Method and system for displaying information during cardiac operation

Abstract

To select information to be displayed to a physician during cardiac surgery and use the information to update a view of electrical activity within the heart.SOLUTION: The present invention relates to a method, apparatus and computer program product. The method comprises obtaining a plurality of electrical signals from an electrode assembly 28 disposed on a catheter 14 inserted into a chamber of a heart of a patient, wherein each electrical signal provides information on electrical activity in locations within the heart 12. Each location is associated with a value for each attribute from the plurality of attributes. The method further comprises receiving from a user a selection of a filtering criteria for the at least one location. The filtering criteria is associated with at least one attribute. The method further comprises: applying the filtering criteria for identifying a subset of locations complying with the filtering criteria from the at least one location; updating a map of electrical activity within the heart; and displaying the map of the electrical activity.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present disclosure relates to a method of selecting information presented to a physician during a heart surgery and using that information to update a view of the electrical activity within the heart.

Background Art

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

[0003] It may be necessary to evaluate the electrical activity at multiple locations on the heart wall in order to assess a patient's condition and determine a treatment such as applying one or more ablations. This activity can be obtained from a plurality of electrodes disposed at the distal tip of an intracardiac catheter inserted into one or more heart chambers of the heart. The plurality of acquired signals can be displayed to a user such as a physician performing the surgery. The acquired signals can also be used to generate a map of the electrical activity within the heart.

Brief Description of the Drawings

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

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[0005] The following description sets forth numerous specific details in order to provide a thorough understanding of the present invention. However, it will be apparent to those skilled in the art that the present invention may be practiced without these specific details. In other instances, detailed descriptions of well-known circuits, control logic, and computer program instructions related to conventional algorithms and processes are not shown so as not to unnecessarily obscure the present invention.

[0006] The software programming code embodying aspects of the present invention is typically maintained on a permanent storage device such as a computer-readable medium. In a client-server environment, such software programming code may be stored on the client or the server. The software programming code may be embodied on any of a variety of well-known media for use in a data processing system. This includes magnetic and optical storage devices such as disk drives, magnetic tapes, compact discs (CDs), digital video discs (DVDs), and computer instruction signals embodied on a transmission medium, whether or not the signal is modulated onto a carrier wave, including, but not limited to, a communication network such as the Internet. Additionally, the present invention may be embodied in computer software, but the functions necessary to implement the present invention may alternatively be embodied, in whole or in part, using hardware components such as application-specific integrated circuits or other hardware, or some combination of hardware components and software.

[0007] Overview The arrhythmogenic tissue associated with atrial fibrillation can be identified by examining an intracardiac electrogram (IEGM) at one or more locations on the atrial wall, such as the inner wall, to detect local potentials caused by depolarization at each of the one or more locations.

[0008] The IEGM is typically detected by one or more electrodes on the distal tip of an intracardiac catheter. In some exemplary embodiments, the intracardiac catheter further includes a position sensor configured to track the position of the distal tip.

[0009] Modern catheters have multiple electrodes distributed across multiple splines of the catheter, and at any given time, each electrode samples the electrical activity at a location. For example, some catheters may have dozens or even 100 electrodes, and thus may collect information about thousands of points within the heart, which corresponds to a significant amount of data. The data can be used to generate a map showing the exact geometric reconstruction of the heart and an overall view of the electrical activity within the heart. The electrical activity can be graphically represented, such as by color-coding regions of the map, pattern coding, etc., according to the electrical activity at each location measured by the electrodes present at that location.

[0010] However, this abundance of data also poses a problem because it may not allow a user, such as a physician or a clinical assistant (CAS), to focus on a specific aspect of the procedure or a specific region of the heart. For example, the user may be interested in viewing only the electrical activity information regarding the region of the heart within the scar border zone where a dangerous isthmus of arrhythmia exists. In another example, the user may be interested in viewing only regions that have a late annotation time (LAT) having a specific value, etc.

[0011] In currently available systems and methods, a user may be presented with a list of positions that were sampled by electrodes and used in constructing a cardiac map. The user may further be presented with a map that is color-coded based on all available positions and the electrical activity therein. The user may manually select individual positions to include or exclude from the view when generating the map. However, due to the large number of electrodes in advanced catheters and the vast number of positions, this approach can be difficult to implement efficiently because it can take a long time for a physician to select positions and identify each position in the list within the map. Such selections can result in inaccurate results because, beyond being infeasible, a physician may make mistakes when identifying desired positions.

[0012] Accordingly, according to some examples of the present disclosure, a user may be presented with a user interface for selecting a subset of available positions according to one or more attributes associated with each position. The user interface may include a list of attributes and one or more possible values applicable for each such attribute. Next, the user can select the attributes to check and the one or more values required for each attribute. The cardiac map can then be updated to show electrical activity based only on positions that match the values of the applicable attributes. Thus, if the selection excludes positions within a particular region, this region will have no display, such as a color display for electrical activity.

[0013] However, it is understood that the geometric reconstruction of the cardiac map can be based on positions among all available positions such that fewer positions are shown while maintaining the map structure and resolution and contributing to the display of electrical activity.

[0014] The reduction in the number of positions allows a physician to focus on specific regions, such as necessary aspects, scar areas.

[0015] Some attributes may be binary, such as a tissue proximity index (TPI) that indicates whether a position is on the heart wall so that a user can select only positions on the heart wall and exclude internal positions from the map and list. Other attributes, such as voltage or impedance, may be associated with a numerical range so that a user can select only positions that have values within a desired range (or, in the case of discrete attributes, belong to a selected set of values).

[0016] For unselected attributes, all values are acceptable, and it is understood that there are no positions that are excluded from the calculation and list due to their values for any one of these attributes.

[0017] It is also understood that the user interface can enable an opt-in where the user can select which attributes to apply, or an opt-out where the user can select which attributes not to apply.

[0018] One or more sets of attributes and corresponding values may be defined, stored, and displayed as presets, such that the user can apply all attributes associated with a preset in a single operation without having to indicate each attribute and its corresponding value. The user can also apply multiple presets. Thus, one or more presets can be stored and displayed for the user to select, whether defined globally as a default or defined by the user.

[0019] The values of the attributes in a preset can vary according to the values of the sampled positions. For example, for the attribute of voltage, if a preset indicates a range of values from 0.5 to 1.5 mV and none of the sampled positions have values exceeding 1.2 mV, the preset can be updated for the current procedure to display a range of 0.5 to 1.2 mV and enable the user to select it.

[0020] The present system and method provide advanced filtering of locations according to one or more specific attributes. Further, a physician who wishes to display only specific locations on a map does not need to consider all available locations and determine which ones to use. Since each map can be based on tens of thousands of locations, it is clearly not feasible to select individual locations as in currently available systems. Thus, the disclosed method and system provide for automatically selecting locations based on a selected combination of attributes. Selective and dynamic coloring of the heart map provides an improved user experience and streamlines the work, thereby also reducing the surgical time.

[0021] Further, the definition of criteria and presets, the storage, and the customizable definition may obviate the need for the user to define the presets anew each time and allow the presets to be changed as needed, thus providing an improvement in the efficiency and flexibility of the system.

[0022] Description of the System Refer to FIG. 1, which shows an exemplary catheter-based electrophysiology mapping and ablation system 10. The system 10 may include a plurality of catheters that can be percutaneously inserted by a physician 24 into a heart chamber or vascular structure of the heart 12 through the vasculature of a patient 23. Typically, a delivery sheath catheter is inserted into the left atrium or right atrium near a desired location of the heart 12. Thereafter, one or more catheters may be inserted into the delivery sheath catheter to reach a desired location within the heart 12. The plurality of catheters may include catheters dedicated to sensing intracardiac electrogram (IEGM) signals, catheters dedicated to ablation, and / or catheters dedicated to both sensing and ablation. An exemplary catheter 14 configured to sense IEGM is illustrated herein. The physician 24 may place the electrode assembly 28 of the catheter 14 in contact with the heart wall to sense a target site in the heart 12. For ablation, the physician 24 may similarly place the distal end of an ablation catheter in contact with a target site for ablation of tissue.

[0023] Catheter 14 is an exemplary catheter that is basket-shaped and includes one or preferably a plurality of electrodes 26 that are optionally distributed across a plurality of splines 22 in electrode assembly 28 and are configured to sense IEGM signals. Each electrode 26 is connected either by passing through spline 22 towards a patient interface unit (PIU) 30, detailed below, or via a wire (not shown) attached to spline 22. Spline 22 can be coupled to the shaft 19 of electrode assembly 28. However, it is understood that the present disclosure is not limited to a basket-shaped electrode assembly 28 and is applicable to any type of catheter having any number of splines and electrodes.

[0024] Catheter 14 can additionally include a position sensor 29 embedded within or near electrode assembly 28 to track the position and orientation of electrode assembly 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.

[0025] 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 electrode assembly 28 of catheter 14 can be tracked based on the magnetic field generated by position pad 25 and sensed by magnetic-based position 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.

[0026] Additionally or alternatively, system 10 may include one or more electrode patches 38 disposed for skin contact on patient 23 to establish position referencing of position pad 25 and impedance-based tracking of electrodes 26. For impedance-based tracking, current is directed to electrodes 26 and sensed at electrode skin patches 38, whereby the position of each electrode can be triangulated via electrode patches 38. Details of impedance-based position tracking techniques are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182.

[0027] System 10 displays on display device 27 a preset selection pane 35, an anatomical map 20 of the heart using color coding to indicate electrical activity within the heart, and a pane 21 of attributes of a plurality of positions captured by electrodes 26 of catheter 14, the plurality of positions being used to color code the map.

[0028] Recorder 11 may include pacing capabilities for pacing the rhythm of the heart and / or may be electrically connected to an independent pacemaker.

[0029] PIU 30 may be configured to establish electrical communication between the catheter, other electrophysiological devices, a power source, and workstation 55 that controls the operation of system 10. The electrophysiological devices of system 10 may include, for example, a plurality of catheters, position pad 25, body surface ECG electrodes 18, electrode patches 38, ablation energy generator 50, and recorder 11. Optionally and preferably, PIU 30 further includes processing capabilities for performing real-time calculations of the position of electrodes 26 and executing ECG calculations.

[0030] The workstation 55 includes a memory, a processor unit having a memory or storage device in which appropriate operating software is stored, and user interface functionality. The workstation 55 may provide a plurality of functions and, optionally, (1) model the endocardial anatomical structure in three dimensions (3D) based on signals received from the electrodes 26 and render the model or anatomical map 20 for display, (2) select a subset of the positions where the electrodes 26 provided information according to an active preset, and (3) display the rendered anatomical map 20 on the display device 27 as color-coded or pattern-coded according to the selected positions, presets, and selected position lists. One commercially available product embodying the elements of the system 10 is available as the CARTO (trademark) 3 system available from Biosense Webster, Inc. (31A Technology Drive, Irvine, CA, 92618).

[0031] Referring to FIG. 2, an exemplary user interface for defining or modifying attributes and presets according to some exemplary embodiments of the present disclosure is shown.

[0032] The user interface, generally referred to by 200, includes a number or other identifier 204 for the preset being defined or modified.

[0033] The user interface 200 further includes a table 208 for defining the attributes to be applied and their respective values. For example, one or more values indicating a range, acceptable values, or binary values may be defined for each such attribute. The values may be provided by the user typing text into a text box, using a slider, selecting from a list, etc. In some embodiments, for example, for an attribute having discrete values, a set of one or more values may be selected.

[0034] For example, for the attribute CL (cycle length), the first value of 180 (212) may be the minimum value, and the second value of 250 (216) may be the maximum value.

[0035] In the case of binary attributes such as TPI (tissue proximity), only one value of 224 can be selected from possible values such as true / false.

[0036] Once the attributes and values are defined, the user can save the set of attributes as a preset by pressing the "Preset Save" button 228. In some embodiments, the user may be prompted to provide a name for the preset.

[0037] In some embodiments, the user can apply the set of active attributes in place only at the currently available location by pressing the Apply button 232 without saving the preset.

[0038] For example, it is understood that the values shown as the first value 212 and the second value 216, or as the first value 224, may have default values proposed to the user. In some embodiments, the values that the user can input or select may be restricted to the values available in the set of positions so that during the operation, the user cannot select a value lower than the minimum value present at any of the points, a value higher than the maximum value present at any of the points, a binary value not available at any of the points, etc.

[0039] An exemplary list of attributes whose values can be restricted includes, but is not limited to, any one or more of the following. Impedance for which a lower and / or upper limit may be provided and an indicator of scar tissue may be provided, Voltage for which a lower and / or upper limit may be provided, LAT (late activation time) for which a lower and / or upper limit may be provided, LAM (Late Annotation Mapping), A BI (average value obtained from bipolar electrodes) for which a lower limit and / or an upper limit can be given, A TPI (tissue proximity) for which a true / false value indicating whether the position is on or inside the heart wall can be provided, A CL (cycle length) for which a lower limit and / or an upper limit can be provided, One or more stability parameters of the signal, A fractionated signal for which a true / false value can be provided, And a connection signal for which a true / false value can be provided.

[0040] Referring now to FIG. 3, a view of a display during a heart surgery after application of a first preset according to some exemplary embodiments of the present disclosure is shown.

[0041] The view generally referenced by 300 is substantially identical to the view displayed on the display 27 of FIG. 1.

[0042] View 300 shows a preset pane 35, and the user can view three presets numbered 1, 2, and 3. For each preset, the attributes associated with the preset are shown split into groups such as a point filter 304, an ECG filter 308, and an ablation filter 312. For each preset, the user can select whether it should be activated using the corresponding entry within the "active" column 316. In the example of FIG. 3, only preset number 1 is activated.

[0043] It is understood that multiple presets can be activated simultaneously such that the selected position is a position whose attributes match all active presets. For example, if one active preset limits the CL attribute to 170 - 240 and another active preset limits the CL attribute to 200 - 270, the value actually used will be 200 - 240.

[0044] The range may be further reduced according to the attribute values of the available positions. For example, if the minimum available value is 210, the range is reduced to 210 - 240.

[0045] In some embodiments, when the user points to or hovers over a specific attribute such as CL, a pop-up window 320 may be displayed, showing the values associated with this attribute in the current situation, such as the range of 210 - 240 above. In other embodiments, the text can display the values determined by the active preset such as 200 - 240 above.

[0046] The view 300 can further display, for example, within the text box 324, the number of active positions, i.e., the number of positions used to estimate the electrical activity in the heart and color the map under the current preset.

[0047] The view 300 can further include a two-dimensional (2D) or three-dimensional (3D) map 20 of the heart, and the map 20 can be operated by the user, for example, rotated, scaled, zoomed, etc.

[0048] The view 300 can further include a list 21 of positions that conform to all active presets and are thus used to estimate the electrical activity of the heart, and some of the attributes of these positions. In some embodiments, the attributes to be displayed may be attributes whose values are restricted by the active preset.

[0049] Referring now to FIG. 4, a view of the display during heart surgery after preset numbers 1 and 2 are activated is shown. This preset selection reduces the number of active positions from 1995 to 732, as shown in the text box 325. This reduction can also be observed by the size of the scroll bar 328 relative to the size of FIG. 3.

[0050] Since the coloring of the map 20 in FIG. 4 is based on a set of different positions, it can be seen that it is different from the coloring in FIG. 3. However, the anatomical reconstruction of the heart does not change because it is based on the position information obtained from the electrodes at all points.

[0051] It is understood that a plurality of maps may be displayed, for example, in different panes or different tabs of a display so that a user can switch between different maps.

[0052] Referring now to FIG. 5, a flowchart of steps of a method for displaying information during a heart surgery according to some exemplary embodiments of the present disclosure is shown.

[0053] In step 504, which may be a preliminary step, one or more filtering criteria may be defined. For example, the defining step 504 may be performed during system configuration by a manufacturer, during system deployment by an expert, or during or before system use by a user such as a physician.

[0054] Step 504 may include step 508 of defining one or more criteria related to the attributes of positions within a patient's heart, or presets related to one or more such attributes. Each attribute included in the criteria or presets may be associated with one or more values, such as a numerical range, a binary value, a selection of discrete values, etc.

[0055] In step 512, the criteria or presets may be stored in a storage device accessible to a computing platform associated with the surgery, such as the workstation 55.

[0056] In step 516, during a heart surgery, a plurality of electrical signals can be obtained from the electrodes of a catheter, and the electrical signals indicate electrical activities at a plurality of positions within or on the wall of the heart. It is understood that when the electrodes are moved by the user, each signal can provide information regarding a plurality of positions. Each of such positions can be associated with a value of each of a plurality of attributes. The positions and the electrical signals can be useful in constructing a map of the heart and encoding the map according to the electrical activities in each region of the heart.

[0057] In step 520, regardless of whether a criterion is part of a preset, a selection of one or more filtering criteria can be received. The filtering criteria may be selected from a predetermined stored criterion or preset, or may be defined on-the-fly by the user of the system.

[0058] In step 524, a filtering criterion or preset can be applied to a plurality of positions to identify positions that conform to the filtering criterion or preset. It is understood that multiple criteria or presets may be applied such that only positions that conform to all applied criteria or presets are identified.

[0059] In step 528, a map indicating the electrical activities within the heart can be updated to indicate the electrical activities based only on the positions that conform to the criterion or preset. Thus, the encoding of the map can be based on fewer positions than before applying the criterion or preset, but the updated map can provide an indicator more suitable for the user's needs.

[0060] In step 532, the updated map can be displayed to the user.

[0061] In step 536, a list of positions that conform to the criterion or preset can be displayed while the display of non-conforming positions is avoided. In some embodiments, values associated with one or more attributes of each position can also be displayed.

[0062] The process may be repeated during heart surgery, and the reference or preset may be reapplied for each repetition with respect to the newly received position. It is understood that the selection of the reference or preset does not need to be repeated for each repetition and needs to be repeated only when there is a change in the user's selection.

[0063] Referring now to FIG. 6, a block diagram of a computing platform 600 for displaying information during heart surgery according to some exemplary embodiments of the present disclosure is shown.

[0064] It is understood that the computing platform 600 may be embedded within the workstation 55, may be a stand-alone computing platform, or may be embedded at other locations and operably communicate with the workstation 55.

[0065] The computing platform 600 may be implemented as one or more computing platforms that can be operably connected to each other. For example, one or more remote computing platforms may be implemented, for example, on a cloud computer. Other computing platforms may be part of a computer network of a related organization. In other embodiments, all functions may be provided by one or more computing platforms that are all part of an organizational network.

[0066] Computing platform 600 may include one or more processors 604, which may or may not be located on the same computing platform. The processor 604 may be one or more central processing units (CPUs), microprocessors, electronic circuits, integrated circuits (ICs), etc. The processor 604 may be configured to provide the required functions, for example, by loading software modules stored in a storage device 612, which will be described in detail below, into memory and activating them.

[0067] Computing platform 600 may include a communication device 608 for communicating with other devices or other computing platforms as needed, such as obtaining information indicating the position and electrical measurements from a catheter treatment controller, and storing data such as presets on a remote storage device. The communication module 608 may interface with any communication channel, such as a local area network (LAN), wide area network (WAN), cellular network, etc., and may be adapted to use any associated communication protocol.

[0068] Computing platform 600 may include a storage device 612, such as a hard disk drive, flash disk, random access memory (RAM), memory chip, etc. In some exemplary embodiments, the storage device 612 may hold program code operable to cause the processor 604 to perform operations associated with any of the modules listed below, or steps of the method of FIG. 5 above. The program code may include one or more executable units, such as functions, libraries, stand-alone programs, etc., adapted to execute the instructions described in detail below.

[0069] Alternatively or additionally, the instructions provided may be stored on a non-transitory tangible computer-readable medium such as magnetic memory, optical memory, or electronic memory.

[0070] The memory device 612 may include a display and user interface module 616 for rendering a display, such as a map of the heart, a list of positions, etc., on the display device 27 for the user. The display and user interface module 616 may also be operable when receiving instructions and operation parameters from the user, for example, when selecting a reference or preset. The display and user interface module 616 may include a reference and preset definition module 620 for defining one or more references or presets, including, for example, selecting attributes and corresponding values as shown in FIG. 2 above.

[0071] The memory device 612 may include a communication module 624 for transmitting and receiving data, such as catheter positions, associated potential maps, user preferences, histograms, etc., between other parts of the system or with other systems via the communication device 608.

[0072] The memory device 612 may include a reference and preset application module 628 for applying the selected reference to the positions where information is received from the electrodes to identify positions that conform to the reference or preset. When multiple presets or references having a common attribute are selected, the identified positions are the positions that conform to the common portion of the defined values.

[0073] The memory device 612 may include an electrical map generation module 632 for generating a geometric reconstruction of the heart and an electrical activity map shown thereon based on all available points.

[0074] The memory device 612 may include an electrical map update module 636 for updating the electrical activity map of the heart to reflect only the electrical information associated with positions that conform to the applied reference or preset.

[0075] The steps and modules disclosed above are required, in addition to software, hardware, firmware, or other modules, for operating a catheter, displaying a catheter treatment process, performing other calculations such as signal analysis, particularly complex fractionated electrogram (CFE) analysis, generating a heart map, and the like. Further details regarding the methods and systems can be found, for example, in U.S. Patent Nos. 8,676,305 and 9,629,567, which are hereby incorporated by reference in their entirety for any purpose.

[0076] The present invention can be a system, a method, and / or a computer program product. The computer program product may include a computer-readable storage medium having computer-readable program instructions for causing a processor to execute aspects of the present invention.

[0077] A computer-readable storage medium can be a tangible device that can hold and store instructions for use by an instruction execution device. The computer-readable storage medium can be, for example, an electronic storage device, a magnetic storage device, an optical storage device, an electromagnetic storage device, a semiconductor storage device, or any suitable combination of the foregoing, but is not limited thereto. A non-exhaustive list of more specific examples of computer-readable storage media includes portable computer disks, hard disks, random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), static random access memory (SRAM), portable compact disk read-only memory (CD-ROM), digital versatile disks (DVDs), memory sticks, floppy disks, mechanically encoded devices such as punch cards or raised structures in grooves in which instructions are recorded, and any suitable combination of the foregoing. As used herein, a computer-readable storage medium should not be construed to be a signal per se that is a transient signal, 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.

[0078] The computer-readable program instructions described herein can be downloaded from a computer-readable storage medium to respective computing / processing devices or to an external computer or external storage device via a network, such as the Internet, a local area network, a wide area network, and / or a wireless network. The network may include copper transmission cables, optical transmission fibers, wireless transmission, routers, firewalls, switches, gateway computers, and / or edge servers. A network adapter card or network interface of each computing / processing device receives the computer-readable program instructions from the network and transfers the computer-readable program instructions for storage on a computer-readable storage medium within each respective computing / processing device.

[0079] Computer-readable program instructions for carrying out the operations of the present invention may be written in any combination of assembly instructions, instruction set architecture instructions, machine instructions, machine-dependent instructions, microcode, firmware instructions, state-setting data, or source code or object code written in one or more programming languages, such as Java, C, C++, Python, etc. The computer-readable program instructions may be executed entirely on the user's computer, partially on the user's computer, as a stand-alone software package, partially on the user's computer and partially on a remote computer, or entirely on a remote computer or server. In the latter scenario, the remote computer may be connected to the user's computer via any type of network, including a local area network (LAN) or a wide area network (WAN), or may be connected to an external computer (e.g., via the Internet using an Internet service provider). In some embodiments, for example, an electronic circuit including a programmable logic circuit, a field-programmable gate array (FPGA), or a programmable logic array (PLA) may execute the computer-readable program instructions by using the state information of the computer-readable program instructions to customize the electronic circuit in order to carry out aspects of the present invention.

[0080] Aspects of the present invention are described herein with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of the invention. It will be understood that each block of the flowchart illustrations and / or block diagrams, and combinations of blocks in the flowchart illustrations and / or block diagrams, can be implemented by computer-readable program instructions.

[0081] These computer-readable program instructions are provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine that, when the instructions are executed by the processor of the computer or other programmable data processing apparatus, creates means for implementing the functions / operations specified in one or more blocks of the flowchart and / or block diagram. These computer-readable program instructions may also be stored in a computer-readable storage medium that can direct a computer, programmable data processing apparatus, and / or other devices to function in a particular manner, such that the computer-readable storage medium storing the instructions comprises an article of manufacture including instructions for implementing the aspects of the functions / operations specified in one or more blocks of the flowchart and / or block diagram.

[0082] Alternatively, the computer-readable program instructions may be loaded onto a computer, other programmable data processing apparatus, or other device to cause a series of operational steps to be performed on the computer, other programmable apparatus, or other device to produce a computer-implemented process, whereby the instructions executed on the computer, other programmable apparatus, or other device implement the functions / operations specified in one or more blocks of the flowchart and / or block diagram.

[0083] 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 include one or more executable instructions for implementing the specified logical function. In some alternative implementations, the functions noted in the blocks may occur out of the order noted in the 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 diagrams, and combinations of blocks in the block diagrams and / or flowchart diagrams, can be implemented by a dedicated hardware-based system that performs the specified functions or operations, or combinations of dedicated hardware and computer instructions.

Example

[0084] (Example 1) A method comprising: obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient, wherein each electrical signal from the plurality of electrical signals provides information regarding electrical activity at at least one location within the heart, and each location of the at least one location is associated with a value of each attribute from a plurality of attributes; receiving, via a user interface, a selection of filtering criteria for at least one location from a user, wherein the filtering criteria is associated with at least one attribute from the plurality of attributes; applying the filtering criteria to identify a subset of locations that conform to the filtering criteria from the at least one location; updating a map of electrical activity within the heart based only on the subset of locations; and displaying the map of electrical activity.

[0085] (Example 2) Performing obtaining, applying, updating, and displaying is the method described in Example 1 that is repeatedly executed.

[0086] (Example 3) Further including displaying to the user a representation of information related to a subset of positions while avoiding displaying information regarding other positions that do not conform to the filtering criteria, the method described in Example 1 or 2.

[0087] (Example 4) The plurality of electrical signals are electrocardiogram (ECG) signals, the method described in any one of Examples 1 to 3.

[0088] (Example 5) At least one attribute is selected from the group consisting of impedance, voltage, late annotation time (LAT) value at a position associated with the electrical signal, late annotation mapping (LAM), tissue proximity index (TPI), a value obtained from bipolar measurement (BI), cycle length (CL) of the electrical signal, at least one stability parameter of the signal, fractionated signal or unfractionated signal, and connected signal or disconnected signal, the method described in any one of Examples 1 to 4.

[0089] (Example 6) At least one filtering criterion is included in at least one preset, and applying the filtering criterion is performed by applying at least one preset to identify a subset of positions, the method described in any one of Examples 1 to 5.

[0090] (Example 7) Further including defining at least one filtering criterion, the method described in any one of Examples 1 to 6.

[0091] (Example 8) Defining at least one filtering criterion includes defining at least one preset associated with at least one attribute, the method described in Example 7.

[0092] (Example 9) The method according to Example 8, further comprising storing at least one preset.

[0093] (Example 10) The method according to Example 8, wherein defining at least one filtering criterion includes selecting at least one attribute and at least one corresponding value.

[0094] (Example 11) The method according to Example 10, wherein at least one corresponding value includes a minimum value or a maximum value of a numerical range of at least one attribute.

[0095] (Example 12) The method according to Example 10, wherein at least one corresponding value includes a binary value for at least one attribute.

[0096] (Example 13) The method according to Example 10, wherein at least one corresponding value includes one or more discrete values for at least one attribute.

[0097] (Example 14) The method according to Example 8, wherein the user interface enables the user to select one or more presets to be applied from at least one preset.

[0098] (Example 15) The method according to Example 14, wherein when the same attribute is included in at least two activated presets, at least one corresponding value of the same attribute conforms to the limitations of the two presets.

[0099] (Example 16) The method according to Example 14, wherein at least one corresponding value of an attribute within a preset conforms to an available value of at least one attribute within at least one position.

[0100] (Example 17) A computerized device having a processor coupled to a memory unit, the processor being configured to: obtain a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient, wherein each electrical signal from the plurality of electrical signals provides information regarding electrical activity at at least one location within the heart, and each location among the at least one location is associated with a value of each attribute from a plurality of attributes; receive from a user, via a user interface, a selection of filtering criteria for at least one location, the filtering criteria being associated with at least one attribute from the plurality of attributes; apply the filtering criteria to identify a subset of locations that conform to the filtering criteria from the at least one location; update a map of electrical activity within the heart based only on the subset of locations; and display the map of electrical activity.

[0101] (Example 18) The apparatus according to Example 17, wherein at least one filtering criterion is included in at least one preset, and applying the filtering criteria is performed by applying at least one preset to identify a subset of locations.

[0102] (Example 19) The apparatus according to Example 18, wherein the processor is further configured to obtain a definition of at least one preset, and the at least one preset is associated with at least one attribute.

[0103] (Example 20) A computer program product comprising a non-transitory computer-readable medium that holds program instructions, which, when read by a processor, cause the processor to: obtain a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient, wherein each electrical signal from the plurality of electrical signals provides information regarding electrical activity at at least one location within the heart, and each location of the at least one location is associated with a value of each of a plurality of attributes; receive, via a user interface, a selection of filtering criteria for at least one location from a user, wherein the filtering criteria is associated with at least one of the plurality of attributes; apply the filtering criteria to identify a subset of locations that conform to the filtering criteria from the at least one location; update a map of electrical activity within the heart based only on the subset of locations; and display the map of electrical activity.

[0104] The embodiments described herein mainly address cardiac diagnostic applications, but the methods and systems described herein can also be used for other medical applications.

[0105] It will be understood that the embodiments described above are given by way of example only, and that the present disclosure is not limited to what is particularly illustrated and described above in this specification. Rather, the scope of the present disclosure includes both combinations and sub-combinations of the various features described above in this specification, as well as variations and modifications thereof that would occur to a person skilled in the art upon reading the foregoing description and that are not disclosed in the prior art.

[0106] 〔Embodiments〕 (1) A method, comprising: Obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient, wherein each electrical signal from the plurality of electrical signals provides information regarding electrical activity at at least one location within the heart, and each location among the at least one location is associated with a value of each attribute from a plurality of attributes; Receiving, from a user via a user interface, a selection of filtering criteria for the at least one location, wherein the filtering criteria is associated with at least one attribute from the plurality of attributes; Applying the filtering criteria to identify a subset of locations that conform to the filtering criteria from the at least one location; Updating a map of electrical activity within the heart based only on the subset of locations; Displaying the map of the electrical activity. A method comprising: (2) The method according to Embodiment 1, wherein the obtaining, applying, updating, and displaying are repeatedly executed. (3) The method according to Embodiment 1, further comprising displaying to the user a representation of information related to the subset of locations while avoiding displaying information regarding other locations that do not conform to the filtering criteria. (4) The method according to Embodiment 1, wherein the plurality of electrical signals are electrocardiogram (ECG) signals. (5) The at least one attribute is selected from the group consisting of impedance, voltage, late annotation time (LAT) value at a location associated with the electrical signal, late annotation mapping (LAM), tissue proximity index (TPI), a value obtained from bipolar measurement (BI), cycle length (CL) of the electrical signal, at least one stability parameter of the signal, fractionated signal or unfractionated signal, connected signal or disconnected signal. The method according to Embodiment 1.

[0107] (6) The method according to embodiment 1, wherein the at least one filtering criterion is included in at least one preset, and applying the filtering criterion is performed by applying the at least one preset to identify a subset of the positions. (7) The method according to embodiment 1, further comprising defining the at least one filtering criterion. (8) The method according to embodiment 7, wherein defining the at least one filtering criterion includes defining at least one preset associated with the at least one attribute. (9) The method according to embodiment 8, further comprising storing the at least one preset. (10) The method according to embodiment 8, wherein defining the at least one filtering criterion includes selecting the at least one attribute and at least one corresponding value.

[0108] (11) The method according to embodiment 10, wherein at least one corresponding value includes a minimum value or a maximum value of a numerical range of the at least one attribute. (12) The method according to embodiment 10, wherein the at least one corresponding value includes a binary value regarding the at least one attribute. (13) The method according to embodiment 10, wherein the at least one corresponding value includes one or more discrete values regarding the at least one attribute. (14) The method according to embodiment 8, wherein the user interface enables a user to select one or more presets to be applied from the at least one preset. (15) The method according to embodiment 14, wherein when the same attribute is included in at least two activated presets, the at least one corresponding value of the same attribute conforms to the limitations of the two presets.

[0109] (16) The method according to embodiment 14, wherein the at least one corresponding value of the attribute within the preset conforms to an available value of the at least one attribute within the at least one position. (17) A computerized device having a processor coupled to a memory unit, wherein the processor obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient's heart, each electrical signal from the plurality of electrical signals providing information regarding electrical activity at at least one position within the heart, each position among the at least one position being associated with a value of each attribute from a plurality of attributes; receiving, from a user via a user interface, a selection of a filtering criterion for the at least one position, the filtering criterion being associated with at least one attribute from the plurality of attributes; applying the filtering criterion to identify a subset of positions that conform to the filtering criterion from the at least one position; updating a map of electrical activity within the heart based only on the subset of positions; and displaying the map of the electrical activity. A computerized device adapted to perform the steps. (18) The device according to embodiment 17, wherein the at least one filtering criterion is included in at least one preset, and applying the filtering criterion is performed by applying the at least one preset to identify the subset of positions. (19) The device according to embodiment 18, wherein the processor is further adapted to obtain a definition of the at least one preset, and the at least one preset is associated with the at least one attribute. A computer program product comprising a non-transitory computer-readable storage medium holding program instructions configured to cause a processor to execute operations, the program instructions being obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient, each electrical signal from the plurality of electrical signals providing information regarding electrical activity at at least one location within the heart, each location of the at least one location being associated with a value of each attribute from a plurality of attributes; receiving, via a user interface, a selection of filtering criteria for the at least one location from a user, the filtering criteria being associated with at least one attribute from the plurality of attributes; applying the filtering criteria to identify a subset of locations that conform to the filtering criteria from the at least one location; updating a map of electrical activity within the heart based only on the subset of locations; displaying the map of the electrical activity. A computer program product that performs the above.

Claims

1. A computerized device having a processor coupled to a memory unit, wherein the processor is configured to: obtain a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient, each electrical signal from the plurality of electrical signals providing information regarding electrical activity at at least one location within the heart, each location of the at least one location being associated with a value of each attribute from a plurality of attributes; receive, from a user via a user interface, a selection of a filtering criterion for the at least one location, the filtering criterion being associated with at least one attribute from the plurality of attributes; apply the filtering criterion to identify a subset of locations that conform to the filtering criterion from the at least one location; update a map of electrical activity within the heart based only on the subset of locations; display the map of electrical activity.

2. The apparatus of claim 1, wherein the at least one filtering criterion is included in at least one preset, and applying the filtering criterion is performed by applying the at least one preset to identify the subset of locations.

3. The apparatus of claim 2, wherein the processor is further configured to obtain a definition of the at least one preset, the at least one preset being associated with the at least one attribute.

4. A computer program product comprising a non-transitory computer-readable storage medium holding program instructions configured to cause a processor to perform operations, the program instructions comprising: obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient, each electrical signal from the plurality of electrical signals providing information regarding electrical activity at at least one location within the heart, each location of the at least one location being associated with a value of each attribute from a plurality of attributes; Receiving, via a user interface, a selection of a filtering criterion from a user for at least one of the positions, wherein the filtering criterion is associated with at least one attribute from the plurality of attributes; Applying the filtering criterion to identify a subset of positions from the at least one position that conform to the filtering criterion; Updating a map of electrical activity within the heart based only on the subset of positions; Displaying the map of the electrical activity; A computer program product for performing.

5. A method comprising: Obtaining a plurality of electrical signals from a plurality of electrodes disposed on a catheter inserted into one or more heart chambers of a patient's heart, wherein each electrical signal from the plurality of electrical signals provides information regarding electrical activity at at least one position within the heart, and each position of the at least one position is associated with a value of each attribute from a plurality of attributes; Obtaining; Receiving, via a user interface, a selection of a filtering criterion from a user for at least one of the positions, wherein the filtering criterion is associated with at least one attribute from the plurality of attributes; Applying the filtering criterion to identify a subset of positions from the at least one position that conform to the filtering criterion; Updating a map of electrical activity within the heart based only on the subset of positions; Displaying the map of the electrical activity; A method comprising.

6. The method according to claim 5, wherein the obtaining, the applying, the updating, and the displaying are repeatedly executed.

7. The method according to claim 5, further comprising displaying, to the user, a representation of information related to the subset of positions while avoiding displaying information related to other positions that do not conform to the filtering criterion.

8. The method according to claim 5, wherein the plurality of electrical signals are electrocardiogram (ECG) signals.

9. The at least one attribute is selected from the group consisting of impedance, voltage, a late annotation time (LAT) value at a position associated with the electrical signal, a late annotation mapping (LAM), a tissue proximity index (TPI), a value obtained from a bipolar measurement (BI), a cycle length (CL) of the electrical signal, at least one stability parameter of the signal, a fractionated signal or an unfractionated signal, and a connected signal or a disconnected signal, the method of claim 5.

10. The at least one filtering criterion is included in at least one preset, and applying the filtering criterion is performed by applying the at least one preset to identify a subset of the positions, the method of claim 5.

11. The method of claim 5, further comprising defining the at least one filtering criterion.

12. Defining the at least one filtering criterion includes defining at least one preset associated with the at least one attribute, the method of claim 11.

13. The method of claim 12, further comprising storing the at least one preset.

14. Defining the at least one filtering criterion includes selecting the at least one attribute and at least one corresponding value, the method of claim 12.

15. The method of claim 14, wherein at least one corresponding value includes a minimum value or a maximum value of a numerical range of the at least one attribute.

16. The method of claim 14, wherein the at least one corresponding value includes a binary value for the at least one attribute.

17. The method of claim 14, wherein the at least one corresponding value includes one or more discrete values for the at least one attribute.

18. The user interface enables a user to select one or more presets to be applied from the at least one preset, the method of claim 12.

19. If the same attribute is included in at least two activated presets, the at least one corresponding value of the same attribute conforms to the limitations of the two presets, the method of claim 18.

20. The method according to claim 18, wherein the at least one corresponding value of the attribute within the preset conforms to an available value of the at least one attribute within the at least one position.

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