Automated tool for vein shaving in anatomical map

Abstract

To improve visualization of an anatomical structure such as the vein in an electro-anatomical map.SOLUTION: An automated technique is for revising an electro-anatomical map generated using a catheter having a plurality of electrodes. A first electro-anatomical map that includes an anatomical structure having a mapped volume with a substantially tubular shape is displayed, and one or more points along a medial axis of the mapped volume are estimated. At a first cross-section of the mapped volume, a first best-fitting ellipse is determined. A generalized cylindrical volume is calculated between the first cross-section and a second cross-section in accordance with at least the first best-fitting ellipse. Data points that are outside of the generalized cylindrical volume are removed from the mapped volume, and a revised map is displayed.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to anatomical mapping, and more particularly to improving the visualization of anatomical structures such as veins in electroanatomical maps. [Background technology]

[0002] Some clinical procedures employ techniques for the analysis of computerized anatomical maps of organs. For example, in electrophysiology (EP) procedures such as catheter-based radiofrequency (RF) ablation for pulmonary vein isolation (the first line of treatment for atrial fibrillation (AF)), anatomical maps of heart chambers are generated and used. Fast anatomical mapping (FAM) is one algorithm for constructing such anatomical maps from electrical signals captured by a catheter on the myocardium. The anatomical maps are used to guide physicians to the desired ablation site. As part of constructing the anatomical map (e.g., the aspect of generating the anatomical map of the FAM), a technician can modify the volume of the FAM by performing a manual, time-consuming shaving process. Shaving is performed for various reasons, including, for example, to present a more anatomically accurate representation and / or to resolve visual artifacts in the map. Summary of the Invention [Problem to be solved by the invention]

[0003] In existing mapping techniques, artifacts of the mapping process can cause anatomical structures, such as veins, to appear narrow in one portion of the vein and large in an adjacent portion of the vein. Such visualization can suggest that pulmonary vein stenosis is present in the area where the vein is narrowed. To remove such artifacts, manual shaving of the map is typically performed by an operator. To address such artifacts (suggestive of pulmonary vein stenosis), voxels are manually removed (shaved) from the vein volume until the vein has a more constant volume. An automated solution to this manual shaving process is needed. [Means for solving the problem]

[0004] An automated technique for correcting an electroanatomical map (e.g., a FAM) is provided. The map is generated using a catheter with multiple electrodes. As the catheter moves within the body during a medical procedure, the map is generated and then corrected based on data points acquired using the electrodes. Initially, a first electroanatomical map including an anatomical structure having a mapped volume having a substantially tubular shape is displayed on a user interface. At a first cross-section of the mapped volume, a first best-fit ellipse is determined based on data points associated with the first cross-section of the mapped volume. A first point along a central axis of the mapped volume is estimated according to the center of the first best-fit ellipse. A second point along the central axis of a second cross-section of the mapped volume is estimated, the first cross-section being different from the second cross-section. The volume of a generalized cylinder spanning between the first cross-section and the second cross-section is calculated according to at least the first best-fit ellipse. Data points outside the volume of the generalized cylinder are removed from the mapped volume. A second electroanatomical map having an updated version of the anatomy generated without the removed data points is displayed on the user interface.

[0005] In some examples, a plurality of points defining a central axis are determined. In some of these examples, the first cross section is perpendicular to the central axis, and the second point is estimated by selecting one of the plurality of points defining the central axis.

[0006] In some examples, additional points along the central axis on additional cross sections of the mapped volume are estimated, and the volume of the generalized cylinder spans the first cross section, the second cross section, and the additional cross sections.

[0007] In some examples, the anatomical structure is a vein associated with the myocardium, and data points associated with a first cross-section of the mapped volume correspond to an ablation tag, and data points associated with a second cross-section and each of the further cross-sections of the mapped volume do not correspond to an ablation tag.

[0008] In some examples, three or more best-fit ellipses are determined based on data points associated with other cross sections of the mapped volume, and the volume of the generalized cylinder is calculated according to the three or more best-fit ellipses.

[0009] In some examples, the first best fit ellipse is a circle and the substantially tubular shape is a ruled surface or a generalized cylinder. In other embodiments, a best fit spline is used.

[0010] In accordance with one or more embodiments, the exemplary embodiments described above may be implemented as a method, apparatus, system, and / or computer program product. [Brief explanation of the drawings]

[0011] A more detailed understanding may be had from the following description, given by way of example in conjunction with the accompanying drawings, in which like reference numerals indicate similar elements and in which: [Figure 1] 1 depicts an exemplary catheter-based electrophysiology mapping and ablation system according to one or more embodiments. [Figure 2]FIG. 1 is a block diagram of an exemplary system for remotely monitoring and communicating biometric data, according to one or more embodiments. [Figure 3] FIG. 1 is a system diagram of an exemplary computing environment in communication with a network, according to one or more embodiments. [Figure 4] FIG. 1 is a block diagram of an example device capable of implementing one or more features of the present disclosure, in accordance with one or more embodiments. [Figure 5A] 1 depicts an electroanatomical map of the heart before performing anatomical matching for ablation tags, according to an example. [Figure 5B] 1 depicts an electroanatomical map of the heart after performing an anatomical match to the ablation tags, according to an example. [Figure 6] 1 depicts an electroanatomical map of the heart along its central axis, according to an example. [Figure 7] 1 shows an electroanatomical map of a pulmonary vein, depicting its central axis and several best-filling ellipses positioned along the central axis, according to an example. [Figure 8] According to an example, several ellipses are drawn along the central axis of the pulmonary vein in FIG. 7 to generate a tubular shape. [Figure 9] 10 depicts a tubular shape used to remove data points from a map, according to an example. [Figure 10] 5C depicts a side-by-side comparison of the map of FIG. 5B with an updated version of that map that has been modified in accordance with the techniques described herein, according to one example. [Figure 11] 1 depicts an electroanatomical map of the heart, according to a further example. [Figure 12] 1 depicts a method according to one or more embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0012] Disclosed herein are methods and / or systems for anatomical mapping. The methods and / or systems include processor-executable code or software that are necessarily mediated by the process operations and hardware operations of medical device equipment that perform and use the anatomical mapping. For ease of explanation, the anatomical maps are described herein with reference to mapping the heart. However, any anatomical structure, body part, organ, or portion thereof can be targeted for mapping using the techniques described herein.

[0013] According to one or more embodiments, the methods and systems disclosed herein generate an anatomical map of the heart, including the endocardial surface of the left atrium (LA). The map can be a three-dimensional (3D) model or a combination of multiple 3D models. The methods and systems can generate and edit cardiac maps and provide real-time or post-processed maps during or in conjunction with an EP procedure (e.g., an ablation procedure). By way of example, the methods and systems can modify the anatomical map using the techniques disclosed herein, thereby improving the performance and results of the anatomical mapping.

[0014] Reference is made to FIG. 1 , which illustrates an exemplary system (e.g., a medical device instrument and / or catheter-based electrophysiological mapping and ablation system) designated as system 10, in which one or more features of the subject matter herein may be implemented according to one or more embodiments. All or a portion of system 100 may be used to collect information (e.g., biometric data) and / or perform map correction techniques, as described herein. In some examples, such techniques are implemented using processor-executable code or software stored in the memory of system 10 and necessarily resident in the process operations by and processing hardware of system 10.

[0015] FIG. 1 illustrates a recorder 11, a heart 12, a catheter 14, a model or anatomical map 20, an electrogram 21, a spline 22, a patient 23, a physician 24 (representing any medical professional, technician, clinician, operator, clinical support specialist, clinical account specialist, healthcare worker, etc.), a location pad 25, one or more electrodes 26, a display device 27, a distal tip 28, a sensor 29, a coil 32, a patient interface unit (PIU) 30, an electrode skin patch 38, an ablation energy generator 50, and a workstation 55. It is further noted that each element and / or item in the system 10 represents one or more of that element and / or item. The exemplary system 10 shown in FIG. 1 implements embodiments disclosed herein. The embodiments of the present disclosure may be similarly applied using other system components and configurations. Additionally, system 10 may include additional components, such as elements for sensing electrical activity, wired or wireless connectors, processing and display devices, or other components.

[0016] The system 10 includes multiple catheters 14 that are percutaneously inserted by a physician 24 through a patient's vascular system into a chamber or vasculature of the heart 12. Typically, a delivery sheath catheter is inserted into the left or right atrium near a desired location within the heart 12. Multiple catheters can then be inserted into the delivery sheath catheter to reach the desired location. The multiple catheters 14 may include catheters dedicated to sensing intracardiac electrogram (IEGM) signals, catheters dedicated to ablation, and / or catheters dedicated to both sensing and ablation. An exemplary catheter 14 configured to sense IEGMs is illustrated herein. To sense a target site within the heart 12, the physician 24 brings a distal tip 28 of the catheter 14 into contact with the heart wall. For ablation, the physician 24 similarly delivers the distal end of an ablation catheter to the target site for ablation.

[0017] The catheter 14 is an exemplary catheter including at least one, and preferably multiple, electrodes 26, optionally distributed across multiple splines 22 at the distal tip 28, configured to sense IEGM signals. The catheter 14 may additionally include a sensor 29 embedded in or near the distal tip 28 to track the position and orientation of the distal tip 28. Optionally and preferably, the position sensor 29 is a magnetic-based position sensor including three magnetic coils for sensing 3D position and orientation. According to one or more embodiments, the shape and parameters of the catheter 14 vary based on whether the catheter 14 is used for diagnostic or ablation purposes, the type of arrhythmia, the patient's anatomy, and other factors affecting catheter maneuverability (e.g., the ability to touch the surface of the catheter 14 and the tracked portion without bending it). The shape and parameters of the catheter 14 also affect the accuracy of the anatomical map. Large, spherical, single-shot catheters capable of ablating pulmonary veins within seconds are common but require guidance from fluoroscopy, CT / MRI, or an additional mapping catheter.

[0018] The sensor 29 (e.g., a position-based or magnetic-based position sensor) may operate in conjunction with a location pad 25 that includes a plurality of magnetic coils 32 configured to generate a magnetic field within a predetermined working volume. The real-time position of the distal tip 28 of the catheter 14 may be tracked based on the magnetic fields generated by the location pad 25 and sensed by the sensor 29. Details of magnetic-based position sensing technology are described in U.S. Patent Nos. 5,5391,199; 5,443,489; 5,558,091; 6,172,499; 6,239,724; 6,332,089; 6,484,118; 6,618,612; 6,690,963; 6,788,967; and 6,892,091.

[0019] System 10 includes one or more electrode patches 38 positioned on patient 23 for skin contact to establish location references for location pads 25 and impedance-based tracking of electrodes 26. For impedance-based tracking, current is directed to electrodes 26 and sensed at patches 38 (e.g., electrode skin patches), allowing the location of each electrode to be triangulated via patches 38. Details of impedance-based position tracking techniques are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182, which are incorporated herein by reference.

[0020] Recorder 11 displays electrograms 21 captured by electrodes 18 (e.g., surface electrocardiogram (ECG) electrodes) and intracardiac electrograms (IEGMs) captured by electrodes 26 on catheter 14. Recorder 11 may include pacing capability for pacing the cardiac rhythm and / or may be electrically connected to a stand-alone pacer.

[0021] The system 10 may include an ablation energy generator 50 adapted to deliver ablation energy to one or more electrodes 26 at the distal tip 28 of the catheter 14 configured for ablation. The energy produced by the ablation energy generator 50 may include, but is not limited to, radiofrequency (RF) energy or pulsed-field ablation (PFA) energy, including monopolar or bipolar high-voltage DC pulses such as may be used to produce irreversible electroporation (IRE), or a combination thereof.

[0022] PIU 30 is an interface configured to establish electrical communication between catheters, electrophysiology equipment, a power source, and a workstation 55 that controls the operation of system 10. The electrophysiology equipment of system 10 may include, for example, multiple catheters 14, location pads 25, body surface ECG electrodes 18, electrode patches 38, ablation energy generators 50, and recorder 11. Optionally and preferably, PIU 30 additionally includes processing capability for performing real-time calculations of catheter locations and for performing ECG calculations.

[0023] The workstation 55 includes a processor unit having memory, memory or storage loaded with appropriate operating software, and user interface functionality. The workstation 55 may optionally provide multiple functions, including: modeling endocardial anatomical structures in three dimensions (3D) and rendering a model or anatomical map 20 (e.g., visualization) for display on a display device 27; displaying activation sequences (or other data) compiled from recorded electrograms 21 with representative visual indicators or images superimposed on the rendered anatomical map 20 on the display device 27; displaying real-time locations and orientations of multiple catheters within the cardiac chambers; and displaying sites of interest, e.g., locations where ablation energy has been applied, on the display device 27. One commercially available product embodying elements of the system 10 is available as the CARTO™ 3 system, commercially available from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA 92618. It should be noted that modeling the endocardial anatomy in 3D can include generating its surface as a triangular mesh.

[0024] For example, system 10 may be part of a surgical system (e.g., the CARTO® system sold by Biosense Webster) configured to acquire biometric data (e.g., anatomical and electrical measurements of a patient's organs, e.g., heart 12, and as described herein) and perform cardiac ablation procedures. More specifically, treatment for cardiac conditions, e.g., cardiac arrhythmias, often requires obtaining detailed mapping of cardiac tissue, chambers, veins, arteries, and / or electrical pathways. For example, a prerequisite for successfully performing catheter ablation is the precise location of the cause of the cardiac arrhythmia within a chamber of heart 12. Such localization may be performed via an electrophysiological study in which electrical potentials are detected and spatially resolved using a mapping catheter (e.g., catheter 14) introduced into a chamber of heart 12. This electrophysiological study, so-called electroanatomical mapping, thus provides 3D mapping data that may be displayed on display device 27. Often, mapping and therapy functions (e.g., ablation) are provided by a single catheter or a group of catheters, such that the mapping catheter also simultaneously operates as a therapy catheter.

[0025] 2 is a block diagram of an exemplary system 100 for remotely monitoring and communicating biometric data (e.g., patient biometric indicators). In the example illustrated in FIG. 2, the system 100 includes a patient biometric monitoring and processing unit 102 associated with a patient 104, a local computing device 106, a remote computing system 108, a first network 110, a patient biometric sensor 112, a processor 114, a user input (UI) sensor 116, a memory 118, a second network 120, and a transmitter-receiver (i.e., transceiver) 122.

[0026] According to one or more embodiments, the patient biometric monitoring and processing device 102 may be a device internal to the patient's body (e.g., subcutaneously implantable), such as the catheter 14 of Figure 1. The patient biometric monitoring and processing device 102 may be inserted into the patient via any applicable modality, including oral injection, surgical insertion via a vein or artery, an endoscopic procedure, or a laparoscopic procedure.

[0027] According to one or more embodiments, the patient biometric monitoring and processing device 102 may be a device external to the patient, such as the electrode patch 38 of FIG. 1. For example, as described in more detail below, the patient biometric monitoring and processing device 102 may include an attachable patch (e.g., attached to the patient's skin). The monitoring and processing device 102 may also include a catheter with one or more electrodes, a probe, a blood pressure cuff, a weight scale, a bracelet or smartwatch biometric tracker, a glucose monitor, a continuous positive airway pressure (CPAP) machine, or virtually any device that can provide input regarding the patient's health or biometrics.

[0028] According to one or more embodiments, the patient biometric monitoring and processing device 102 may include both components that are internal to the patient and components that are external to the patient.

[0029] A single patient biometric monitoring and processing device 102 is shown in FIG. 2. However, an exemplary system may include multiple patient biometric monitoring and processing devices. A patient biometric monitoring and processing device may be in communication with one or more other patient biometric monitoring and processing devices. Additionally or alternatively, a patient biometric monitoring and processing device may be in communication with a network 110.

[0030] One or more patient biometric monitoring and processing devices 102 may acquire biometric data (e.g., patient biometric indicators, e.g., electrical signals, blood pressure, temperature, blood glucose levels, or other biometric data) and may receive at least a portion of the biometric data representative of the acquired patient biometric indicators and additional information associated with the acquired patient biometric indicators from one or more other patient biometric monitoring and processing devices 102. The additional information may be, for example, diagnostic information and / or additional information acquired from an additional device, e.g., a wearable device. Each of the patient biometric monitoring and processing devices 102 may process data, including its own biometric data and data received from one or more other patient biometric monitoring and processing devices 102.

[0031] The biometric data (e.g., patient biometrics, patient data, or patient biometric data) may include one or more of local activation time (LAT), electrical activity, topology, bipolar mapping, baseline activity, ventricular activity, dominant frequency, impedance, or other data. LAT may be a time point of threshold activity corresponding to local activation calculated based on a normalized initial starting point. Electrical activity may be any applicable electrical signal that can be measured based on one or more thresholds and sensed and / or enhanced based on signal-to-noise ratio and / or other filters. Topology may correspond to the physical structure of a body part or portion of a body part, or may correspond to changes in the physical structure for different portions of the body part or for different body parts. The dominant frequency may be a frequency or range of frequencies commonly found in a portion of a body part and may differ in different portions of the same body part. For example, the dominant frequency of the PVs of a heart may differ from the dominant frequency of the right atrium of the same heart. Impedance may be a resistance measurement in a given region of a body part.

[0032] Examples of biometric data include, but are not limited to, patient identification data, intracardiac electrocardiogram (IC ECG) data, bipolar intracardiac reference signals, anatomical and electrical measurements, trajectory information, body surface (BS) ECG data, historical data, brain biomarkers, blood pressure data, ultrasound signals, radio signals, audio signals, two-dimensional or three-dimensional image data, blood glucose data, and temperature data. Biomarker data generally can be used to monitor, diagnose, and treat any number of different diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathies, and coronary artery disease) and autoimmune diseases (e.g., type I and type II diabetes). Note that BS ECG data can include data and signals collected from electrodes on the patient's surface, IC ECG data can include data and signals collected from electrodes inside the patient's body, and ablation data can include data and signals collected from tissue being ablated. Additionally, the BS ECG data, IC ECG data, and ablation data, along with catheter electrode position data, may be derived from one or more treatment records.

[0033] 2, network 110 is an example of a short-range network (e.g., a local area network (LAN) or a personal area network (PAN)). Information can be transmitted between the patient biometric monitoring and processing device 102 and the local computing device 106 over network 110 using any one of a variety of short-range wireless communication protocols, such as Bluetooth, Wi-Fi, ZigBee, Z-Wave, near field communication (NFC), ultra-wideband, or infrared (IR).

[0034] Network 120 may be a wired network, a wireless network, or may include one or more wired and wireless networks. For example, network 120 may be a long-range network (e.g., a wide area network (WAN), the Internet, or a cellular network). Information may be transmitted over network 120 using any one of a variety of long-range wireless communication protocols (e.g., TCP / IP, HTTP, 3G, 4G / LTE, or 5G / New Radio).

[0035] The patient biometric monitoring and processing device 102 may include patient biometric sensors 112, a processor 114, UI sensors 116, memory 118, and a transceiver 122. The patient biometric monitoring and processing device 102 may continuously or periodically monitor, store, process, and communicate any number of different biometric data over the network 110. Examples of biometric data include electrical signals (e.g., ECG signals and brain biomarkers), blood pressure data, blood glucose data, and temperature data. The biometric data may be monitored and communicated for treatment across any number of different diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathies, and coronary artery disease) and autoimmune diseases (e.g., type 1 and type 2 diabetes).

[0036] The patient biometric sensor 112 may include, for example, one or more sensors configured to sense some type of biometric data. For example, the patient biometric sensor 112 may include electrodes configured to acquire electrical signals (e.g., cardiac signals, brain signals, or other bioelectrical signals), a temperature sensor, a blood pressure sensor, a blood glucose sensor, a blood oxygen sensor, a pH sensor, an accelerometer, and a microphone.

[0037] As described in more detail below, the patient biometric monitoring and processing device 102 may be an ECG monitor for monitoring ECG signals of a heart (e.g., heart 12). The patient biometric sensor 112 of the ECG monitor may include one or more electrodes for acquiring the ECG signals. The ECG signals may be used in the treatment of various cardiovascular diseases, as well as anatomical mapping.

[0038] The transceiver 122 may include a separate transmitter and receiver, or alternatively, the transceiver 122 may include a transmitter and receiver integrated into a single device.

[0039] The processor 114 may be configured to store biometric data acquired by the patient biometric sensors 112 in the memory 118 and to communicate the biometric data over the network 110 via the transmitter of the transceiver 122. Data from one or more other patient biometric monitoring and processing devices 102 may also be received by the receiver of the transceiver 122, as described in more detail herein. By way of example, the automated map correction techniques described herein are implemented as processor-executable code or software that may be stored on the memory 118 (as shown) and executed by the processor 114. By way of further example, the automated map correction techniques are implemented as code that is stored and executed on the local computing device 106 and / or the remote computing system 108. Thus, the operation of the automated map correction techniques is necessarily rooted in the process operations by the system 100 and its hardware processing.

[0040] According to one or more embodiments, the system 100 operates to generate an initial visualization (e.g., a first electroanatomical map) on a display (e.g., display device 27) during an ablation procedure. The initial visualization is generated from data points sensed by a catheter positioned within a patient and includes an anatomical structure (e.g., a vein) having a mapped volume having a substantially tubular shape. Applying techniques described in connection with FIGS. 5-12 below, the system 100 determines a first best-fit ellipse at a first cross-section of the mapped volume based on data points associated with the first cross-section. A first point along a central axis of the mapped volume is estimated according to (e.g., from) the center of the first best-fit ellipse. A second point along the central axis on a second cross-section of the mapped volume is estimated, the first cross-section being different from the second cross-section. The volume of a generalized cylinder spanning between the first cross-section and the second cross-section is calculated according to at least the first best-fit ellipse. The system 100 removes data points from the mapped volume that are outside the volume of the generalized cylinder. A second electroanatomical map having an updated version of the anatomy generated without the removed data points is displayed as part of the user interface (eg, on display device 27).

[0041] In some examples, the anatomical structure is a vein associated with the myocardium, and data points associated with a first cross-section of the mapped volume correspond to an ablation tag, and data points associated with a second cross-section and additional cross-sections of the mapped volume do not correspond to an ablation tag.

[0042] In some examples, a plurality of points defining a central axis are determined. In some of these examples, the first cross section is perpendicular to the central axis, and the second point is estimated by selecting one of the plurality of points defining the central axis.

[0043] According to one or more embodiments, the patient biometric monitoring and processing device 102 includes a UI sensor 116, which may be, for example, a piezoelectric or capacitive sensor configured to receive user input, such as a tap or touch. For example, the UI sensor 116 may be controlled to perform capacitive coupling in response to the patient 104 tapping or touching the surface of the patient biometric monitoring and processing device 102. Gesture recognition may be performed via any one of a variety of capacitance types, such as resistive capacitance, surface capacitance, projected capacitance, surface acoustic wave, piezoelectric, and infrared touch. The capacitance sensor may be positioned over a small area or over the length of the surface such that a tap or touch on the surface activates the monitoring device.

[0044] As described in more detail below, the processor 114 may be configured to selectively respond to different tapping patterns (e.g., single tap or double tap) of a capacitive sensor, which may be the UI sensor 116, so that different tasks of the patch (e.g., data acquisition, storage, or transmission) may be initiated based on the detected pattern. In some embodiments, when a gesture is detected, audible feedback may be provided to the user from the patient biometric monitoring and processing device 102.

[0045] The local computing device 106 of the system 100 may be configured to communicate with the patient biometric monitoring and processing device 102 and to act as a gateway to the remote computing system 108 via the second network 120. The local computing device 106 may be, for example, a smartphone, smartwatch, tablet, or other portable smart device configured to communicate with other devices via the network 120. Alternatively, the local computing device 106 may be a fixed or stand-alone device, such as a desktop or laptop computer that uses executable programs to communicate information between the patient biometric monitoring and processing device 102 and the remote computing system 108 via, for example, a fixed base station, a wireless module in a PC, or a USB dongle, including, for example, modem and / or router capabilities. Biometric data may be communicated between the local computing device 106 and the patient biometric monitoring and processing device 102 via a short-range wireless network 110, such as a local area network (LAN) (e.g., a personal area network (PAN)) using short-range wireless technology standards (e.g., Bluetooth, Wi-Fi, ZigBee, Z-wave, and other short-range wireless standards). In some embodiments, the local computing device 106 may also be configured to display the acquired patient electrical signals and information associated with the acquired patient electrical signals, as described in more detail herein.

[0046] In some embodiments, the remote computing system 108 can be configured to receive at least one of the monitored patient biometrics and information associated with the monitored patient via the network 120, which is a long-range network. For example, if the local computing device 106 is a cellular phone, the network 120 can be a wireless cellular network, and information can be communicated between the local computing device 106 and the remote computing system 108 via a wireless technology standard, such as any of the wireless technologies mentioned above. As described in more detail below, the remote computing system 108 can be configured to provide (e.g., visually display and / or audibly provide) at least one of the patient biometrics and associated information to the physician 24.

[0047] 3 is a system diagram of an example computing environment 200 in communication with network 120. In some examples, computing environment 200 is incorporated into a public cloud computing platform (e.g., Amazon Web Services or Microsoft Azure), a hybrid cloud computing platform (e.g., HP Enterprise OneSphere), or a private cloud computing platform.

[0048] As shown in Figure 3, computing environment 200 includes computer system 210, which is an example of workstation 55 of Figure 1, local computing device 106 of Figure 2, and / or remote computing system 108 of Figure 2, on which embodiments described herein may be implemented. By way of example, the tenting detection and correction techniques described herein are implemented as processor-executable code or software that may be stored on system memory 231 (as shown), executed by processor 220, and that may be mediated by process operations by computing environment 200 and its hardware operations.

[0049] Computer system 210 can perform various functions via processor 220, which may include one or more processors. Functions may include analyzing monitored biometric data and related information and providing alerts, additional information, or instructions (e.g., via display 266) according to physician-determined or algorithm-driven thresholds and parameters. This functionality may include operation of the tenting error and correction techniques described herein. As described in more detail herein, computer system 210 may be used to provide a dashboard of patient information to physician 24 of FIG. 1 (e.g., via display 266); such information may enable physician 24 to identify and prioritize patients with more critical needs than others.

[0050] 3, computer system 210 may include a communication mechanism, such as a bus 221 or other communication mechanism, for communicating information within computer system 210. Computer system 210 further includes one or more processors 220 coupled with bus 221 for processing information. Processor 220 may include one or more CPUs, GPUs, or any other processors known in the art.

[0051] Computer system 210 also includes a system memory 230 coupled to bus 221 for storing information and instructions executed by processor 220. System memory 230 may include computer-readable storage media in the form of volatile and / or nonvolatile memory, such as read-only system memory (ROM) 231 and / or random-access memory (RAM) 232. System memory RAM 232 may include other dynamic storage devices (e.g., dynamic RAM, static RAM, and synchronous DRAM). System memory ROM 231 may include other static storage devices (e.g., programmable ROM, erasable PROM, and electrically erasable PROM). Additionally, system memory 230 may be used to store temporary variables or other intermediate information during execution of instructions by processor 220. A basic input / output system (BIOS) 233 may include routines for transferring information between elements within computer system 210, such as during start-up, which may be stored in system memory ROM 231. RAM 232 may contain data and / or program modules that are immediately accessible to and / or presently being operated on by processor 220. System memory 230 may also include, for example, an operating system 234, application programs 235, other program modules 236, and program data 237.

[0052] The illustrated computer system 210 also includes a disk controller 240 coupled to bus 221 to control one or more storage devices, such as a magnetic hard disk 241 and a removable media drive 242 (e.g., a floppy disk drive, a compact disk drive, a tape drive, and / or a solid state drive), for storing information and instructions. Storage devices may be added to computer system 210 using an appropriate device interface (e.g., small computer system interface (SCSI), integrated device electronics (IDE), Universal Serial Bus (USB), or FireWire).

[0053] Computer system 210 may also include a display controller 265 coupled to bus 221 to control a monitor or display 266, such as a cathode ray tube (CRT) or liquid crystal display (LCD), for displaying information to a computer user. The illustrated computer system 210 includes a user input interface 260 and one or more input devices, such as a keyboard 262 and a pointing device 261, for interacting with a computer user and providing information to processor 220. Pointing device 261 may be, for example, a mouse, trackball, or pointing stick for communicating instructional information and command selections to processor 220 and for controlling cursor movement on display 266. Display 266 may provide a touchscreen interface that can enable input that complements or replaces the communication of instructional information and command selections by pointing device 261 and / or keyboard 262.

[0054] Computer system 210 may perform some or each of the functions and methods described herein in response to processor 220 executing one or more sequences of one or more instructions contained in a memory, such as system memory 230. Such instructions may be read into system memory 230 from another computer-readable medium, such as hard disk 241 or removable media drive 242. Hard disk 241 may include one or more data stores and data files used by the embodiments described herein. Data store contents and data files may be encrypted for improved security. Processor 220 may also be employed in a multi-processing configuration to execute one or more sequences of instructions contained in system memory 230. In alternative embodiments, hardwired circuitry may be used in place of or in combination with software instructions. Thus, embodiments are not limited to any specific combination of hardware circuitry and software.

[0055] As mentioned above, computer system 210 may include at least one computer-readable medium or memory for retaining instructions programmed according to embodiments described herein (e.g., embodiments of the tenting error detection and correction techniques) and for containing data structures, tables, records, or other data described herein. As used herein, the term computer-readable medium refers to any non-transitory, tangible medium that participates in providing instructions to processor 220 for execution. Computer-readable media can take many forms, including, but not limited to, non-volatile media, volatile media, and transmission media. Non-limiting examples of non-volatile media include optical disks, solid-state drives, magnetic disks, and magneto-optical disks, such as hard disk 241 or removable media drive 242. Non-limiting examples of volatile media include dynamic memory, such as system memory 230. Non-limiting examples of transmission media include coaxial cables, copper wire, and fiber optics, including the wires that comprise bus 221. Transmission media may also take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications.

[0056] The computing environment 200 may further include a computer system 210 operating in a networked environment using logical connections to the local computing device 106 and one or more other devices, such as a personal computer (laptop or desktop), a mobile device (e.g., a patient mobile device), a server, a router, a network PC, a peer device, or other common network node, and typically includes many or all of the elements described above for the computer system 210. When used in a networking environment, the computer system 210 may include a modem 272 for establishing communications over the network 120, e.g., the Internet. The modem 272 may be connected to the system bus 221 via a network interface 270 or another appropriate mechanism.

[0057] Network 120 as shown in FIGS. 2 and 3 may be any network or system generally known in the art, including the Internet, an intranet, a local area network (LAN), a wide area network (WAN), a metropolitan area network (MAN), a direct connection or series of connections, a cellular telephone network, or any other network or medium capable of facilitating communication between computer system 210 and other computers (e.g., local computing device 106).

[0058] 4 is a block diagram of an example device 400 capable of implementing one or more features of the present disclosure. Device 400 may be, for example, local computing device 106. Device 400 may include, for example, a computer, a gaming device, a handheld device, a set-top box, a television, a mobile phone, or a tablet computer. Device 400 includes a processor 402, a memory 404, a storage device 406, one or more input devices 408, and one or more output devices 410. Device 400 may also optionally include an input driver 412 and an output driver 414. It is understood that device 400 may include additional components not shown in FIG. 4, including an artificial intelligence accelerator.

[0059] In various alternatives, processor 402 includes a central processing unit (CPU), a graphics processing unit (GPU), a CPU and a GPU located on the same die, or one or more processor cores, each of which may be a CPU or a GPU. In various alternatives, memory 404 is located on the same die as processor 402 or is located separately from processor 402. Memory 404 includes volatile or non-volatile memory, such as random access memory (RAM), dynamic RAM, or cache. By way of example, the map modification techniques described herein are implemented as processor-executable code or software that may be stored on memory 404 (as shown) and executed by processor 402, and that may be rooted in process operations by exemplary device 400 and its hardware operations.

[0060] The storage device 406 includes fixed or removable storage means, such as a hard disk drive, solid state drive, optical disk, or flash drive. The input device 408 includes, but is not limited to, a keyboard, keypad, touch screen, touchpad, detector, microphone, accelerometer, gyroscope, biometric scanner, or network connection (e.g., a wireless local area network card for transmitting and / or receiving wireless IEEE 802 signals). The output device 410 includes, but is not limited to, a display device, a speaker, a printer, a haptic feedback device, one or more lights, an antenna, or a network connection (e.g., a wireless local area network card for transmitting and / or receiving wireless IEEE 802 signals).

[0061] The input driver 412 communicates with the processor 402 and the input device 408, allowing the processor 402 to receive input from the input device 408. The output driver 414 communicates with the processor 402 and the output device 410, allowing the processor 402 to send output to the output device 410. Note that the input driver 412 and the output driver 414 are optional components; if the input driver 412 and the output driver 414 are not present, the device 400 would operate in the same manner. The output driver 414 includes an accelerated processing device (“APD”) 416 that communicates with the display device represented by the output device 410. The APD 416 receives calculation commands and graphics rendering commands from the processor 402, processes the calculation commands and graphics rendering commands, and provides pixel output to the display device for display. As described in further detail below, APD 416 includes one or more parallel processing units for performing computations according to the single-instruction-multiple-data (SIMD) paradigm. Accordingly, although various functions are described herein as being performed by or in conjunction with APD 416, in various alternatives, functions described as being performed by APD 416 are additionally or alternatively performed by other computing devices that are not driven by a host processor (e.g., processor 402) but have similar capabilities for providing graphical output to a display device. For example, it is contemplated that any processing system that performs processing tasks according to the SIMD paradigm can perform the functions described herein. Alternatively, it is contemplated that computing systems that do not perform processing tasks according to the SIMD paradigm perform the functions described herein.

[0062] FIG. 5A depicts an electroanatomical map of a heart 500 prior to performing an anatomical match for an ablation tag, according to one example. The heart 500 includes a pulmonary vein 502 extending along a length 504a. The vein 502 has a substantially tubular shape along the length 504a. In FIG. 5A, the substantially tubular shape of the vein 502 has a cross-sectional size that varies along the length 504a, consistent with a normal (healthy) vein. The electroanatomical map also includes multiple tags 501. One example of a tag 501 is an ablation tag, which objectively identifies and annotates a site on the electroanatomical map whenever predetermined criteria, such as catheter stability, time, contact force, or impedance drop, are met. An example of an ablation tag is provided by The CARTO VISITAG™ system sold by Biosense Webster. In one embodiment of that system, the system calculates an index known as the ablation tag index, which is a numerical value that reflects the quality and effectiveness of ablation at a particular location. This index helps the electrophysiologist assess whether enough tissue has been treated to achieve the desired therapeutic effect. The system is often integrated with a 3D mapping system, allowing the electrophysiologist to visualize the cardiac anatomy in three dimensions. This integration helps guide the catheter to the target area and provides a comprehensive view of the ablation procedure. In Figure 5A, an ablation tag 501 is shown on the map, corresponding to the location of the ablation site.

[0063] In some examples, during a medical procedure such as cardiac ablation, a fast anatomical map (FAM) (e.g., as shown in FIGS. 5A and 5B ) is generated and used to provide a 3D map of the heart 500. The points used to generate the FAM are collected without regard to other conditions, such as the heart's breathing or the catheter's pressing against the tissue wall. The fact that such points are used to generate the FAM can result in the FAM being too large. In other examples, a vein 502 may lack precision for the FAM due to a lack of data points. FIG. 5B depicts an electroanatomical map of the heart with an additional ablation tag 501 a. The ablation tag 501 a passes under the vein 502 and continues around the surface of the heart.

[0064] In some examples, techniques are implemented to match or adapt the FAM (which, as noted above, may be oversized or inaccurate) to the anatomical structure defined by the ablation tag 501a. In some cases, this occurs when a physician is performing an ablation and the catheter is in contact with tissue, but the ablation electrode is not visualized on the surface (because the surface is oversized). In response, the technician shaves the FAM to ensure that the ablation tag is placed on the surface, not inside it. This process requires "fitting" the anatomical structure so that the ablation tag is placed accurately on the surface. During this fitting, the location information of the ablation tag 501, 501a is considered more accurate and is therefore weighted more heavily in the ablation tag location than the other data used to generate the FAM. In the example of FIG. 5B, the anatomical fit results in a visual artifact that causes the underside of the vein 502 to appear pinched at the location identified by the arrow 505 where the vein 502 intersects with the heart chamber. This "pinching" artifact occurs when the portion of the heart shown on the map proximate the ablation tag contracts without contracting or adjusting the rest of the FAM due to anatomical fit, causing the vein 502 to falsely assume an appearance consistent with a stenosis. As explained below, the techniques described herein provide a solution for removing this artifact from the FAM by matching the rest of the vein 502 (not proximate the ablation tag 501 a) in a manner consistent with the contraction of the vein 502 proximate the tag 501 a, so that the vein 502 no longer appears to be undergoing a stenosis. The techniques described herein are not limited to correcting stenosis-like artifacts, but more generally apply to processing FAMs containing data points of various levels of precision.

[0065] FIG. 6 depicts an electroanatomical map of a heart along its central axis, according to one example. In contrast to FIG. 5B , which shows only the ablation tags on the anterior surface of the heart, FIG. 6 shows the ablation tags 501 a on the anterior surface using solid dots, and the ablation tags 501 b on the posterior surface of the heart using silhouetted dots. The central axis 601 of the heart 500 is also shown, along with the central axis 601 a of the vein 502. In some examples, the system 100 determines and displays the central axes 601, 601 a during an ablation procedure. A central axis, sometimes referred to as a skeleton or centerline, is a geometric concept used in computational geometry and represents a set of points within a shape where two or more points are equidistant from the shape's boundary. A central axis is often considered to represent the core or central portion of a shape. In medical imaging, for example, a central axis can be used to represent the central structure of an organ, such as the heart 500. 6, the entire medial axis 601 is shown as being determined by the system 100, while in other examples (e.g., the example of FIG. 11), only one or more points on the medial axis are estimated. References herein to "estimating" a point on the medial axis will be understood to include both selection of a previously calculated point on the medial axis and other techniques in which one or more points along the medial axis are estimated.

[0066] Continuing with reference to FIG. 6 , as part of a technique for removing the “pinching” artifact, identified by arrow 505, from the map, the system 100 calculates at least one best-fit ellipse 602 that lies in a plane that passes through and is perpendicular to the central axis 601 a within the vein 502. In some examples, the best-fit ellipse 602 is an ellipse that is determined to be the most appropriate or optimal representation of a set of data points represented by ablation tags on the surface of the vein 502 in the plane of the ellipse. Fitting an ellipse to these points involves finding an ellipse that minimizes some measure of difference between the ellipse and the data points on the surface of the vein 502 in the plane of the ellipse. There are various methods for fitting an ellipse to a set of points, and the techniques described herein are not limited to any particular method for determining a best-fit ellipse. A common approach for determining a best-fit ellipse applicable to the techniques described herein is the least-squares method, in which the sum of squared distances between data points on the surface of the vein 502 in the plane of the ellipse is minimized. It will be understood that a best-fit circle is a particular case of an ellipse whose two foci meet at the center and have zero eccentricity. While the description provided herein uses a best-fit ellipse to match the FAM (and, for example, the vein 502) to the size information provided by the ablation tag 501a, the use of other best-fit shapes, including best-fit circles and best-fit closed splines, is within the scope of this disclosure. A best-fit closed spline refers to a spline curve that has been adjusted or fitted to a set of data points so as to minimize some measure of difference between the spline and the given data.

[0067] In some examples, after a best-fit ellipse is determined based on the collected data points, the size of the best-fit ellipse is compared to minimum and / or maximum thresholds. In one example, these thresholds correspond to minimum and maximum vein sizes associated with typical vein sizes for a person with a profile similar to that of the patient. In these examples, if the best-fit ellipse is less than the minimum threshold and / or greater than the maximum threshold, the best-fit ellipse calculated based on the collected data points is not used for further calculations. In some such examples, if the best-fit ellipse calculated from the collected data points is less than a minimum value, an ellipse equal in size to the minimum threshold is substituted, and / or if the best-fit ellipse calculated from the collected data points exceeds a maximum value, an ellipse equal in size to the maximum threshold is substituted.

[0068] In the embodiment of Figure 6, data points corresponding to ablation tags are not available anywhere other than in the region proximate to the rightmost best-fit ellipse 602. In such a situation, system 100 may lack the data points needed to separately calculate an additional best-fit ellipse along the central axis. Instead of calculating such an additional best-fit ellipse, in the embodiment of Figure 6, a copy of the rightmost ellipse is projected along the central axis at an angle perpendicular to it, as shown.

[0069] 7 depicts an electroanatomical map of a pulmonary vein 502 showing its central axis 601a according to an alternative embodiment in which the system 100 separately calculates additional best-fit ellipses 603-605, each ellipse passing through the central axis 601a within the vein 502 and lying in a plane perpendicular to the central axis 601a. ​​In the example shown, the best-fit ellipse 602a is located proximate to the location of the ablation tags 501a, 501b (not shown), which, as described above, correspond more closely to the actual size of the vein than other points on the FAM. The best-fit ellipses 603-605 are calculated based on available data (e.g., additional ablation tags corresponding to the vein 502) positioned at different cross sections of the mapped volume of the vein 502 perpendicular to the central axis 601a. In one example, the major and minor axis lengths of each of best fit ellipses 603-605 are reduced to correspond to or equal the major and minor axis lengths, respectively, of best fit ellipse 602. In another embodiment, information indicative of vein size is derived from pre-acquired images, such as CT or MRI, and used to adjust or reduce ellipses 603-605. In a further embodiment, vein size information is estimated from the sizes of other veins (e.g., two or three other veins) depicted in the electro-anatomical map, and this estimate is used to adjust or reduce ellipses 602-605. In yet a further embodiment, information indicative of the amount of shaving required for a vein is estimated based on the amount of shaving required for other veins, and this estimate is used to adjust or reduce ellipses 602-605. In the example shown, four best fit ellipses are used along the length of vein 502, although any suitable number of best fit ellipses can be used to implement the techniques described herein. After the best fit ellipses 603-605 are each reduced to a size that more closely corresponds to the size of the best fit ellipse 602, the corrected volume of the vein 502 is determined by the mapping system, as described more fully below.

[0070] 8 depicts one example of a technique for removing "pinching" artifacts similar to that of FIG. 6, except that copies 602b-602d of the rightmost best-fit ellipse 602 are projected along the central axis at angles perpendicular to the central axis. After copies 602b-d are projected along the central axis, the corrected volume of vein 502 is determined by a mapping system, as described more fully below. In the example shown, four copies of ellipse 602a are used along the length of vein 502, although any suitable number of copies can be used to implement the techniques described herein.

[0071] After calculating the ellipse described in connection with the examples of FIGS. 6-8, a modified volume of the vein 502 is determined by the mapping system. In the example of FIG. 9, the system 100 calculates a new volume 901 (corresponding to the modified surface of the vein 502) by interpolating between the boundaries of copies 602a-d of the ellipse 601a along the central axis 601a. ​​For purposes of the techniques described herein, the volume 901 is considered to be a generalized cylinder or ruled surface extending along the central axis 601a, like a pipe or tube. However, because the volume 901 corresponds to a vein, it does not correspond in shape to a perfect or regular cylinder. Following calculation of the volume 901, voxels in the FAM between the original volume 902 and the new volume 901 are removed, and an updated version of the vein 502 (free of the artifacts described above) is displayed. In the above example, the voxels between the original volume 902 and the new volume 901 are automatically removed in a single step (e.g., actuated by a single click of the operator via a user interface), but it will be appreciated that the removal of these voxels may be performed in multiple steps using an automatic shaving procedure in which voxels from volume 902 are shaved in layers until they reach the new volume 901. In some examples, this step-by-step procedure is achieved by the operator shaving successive layers from the original volume 902 via a user interface on display 27.

[0072] In the example of FIG. 9, the volume 901 is calculated based on four copies of one best-fit ellipse, but it will be appreciated that in other examples, such as that shown in FIG. 7, additional, separately calculated best-fit ellipses are used to calculate the volume 901. In some examples, more than one best-fit ellipse is used. In some examples, the number of best-fit ellipses used to calculate the tubular volume 901 involves a compromise between accuracy and efficiency. In these examples, the computation time required to calculate each best-fit ellipse is balanced against the increased accuracy of the volume 901 associated with each additional best-fit ellipse, and the optimal number of best-fit ellipses is selected based on these considerations.

[0073] FIG. 10 depicts a side-by-side comparison of the map of FIG. 5B (left) with an updated version of that map (right) that has been corrected according to the techniques described herein, according to one example. In the example of FIG. 5B, the anatomical fit resulted in a visual artifact that caused the vein 502 to appear pinched at the location identified by the arrow 505 where the vein 502 intersects with the heart chamber. The map shown on the right side of FIG. 10 has been corrected according to the techniques described above so that the remaining portion of the vein 502 along length 504c has been reduced in size to more closely correspond to a portion of the proximal vein region 505. In the corrected map, the vein 502 appears healthy and no longer resembles a vein undergoing stenosis.

[0074] In the above example, the techniques for modifying the FAM are described in relation to vein 502, but the techniques described herein are not limited to veins and can be applied to other anatomical structures in the heart or elsewhere in the human body.

[0075] FIG. 11 depicts an electroanatomical map of the heart, according to a further example. While in the examples of FIGS. 6-8 , sufficient data points were calculated to define all or most of the central axis 601 a, in the example of FIG. 11 , the central axis is not calculated in its entirety. Rather, in the example of FIG. 11 , a limited number of data points (e.g., one or more data points) are estimated to lie along the central axis. In the example of FIG. 11 , a best-fit ellipse 602 is calculated, as described above, to be the most appropriate or optimal representation of the set of data points represented by the ablation tags on the surface of the vein 502 within the plane of the ellipse. The system 100 calculates a center point 901 of the ellipse 602 and a radius 902 of the ellipse 602. In one embodiment, the system 100 estimates that the center point 901 lies along the central axis (not shown) of the vein 502. The system 100 projects a distance corresponding to a line 903 in a direction perpendicular to the plane of the ellipse 602 to estimate additional data points 904 along the central axis. System 100 identifies point 906 by projecting a distance corresponding to the length of radius 902 from point 904 along line 905. Line 905 is perpendicular to line 903. System 100 identifies point 907 on the map surface that is closest to point 906 and uses point 907 to calculate a closed curve 908 that estimates the surface of vein 502 in a cross section passing through point 904. Techniques for calculating closed curve 908 are disclosed, for example, in connection with the discussion of FIG. 3 in commonly owned U.S. Pat. No. 11,461,895. The contents of U.S. Pat. No. 11,461,895 are incorporated by reference in their entirety. While only a single closed curve is shown in FIG. 11 , it will be understood that in other examples, system 100 calculates multiple additional closed curves along vein 502 by repeating the above-described process until multiple closed curves have been determined along the length of the vein.

[0076] Continuing with the example of FIG. 11, the system 100 calculates a new volume (corresponding to the modified surface of the vein 502) by interpolating between the boundary of the ellipse 602 and the calculated long vein 502 of each successive closed curve. This process is similar to the process described in connection with FIG. 9, except that one or more of the ellipses shown in FIG. 9 are substituted with closed curves. The new volume corresponds to a generalized cylinder or ruled surface extending along the vein, such as a pipe or tube. Following calculation of the new volume, voxels in the FAM between the original volume and the new volume are removed, and an updated version of the vein 502 is displayed. The voxels between the original volume and the new volume 901 are removed automatically in a single step (e.g., activated by a single click of the operator via the user interface) or in multiple steps using an automated shaving procedure in which voxels from the old volume are shaved in layers until the new volume is reached. In some examples, this step-by-step procedure is achieved by the operator shaving successive layers from the original volume via a user interface on the display 27.

[0077] Referring now to Figure 12, a method 1200 according to one or more exemplary embodiments is illustrated. Method 1200 is an exemplary series of operations resident in and performed by workstation 55 of Figure 1, local computing device 106 of Figure 2, remote computing system 108 of Figure 2, and / or exemplary device 400 of Figure 4. Method 1200 illustrates an example of how system 100 generates and presents maps of anatomical structures (e.g., one or more 3D models) on a user interface and modifies such maps according to techniques described herein, for example, during an EP procedure (e.g., an ablation procedure).

[0078] Method 1200 begins at block 1201, where a first electro-anatomical map including an anatomical structure having a mapped volume having a substantially tubular shape is displayed on a user interface. In one example, the first electro-anatomical map corresponds to the map shown in FIG. 5B, the anatomical structure having a mapped volume having a substantially tubular shape corresponds to vein 502 shown in FIG. 5B, and the user interface corresponds to a user interface displayed on display device 27 (shown in FIG. 1). In this example, the anatomical map depicts a 3D rendering of the heart and includes features such as one or more ablation tags.

[0079] At block 1202, a first best-fit ellipse (or other best-fit shape) is determined for a first cross-section of the mapped volume based on the data points associated with the first cross-section of the mapped volume. In one example, the first best-fit ellipse corresponds to ellipse 602 (FIG. 7).

[0080] In block 1203, at least one point along the central axis (e.g., axis 601a) of the mapped volume (e.g., vein 502) is estimated. While the example of FIG. 6 shows the entire central axis 601 as being determined (or estimated) by system 100, in other examples (e.g., the example of FIG. 11), only one or more points on the central axis are estimated. References herein to "estimating" a point on the central axis will be understood to include both selection of a previously calculated (estimated) point on the central axis and other techniques (e.g., the technique of FIG. 11) in which one or more points along the central axis are estimated.

[0081] At block 1204, a second point along the central axis on a second cross-section of the mapped volume is estimated. In some examples, a copy of the first best-fit ellipse is positioned on the second cross-section. In some such examples, a further copy of the first best-fit ellipse is positioned on a further cross-section along the vein in a direction perpendicular to the estimated central axis. In other examples, a second best-fit ellipse is separately calculated and positioned on the second cross-section. In one example, the second best-fit ellipse is first calculated based on the original volume 902 of the vein 502 and then modified (or, for example, reduced) in size to more closely correspond to the first best-fit ellipse. In some such examples, a further best-fit ellipse (separately calculated) is positioned on a further cross-section along the vein in a direction perpendicular to the estimated central axis. In other embodiments, a combination of copies of the first best-fit ellipse and another separately calculated best-fit ellipse is positioned along the vein. As mentioned above, other best-fit shapes are within the scope of the techniques described herein.

[0082] In block 1205, the volume of a generalized cylinder is calculated along the estimated central axis and spanning between the first and second cross sections according to the first best-fit ellipse. In one example, the volume of the generalized cylinder corresponds to volume 901 ( FIG. 9 ) and is determined by interpolating between the boundaries of copies of the first best-fit ellipse or between the first and second best-fit ellipses along the estimated central axis. In some embodiments, if multiple best-fit ellipses are determined along the length of vein 502, the volume is determined in block 1205 by interpolating between the boundaries of the multiple best-fit ellipses along the estimated central axis. In block 1206, data points (or voxels, as the case may be) outside the volume are removed. In some examples, this step includes removing all voxels between new volume 901 and original volume 902, as shown in FIG. 9 , and is performed in a single step or multiple steps by an operator during a medical procedure. In block 1207, a second electroanatomical map (e.g., the map shown on the right side of FIG. 10) having an updated version of the anatomical structure generated without the removed data points is displayed on the user interface.

[0083] 12 is applied to a vein associated with the myocardium, and data points associated with a first cross-section of the mapped volume correspond to ablation tags. In some such examples, in one or more of a plurality of additional cross-sections of the mapped volume perpendicular to and along the length of the central axis, data points associated with the cross-section do not correspond to ablation tags. In some examples, the first best-fit ellipse is a circle, and the substantially tubular shape is a substantially cylindrical shape. In some embodiments, the electro-anatomical map is a fast anatomical map generated during a cardiac ablation procedure.

[0084] 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 a flowchart or block diagram may represent a module, segment, or portion of instructions, including one or more executable instructions for implementing the specified logical function(s). In some alternative implementations, the functions shown in the blocks may occur out of the order shown in the figures. For example, two blocks shown in succession may in fact be executed substantially concurrently, or the blocks may, in some cases, be executed in the reverse order, depending on the functionality involved. It should also be noted that each block of the block diagrams and / or flowchart illustrations, and combinations of blocks in the block diagrams and / or flowchart illustrations, may be implemented by a dedicated hardware-based system that performs the specified functions or operations, or may operate or execute a combination of dedicated hardware and computer instructions.

[0085] While features and elements have been described above in particular combinations, those skilled in the art will understand that each feature or element can be used alone or in combination with other features and elements. Additionally, the methods described herein can be implemented in a computer program, software, or firmware embodied in a computer-readable medium for execution on a computer or processor. Computer-readable medium, as used herein, should not be construed as being a transitory signal per se, such as an electric wave or other freely propagating electromagnetic wave, an electromagnetic wave propagating through a waveguide or other transmission medium (e.g., a light pulse passing through a fiber optic cable), or an electrical signal transmitted through a current line.

[0086] Examples of computer-readable media include electrical signals (transmitted via wired or wireless connections) and computer-readable storage media. Examples of computer-readable storage media include, but are not limited to, registers, cache memory, semiconductor memory devices, magnetic media (e.g., internal hard disks and removable disks), magneto-optical media, optical media (e.g., compact disks (CDs) and digital versatile disks (DVDs)), random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), static random access memory (SRAM), and memory sticks. A processor together with software can be used to implement a radio frequency transceiver for use in a terminal, a base station, or any host computer.

[0087] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms "a," "an," and "the" are intended to include the plural forms unless the context clearly dictates otherwise. It is further understood that the terms "comprise" and / or "comprising," when used herein, indicate the presence of stated features, integers, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or other features, integers, steps, operations, elements, components, and / or groups thereof.

[0088] The descriptions of different embodiments herein are provided for illustrative purposes, but are not intended to be exhaustive or limited to the disclosed embodiments. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the described embodiments. The terms used herein are selected to best explain the principles, practical applications, or technical improvements of the embodiments compared to technologies found on the market, or to enable those skilled in the art to understand the embodiments disclosed herein.

[0089] [Embodiment] (1) A method for correcting an electroanatomical map generated using a catheter positioned within a human body, the catheter having a plurality of electrodes, the map generated from data points acquired using the electrodes as the catheter moves within the body during a medical procedure, the method comprising: displaying a first electroanatomical map including an anatomical structure having a mapped volume having a substantially tubular shape; determining, at a first cross-section of the mapped volume, a first best-fit ellipse based on data points associated with the first cross-section of the mapped volume; estimating a first point along a central axis of the mapped volume according to the center of the first best-fit ellipse; estimating a second point along the central axis on a second cross-section of the mapped volume, the first cross-section being different from the second cross-section; and calculating a volume of a generalized cylinder spanning between the first cross section and the second cross section according to at least the first best fit ellipse; removing data points from the mapped volume that lie outside the volume of the generalized cylinder; and displaying a second electro-anatomical map having an updated version of the anatomy generated without the removed data points. (2) The method of embodiment 1, further comprising determining a plurality of points defining the central axis, the first cross section being perpendicular to the central axis, and the step of estimating the second point comprising selecting one of the plurality of points. (3) The method of embodiment 1, wherein the anatomical structure is a vein associated with the myocardium. (4) The method of embodiment 1, wherein the data points associated with the first cross section of the mapped volume correspond to ablation tags. (5) estimating additional points along the central axis on additional cross sections of the mapped volume; 5. The method of claim 4, wherein the volume of the generalized cylinder spans the first cross section, the second cross section, and the further cross section.

[0090] (6) The method of embodiment 4, wherein data points associated with each of the second cross-section and the further cross-section of the mapped volume do not correspond to ablation tags. (7) The method of claim 6, wherein the generalized cylindrical volume is substantially cylindrical in shape. (8) The method of embodiment 1, wherein the electroanatomical map is a high-speed anatomical map. (9) A system for modifying an electroanatomical map generated using a catheter positioned within a human body, the catheter having a plurality of electrodes, the map generated from data points acquired using the electrodes as the catheter moves within the body during a medical procedure, the system comprising: a memory for storing the electroanatomical map; a processor coupled to the memory; a user interface coupled to the processor; The processor: displaying on the user interface a first electroanatomical map including an anatomical structure having a mapped volume having a substantially tubular shape; determining, at a first cross-section of the mapped volume, a first best-fit ellipse based on data points associated with the first cross-section of the mapped volume; estimating a first point along a central axis of the mapped volume according to the center of the first best-fit ellipse; estimating a second point along the central axis on a second cross-section of the mapped volume, the first cross-section being different from the second cross-section; and calculating a volume of a generalized cylinder spanning between the first cross section and the second cross section according to at least the first best fit ellipse; removing data points from the mapped volume that lie outside the volume of the generalized cylinder; displaying on the user interface a second electro-anatomical map having an updated version of the anatomical structure generated without the removed data points. (10) The system of embodiment 9, further comprising determining a plurality of points defining the central axis, the first cross section being perpendicular to the central axis, and the step of estimating the second point comprising selecting one of the plurality of points.

[0091] (11) The system of embodiment 9, wherein the anatomical structure is a vein associated with the myocardium. (12) The system of embodiment 10, wherein the data points associated with the first cross section of the mapped volume correspond to ablation tags. (13) The processor: further configured to estimate additional points along the central axis on additional cross sections of the mapped volume; 13. The system of claim 12, wherein the volume of the generalized cylinder spans the first cross section, the second cross section, and the further cross section. (14) The system of embodiment 12, wherein the data points associated with the second cross-section and each further cross-section of the mapped volume do not correspond to ablation tags. (15) The system of embodiment 14, wherein the generalized cylindrical volume is substantially cylindrical in shape.

[0092] (16) The system described in embodiment 10, wherein the electroanatomical map is a high-speed anatomical map. (17) A non-transitory computer-readable medium storing instructions that, when executed by a processor, cause the processor to: displaying a first electroanatomical map including an anatomical structure having a mapped volume having a substantially tubular shape; determining, at a first cross-section of the mapped volume, a first best-fit ellipse based on data points associated with the first cross-section of the mapped volume; estimating a first point along a central axis of the mapped volume according to the center of the first best-fit ellipse; estimating a second data point along the central axis on a second cross-section of the mapped volume, the first cross-section being different from the second cross-section; calculating a volume of a generalized cylinder spanning between the first cross section and the second cross section along the central axis according to at least the first best fit ellipse; removing data points from the mapped volume that lie outside the volume of the generalized cylinder; and displaying a second electro-anatomical map having an updated version of the anatomical structure generated without the removed data points. (18) The non-transitory computer-readable medium of embodiment 18, wherein the operations further include determining a plurality of points defining the central axis, the first cross section being perpendicular to the central axis, and estimating the second point includes selecting one of the plurality of points. (19) The non-transitory computer-readable medium of embodiment 17, wherein the anatomical structure is a vein associated with the myocardium. (20) The non-transitory computer-readable medium of embodiment 19, wherein the data points associated with the first cross-section of the mapped volume correspond to ablation tags.

Claims

1. 1. A system for modifying an electroanatomical map generated using a catheter positioned within a human body, the catheter having a plurality of electrodes, the map generated from data points acquired using the electrodes as the catheter moves within the body during a medical procedure, the system comprising: a memory for storing the electroanatomical map; a processor coupled to the memory; a user interface coupled to the processor; The processor: displaying on the user interface a first electroanatomical map including an anatomical structure having a mapped volume having a substantially tubular shape; determining, at a first cross-section of the mapped volume, a first best-fit ellipse based on data points associated with the first cross-section of the mapped volume; estimating a first point along a central axis of the mapped volume according to the center of the first best-fit ellipse; estimating a second point along the central axis on a second cross-section of the mapped volume, the first cross-section being different from the second cross-section; and calculating a volume of a generalized cylinder spanning between the first cross section and the second cross section according to at least the first best fit ellipse; removing data points from the mapped volume that lie outside the volume of the generalized cylinder; displaying on the user interface a second electro-anatomical map having an updated version of the anatomical structure generated without the removed data points.

2. 2. The system of claim 1, further comprising determining a plurality of points defining the central axis, the first cross section being perpendicular to the central axis, and estimating the second point comprising selecting one of the plurality of points.

3. The system of claim 1 , wherein the anatomical structure is a vein associated with the myocardium.

4. The system of claim 2 , wherein the data points associated with the first cross-section of the mapped volume correspond to ablation tags.

5. the processor: further configured to estimate additional points along the central axis on additional cross sections of the mapped volume; The system of claim 4 , wherein the volume of the generalized cylinder spans the first cross section, the second cross section, and the further cross section.

6. The system of claim 4 , wherein the data points associated with the second and each further cross-section of the mapped volume do not correspond to ablation tags.

7. The system of claim 6 , wherein the generalized cylindrical volume is substantially cylindrical in shape.

8. The system of claim 2 , wherein the electro-anatomical map is a high-speed anatomical map.

9. A non-transitory computer-readable medium storing instructions that, when executed by a processor, cause the processor to: displaying a first electroanatomical map including an anatomical structure having a mapped volume having a substantially tubular shape; determining, at a first cross-section of the mapped volume, a first best-fit ellipse based on data points associated with the first cross-section of the mapped volume; estimating a first point along a central axis of the mapped volume according to the center of the first best-fit ellipse; estimating a second data point along the central axis on a second cross-section of the mapped volume, the first cross-section being different from the second cross-section; calculating a volume of a generalized cylinder spanning between the first cross section and the second cross section along the central axis according to at least the first best fit ellipse; removing data points from the mapped volume that lie outside the volume of the generalized cylinder; and displaying a second electro-anatomical map having an updated version of the anatomical structure generated without the removed data points.

10. 10. The non-transitory computer-readable medium of claim 9, wherein the operations further include determining a plurality of points defining the central axis, the first cross section being perpendicular to the central axis, and estimating the second point includes selecting one of the plurality of points.

11. The non-transitory computer-readable medium of claim 9 , wherein the anatomical structure is a vein associated with myocardium.

12. The non-transitory computer-readable medium of claim 11 , wherein the data points associated with the first cross-section of the mapped volume correspond to ablation tags.

13. 1. A method for modifying an electroanatomical map generated using a catheter positioned within a human body, the catheter having a plurality of electrodes, the map being generated from data points acquired using the electrodes as the catheter moves within the body during a medical procedure, the method comprising: displaying a first electroanatomical map including an anatomical structure having a mapped volume having a substantially tubular shape; determining, at a first cross-section of the mapped volume, a first best-fit ellipse based on data points associated with the first cross-section of the mapped volume; estimating a first point along a central axis of the mapped volume according to the center of the first best-fit ellipse; estimating a second point along the central axis on a second cross-section of the mapped volume, the first cross-section being different from the second cross-section; and calculating a volume of a generalized cylinder spanning between the first cross section and the second cross section according to at least the first best fit ellipse; removing data points from the mapped volume that lie outside the volume of the generalized cylinder; and displaying a second electro-anatomical map having an updated version of the anatomy generated without the removed data points.

14. 14. The method of claim 13, further comprising determining a plurality of points defining the central axis, the first cross section being perpendicular to the central axis, and estimating the second point comprising selecting one of the plurality of points.

15. The method of claim 13 , wherein the anatomical structure is a vein associated with the myocardium.

16. The method of claim 13 , wherein the data points associated with the first cross-section of the mapped volume correspond to ablation tags.

17. estimating additional points along the central axis on additional cross sections of the mapped volume; The method of claim 16 , wherein the volume of the generalized cylinder spans the first cross section, the second cross section, and the further cross section.

18. The method of claim 16 , wherein data points associated with each of the second and further cross sections of the mapped volume do not correspond to ablation tags.

19. 20. The method of claim 18, wherein the generalized cylindrical volume is substantially cylindrical in shape.

20. The method of claim 13 , wherein the electroanatomical map is a high-speed anatomical map.

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