Ablation location prediction over anatomical maps

Abstract

To provide a system and method for real-time planning and monitoring of cardiac ablation using an anatomical map.SOLUTION: A method includes receiving an anatomical map of wall tissue of at least a portion of a ventricle, the map overlaid with a grid of ablation tags that are graphically encoded according to respective levels of ablation of the wall tissue. Upon placing a multi-electrode ablation catheter in the vicinity of the wall tissue, one or more of the ablation tags are graphically re-encoded according to (i) existing levels of ablation associated with the tags and (ii) electrode proximity to wall tissue locations associated with the tags. The anatomical map, having the re-encoded ablation tags, is displayed to a user.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present disclosure relates generally to cardiac ablation, and more particularly to systems and methods for real-time planning and monitoring of cardiac ablation using anatomical maps. [Background technology]

[0002] Providing indications of ablation points on an anatomical map of the inner wall of a cardiac chamber has been proposed in the patent literature. For example, U.S. Patent No. 9,757,182 describes a method that includes receiving the locations of multiple ablation sites formed on the surface of the heart. Distances are measured between at least some of the ablation sites based on the locations. One or more gaps between the ablation sites that meet alarm criteria are identified. The identified gaps are displayed to the operator.

[0003] As another example, U.S. Patent No. 8,900,225 describes a method for performing a medical procedure that includes contacting a probe with an organ within a patient's body. A map of the organ is displayed, and the position of the probe relative to the map is tracked. Therapy is applied via the probe at multiple tissue sites in the organ that are in contact with the probe. While applying the therapy, the stability of contact between the probe and the tissue sites is assessed. In response to the assessed stability, the map is automatically marked to indicate the tissue sites to which the therapy has been applied. [Brief explanation 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 when read in conjunction with the drawings. [Figure 1] 1 is a schematic, pictorial illustration of a catheter-based electroanatomical (EA) mapping and ablation system, according to one embodiment of the present disclosure; [Figure 2]1 is an anatomical map of cardiac wall tissue overlaid with a grid of ablation tags graphically coded according to existing ablation levels, according to one embodiment of the present disclosure. [Figure 3] FIG. 3 is a schematic diagram of a graphical user interface (GUI) used to classify and graphically encode the ablation tags of FIG. 2 according to the level of existing ablation, according to one embodiment of the present disclosure. [Figure 4A] 10 is an anatomical map illustrating real-time graphical re-encoding of ablation tags to identify catheter electrodes suitable for ablating wall tissue, according to one embodiment of the present disclosure. [Figure 4B] 10 is an anatomical map illustrating real-time graphical re-encoding of ablation tags to identify catheter electrodes suitable for ablating wall tissue, according to one embodiment of the present disclosure. [Figure 5] 1 is a flow chart that schematically illustrates a method for planning and monitoring ablation by graphically re-encoding ablation tags according to electrode proximity, according to one embodiment of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0005] overview In cardiac ablation procedures, such as pulmonary vein isolation (PVI) for treating atrial fibrillation, physicians ablate tissue within a specific anatomical region (e.g., around the entire circumference of the ostium of the PV). Ablation, such as those using pulsed-field ablation (PFA) techniques, may require multiple iterations to completely cover the entire circumference of the ostium. Each iteration requires moving the multi-electrode ablation catheter into areas that are still insufficiently or not ablated at all.

[0006] Physicians attempting to complete an ablation may face several challenges, including (i) difficulty in closing the ablation gap, (ii) difficulty in aligning the visualized 3D location with previous ablation locations, and (iii) preventing repeat ablations on the same tissue location.

[0007] In the applications discussed, the physician is typically assisted by an anatomical 3D map that displays ablation tags (hereafter defined as tags associated with grid ablation points as seen in Figure 2) on top of a grid of ablation points defined by a 3D mapping coordinate system. The grid of ablation points densely (e.g., submillimeter) divides the 3D space.

[0008] The disclosed ablation tags are located on the anatomical 3D map surface, including those initially located sufficiently close to the anatomical 3D map surface to be accurately projected onto the surface. In one example shown in Figure 3, a graphical user interface (GUI) provided by the disclosed technique allows a user to select to show graphically encoded ablation tags according to fully ablated wall tissue locations and / or partially ablated (e.g., incompletely ablated) wall tissue locations.

[0009] The technique also displays a new ablation tag on each tissue location of any ablation point that was not previously ablated when the electrode proximity to the wall tissue location associated with the ablation point is below a given threshold.

[0010] Some examples of the present disclosure described herein provide real-time visualization techniques that address the challenges listed above and assist physicians in making the right decisions about where and how to perform further ablation.

[0011] In the disclosed real-time visualization technique, a processor receives an anatomical map of wall tissue of at least a portion of a ventricle, which map is overlaid with a grid of ablation tags graphically encoded according to respective levels of ablation of the wall tissue.

[0012] When a user (e.g., a physician) brings an ablation electrode of a multi-electrode or single-electrode catheter into proximity with wall tissue, the processor re-encodes ablation tags on the map according to (i) the existing ablation level and (ii) the electrode proximity to the tissue area. Based on the re-encoded ablation tags in proximity to the electrodes, the user may, for example, select whether to ablate with a particular electrode or to avoid ablation in that area.

[0013] If a particular electrode location overlaps an area that is partially ablated or not ablated, the ablation tag in that area may, for example, exhibit a new color (e.g., appear green). If a particular electrode overlaps an area that was previously fully ablated, the ablation tag may, for example, exhibit a new color (e.g., appear red).

[0014] Different graphical coding of the ablation grid points may be used. For example, as an alternative to the color coding of Figure 2, the technique may use icons of one shape or another, such as solid and empty icons or circles and diamonds, for real-time marking of ablation tags over fully ablated and partially ablated surface area locations, respectively.

[0015] The ablation tags may be overlaid onto a 3D anatomical model that additionally displays another electrophysiological parameter, such as a Local Activation Time (LAT) 3D electroanatomical (EA) map.

[0016] Finally, the disclosed techniques are applicable to catheters located in space without regard to 3D anatomy, such as within the blood pool of a cardiac chamber. A volumetric grid of ablation points defined across 3D space may still be tagged based on electrode proximity.

[0017] System Description FIG. 1 is a schematic, pictorial illustration of a catheter-based electroanatomical (EA) mapping and ablation system 10, according to one embodiment of the present disclosure.

[0018] The system 10 includes multiple catheters that are percutaneously inserted by a physician 24 through the patient's vascular system into the chambers or vasculature of the heart 12 (see inset 45). Typically, a delivery sheath catheter is inserted into a chamber, such as 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 can include catheters dedicated to pacing, catheters for sensing intracardiac electrogram signals, catheters dedicated to ablation, and / or catheters dedicated to both EA mapping and ablation. The exemplary catheter 14 shown herein is configured to sense bipolar electrograms and pulsed field ablation (PFA). The physician 24 brings a distal tip 28 (hereinafter also referred to as a distal end assembly 28) of the catheter 14 into contact with the heart wall to ablate a target site within the heart 12.

[0019] As seen in inset 65, catheter 14 is an exemplary catheter that optionally includes a lasso distal tip assembly 28 that includes one, and preferably multiple, electrodes 26 distributed across curved spline 22. Catheter 14 may further include a position sensor 29 embedded in or near distal tip 28 on shaft 46 of catheter 14 for tracking the position and orientation of distal tip 28. Optionally and preferably, position sensor 29 is a magnetic-based position sensor that includes three magnetic coils for sensing three-dimensional (3D) position and orientation.

[0020] The magnetic-based position sensor 29 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 magnetic-based position 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.

[0021] System 10 includes one or more electrode patches 38 positioned for skin contact with patient 23 to establish a position reference for location pads 25, as well as impedance-based tracking of electrodes 26. For impedance-based tracking, current is directed to electrodes 26 and sensed at electrode skin patches 38, thereby allowing the position of each electrode to 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.

[0022] Recorder 11 displays cardiac signals 21 (e.g., electrograms acquired at each tracked cardiac tissue location) acquired using body surface ECG electrodes 18 and intracardiac electrograms acquired using electrodes 26 of catheter 14. Recorder 11 may include pacing capability for pacing the cardiac rhythm and / or may be electrically connected to a stand-alone pacer.

[0023] The system 10 may include an ablation energy generator 50 adapted to deliver ablation energy to one or more electrodes at the distal tip of a catheter configured for ablation. The energy generated by the ablation energy generator 50 may include, but is not limited to, radiofrequency (RF) energy or pulsed field (PF) energy, or combinations thereof, including monopolar or bipolar, biphasic, monophasic high-voltage DC pulses used to produce irreversible electroporation (IRE).

[0024] The patient interface unit (PIU) 30 is an interface configured to establish electrical communication between the catheters, electrophysiology equipment, power source, and workstation 55 to control the operation of system 10 and to receive EA signals from the catheters. The electrophysiology equipment of system 10 may include, for example, multiple catheters, location pads 25, body surface ECG electrodes 18, electrode patches 38, ablation energy generator 50, and recorder 11. Optionally and preferably, PIU 30 additionally includes processing capability to perform real-time calculations of catheter position and to perform ECG calculations.

[0025] The workstation 55 includes a processor 56 unit having memory 57, memory or storage loaded with appropriate operating software, and user interface functionality. The workstation 55 may optionally provide multiple functions, including (i) modeling the endocardial anatomical structure in three dimensions (3D) and rendering the model or anatomical map 20 for display on the display device 27, (ii) displaying activation sequences (or other data) compiled from the recorded cardiac signals 21 in a representative visual representation or image superimposed on the rendered anatomical map 20 on the display device 27, (iii) displaying the real-time position and orientation of multiple catheters within the cardiac chambers, and (iv) displaying sites of interest, such as locations where ablation energy has been applied, on the display device 27. One commercially available product embodying elements of the system 10 is available as the CARTO™ 3 system, available from Biosense Webster, Inc., 31A Technology Drive, Irvine, CA 92618.

[0026] In the disclosed embodiment, the processor 56 operates an algorithm that presents the physician 24 with regions of the anatomical map that are graphically recoded (e.g., recolored) in real time according to the existing ablation level and ablation electrode proximity, as shown in FIG.

[0027] In some embodiments, processor 56 typically comprises a general-purpose computer that is programmed with software to perform the functions described herein. The software may be downloaded to the computer in electronic form, for example, over a network, or alternatively or additionally, may be provided and / or stored on non-transitory, tangible media, such as magnetic, optical, or electronic memory.

[0028] This configuration of system 10 is presented as an example to illustrate the particular problem addressed by embodiments of the present disclosure and to demonstrate the application of these embodiments in improving the performance of such systems. However, embodiments of the present disclosure are in no way limited to this particular type of exemplary system, and the principles described herein may be applied to other types of medical systems as well. For example, other multi-electrode catheter types, such as basket catheters, may be used.

[0029] Graphical coding of ablation grid points according to ablation level As described above, the disclosed techniques allow for the grid ablation points to be graphically re-encoded on the anatomical map according to the existing ablation level in the anatomical map and the proximity of the ablation catheter electrodes, with the re-encoding being performed on ablation tags that have already been graphically encoded according to the existing ablation level, including when no ablation was performed and whether the ablation was sufficient according to physician-defined parameters such as contact and positional stability.

[0030] 2 illustrates an anatomical map 200 of cardiac wall tissue 202 overlaid with a grid of ablation tags 205 graphically coded (204, 206) according to existing ablation levels, according to one embodiment of the present disclosure. Darkly shaded 204 grid-based ablation tags indicate fully ablated areas. Lightly shaded 206 grid-based ablation tags indicate partially ablated areas (e.g., areas with incomplete ablation as identified using physician criteria). Dashed icons 208 represent ablation points 208 on unablative areas where ablation tags may appear if the catheter electrodes are in sufficient proximity.

[0031] The ostial 210 surface of the PV shows partially ablated or unablative areas that require further ablation. However, some ostial regions also contain fully ablated areas. Physicians attempting to complete ostial 210 ablation may face several challenges, including (i) difficulty in closing the ablation gap, (ii) difficulty in aligning the visualized 3D location with previous ablation locations, and (iii) preventing repeat ablation on the same tissue location.

[0032] 3, which is a schematic diagram of a graphical user interface (GUI) 111 used to classify and graphically encode the ablation tags 205 of FIG. 2 according to existing ablation levels, in accordance with one embodiment of the present disclosure. A checkbox 333 on the GUI is used to select whether to show only fully ablated regions of wall tissue or both fully and partially ablated regions.

[0033] The disclosed real-time visualization technique re-encodes the ablation tags 205 to guide the user of the 3D anatomical model as to where to apply the next ablation using the selected electrode, as seen in FIG.

[0034] Graphical recoding of ablation grid points according to level of ablation and electrode proximity 4A and 4B are anatomical maps illustrating real-time graphical re-encoding (404, 406) of ablation tags 405 to identify electrodes 426 of a catheter assembly 428 suitable for ablating wall tissue, according to one embodiment of the present disclosure.

[0035] 4A and 4B, an ablation catheter, such as a loop catheter assembly 428 (e.g., a VARIPULSE® catheter offered by Biosense Webster) carrying an electrode 426, is shown brought into proximity with wall tissue to complete the ablation. A processor graphically re-encodes (404, 406) only those ablation tags 405 that are sufficiently close to any given electrode 426 (e.g., based on a tissue proximity index (TPI) algorithm described elsewhere).

[0036] Figures 4A and 4B capture different real-time positions of the VARIPULSE® catheter assembly 428, and the two figures differ only in the real-time re-encoding layout of the electrode identification information and ablation tags 405 relative to the wall tissue, respectively.

[0037] The re-encoded tag 406 marks areas that require subsequent ablation, either because no ablation occurred in that area or because insufficient ablation occurred in that area. The re-encoded tag 404 marks areas that have already been fully ablated, indicating to the user that electrode 426 does not need to apply further ablation nearby. In the example shown in Figure 4A, electrode 3 should not be activated, but electrodes #4 and #5 should be activated, while in the example shown in Figure 4B, electrode 10 should not be activated, but electrode #8 should be activated.

[0038] As further seen in Figures 4A and 4B, grid ablation tags that are now distant from the ablation catheter 428 maintain their original graphical encoding (204, 206) because they are too far from any electrodes.

[0039] The processor displays one or more new ablation tags (405) on a previously unablative ablation point when the electrode proximity to the wall tissue location associated with the ablation point is less than a given threshold.

[0040] Finally, different graphical recodings (404, 406) of the ablation grid points may be used. In one embodiment, color recodings (404, 406) may be used as (red, green). In another example, the technique may use icons of one shape or another, such as (filled, empty) icons or (circles, diamonds), for real-time marking of ablation tags on fully ablated and partially ablated surface area locations, respectively.

[0041] A method for graphical recoding of ablation grid points according to ablation level and electrode proximity. 5 is a flow chart that schematically illustrates a method for planning and monitoring grid ablation by graphically re-encoding ablation tags according to electrode proximity in real time, according to one embodiment of the present disclosure. The algorithm, according to the presented embodiment, performs a process that begins with processor 56 receiving, in ablation map receive step 502, an anatomical map, such as 3D map 200, superimposed with a grid of ablation tags indicating wall tissue locations that have already been completely ablated and / or that have not been completely ablated.

[0042] Next, as the physician brings the multi-electrode ablation catheter into proximity with the wall tissue, the processor detects the level of electrode proximity to the tissue in a pre-ablation step 504 .

[0043] In response to detecting the proximity, the processor, in an ablation tag re-encoding step 506, re-encodes the ablation tags according to the existing level of tissue ablation (complete, partial, none) and according to the varying proximity of each electrode to the tissue region, as seen in Figures 4A and 4B.

[0044] In a map presentation step 508, the processor presents the real-time re-encoded map to the user to guide the physician as to where to apply the next ablation using which electrodes. [Example]

[0045] Example 1 The method includes receiving an anatomical map (200) of wall tissue of at least a portion of a cardiac chamber, the map being overlaid with a grid of ablation tags (205) graphically coded (204, 206) according to respective levels of ablation of the wall tissue. Upon positioning one of a multi-electrode (26, 28) or single-electrode ablation catheter (14) proximate the wall tissue, one or more of the ablation tags (205) are graphically recoded (404, 406) according to (i) the existing ablation level associated with the tag (205) and (ii) the electrode (26) proximity to the wall tissue location associated with the tag (205). The anatomical map (400) with the recoded ablation tags (405) is displayed to a user.

[0046] Example 2 The method of Example 1, comprising displaying one or more new ablation tags (405) on a previously unablated ablation point (208), and displaying to a user an anatomical map (400) having the one or more new ablation tags (405) when the proximity of an electrode (26) to a wall tissue location associated with the ablation point is less than a given threshold.

[0047] Example 3 The method of any of Examples 1 and 2, wherein the level of ablation indicates wall tissue locations that are fully ablated, partially ablated, or not ablated.

[0048] Example 4 Graphically re-encoding (404, 406) the ablation tag (405) Identifying ablation tags (405) that are predicted to be damaged if further ablated based on existing ablation levels and electrode proximity; and graphically re-encoding (404) the identified ablation tag (405) to indicate a warning.

[0049] Example 5 Graphically re-encoding (404, 406) the ablation tag (405) Identifying ablation tags (405) that are predicted to remain safe if further ablated based on existing ablation levels and electrode proximity; and graphically re-encoding (406) the identified ablation tag to indicate safe ablation.

[0050] Example 6 6. The method of any of Examples 1-5, wherein the graphical re-encoding (404, 406) comprises using red tags to mark fully ablated locations and green tags to mark partially ablated or non-ablated locations.

[0051] Example 7 7. The method of any of Examples 1-6, wherein the graphical re-encoding (404, 406) comprises using icon tags of one shape to mark fully ablated locations and icon tags of another shape to mark partially ablated or non-ablated locations.

[0052] Example 8 8. The method of any one of claims 1 to 7, wherein the graphical re-encoding of the ablation tags (404, 406) is performed in real time.

[0053] Example 9 9. The method according to any one of claims 1 to 8, wherein the anatomical map (200, 400) is an electroanatomical (EA) map.

[0054] Example 10 The system includes an interface (30) and a processor (56). The interface (30) is configured to receive an anatomical map (200) of wall tissue of at least a portion of a cardiac chamber, the map overlaid with a grid of ablation tags (205) graphically encoded (204, 206) according to respective levels of ablation of the wall tissue. The processor (56) is configured to: (i) upon positioning one of the multi-electrode ablation catheters (26, 28) or the single-electrode ablation catheter (14) proximate the wall tissue, graphically re-encode (404, 406) one or more of the ablation tags according to (i) the existing ablation level associated with the tag (205) and (ii) electrode proximity to the wall tissue location associated with the tag (205), and (ii) display the anatomical map (400) with the re-encoded ablation tags (404, 406) to a user.

[0055] Although the examples described herein primarily address cardiac diagnostic applications, the methods and systems described herein may also be used in other medical applications.

[0056] It will be understood that the above-described embodiments are given by way of example, and that the present disclosure is not limited to what is particularly shown and described hereinabove. Rather, the scope of the present disclosure includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof not disclosed in the prior art that would occur to one skilled in the art upon reading the foregoing description.

[0057] [Embodiment] (1) A method comprising: receiving an anatomical map of wall tissue of at least a portion of a cardiac chamber, the map overlaid with a grid of ablation tags graphically encoded according to respective levels of ablation of the wall tissue; upon positioning one of a multi-electrode or single-electrode ablation catheter proximate the wall tissue, graphically re-encoding one or more of the ablation tags according to (i) an existing ablation level associated with the tag, and (ii) electrode proximity to the wall tissue location associated with the tag; and displaying the anatomical map with the re-encoded ablation tags to a user. (2) A method as described in embodiment 1, comprising: displaying one or more new ablation tags on a previously unablated ablation point when electrode proximity to a wall tissue location associated with the ablation point is less than a given threshold; and displaying the anatomical map with the one or more new ablation tags to the user. (3) The method of embodiment 1, wherein the level of ablation indicates a wall tissue location that is completely ablated, partially ablated, or not ablated. (4) graphically re-encoding the ablation tag; identifying an ablation tag that is predicted to be damaged if a wall tissue location is further ablated based on the existing ablation level and the electrode proximity; and graphically re-encoding the identified ablation tag to indicate a warning. (5) graphically re-encoding the ablation tag; identifying an ablation tag that is predicted to remain safe if further ablated based on the existing ablation level and the electrode proximity; and graphically re-encoding the identified ablation tag to indicate safe ablation.

[0058] (6) The method of embodiment 1, wherein the graphical re-encoding includes marking fully ablated locations using red tags and marking partially ablated or non-ablated locations using green tags. (7) The method of embodiment 1, wherein the graphical re-encoding includes using icon tags of one shape to mark fully ablated locations and icon tags of another shape to mark partially ablated or non-ablated locations. (8) The method of embodiment 1, wherein the graphical re-encoding of the ablation tag is performed in real time. (9) The method of embodiment 1, wherein the anatomical map is an electroanatomical (EA) map. (10) A system comprising: an interface configured to receive an anatomical map of wall tissue of at least a portion of a cardiac chamber, the map overlaid with a grid of ablation tags graphically encoded according to respective levels of ablation of the wall tissue; a processor, the processor comprising: upon positioning one of a multi-electrode or single-electrode ablation catheter proximate the wall tissue, graphically re-encoding one or more of the ablation tags according to (i) an existing ablation level associated with the tag, and (ii) electrode proximity to the wall tissue location associated with the tag; and displaying the anatomical map with the re-encoded ablation tags to a user.

[0059] (11) The system of embodiment 10, wherein the processor is further configured to display one or more new ablation tags on a previously unablated ablation point when electrode proximity to a wall tissue location associated with the ablation point is less than a given threshold, and to display the anatomical map with the one or more new ablation tags to the user. (12) The system of embodiment 10, wherein the level of ablation indicates a wall tissue location that is completely ablated, partially ablated, or not ablated. (13) The processor: identifying an ablation tag that is predicted to be damaged if a wall tissue location is further ablated based on the existing ablation level and the electrode proximity; The system of embodiment 10, wherein the system is configured to graphically re-encode the identified ablation tag to indicate a warning. (14) The processor: identifying an ablation tag that is predicted to remain safe if further ablated at a wall tissue location based on the existing ablation level and the electrode proximity; The system of embodiment 10, wherein the system is configured to graphically re-encode the identified ablation tag to indicate safe ablation. (15) The system of embodiment 10, wherein the processor is configured to graphically re-encode by using red tags to mark fully ablated locations and green tags to mark partially ablated or non-ablated locations.

[0060] (16) The system of embodiment 10, wherein the processor is configured to graphically re-encode by using icon tags of one shape to mark fully ablated locations and icon tags of another shape to mark partially ablated or non-ablated locations. (17) The system of embodiment 10, wherein the processor is configured to graphically re-encode the ablation tag in real time. (18) The system described in embodiment 10, wherein the anatomical map is an electroanatomical (EA) map.

Claims

1. 1. A system comprising: an interface configured to receive an anatomical map of wall tissue of at least a portion of a cardiac chamber, the map overlaid with a grid of ablation tags graphically encoded according to respective levels of ablation of the wall tissue; a processor, the processor comprising: upon positioning one of a multi-electrode or single-electrode ablation catheter proximate the wall tissue, graphically re-encoding one or more of the ablation tags according to (i) an existing ablation level associated with the tag, and (ii) electrode proximity to the wall tissue location associated with the tag; and displaying the anatomical map with the re-encoded ablation tags to a user.

2. 2. The system of claim 1, wherein the processor is further configured to: display one or more new ablation tags on a previously unablated ablation point when electrode proximity to a wall tissue location associated with the ablation point is less than a given threshold; and display the anatomical map with the one or more new ablation tags to the user.

3. The system of claim 1 , wherein the level of ablation indicates wall tissue locations that are fully ablated, partially ablated, or not ablated.

4. the processor: identifying an ablation tag that is predicted to be damaged if a wall tissue location is further ablated based on the existing ablation level and the electrode proximity; 10. The system of claim 1, further configured to graphically re-encode the identified ablation tag by:

5. the processor: identifying an ablation tag that is predicted to remain safe if further ablated at a wall tissue location based on the existing ablation level and the electrode proximity; 10. The system of claim 1, further comprising: a) graphically re-encoding the identified ablation tag to indicate safe ablation; and b) graphically re-encoding the identified ablation tag to indicate safe ablation.

6. 6. The system of claim 1, wherein the processor is configured to graphically re-encode by using red tags to mark fully ablated locations and green tags to mark partially ablated or non-ablated locations.

7. 6. The system of claim 1, wherein the processor is configured to graphically re-encode by using icon tags of one shape to mark fully ablated locations and icon tags of another shape to mark partially ablated or non-ablated locations.

8. The system of any one of claims 1 to 5, wherein the processor is configured to graphically re-encode the ablation tag in real time.

9. The system of any one of claims 1 to 5, wherein the anatomical map is an electroanatomical (EA) map.

10. 1. A method comprising: receiving an anatomical map of wall tissue of at least a portion of a cardiac chamber, the map overlaid with a grid of ablation tags graphically encoded according to respective levels of ablation of the wall tissue; upon positioning one of a multi-electrode or single-electrode ablation catheter proximate the wall tissue, graphically re-encoding one or more of the ablation tags according to (i) an existing ablation level associated with the tag, and (ii) electrode proximity to the wall tissue location associated with the tag; and displaying the anatomical map with the re-encoded ablation tags to a user.

11. 11. The method of claim 10, comprising: displaying one or more new ablation tags on a previously unablated ablation point when electrode proximity to a wall tissue location associated with the ablation point is below a given threshold; and displaying the anatomical map with the one or more new ablation tags to the user.

12. The method of claim 10 , wherein the level of ablation indicates wall tissue locations that are fully ablated, partially ablated, or not ablated.

13. graphically re-encoding the ablation tag; identifying an ablation tag that is predicted to be damaged if a wall tissue location is further ablated based on the existing ablation level and the electrode proximity; and graphically re-encoding the identified ablation tag to indicate a warning.

14. graphically re-encoding the ablation tag; identifying an ablation tag that is predicted to remain safe if further ablated at a wall tissue location based on the existing ablation level and the electrode proximity; and graphically re-encoding the identified ablation tag to indicate safe ablation.

15. 15. The method of any one of claims 10 to 14, wherein the graphically re-encoding comprises using red tags to mark fully ablated locations and green tags to mark partially ablated or non-ablated locations.

16. 15. The method of any one of claims 10 to 14, wherein the graphically re-encoding comprises using icon tags of one shape to mark fully ablated locations and icon tags of another shape to mark partially ablated or non-ablated locations.

17. The method of any one of claims 10 to 14, wherein the graphical re-encoding of the ablation tag is performed in real time.

18. The method of any one of claims 10 to 14, wherein the anatomical map is an electroanatomical (EA) map.

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