CARTO® system sold by Biosense Webster) configured to acquire biometric data (e.g., anatomical and electrical measurements of a patient's organs such as heart 12 as described herein) and perform a cardiac ablation procedure. More specifically, in the treatment of cardiac conditions such as arrhythmias, it is often required to obtain a detailed mapping of cardiac tissue, cardiac chambers, veins, arteries, and / or electrical pathways. For example, a prerequisite for successfully performing catheter ablation (as described herein) is that the cause of the arrhythmia is accurately located within the cardiac chambers of heart 12. Such location is performed by an electrophysiological examination, during which spatially resolved potentials can be detected by a mapping catheter (e.g., catheter 14) introduced into the cardiac chambers of heart 12. This electrophysiological examination, so-called electroanatomical mapping, provides 3D mapping data that can be displayed on display device 27. In many cases, the mapping function and the treatment function (e.g., ablation) are provided by a single catheter or a group of catheters, and the mapping catheter also operates as a treatment (e.g., ablation) catheter simultaneously.

[0022] FIG. 2 is a block diagram of an exemplary system 100 for remotely monitoring and communicating a patient's biometric metrics (i.e., patient data). In the example shown in FIG. 2, system 100 includes a patient biometric monitoring and processing device 102 associated with 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.

[0023] According to one example, the patient biometric monitoring and processing device 102 may be a device (e.g., implantable subcutaneously) inside the patient's body, such as the catheter 14 of FIG. 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, endoscopic procedure, or laparoscopic procedure.

[0024] According to one example, the patient biometric monitoring and processing device 102 may be a device outside the patient's body, such as the electrode patch 38 of FIG. 1. For example, as described in more detail below, the patient biometric monitoring and processing device 102 may include an attachable patch (e.g., attachable to the patient's skin). The monitoring and processing device 102 may also include a catheter, probe, blood pressure cuff, scale, bracelet or smartwatch biometric tracker, glucose monitor, continuous positive airway pressure (CPAP) machine, or substantially any device that can provide input regarding the patient's health or biometrics.

[0025] According to one example, the patient biometric monitoring and processing device 102 may include both components inside the patient and components outside the patient.

[0026] 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. The patient biometric monitoring and processing device may communicate with one or more other patient biometric monitoring and processing devices. Additionally or alternatively, the patient biometric monitoring and processing device may communicate with the network 110.

[0027] One or more patient biometric monitoring and processing devices 102 can acquire patient biometric measurement data (e.g., electrical signals, blood pressure, body temperature, blood glucose levels, or other biometric measurement data), and can receive at least a portion of the patient biometric measurement data representing the acquired patient biometric metrics, as well as additional information associated with the patient biometric metrics acquired 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 an additional device such as a wearable device. Each patient biometric monitoring and processing device 102 can process data including its own acquired patient biometric metrics and data received from one or more other patient biometric monitoring and processing devices 102.

[0028] Biometric measurement data (e.g., patient biometric measurements, patient data, or patient biometric measurement data) can include one or more of local activation time (LAT), electrical activity, topology, bipolar mapping, reference activity, ventricular activity, dominant frequency, impedance, etc. The LAT can be the time point of threshold activity corresponding to local activation, calculated based on a normalized initial starting point. The electrical activity can be any applicable electrical signal that can be measured based on one or more thresholds and can be sensed and / or enhanced based on a signal-to-noise ratio and / or other filters. The topology can correspond to the physical structure of a body part or a portion of a body part and can correspond to changes in the physical structure regarding different parts of the body part or regarding different body parts. The dominant frequency can be a frequency or a range of frequencies commonly seen in a portion of a body part and can be different in different portions of the same body part. For example, the dominant frequency of the PV of the heart can be different from the dominant frequency of the right atrium of the same heart. The impedance can be a resistance measurement value in a specific region of a body part.

[0029] Examples of biometric measurement 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 biometric indicators, blood pressure data, ultrasonic signals, wireless signals, voice signals, two-dimensional or three-dimensional image data, blood glucose data, and temperature data. Biometric measurement data can generally be used to monitor, diagnose, and treat any number of various diseases such as cardiovascular diseases (e.g., arrhythmia, cardiomyopathy, and coronary artery disease), and autoimmune diseases (e.g., type I and type II diabetes). Note that BS ECG data can include data and signals collected from electrodes on the patient's surface, IC ECG data can include data and signals collected from electrodes within the patient's body, and ablation data can include data and signals collected from ablated tissue. Further, BS ECG data, IC ECG data, and ablation data can be derived from one or more treatment records along with catheter electrode position data.

[0030] In FIG. 2, network 110 is an example of a short-range network (e.g., a local area network (LAN) or a personal area network (PAN)). Information can be transmitted between patient biometric measurement monitoring and processing device 102 and local computing device 106 via network 110 using any one of various short-range wireless communication protocols such as Bluetooth, Wi-Fi, Zigbee, Z-Wave, near field communication (NFC), ultra-wideband wireless, Zigbee, or infrared (IR).

[0031] 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-distance network (e.g., a wide area network (WAN), the Internet, or a cellular network). Information may be transmitted via network 120 using any one of various long-distance wireless communication protocols (e.g., TCP / IP, HTTP, 3G, 4G / LTE, or 5G / New Radio).

[0032] 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 the biometric indicators of any number of various patients via network 110. Examples of patient biometric indicators include electrical signals (e.g., ECG signals and brain biometric indicators), blood pressure data, blood glucose data, and body temperature data. The patient biometric indicators may be monitored and communicated for treatment across any number of various diseases such as cardiovascular diseases (e.g., arrhythmia, cardiomyopathy, and coronary artery disease), and autoimmune diseases (e.g., type I and type II diabetes).

[0033] The patient biometric sensor 112 may include, for example, one or more sensors configured to sense the type of biometric indicators of the biometric measurement patient. For example, the patient biometric sensor 112 may include electrodes configured to acquire electrical signals (e.g., heart signals, brain signals, or other bioelectrical signals), a body temperature sensor, a blood pressure sensor, a blood glucose sensor, a blood oxygen sensor, a pH sensor, an accelerometer, and a microphone.

[0034] As will be described in more detail below, the patient biometric measurement monitoring and processing device 102 can be an ECG monitor for monitoring the ECG signals of the heart (e.g., heart 12). The patient biometric measurement sensor 112 of the ECG monitor can include one or more electrodes for acquiring the ECG signals. The ECG signals can be used for the treatment of various cardiovascular diseases.

[0035] In another example, the patient biometric measurement monitoring and processing device 102 can be a continuous glucose monitor (CGM) for continuously monitoring the blood glucose level of a patient on a continuous basis for the treatment of various diseases such as type I and type II diabetes. The CGM can include a subcutaneous electrode that can monitor the blood glucose level from the interstitial fluid of the patient. The CGM can be a component of a closed-loop system where blood glucose data is sent to an insulin pump, for example, for the calculated delivery of insulin without user intervention.

[0036] The transceiver 122 can include a separate transmitter and receiver. Alternatively, the transceiver 122 can include a transmitter and receiver integrated into a single device.

[0037] The processor 114 may be configured to store patient data, such as patient biometric measurement data acquired by the patient biometric measurement sensor 112, in the memory 118 and communicate the patient data over the network 110 via the transmitter of the transceiver 122. Data from one or more other patient biometric measurement monitoring and processing devices 102 can also be received by the receiver of the transceiver 122, as will be described in more detail below.

[0038] According to one example, the patient biometric measurement monitoring and processing device 102 may include a UI sensor 116, which may be a piezoelectric sensor or a capacitance sensor configured to receive user input such as a tap or a 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 measurement monitoring and processing device 102. Gesture recognition can be implemented by any one of various capacitive types such as resistive capacitive, surface capacitive, projected capacitive, surface acoustic wave, piezoelectric, and infrared touch. The capacitance sensor may be arranged over a small area or length of the surface such that a tap or touch on the surface activates the monitoring device.

[0039] As will be 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 the capacitance sensor, which may be the UI sensor 116, such that different tasks of the patch (e.g., data acquisition, storage, or transmission) may be initiated based on the detected pattern. In some embodiments, audible feedback may be provided to the user from the patient biometric measurement monitoring and processing device 102 when a gesture is detected.

[0040] The local computing device 106 of the system 100 communicates with the patient biometric monitoring and processing device 102 and may be configured to function as a gateway to the remote computing system 108 via the second network 120. The local computing device 106 can 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 can be, for example, a fixed base station including modem and / or router capabilities, a desktop computer or laptop computer that uses 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 fixed or stand-alone device such as a USB dongle. The patient's biometric indicators can be communicated between the local computing device 106 and the patient biometric monitoring and processing device 102 using a short-range wireless network 110 such as a local area network (LAN) (e.g., personal area network (PAN)) and a short-range wireless technology standard (e.g., Bluetooth, Wi-Fi, ZigBee, Z-wave, and other short-range wireless standards). In some embodiments, the local computing device 106 may also be configured to display the acquired patient electrical signals and information associated with the acquired patient electrical signals, as described in more detail below.

[0041] In some embodiments, the remote computing system 108 can be configured to receive at least one of the monitored patient's biometric metrics and information associated with the monitored patient via a long-distance network, the network 120. For example, if the local computing device 106 is a mobile phone, the network 120 can be a wireless cellular network, and the information can 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 described above. As will be described in more detail below, the remote computing system 108 can be configured to provide (e.g., visually display and / or aurally provide) at least one of the patient's biometric metrics and associated information to a medical professional (e.g., a physician).

[0042] Figure 3 is a system diagram of an example of a computing environment 200 that communicates with the network 120. In some examples, the computing environment 200 is incorporated into a public cloud computing platform (such as Amazon Web Services or Microsoft Azure), a hybrid cloud computing platform (such as HP Enterprise OneSphere), or a private cloud computing platform.

[0043] As shown in FIG. 3, the computing environment 200 includes a remote computing system 108 (hereinafter, a computer system), which is an example of a computing system in which the embodiments described herein may be implemented.

[0044] The remote computing system 108 can perform various functions via a processor 220 that can include one or more processors. The functions can include analyzing biometric metrics of a monitored patient and associated information and providing warnings, additional information, or instructions (e.g., via display 266) according to thresholds and parameters determined by a physician or algorithm-driven. As described in more detail below, the remote computing system 108 can be used to provide a patient information dashboard (e.g., via display 266) to healthcare providers (e.g., physicians), where the patient information can enable the healthcare provider to identify and prioritize patients who have more critical needs than other patients.

[0045] As shown in FIG. 3, computer system 210 may include a communication mechanism such as bus 221 or any other communication mechanism for communicating information within computer system 210. Computer system 210 further includes one or more processors 220 coupled to bus 221 for processing information. Processor 220 may include one or two or more CPUs, GPUs, or any other processor known in the art.

[0046] Computer system 210 also includes a system memory 230 coupled to bus 221 for storing information and instructions to be executed by processor 220. System memory 230 may include computer-readable storage media in the form of volatile and / or non-volatile memory such as read only system memory (ROM) 231 and / or random access memory (RAM) 232. System memory RAM 232 may include other dynamic storage devices (e.g., dynamic RAM, static RAM, and synchronous DRAM). System memory ROM 231 may include other static storage devices (e.g., programmable ROM, erasable PROM, and electrically erasable PROM). Additionally, system memory 230 can be used to store temporary variables or other intermediate information during execution of instructions by processor 220. Basic input / output system 233 (BIOS) may include routines that transfer information stored in system memory ROM 231 among elements within computer system 210, such as at startup. RAM 232 can be immediately accessible to processor 220 and / or may include data and / or program modules currently being operated on by processor 220. System memory 230 may further include, for example, operating system 234, application program 235, other program modules 236, and program data 237.

[0047] 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 magnetic hard disk 241 and a removable media drive 242 (e.g., floppy disk drive, compact disk drive, tape drive, and / or solid state drive). The 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).

[0048] The computer system 210 may also include a display controller 265 coupled to bus 221 for controlling 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 keyboard 262 and pointing device 261, for interacting with a computer user to provide information to processor 220. Pointing device 261 may be, for example, a mouse, trackball, or pointing stick for communicating indication information and command selections to processor 220 and for controlling cursor movement on display 266. Display 266 may provide a touch screen interface that enables input that complements or replaces communication of indication information and command selections by pointing device 261 and / or keyboard 262.

[0049] Computer system 210 may perform some or each of the functions and methods described herein in response to a processor 220 that executes one or more sequences of one or more instructions included in a memory such as system memory 230. Such instructions can be read into system memory 230 from another computer-readable medium such as a hard disk 241 or a removable media drive 242. 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. Processor 220 may also be employed in a multiprocessing configuration to execute one or more sequences of instructions included in system memory 230. In alternative embodiments, hardwired circuitry may be used in place of, or in combination with, software instructions. Accordingly, embodiments are not limited to any specific combination of hardware circuitry and software.

[0050] As described 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 the data structures, tables, records, or other data described herein. As used herein, the term computer-readable medium refers to any non-transitory tangible medium that participates in providing instructions to a processor 220 for execution. The computer-readable medium 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 make up bus 221. The transmission media can also take the form of acoustic or light waves, such as those generated during radio frequency and infrared data communications.

[0051] Computing environment 200 can further include a computer system 210 that operates in a networked environment using logical connections to a 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 nodes, and typically includes many or all of the elements described above with respect to computer system 210. When used in a network environment, computer system 210 may include a modem 272 for establishing communications via a network 120, such as the Internet. Modem 272 may be connected to system bus 221 via network interface 270 or via some other suitable mechanism.

[0052] Network 120, as shown in FIGS. 2 and 3, can be any network or system generally known in the art, including the Internet, an intranet, a local area network (LAN), a wide area network (WAN), a metropolitan area network (MAN), a direct connection or a series of connections, a cellular telephone network, or any other network or medium that can facilitate communication between computer system 610 and other computers (e.g., local computing device 106).

[0053] The treatment of heart diseases such as arrhythmia often requires obtaining detailed mapping of heart tissue, heart chambers, veins, arteries, and / or electrical pathways. For example, a prerequisite for performing catheter ablation without problems is to accurately locate the cause of the arrhythmia within the heart chamber. Such location can be performed by an electrophysiological investigation, during which the potential is detected and spatially resolved by a mapping catheter introduced into the heart chamber. Therefore, this electrophysiological investigation, so-called electroanatomical mapping, provides 3D mapping data, which can be displayed on a monitor. In many cases, the mapping function and the treatment function (e.g., ablation) are provided by a single catheter or a group of catheters. Therefore, the mapping catheter also operates as a treatment (e.g., ablation) catheter at the same time.

[0054] Mapping of cardiac regions, such as cardiac sites, tissues, veins, arteries, and / or electrical pathways of the heart, can lead to the identification of 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. Further, cardiac mapping can include mapping based on one or more modalities, including but not limited to local activation time (LAT), electrical activity, topology, bipolar mapping, dominant frequency, or impedance. Data corresponding to multiple modalities can be captured using catheters inserted into the patient's body and provided for rendering simultaneously or at different times based on corresponding set values and / or medical expert preferences.

[0055] Cardiac mapping can be performed using one or more techniques. As an example of a technique, cardiac mapping may be performed by sensing electrical properties of cardiac tissue, such as local excitation time, as a function of the exact location within the heart. The corresponding data can be acquired using one or more catheters advanced into the heart using a catheter having electrical and location sensors at its distal tip. As a specific example, location and electrical activity can first be 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 heart surface of satisfactory quality. This preliminary map can be combined with data acquired at additional points to generate a more comprehensive map of the electrical activity of the heart. In a clinical setting, it is not uncommon to accumulate data at over 100 sites to generate a detailed and comprehensive map of the electrical activity of the cardiac chamber. The generated detailed map can then serve as a basis for making treatment decisions, such as decisions regarding tissue ablation, to modify the propagation of the electrical activity of the heart and restore normal cardiac rhythm.

[0056] Using a catheter that houses a position sensor, the trajectory of each point on the heart surface can be determined. Using these trajectories, the motion characteristics such as the contractile force of the tissue can be inferred. A map showing such motion characteristics can be constructed when the trajectory information is sampled at a sufficient number of points within the heart.

[0057] The electrical activity at a point within the heart can usually be measured by advancing a catheter that houses an electrical sensor at or near its distal tip to a specific point within the heart, bringing the tissue into contact with the sensor, and acquiring data at that point. One drawback associated with mapping the ventricles using a catheter that houses only a single distal tip electrode is that it takes a long time to accumulate data point by point for the required number of points overall required for a detailed map of the heart cavity. Therefore, multi-electrode catheters and high-density mapping catheters have been developed to simultaneously measure the electrical activity at multiple points within the heart.

[0058] The multi-electrode catheter can be implemented using any applicable shape such as a linear catheter having a plurality of electrodes, a balloon catheter including electrodes disposed on a plurality of struts forming a balloon, a lasso catheter or loop catheter having a plurality of electrodes, or any other applicable shape. FIG. 4A shows an example of a linear catheter 402 that includes a plurality of electrodes 404, 405, and 406 that can be used to map a heart region. The linear catheter 402 can be fully or partially elastic so that it can twist, bend, and / or otherwise change its shape based on the received signal and / or based on the application of an external force (e.g., heart tissue) to the linear catheter 402.

[0059] FIG. 4B shows an example of an exemplary balloon catheter 412 that includes a plurality of splines (e.g., 12 splines in the specific example of FIG. 4B) including splines 414, 416, 417, and a plurality of electrodes on each spline including electrodes 421, 422, 423, 424, 425, and 426 as illustrated. The balloon catheter 412 may be designed such that when deployed within a patient's body, its electrodes can be held in close contact with the surface of the endocardium. By way of example, the balloon catheter can be inserted into a lumen such as a pulmonary vein (PV). The balloon catheter can be inserted into the PV in a collapsed state, such that the balloon catheter does not occupy the maximum volume of the PV while it is being inserted into the PV. The balloon catheter may expand while inside the PV, whereby 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.

[0060] FIG. 4C shows an example of a loop catheter 430 (also referred to as a lasso catheter) that includes a plurality of electrodes 432, 434, and 436 that can be used to map a cardiac region. The loop catheter 430 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) on the loop catheter 430.

[0061] FIG. 4D shows an example of an intracardiac echocardiogram (ICE) catheter 450 that can provide real-time three-dimensional visualization of the interior of the heart. The ICE catheter 450 includes a torque-transmittable and deflectable shaft 452 that provides extension and rotation of the transducer. The ICE catheter 450 includes a transducer orientation adjuster 454 and a shaft deflector 456, as well as a connector cable 458. The ICE catheter 450 can provide a 4D intracardiac echocardiogram with a 90-degree by 90-degree field of view. The ICE catheter 450 may include independent rotation and extension via the shaft 452 and adjuster 454.

[0062] According to one example, a multi-electrode catheter can be advanced into a heart chamber. Anteroposterior (AP) and lateral fluoroscopic images can be acquired to establish the position and orientation of each of the electrodes. An electrogram can be recorded from each of the electrodes that contact the heart surface relative to a time reference such as the onset of the P wave in sinus rhythm from a body surface ECG. The systems further disclosed herein can distinguish between electrodes that record electrical activity and electrodes that do not record electrical activity by being not in proximity to the endocardial wall. After an initial electrogram is recorded, the catheter can be repositioned and the fluoroscopic and electrogram images can be recorded again. An electrical map can then be constructed from repeated performance of the above process.

[0063] According to one example, cardiac mapping can be generated based on the detection of the intracardiac potential field. A non-contact method can be implemented to simultaneously acquire a large amount of cardiac electrical information. For example, a catheter having a distal end portion can include a series of sensor electrodes distributed over its entire surface and connected to an insulating conductor for connection to signal sensing and processing means. The size and shape of the end portion can be such that the electrodes are disposed at a large distance from the wall of the cardiac chamber. The intracardiac potential field can be detected during one heartbeat. According to one example, the sensor electrodes can be distributed on a series of circumferences located in a plane spaced from each other. These planes can be perpendicular to the major axis of the end of the catheter. At least two additional electrodes can be disposed adjacent to both ends of the major axis of the end. As a more specific example, the catheter can include four circumferences having eight electrodes equally angularly spaced on each circumference. Thus, in this particular implementation, the catheter can include at least 34 electrodes (32 circumferential electrodes and two end electrodes).

[0064] According to another example, an electrophysiological cardiac mapping system and technique based on a non-contact and non-expanding multi-electrode catheter can be implemented. An electrogram can be acquired using a catheter having a plurality of electrodes (e.g., 42 to 122 electrodes). According to this example, knowledge of the relative geometric shape of the probe and the endocardium can be obtained by an independent imaging modality such as transesophageal echocardiography. After independent imaging, non-contact electrodes can be used to measure the cardiac surface potential and construct a map therefrom. This technique can include the following steps (after the independent imaging step), namely, (a) measuring the potential by a plurality of electrodes disposed on a probe positioned within the heart, (b) determining the geometric relationship between the probe surface and the endocardial surface, (c) generating a matrix of coefficients representing the geometric relationship between the probe surface and the endocardial surface, and (d) determining the endocardial potential based on the electrode potential and the matrix of coefficients.

[0065] According to one example, a technique and apparatus for mapping the electrical potential distribution of a heart chamber can be implemented. An intracardiac multi-electrode mapping catheter assembly can be inserted into a patient's heart. This 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 number of individual electrode sites (e.g., at least 24). Additionally, this exemplary technique can be implemented with knowledge of the position of each of the electrode sites on the array and knowledge of the geometry of the heart. These locations are preferably determined by impedance plethysmography.

[0066] According to one example, a cardiac mapping catheter assembly can include an electrode array that defines a number of electrode sites. This mapping catheter assembly can also include a lumen for receiving a reference catheter having a distal tip electrode assembly that can be used to examine the heart wall. The mapping catheter can include a braid of insulating wires (e.g., having 24 to 64 wires in the braid), and each of the wires can be used to form an electrode site. The catheter can be easily positionable within the heart so as 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.

[0067] According to one example, another catheter for mapping the electrophysiological activity within the heart can be implemented. The catheter body can include a distal tip adapted to supply a stimulation pulse for pacing the heart or an ablation electrode for ablating tissue that contacts its tip. The catheter may further include at least a pair of orthogonal electrodes, and the orthogonal electrodes generate a differential signal indicative of local cardiac electrical activity adjacent to the orthogonal electrodes.

[0068] According to one example, a process for measuring electrophysiological data within a heart chamber can be implemented. This method can include, in part, positioning a set of active and passive electrodes on the heart, supplying 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 the inflatable balloon of a balloon catheter. In a preferred embodiment, the array is said to have 60 to 64 electrodes.

[0069] According to one example, cardiac imaging can be performed using one or more ultrasonic transducers. The ultrasonic transducers can be inserted into the patient's heart and can collect a plurality of ultrasonic slices (e.g., two-dimensional or three-dimensional slices sometimes called wedges or volumes) at various positions and orientations within the heart. The position and orientation of a particular ultrasonic transducer may be known and the collected ultrasonic slices can be stored so that they can be displayed later. One or more ultrasonic slices corresponding to the position of a probe (e.g., a therapeutic catheter) can be displayed later and the probe can be overlaid on the one or more ultrasonic slices.

[0070] According to other examples, the body patch and / or body surface electrodes can also be arranged on or in proximity to the patient's body. A catheter having one or more electrodes can be positioned within the patient's body (e.g., within the patient's heart), and the position of the catheter can be determined by the system based on signals transmitted and received between one or more electrodes of the catheter and the body patch and / or body surface electrodes. Further, the catheter electrodes can sense biological data (e.g., LAT value) from within the patient's body (e.g., within the heart). The biological data can be associated with the determined position of the catheter, and as a result, a rendering of the patient's body part (e.g., the heart) can be displayed, showing the biological data superimposed on the shape of the body part as measured for each position of the catheter. The 4D ICE system can include viewing modes including a dual plane mode, a multi-plane mode, and 4D. The dual plane mode / multi-plane mode generally provides 2D images with higher resolution as compared to 2D images extracted from the 4D mode.

[0071] In one example, a graphical user interface (GUI) may be provided. The GUI can provide the user with a visual display for interacting with a cardiac mapping system, such as the exemplary systems described above. Specifically, the GUI can provide the user with information for guiding the user on how to operate a catheter, such as the catheter described above with respect to FIGS. 4A-4D. This information can be based on the known position and orientation of the catheter or another object of interest. The GUI can provide tilt and / or tilt and rotation values along with the associated directions for guiding the user regarding the operation of the catheter to change and adjust the tilt and rotation angle of the field of view or fan displayed from the catheter. Further, the system can receive this information and operate the catheter based on that information. In one example, arrows can be used to indicate the direction of tilt and / or tilt and rotation of the fan displayed from the catheter and, for example, provide a direction to increase or decrease. The required tilt and rotation may be updated in real time to adapt to the movement of the object of interest. In this way, the user can capture slices that show the object of interest at high resolution.

[0072] FIG. 5 shows a graphical user interface (GUI) 500 configured to provide the tilts and rotations necessary to track an object of interest. As shown, GUI 500 can include a first view window 510 and a second view window 520. When tracking a point of interest, GUI 500 can provide guidance regarding tilt angles and rotation angles to adjust to view the point of interest. The guidance tilt angles and rotation angles may be provided within window 530. Window 530 may be displayed as an overlay window that overlays one or both of the first view window 510 and the second view window 520. Further, information related to the measurements being performed may be included. As shown in FIG. 5, the heart rate 540 may be provided in signal form. The average heart may additionally be displayed. As described herein, the position of any element can be tracked. This example is merely by way of example and is directed to an ablation catheter.

[0073] In one example, the system can recognize or define the position of an ablation catheter and provide a depiction of the ablation catheter within a first view window 510 from a first perspective and within a second view window 520 from a second perspective. The first perspective and the second perspective may be orthogonal to each other to provide the best view to the user of the ablation catheter. As the ablation catheter moves, the ablation catheter can move out of the first view window 510 and / or the second view window 520. In this example, the tilt angles and rotation angles may be displayed within window 530. The tilt angles and rotation angles may each be calculated as described below and may be configured to maintain the view of the ablation catheter within the first view window 510 and / or the second view window.

[0074] FIG. 6A shows a graphical user interface (GUI) 600 configured to provide a user with a tilt suggestion for tracking the ablation catheter tip. Similarly, FIG. 6B shows a graphical user interface (GUI) 650 configured to provide a user with a tilt suggestion for tracking the ablation catheter tip. Collectively, GUI 600 and GUI 650 show an exemplary depiction of a tilt suggestion for tracking the ablation catheter tip. Each of GUI 600 and GUI 650 represents that changing the tilt to 39 degrees tracks the catheter tip (displayed within window 530). As described above with respect to FIG. 5, the first view window 510, the second view window 520, and window 530 for displaying the tilt suggestion are included in each of GUI 600 and GUI 650.

[0075] Illustrated in both FIGS. 6A and 6B is the graphical user interface of FIG. 5. Specifically, the first view window 510 and the second view window 520. Further, the tilt angle may be displayed in window 530 shown as part of the second view window 520. As shown in the exemplary windows of FIGS. 6A and 6B, a tilt angle of 39 degrees enables tracking of the catheter tip (shown in window 530). FIG. 6A represents a view before applying the proposed tilt angle, and FIG. 6B represents a view after the proposed tilt angle has been applied.

[0076] Referring particularly to FIG. 6A, a view in the complex plane mode of the proposed tilt angle is shown. In the left portion of FIG. 6A, the plane of the viewing fan (shown in windows 510, 520) and a particular object, which in this case is the catheter, are shown. There are two view planes provided to represent the plane or axis of the view, in one case the axis is shown within window 510 and in the other case the axis is shown within window 520. As shown in the two windows 510, 520 of FIG. 6A, the viewing fan is not tracking the catheter. The offset angle required to track the catheter is calculated to be 39 degrees.

[0077] Referring specifically to FIG. 6B, a view in the complex plane mode of the proposed tilt angle is shown as compared to that of FIG. 6A, and FIG. 6B shows post-tilt adjustment. In the left portion of FIG. 6B, the plane of the viewing fan (shown in windows 510, 520) and a particular object which in this case is a catheter are shown. Similar to FIG. 6A, two planes are provided which represent the plane or the viewing axis, in one case the axis shown in window 510 and in the other case the axis shown in window 520. As shown in the two windows 510, 520 of FIG. 6B, after considering the offset of FIG. 6A, the viewing fan is tracking the catheter.

[0078] FIG. 7A shows a graphical user interface (GUI) 700 configured to provide a user with proposals for tilt and rotation to track the ablation catheter tip and the direction of the ablation catheter. Similarly, FIG. 7B shows a graphical user interface (GUI) 750 configured to provide a user with proposals for tilt and rotation to track the ablation catheter tip and the direction of the ablation catheter. Collectively, GUI 700 and GUI 750 show a depiction of exemplary proposals for tilt and rotation to track the ablation catheter tip and its direction. Each of GUI 700 and GUI 750 represents that changing the tilt to -14 degrees and the rotation to 34 degrees will track the catheter tip (displayed within window 530). As described above with respect to FIG. 5, the first view window 510, the second view window 520, and window 530 for display of tilt proposals are included in GUI 600 and GUI 650 respectively.

[0079] Shown in both FIGS. 7A and 7B is the graphical user interface of FIG. 5. Specifically, it is the first view window 510 and the second view window 520. Further, the tilt angle and the rotation angle may be displayed in a window 530 shown as part of the second view window 520. As shown in the exemplary windows of FIGS. 7A and 7B, a tilt angle of -14 degrees and a rotation angle of 34 degrees enable tracking of the catheter tip (shown in window 530). FIG. 7A represents a view before applying the proposed tilt angle and rotation angle, and FIG. 7B represents a view after applying the proposed tilt angle and rotation angle.

[0080] Referring particularly to FIG. 7A, a view in the complex plane mode of the proposed angles of tilt and rotation is shown. In the left portion of FIG. 7A, the plane of the viewing fan (shown in windows 510, 520) and a particular object, which in this case is a catheter, are shown. There are two view planes provided to represent the plane or axis of the view, in one case the axis is shown within window 510 and in the other case the axis is shown within window 520. As shown in the two windows 510, 520 of FIG. 7A, the viewing fan is not tracking the catheter. The offset angles of tilt and rotation required to track the catheter are calculated as a tilt angle of -14 degrees and a rotation angle of 34 degrees.

[0081] Referring particularly to FIG. 7B, a view in the complex plane mode of the proposed angles of tilt and rotation is shown as compared to that of FIG. 7A, and FIG. 7B shows the adjustment after tilt and rotation. In the left portion of FIG. 7B, the plane of the viewing fan (shown in windows 510, 520) and a particular object, which in this case is a catheter, are shown. Similar to FIG. 7A, two planes are provided to represent the plane or the axis of the field of view, in one case the axis shown in window 510 and in the other case the axis shown in window 520. As shown in the two windows 510, 520 of FIG. 7B, after considering the offset angles of tilt and rotation of FIG. 6A, the viewing fan is tracking the catheter.

[0082] Figure 8 shows a method 800 for tracking a point of interest according to an example described herein. Examples of points of interest may include, for example, the ablation catheter tip. Method 800 includes, at 810, displaying to the user on a graphical user interface (GUI) an inclination angle for tracking a point of interest (which is often referred to as a target, for example). At 820, method 800 includes inputting into a processor associated with the GUI the rotation angle of the current slice of the view in the mapping. The rotation angle takes the orientation axis provided by the system and is calculated by computing the angle between the current axis and the axis required to track the target. At 830, method 800 includes inputting into a processor associated with the GUI the point of interest, which may include, for example, the transducer position. These inputs may be, for example, system measurements. For example, when tracking a point of interest, a matrix can be created using the transducer position and the transducer rotation value to convert real-world coordinates to ULS coordinates. This matrix can be used to convert the coordinates of the target of interest in real-world coordinates to ULS coordinates.

[0083] At 840, a calculation of a new plane of the fan is performed to calculate a proposed inclination for tracking the ablation catheter tip. The plane is represented by (a) a vector on the x-axis after rotation (the rotation follows the rotation angle of the current slice), and (b) a vector from the tip center point to the point of interest. At 850, method 800 includes calculating the angle between the original plane and the new plane based on, for example, Euler angles, proposing a new inclination angle, and providing the proposed inclination angle either in absolute terms or as a delta angle from the current angle.

[0084] FIG. 9 shows a method 900 for tracking a point of interest and the direction of the point of interest according to an example described in this specification. Examples of points of interest may include, for example, the tip of an ablation catheter. Method 900 includes, at 910, displaying the tilt angle and the rotation angle to the user on a graphical user interface (GUI). At 920, method 900 includes inputting the transducer position to a processor associated with the GUI. At 930, method 900 includes inputting the point of interest to a processor associated with the GUI. At 940, the method includes inputting the direction of the point of interest to a processor associated with the GUI. These inputs may be, for example, system measurements.

[0085] At 950, method 900 includes calculating the normal of the plane (plane normal) represented by the direction of the point of interest (object) and the vector tip of the transducer. At 960, method 900 includes calculating a new plane of the fan (where the position and direction of the tip of the ablation catheter appear on the ultrasound image) using (a) the vector calculated from the cross product between the plane normal and the tip transducer, and (b) the tip transducer vector. This calculation may include calculating the vector between the point of interest and the transducer position (scanning origin). This vector is referred to as tip2transducer. The calculation of the normal of the plane represented by the direction of the object and the vector tip2transducer is performed. This vector is called the plane normal. The calculation of the normal between the plane normal and the tip transducer vector is performed. This normal is called vector X. A new plane of the fan is calculated and is represented by the vector calculated from the cross product between vector X and the tip transducer vector.

[0086] At 960, method 900 includes calculating the angle between the original plane and the new plane based on the Euler angles and providing the tilt angle and the rotation angle either in absolute terms or as a delta angle from the current angle.

[0087] In some examples, the location of the catheter on the CARTO (registered trademark) 3 System Location Pad coordinates, i.e., the target point and the direction of the target point of the element to be tracked, such as the ablation catheter tip and its direction, can be based on existing CARTO system magnetic positioning technology. For example, in some configurations, the ultrasound catheter may not be actually moved by the system and instead may be manually controlled by the physician. Tracking in this context is directed when the catheter is placed, and the ultrasound beam that is continuously emitted and received to form the volume wedges described above may be clipped or the beam gain / depth may be varied so that the associated anatomical structure remains within the field of view.

[0088] Although the features and elements have been described above in specific combinations, those skilled in the art will understand that each feature or element can be used alone or in combination with other features and elements. Additionally, the methods described herein can be implemented in a computer program, software, or firmware incorporated in a computer-readable medium for execution by a computer or processor. Examples of computer-readable media include electronic signals (transmitted via wired or wireless connections) and computer-readable storage media. Examples of computer-readable storage media include, but are not limited to, read-only memory (ROM), random access memory (RAM), registers, cache memory, semiconductor memory devices, magnetic media such as internal hard disks and removable disks, magneto-optical media, and optical media such as CD-ROM disks and digital versatile disks (DVDs). A processor associated with the software can be used to implement a radio frequency transceiver for use in a WTRU, UE, terminal, base station, RNC, or any host computer.

[0089] 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 flowchart or block diagram may represent a module, segment, or portion of instructions that includes one or more executable instructions for implementing the indicated logical function. In some alternative implementations, the functions noted in the blocks may occur out of the order noted in the figures. For example, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending upon the functionality involved. It should also be noted that each block of the block diagrams and / or flowchart, and combinations of blocks in the block diagrams and / or flowchart, may be implemented by a dedicated hardware-based system that performs the specified functions or operations, or by combinations of dedicated hardware and computer instructions.

[0090] Although the features and elements have been described above in particular combinations, one of ordinary skill in the art will understand that each feature or element can be used alone or in combination with other features and elements. Additionally, the methods described herein may be implemented in a computer program, software, or firmware incorporated in a computer-readable medium for execution by a computer or processor. As used herein, a computer-readable medium should not be construed to be a signal per se, such as a radio wave or other freely propagating electromagnetic wave, an electromagnetic wave propagating through a waveguide or other transmission medium (e.g., an optical pulse passing through an optical fiber cable), or an electrical signal transmitted through a wire that is inherently a transient signal.

[0091] 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 registers, cache memories, semiconductor memory devices, magnetic media such as internal hard disks and removable disks, magneto-optical media, optical media such as compact disks (CDs) and digital versatile disks (DVDs), random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), static random access memory (SRAM), and memory sticks, but are not limited thereto. A processor can be used together with software to implement a radio frequency transceiver for use in a terminal, a base station, or any host computer.

[0092] The terms used in this specification are for the purpose of describing particular embodiments only and are not intended for purposes of limitation. As used in this specification, the singular forms "a," "an," and "the" include the plural forms as well, unless the context clearly dictates otherwise. The terms "comprise" and / or "comprising," as used in this specification, indicate the presence of the recited features, integers, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and / or groups thereof.

[0093] The descriptions of different embodiments in this specification are presented for illustrative purposes and are 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 of the embodiments, their practical applications, or technical improvements found in the market compared to the technology, or to enable those skilled in the art to understand the embodiments disclosed in this specification.

[0094] 〔Embodiment〕 (1) A system for providing proposed orientations in multiple planes by visually tracking a target anatomical structure for display, the system being configured to interface with a 4D intracardiac echocardiogram (4D-ICE) catheter, the catheter providing information to a processor via an I / O device, the system comprising: a processor; an input / output (I / O) device configured to provide input to and output from the processor; a graphical user interface (GUI) displayed on a display communicatively coupled to the processor, the GUI being used to monitor the catheter and configured to maintain inclusion of a vein in the field of view of the catheter during a medical electrophysiology procedure; the system being configured to: display an inclination angle for tracking the target anatomical structure by the catheter; receive, as a first input, an angle of the current plane of the view of the catheter; receive, as a second input, a point of interest associated with the target anatomical structure; calculate a new plane of the view of the catheter using a vector on the rotated axis and a vector from the catheter to the point of interest; To provide angular motion of the catheter to maintain inclusion of the target anatomical structure in the display, a tilt angle is calculated as the difference between the angle of the current plane and the angle of the new plane, A system that adjusts the catheter to the new plane by the tilt angle, thereby operating to maintain the point of interest within the display. (2) The system according to embodiment 1, wherein the calculated tilt angle is multi-planar. (3) The system according to embodiment 2, wherein the multi-plane represents the tilt and rotation of the catheter. (4) The system according to embodiment 1, wherein the system is configured to generate a dual-plane mode, a multi-plane mode, and a 4D mode. (5) The system according to embodiment 1, wherein the target anatomical structure is a vein.

[0095] (6) A method for tracking a target to maintain inclusion of the target in a display of a device during a procedure, the method comprising: displaying a tilt angle for tracking the target of the procedure on the device; receiving, as a first input, an angle of a current plane of a view of the device; receiving, as a second input, a point of interest associated with the target; calculating a new plane of the view of the device using a vector on the axis after rotation and a vector from the device to the point of interest; calculating a tilt angle as the difference between the angle of the current plane and the angle of the new plane to provide movement of the device to maintain inclusion of the target in the display; adjusting the device to the new plane of the view by the tilt angle, thereby maintaining the point of interest within the display. (7) The method according to embodiment 6, wherein the calculated tilt angle is multi-planar. (8) The method according to embodiment 7, wherein the multi-plane represents the inclination and rotation of the device. (9) The method according to embodiment 6, wherein the new plane tracks the point of interest in the display. (10) The method according to embodiment 6, wherein the device is a catheter and the target is a pulmonary vein.

[0096] (11) A method for tracking a target and the direction of the target to maintain inclusion of the target in a display of a device during a procedure, the method comprising: displaying, on the display, an inclination angle and a rotation angle for tracking the target by the device during the procedure; receiving a device position, a point of interest related to the target, and a direction of the point of interest; calculating a normal of a plane represented by the direction of the point of interest and the device position; calculating a new plane of the view of the device using a vector calculated from an outer product between the calculated normal of the plane and a vector of the device, and the vector of the device; calculating an angle between the current plane of the device represented by the calculated normal of the plane and the calculated new plane of the view of the device. (12) The method according to embodiment 11, wherein the angle is a multi-plane. (13) The method according to embodiment 12, wherein the multi-plane represents the inclination and rotation of the device. (14) The method according to embodiment 11, further comprising changing the angle of the device to the calculated new plane of the view of the device. (15) The method according to embodiment 14, wherein the new plane tracks the target.

[0097] (16) The method according to embodiment 11, wherein the device is a medical probe. (17) The method according to embodiment 16, wherein the target is a part of a patient's body. (18) The method according to embodiment 11, wherein the device is a catheter and the target is a pulmonary vein. (19) The method according to embodiment 11, wherein the device is a four-dimensional catheter having views including a dual-plane mode, a multi-plane mode, and 4D. (20) The method according to embodiment 11, wherein the device comprises a transducer of the catheter.

Claims

1. 1. A system for providing multi-planar suggested orientations by visually tracking a target anatomical structure for display, the system being configured to interface with a 4D Intracardiac Echocardiography (4D-ICE) catheter, the catheter providing information to a processor via an I / O device, the system comprising: A processor; an input / output (I / O) device configured to provide input to and output from the processor; a graphical user interface (GUI) displayed on a display communicatively coupled to the processor, the GUI being used to monitor the catheter and configured to maintain inclusion of a vein in a field of view of the catheter during a medical electrophysiology procedure; The system further comprises: indicating a tilt angle that causes the catheter to track the target anatomical structure; receiving as a first input a current plane of view angle of the catheter; receiving as a second input a point of interest associated with the target anatomical structure; calculating a new plane of view of the catheter using a vector at the rotated axis and a vector from the catheter to the point of interest; calculating a tilt angle as the difference between the angle of the current plane and the angle of the new plane to provide angular motion of the catheter to maintain inclusion of the target anatomical structure in the display; The system operates to adjust the catheter by the tilt angle to the new plane, thereby maintaining the point of interest within the display.

2. The system of claim 1 , wherein the calculated tilt angles are multi-planar.

3. The system of claim 2 , wherein multiple planes represent the tilt and rotation of the catheter.

4. The system of claim 1 , wherein the system is configured to generate biplanar, multiplanar, and 4D modes.

5. The system of claim 1 , wherein the target anatomical structure is a vein.

6. 1. A method for tracking a target to maintain inclusion of the target on a display of a device during a procedure, the method comprising: displaying a tilt angle for causing the device to track the target of the procedure; and receiving as a first input an angle of a current plane of view of the device; receiving, as a second input, a point of interest associated with the target; calculating a new plane of the view of the device using a vector on the rotated axis and a vector from the device to the interest point; calculating a tilt angle as the difference between the angle of the current plane and the angle of the new plane to provide movement of the device to maintain inclusion of the target on the display; and adjusting the device by the tilt angle to the new plane of view, thereby maintaining the point of interest within the display.

7. The method of claim 6 , wherein the calculated tilt angles are multiplanar.

8. The method of claim 7 , wherein multiple planes represent the tilt and rotation of the device.

9. The method of claim 6 , wherein the new plane tracks the point of interest on the display.

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

11. 1. A method for tracking a target and an orientation of the target to maintain inclusion of the target on a display of a device during a procedure, the method comprising: displaying on the display tilt and rotation angles for causing the device to track the target during the procedure; receiving a device position, a point of interest relative to the target, and a direction of the point of interest; Calculating a normal to a plane represented by the direction of the point of interest and the device position; calculating a new plane of view of the device using a vector calculated from a cross product between the calculated normal of the plane and a vector of the device, and the vector of the device; and calculating an angle between the device's current plane, represented by the calculated normal to the plane, and the calculated new plane of the device's view.

12. The method of claim 11 , wherein the angle is multiplanar.

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

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

15. The method of claim 14 , wherein the new plane tracks the target.

16. The method of claim 11 , wherein the device is a medical probe.

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

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

19. The method of claim 11 , wherein the device is a four-dimensional catheter with views including biplanar modes, multiplanar modes, and 4D.

20. The method of claim 11 , wherein the device comprises a catheter transducer.

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