GUI to visually connect features identified in electroanatomical (EA) map to ECG signals

Abstract

To graphically indicate intracardiac electrograms that correspond together to a regional arrhythmogenic electrical activity in a cardiac chamber.SOLUTION: A system includes a display device and a processor. The processor is configured to (i) present, on the display device, intracardiac electrograms recorded over tissue of a portion of a cardiac chamber, (ii) identify a subset of the electrograms that show arrhythmogenic activity, (iii) analyze one or more characteristics of the arrhythmogenic activity, and (iv) graphically interconnect the electrograms in the subset to present the one or more characteristics of the arrhythmogenic activity to a user.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present disclosure generally relates to the diagnosis and treatment of arrhythmias, and more particularly to graphically presenting an intracardiac electrogram that corresponds to local arrhythmic electrical activity within the heart cavity.

Background Art

[0002] Displaying intracardiac electrograms acquired using multi-electrode catheters has been previously proposed in the patent literature, including presenting these spatio-temporal analyses. For example, U.S. Patent No. 10,349,855 describes recording intracardiac electrograms using a multi-electrode catheter and establishing respective annotations. Within a time window, a pattern is detected that includes a monotonically increasing sequence of local excitation times from a set of electrograms from neighboring electrodes. The sets are sorted and displayed to the operator.

[0003] As another example, U.S. Patent Application Publication No. 2022 / 0369991 describes a medical device and method for diagnosing and localizing arrhythmias within a subject's heart. A computing device receives, records, and processes electrocardiogram (ECG) signals in the form of bipolar and unipolar ECGs associated with respective locations of heart tissue corresponding to the location of the catheter distal end sensor in situ. By analyzing a unipolar ECG that includes signals from a plurality of consecutive heartbeats corresponding to locations within the investigation area to define a complex of unipolar ECGs corresponding to each bipolar activation window, a fractionated unipolar ECG signal complex (FUESC) of the unipolar ECG is identified.

[0004] A more complete understanding of the present disclosure will be obtained by reading the following detailed description of the embodiments of the present disclosure in conjunction with the drawings.

Brief Description of the Drawings

[0005]

Figure 1

Figure 2A

Figure 2B

Figure 3

Figure 4

[0006] Overview Cardiac arrhythmias, such as atrial fibrillation, are a group of conditions with an irregular rhythm of the heart rate. Electrical anatomical (EA) mapping of a patient's heart can serve as a basis for determining treatment strategies, such as tissue ablation, to restore normal heart rhythm by altering the propagation of electrical activity in the heart tissue.

[0007] The electrical activity in a tissue region within the heart can be measured by contacting the tissue with an electrode of a catheter having a position sensor at its distal end, while simultaneously acquiring an intracardiac electrogram at each measured position within that region. Optionally, the analysis can be performed based on data accumulated over time. The acquired data points are used to generate a detailed cardiac EA map of diagnostic values. Using EA mapping, electrical properties of the heart tissue, such as local activation time (LAT) and local activation amplitude, can be visualized on a rendering of a portion of the heart.

[0008] However, many electrophysiologists prefer to examine the intracardiac electrogram itself in detail to evaluate local arrhythmogenic properties (e.g., changes in activation amplitude and / or timing, correspondence between annotated activations on the same or different electrograms, and pattern changes such as fragmentation in activation). However, practical experience has shown that it is difficult for electrophysiologists to incorporate the information provided by both the EA map and the intracardiac electrogram. Moreover, most electrograms in each given acquisition with a multi-electrode catheter (out of the hundreds presented) may be irrelevant, making it difficult to use electrograms alone.

[0009] Embodiments of the disclosure described herein provide a technique for graphically highlighting, on a display, a subset of intracardiac electrograms that best exhibit the properties of local arrhythmias. The subset is automatically identified by a processor based on analysis of the captured instantaneous cardiac signals and / or based on analysis of the EA map. The algorithm for identifying the subset typically does this by detecting some spatio-temporal relationships between the relevant electrograms.

[0010] In one embodiment, the processor uses an algorithm to graphically indicate a subset of electrograms from local arrhythmias (e.g., focal arrhythmias of fibrillation nests or spiral wave circles of excitation) displayed on the EA map. For this purpose, the processor or the user first identifies and marks the local arrhythmogenic tissue on the EA map. The disclosed method may graphically present the connection between the area in the EA map and the subset using arrows, annotations, highlighting, and other methods.

[0011] The processor executes an algorithm that analyzes the subset to evaluate the characteristics of the arrhythmogenic activity. Such characteristics may include at least one of activation amplitude, activation timing, and activation pattern (e.g., electrogram signal subdivision). The processor then graphically interconnects the electrograms within the subset so as to visually highlight the characteristics (e.g., propagation) of the arrhythmogenic activity to the user on the subset.

[0012] In known systems, the electrodes at the distal end of the catheter are associated with numbers, and the electrograms sensed from the electrodes are typically displayed in real time in numerical order, as seen in FIG. 2. This may assist the user in understanding the spatio-temporal relationship between the associated electrograms. In some exemplary systems, up to 100 electrodes may collect electrogram signals simultaneously, and all electrograms may be displayed in numerical order alongside the constructed EA map.

[0013] It is also possible to display electrograms while viewing an existing, e.g., stored EA map. The electrograms over the selected region of interest may be displayed alongside the EA map. The order in which the electrograms are displayed may follow the numerical order of the points collected within the region of interest, as seen in FIG. 3. Each electrogram is associated with the position where it was captured.

[0014] Propagation along tissue need not necessarily follow the order in which the electrograms are displayed. In such cases, it can be difficult for a user to track the propagation when viewing the electrograms. For example, it can be difficult to track local nests or spiral wave propagation that appears only in a portion of the electrogram. In embodiments of the present disclosure, spatio-temporal analysis of the electrograms is performed to detect the progression pattern in the region of interest. Based on the analysis, arrows indicating the progression between respective electrograms are added to show the progression of the detected propagation (e.g., FIG. 2). Optionally, the processor is configured to selectively display a subset of the electrograms associated with the detected propagation signal based on user selection. Optionally, the processor is also configured to rearrange the order in which the subset is displayed to correspond to the order of the detected propagation based on user selection.

[0015] The processor provides a graphical display (e.g., an arrow) indicating the behavior (e.g., progression) of arrhythmia on the electrogram. Since each electrogram is acquired by an electrode at a certain tissue location, the user can infer the spatial order from the order of the electrograms.

[0016] In some embodiments, the processor graphically interconnects the electrograms based on the spatio-temporal relationship between arrhythmia-induced activations in the electrograms. For this purpose, the processor annotates the arrhythmia-induced activations of the arrhythmia-induced activity on at least one of the subset of electrograms.

[0017] As described above, the processor may use arrows, for example, to show the progression of abnormal electrical activity, to graphically interconnect the subset of electrograms. In another embodiment, the processor graphically highlights at least one electrogram (e.g., one that functions as a healthy reference position or a critical condition position) within the subset.

[0018] Description of the System FIG. 1 is a schematic depiction of a catheter-based electrophysiology (EA) mapping and ablation system 10 according to an embodiment of the present disclosure.

[0019] System 10 includes a plurality of catheters (see insertion FIG. 45) that are percutaneously inserted by physician 24 into a chamber or vascular structure of heart 12 through a patient's vasculature. Typically, the delivery sheath catheter is inserted into a heart chamber, such as into the left atrium or right atrium near the desired location of heart 12. Thereafter, the plurality of catheters are inserted into the delivery sheath catheter to reach the desired location. The plurality of catheters can include a pacing-only catheter, a catheter for sensing intracardiac electrogram signals, an ablation-only catheter, and / or a catheter for both EA mapping and ablation. The exemplary catheter 14 shown herein is configured to sense a bipolar electrogram. Physician 24 contacts the distal tip 28 (hereinafter also referred to as distal end assembly 28) of catheter 14 with the heart wall to sense a target site of heart 12. For ablation, physician 24 similarly brings the distal end of the ablation catheter to the target site.

[0020] As seen in insertion FIG. 65, catheter 14 is an exemplary catheter that optionally includes one, preferably a plurality of electrodes 26 distributed across a plurality of splines 22 at distal tip 28 and configured to sense IEGM signals, and includes a basket-shaped distal tip 28. Catheter 14 can additionally include a position sensor 29 embedded within or near distal tip 28 on shaft 46 of catheter 14 that is used to track the position and orientation of distal tip 28. Optionally and preferably, position sensor 29 is a magnetic-based position sensor that includes three magnetic coils for sensing three-dimensional (3D) position and orientation. As seen, distal tip 28 further includes an expansion / crushing rod 42 of expandable assembly 28 that is mechanically connected to basket assembly 28 at the distal edge 41 of assembly 28.

[0021] The magnetic-based position sensor 29 can operate with a position 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 can be tracked based on the magnetic field generated by the position pad 25 and sensed by the magnetic-based position sensor 29. Details of the magnetic-based position sensing technique 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, and 6,892,091.

[0022] The system 10 includes one or more electrode patches 38 disposed for skin contact on the patient 23 to establish position referencing of the position pad 25 and impedance-based tracking of the electrodes 26. For impedance-based tracking, current is directed to the electrodes 26 and sensed at the electrode-skin patches 38, whereby the position of each electrode can be triangulated via the electrode patches 38. Details of the impedance-based position tracking technique are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182.

[0023] The recorder 11 displays on the display device 27 a cardiac signal 21 (e.g., an electrogram acquired at each tracked cardiac tissue position) acquired using the body surface ECG electrodes 18 and an intracardiac electrogram acquired using the electrodes 26 of the catheter 14. The recorder 11 may include pacing capabilities for pacing the rhythm of the heart and / or may be electrically connected to an independent pacemaker.

[0024] Workstation 55 includes a memory 57, a processor 56 unit having a memory or storage device loaded with appropriate operating software, and a user interface function. The workstation 55 may optionally (i) render to model in three dimensions (3D) the endocardial anatomical structure and display a model or EA map 20 on a display device 27, (ii) display on the display device 27, in a representative visual display or image overlaid on the rendered EA map 20, an activation sequence (or other data) compiled from the recorded heart signals 21, (iii) display the real-time positions and orientations of a plurality of catheters within the heart chamber, and (iv) display on the display device 27 regions of interest such as locations where ablation energy has been applied, and may provide a plurality of functions including these. One commercially available product embodying the elements of system 10 is available as the CARTO (trademark) 3 system, obtainable from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA, 92618.

[0025] In the disclosed embodiments, the processor 56 executes an algorithm that identifies a subset of electrograms 21 indicative of arrhythmogenic activity. The processor analyzes the type of arrhythmogenic activity and graphically interconnects the electrograms within the subset to present the type of arrhythmogenic activity to the user. The processor 56 uses the algorithm to graphically associate the intracardiac electrogram-based analysis with a graphical display on the EA map 20. The physician 24 may select / deselect how to manipulate the algorithm and / or the graphics, for example, via a graphical user interface (GUI) 111.

[0026] System 10 may include an ablation energy generator 50 adapted to deliver ablation energy to one or more electrodes at a distal tip of a catheter configured for ablation. The energy generated 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 may be used to effect irreversible electroporation (IRE), but is not limited thereto.

[0027] A patient interface unit (PIU) 30 is an interface configured to establish electrical communication between a catheter, electrophysiological equipment, a power source, and a workstation 55 to control the operation of system 10 and to receive an EA signal from the catheter. The electrophysiological equipment of system 10 may include, for example, a plurality of catheters, position pads 25, body surface ECG electrodes 18, electrode patches 38, an ablation energy generator 50, and a recorder 11. Optionally and preferably, PIU 30 additionally includes processing capabilities for performing real-time calculations of catheter position and for performing ECG calculations.

[0028] In some embodiments, processor 56 typically includes a general-purpose computer programmed with software to perform the functions described herein. The software may be downloaded to the computer in electronic form via a network, or alternatively or additionally, may be provided and / or stored on a non-transitory tangible medium such as magnetic memory, optical memory, or electronic memory.

[0029] This configuration of system 10 is shown as an example to illustrate the specific problems addressed by embodiments of the present disclosure and to demonstrate the application of these embodiments in improving the performance of such systems. However, embodiments of the present disclosure are in no way limited to this particular type of exemplary system, and the principles described herein may equally apply to other types of medical systems. For example, other multi-electrode catheter types such as multi-arm OCTARAY (trademark) catheters or flat catheters may be used.

[0030] GUI for visually connecting features identified in the EA map to the ECG signal In FIG. 2, a multi-arm mapping catheter is schematically shown (224) superimposed on the EA map used to acquire the potential map. The spatio-temporal relationships can be found between the associated potential maps by numbering the potential maps according to the electrode numbers (when shown, there are 20 electrodes, 4 in each arm, and thus the potential map 221 in FIG. 2A and the potential map 231 in FIG. 2B are numbered e1, e2,... e20). The potential maps shown are schematic diagrams of signals obtained from the exemplary mapping catheter 224.

[0031] FIG. 2A shows a graphical display (215) on an EA map (201) of a focal excitation type arrhythmia graphically linked (227) to a subset (223) of an intracardiac potential map (221) according to an embodiment of the present disclosure, and the subset (223) is graphically indicated by an arrow 225 to evaluate the spatio-temporal progression of the focal excitation arrhythmia.

[0032] FIG. 2B shows a graphical display (235) on an EA map (202) of a spiral-type swirling excitation wave type arrhythmia graphically linked (237) to a subset (233) of an intracardiac potential map (231) according to an embodiment of the present disclosure, and the subset (233) is graphically indicated by an arrow 245 to evaluate the spatio-temporal progression of the spiral-type swirling excitation wave arrhythmia.

[0033] Both EA maps 201 and 202 include a rendering of the anatomical surface of a cardiac chamber (e.g., the left atrium) and respective electrical values (e.g., activation amplitude and / or time) superimposed on the rendered anatomical surface at each mapped location.

[0034] Processor 56 of system 10 presents on display device 27 an intracardiac electrogram (221, 231) recorded on tissue of a portion of the cardiac chamber shown by EA maps 201 and 202. Using the EA maps, the processor identifies a subset of electrograms indicative of arrhythmogenic activity.

[0035] The processor analyzes several characteristics of the arrhythmogenic activity and graphically interconnects the electrograms within the subset (225, 245) to present the characteristics of the arrhythmogenic activity to the user. The characteristics can include activation amplitude, activation timing, and activation pattern.

[0036] As can be seen, the processor graphically shows the type of arrhythmogenic activity on the EA map (e.g., by indicating a local focal excitation type (215) or a spiral wave type of arrhythmogenic activity (235)). The processor graphically connects the activity on the EA map to at least one of the electrograms within each respective subset (223, 233) (227, 237).

[0037] Optionally, the user can manually indicate some of the activities described above instead of the processor's automatic indication. For example, the user can identify a local focal excitation or a spiral wave type of arrhythmogenic activity on the EA map.

[0038] Typically, the algorithm executed by the processor annotates the arrhythmogenic activation of the arrhythmogenic activity on at least one of the electrograms within the subset.

[0039] Figure 3 is a rendering of an EA map 360 that overlays an area of interest 362 indicative of a potential arrhythmia and respective schematically presented intracardiac electrograms (321, 331) from that area. The area is defined by a schematically shown enclosure that can be applied to the map by a processor or user and includes data points (364, 366) each having a recorded electrode position and a recorded electrogram at that position. In this case, the order is based on the numbering of points on the map. It can be collected over time. The electrograms (321, 331) are numbered according to the data point index in each area as P1, P2,...PN.

[0040] In the illustrated embodiment, the user views an existing EA map. When viewing the map, the user can select an area (362), and the processor displays to the user all electrograms (321, 3331) within each selected area 362.

[0041] In another embodiment, the processor displays only electrograms within an area that are instantaneous signals captured simultaneously using a multi - electrode catheter. In this embodiment, the electrograms are enumerated based on the electrode numbers from which they are derived.

[0042] In both cases, the user or processor executing the algorithm performs a spatio - temporal analysis to identify the pattern of propagated cardiac activation in area 362. As can be seen, Figure 3 associates area 362 with respective subsets (323, 333) of intracardiac electrograms (321, 331), and the subsets (323, 333) are schematically shown by arrows (325, 345) to evaluate the spatio - temporal progression of focal excitation arrhythmias and spiral - type reentrant excitation wave arrhythmias.

[0043] Method for Visually Connecting Features Identified in an EA Map to an ECG Signal FIG. 4 is a flowchart schematically showing a method of associating a graphical display of local arrhythmogenic activity on an EA map with a subset of intracardiac electrograms and collectively graphically showing arrhythmogenic characteristics on the subset, according to an embodiment of the present disclosure.

[0044] The process begins in the EA map and associated electrogram display step 402 with the processor executing an algorithm that presents, on a display service, an EA map of at least a portion of a heart chamber that may include arrhythmogenic activity, along with electrogram columns.

[0045] In the arrhythmogenic activity indication step 404, either the processor or the user receives an indication of a region of interest that may have arrhythmogenic activity.

[0046] In the electrogram collection step 406, the processor collects electrograms within the region of interest or identifies previously collected electrograms within the region of interest. Optionally, the system substantially simultaneously samples electrograms from electrodes at the distal end of a catheter. The distal end may include, for example, 20 to 120 electrodes, and the electrodes each capture electrograms at different locations. The location where each electrogram is located may be known. For example, the position and orientation of the distal end of the catheter shaft may be monitored based on a magnetic-based position sensor, and the position of each of the electrodes may be inferred based on their known positions relative to the shaft. Optionally, impedance-based tracking may provide an indication of the electrode positions.

[0047] In the analysis step 408, the processor analyzes (in an automated process) the electrograms and / or EA map within the region of interest to identify the progression of propagation within that region. Optionally, the processor is configured to execute an algorithm that identifies a subset of electrograms that characterize arrhythmias from within the set. Algorithms for finding the subset typically use some spatio-temporal and / or amplitude characteristics displayed by the associated electrograms and the order of the propagation signals within the subset.

[0048] Identification of arrhythmic propagation (e.g., one of a spiral wave excitation pattern or a focal excitation pattern of propagation) can be based on analysis of an electrogram, analysis of one or more EA maps, or analysis of both an electrogram and one or more EA maps. In some embodiments, the order in which activation signals appear in each of the electrograms within a column of electrograms is determined, and this information is related to the relative positions at which each electrogram was captured.

[0049] Finally, in the visual display step 410, the processor visually shows the user the order of progression in the electrogram as seen by the arrows (225, 245) of FIGS. 2A and 2B and the arrows (325, 345) of FIG. 3, respectively.

Example

[0050] (Example 1) The system (10) includes a display device (27) and a processor (56). The processor (56) is configured to (i) present on the display device (27) intracardiac electrograms (221, 231) recorded on tissue of a portion of a heart chamber, (ii) identify a subset (223, 233) of the electrograms (221, 231) indicative of arrhythmogenic activity, (iii) analyze one or more characteristics of the arrhythmogenic activity, and (iv) graphically interconnect the electrograms of the subset (223, 233) (225, 245) to present one or more characteristics of the arrhythmogenic activity to the user.

[0051] (Example 2) The system (10) of Example 1, wherein the one or more characteristics include at least one of activation amplitude, activation timing, spatio-temporal progression of activation, and activation pattern.

[0052] (Example 3) The processor (56) is configured to graphically interconnect (225, 245) the potential maps of the subsets (223, 233) using arrows to present one or more characteristics, for the system (10) according to Example 1 or 2.

[0053] (Example 4) The processor (56) is configured to identify subsets (223, 233) of potential maps (221, 231) by using electroanatomical (EA) maps (201, 202) of a portion of a heart chamber, for the system (10) according to any one of Examples 1 to 3.

[0054] (Example 5) The processor (56) is further configured to present the EA maps (201, 202) on a display device, graphically indicate (215, 235) the types of arrhythmogenic activities on the EA maps (201, 202), and graphically connect (227, 237) the activities on the EA maps to at least one of the potential maps of the subsets (223, 233), for the system (10) according to any one of Examples 1 to 4.

[0055] (Example 6) The processor (56) is configured to graphically interconnect at least some of the potential maps of the subsets (223, 233) based on the spatio-temporal relationship between arrhythmogenic activations in the potential maps of the subsets (223, 233), for the system (10) according to any one of Examples 1 to 5.

[0056] (Example 7) The processor (56) is further configured to annotate the arrhythmogenic activations of the arrhythmogenic activities on at least one of the potential maps of the subsets (223, 233), for the system (10) according to any one of Examples 1 to 6.

[0057] (Example 8) 8. The processor (56) is further configured to present on the display device (27) at least some of the electrograms of the subset (223, 233) in an order based on the spatio-temporal progression of the arrhythmogenic activity, for the system (10) according to any one of Examples 1-7.

[0058] (Example 9) The processor (56) is further configured to identify on the EA map (201, 202) one of a local focal excitation and a spiral wave type of arrhythmogenic activity, for the system (10) according to any one of Examples 1-8.

[0059] (Example 10) 10. The processor (56) is further configured to present on the EA map (201, 202) the type of arrhythmogenic activity by presenting (215, 235) one of a local focal excitation and a spiral wave type of arrhythmogenic activity, for the system (10) according to any one of Examples 1-9.

[0060] (Example 11) The method includes presenting on a display device (27) an intracardiac electrogram (221, 231) recorded on tissue of a portion of a heart chamber. A subset (223, 233) of electrograms indicative of arrhythmogenic activity is identified. One or more characteristics of the arrhythmogenic activity are analyzed. The electrograms of the subset (223, 233) are graphically interconnected (225, 245) to present one or more characteristics of the arrhythmogenic activity to a user.

[0061] The examples described herein mainly address cardiac diagnostic applications, but the methods and systems described herein can also be used for other medical applications.

[0062] The embodiments described above are given as examples, and it should be understood that the present disclosure is not limited to those specifically illustrated and described hereinabove. Rather, the scope of the present disclosure includes both various combinations and sub - combinations of the features described hereinabove, as well as variations and modifications thereof that are not disclosed in the prior art and would be conceived by those skilled in the art upon reading the foregoing description.

[0063] [Embodiment] (1) A system comprising: a display device, and a processor, wherein the processor is configured to: present an intracardiac electrogram recorded on tissue of a portion of a heart chamber on the display device, identify a subset of the electrograms indicating arrhythmogenic activity, analyze one or more characteristics of the arrhythmogenic activity, graphically interconnect the subset of the electrograms to present the one or more characteristics of the arrhythmogenic activity to a user. (2) The system according to embodiment 1, wherein the one or more characteristics include at least one of activation amplitude, activation timing, spatio - temporal progression of activation, and activation pattern. (3) The system according to embodiment 1, wherein the processor is configured to graphically interconnect the subset of the electrograms by using arrows to present the one or more characteristics. (4) The system according to embodiment 1, wherein the processor is configured to identify the subset of the electrograms by using an electroanatomical (EA) map of the portion of the heart chamber. (5) The system according to embodiment 4, wherein the processor is further configured to present the EA map on the display device, graphically indicate the type of the arrhythmogenic activity on the EA map, and graphically connect the activity on the EA map to at least one of the subset of the electrograms.

[0064] (6) The system according to embodiment 1, wherein the processor is configured to graphically interconnect at least some of the potential maps of the subset based on a spatio-temporal relationship between arrhythmogenic activations in the potential maps of the subset. (7) The system according to embodiment 1, wherein the processor is further configured to annotate arrhythmogenic activations of the arrhythmogenic activity on at least one of the potential maps of the subset. (8) The system according to embodiment 1, wherein the processor is further configured to present at least some of the potential maps of the subset on the display device in an order based on a spatio-temporal progression of the arrhythmogenic activity. (9) The system according to embodiment 1, wherein the processor is further configured to identify on the EA map one of a regional focal source type and a rotor type of arrhythmogenic activity. (10) The system according to embodiment 1, wherein the processor is further configured to present the type of the arrhythmogenic activity on the EA map by presenting one of a regional focal source type and a rotor type of the arrhythmogenic activity.

[0065] (11) A method comprising: presenting on a display device an intracardiac potential map recorded on tissue of a portion of a heart chamber; identifying a subset of the potential maps indicative of arrhythmogenic activity; analyzing one or more characteristics of the arrhythmogenic activity; graphically interconnecting the potential maps of the subset to present the one or more characteristics of the arrhythmogenic activity to a user. (12) The method according to embodiment 11, wherein the one or more characteristics include at least one of activation amplitude, activation timing, spatio-temporal progression of activation, and activation pattern. (13) The method according to embodiment 11, wherein graphically interconnecting the subset of the potential maps to present the one or more characteristics includes using arrows. (14) The method according to embodiment 11, wherein identifying the subset of the potential maps includes using an electroanatomical (EA) map of the portion of the heart chamber. (15) The method according to embodiment 14, including presenting the EA map on the display device, graphically indicating the type of arrhythmogenic activity on the EA map, and graphically connecting the activity on the EA map to at least one of the subset of the potential maps.

[0066] (16) The method according to embodiment 11, wherein graphically interconnecting at least some of the subset of the potential maps is based on the spatio-temporal relationship between arrhythmogenic activations in the subset of the potential maps. (17) The method according to embodiment 11, including annotating the arrhythmogenic activations of the arrhythmogenic activity on at least one of the subset of the potential maps. (18) The method according to embodiment 11, including presenting at least some of the subset of the potential maps on the display device in an order based on the spatio-temporal progression of the arrhythmogenic activity. (19) The method according to embodiment 11, including identifying on the EA map one of a local focal excitation type and a spiral wave type of arrhythmogenic activity. (20) The system according to embodiment 11, including presenting the type of arrhythmogenic activity on the EA map by presenting one of a local focal excitation type and a spiral wave type of arrhythmogenic activity.

Claims

1. 1. A system comprising: A display device; a processor, the processor comprising: presenting on said display device an intracardiac electrogram recorded on tissue of a portion of a cardiac chamber; identifying a subset of said electrograms indicative of arrhythmogenic activity; analyzing one or more characteristics of the arrhythmogenic activity; The system is configured to graphically interconnect the electrograms of the subset to present to a user the one or more characteristics of the arrhythmogenic activity.

2. The system of claim 1 , wherein the one or more characteristics include at least one of activation amplitude, activation timing, spatiotemporal progression of activation, and activation pattern.

3. 2. The system of claim 1, wherein the processor is configured to graphically interconnect the electrograms of the subset by using arrows to present the one or more characteristics.

4. The system of claim 1 , wherein the processor is configured to identify the subset of electrograms by using an electroanatomical (EA) map of the portion of the heart chamber.

5. 5. The system of claim 4, wherein the processor is further configured to present the EA map on the display device, graphically indicate the type of arrhythmogenic activity on the EA map, and graphically connect the activity on the EA map to at least one of the electrograms of the subset.

6. 2. The system of claim 1, wherein the processor is configured to graphically interconnect at least some of the electrograms of the subset based on spatiotemporal relationships between arrhythmogenic activations in the electrograms of the subset.

7. 2. The system of claim 1, wherein the processor is further configured to annotate arrhythmogenic activation of the arrhythmogenic activity on at least one of the electrograms of the subset.

8. 2. The system of claim 1, wherein the processor is further configured to present at least some of the electrograms of the subset on the display device in an order based on the spatiotemporal progression of the arrhythmogenic activity.

9. 2. The system of claim 1, wherein the processor is further configured to identify, on the EA map, one of a local focal activation type and a spiral swirling activation wave type of arrhythmogenic activity.

10. 2. The system of claim 1, wherein the processor is further configured to present the type of arrhythmogenic activity on the EA map by presenting one of a local focal activation type and a spiral swirling activation wave type of arrhythmogenic activity.

11. 1. A method comprising: presenting on a display device an intracardiac electrogram recorded on tissue in a portion of a cardiac chamber; identifying a subset of said electrograms indicative of arrhythmogenic activity; analyzing one or more characteristics of the arrhythmogenic activity; and and graphically interconnecting the electrograms of the subset to present the one or more characteristics of the arrhythmogenic activity to a user.

12. 12. The method of claim 11, wherein the one or more characteristics include at least one of activation amplitude, activation timing, spatiotemporal progression of activation, and activation pattern.

13. The method of claim 11 , wherein graphically interconnecting the electrograms of the subset to present the one or more characteristics comprises using arrows.

14. 12. The method of claim 11, wherein identifying the subset of electrograms comprises using an electroanatomical (EA) map of the portion of the heart chamber.

15. 15. The method of claim 14, comprising presenting the EA map on the display device, graphically indicating a type of the arrhythmogenic activity on the EA map, and graphically connecting the activity on the EA map to at least one of the electrograms of the subset.

16. 12. The method of claim 11, wherein graphically interconnecting at least some of the electrograms of the subset comprises based on spatiotemporal relationships between arrhythmogenic activations in the electrograms of the subset.

17. 12. The method of claim 11, comprising annotating arrhythmogenic activation of the arrhythmogenic activity on at least one of the electrograms of the subset.

18. 12. The method of claim 11, comprising presenting at least some of the electrograms of the subset on the display device in an order based on the spatiotemporal progression of the arrhythmogenic activity.

19. 12. The method of claim 11, comprising identifying on the EA map one of a local focal activation type and a spiral swirling activation wave type of arrhythmogenic activity.

20. The system of claim 11, further comprising presenting the type of arrhythmogenic activity on the EA map by presenting one of a local focal excitation type and a spiral swirling excitation wave type of arrhythmogenic activity.

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