Cardiac venous ablation visualization system and catheter

Abstract

A computing system is provided. The computing system includes a memory that stores processor-executable code. The computing system includes a processor that executes the code. The code causes the computing system to generate a graphical user interface including topological maps constructed from a three-dimensional anatomical model of a portion of an anatomical feature. The topological maps include an internal map view of the portion of the anatomical feature from the perspective of a device inserted into a patient. The code causes the computing system to generate a device icon on each of the topological maps. The device icon indicates a real-time location of the ablation surface of the device in relation to each map view of the topological map.

Description

[Technical field]

[0001] (Incorporated by reference) This application claims priority to U.S. Provisional Patent Application No. 63 / 288,034, filed December 10, 2021, and incorporated herein by reference in its entirety.

[0002] FIELD OF THEINVENTION The systems and methods herein relate generally to signal processing. [Background technology]

[0003] Cardiac imaging with conventional systems and methods involves generating three-dimensional (3D) images of the heart. For example, a medical professional navigates a catheter through a patient's blood vessels until the catheter is inside the heart. While being navigated, the catheter senses electrical activity which conventional systems and methods analyze to provide a 3D image. The 3D image is used by a medical professional (e.g., a physician) when performing a procedure such as cardiac ablation to treat arrhythmias (e.g., atrial fibrillation or aFib), allowing the medical professional to locate the source of the arrhythmia.

[0004] However, these 3D images are crude surface perspective views because conventional systems and methods are not suitable for detailed cardiac mapping, i.e., conventional systems and methods that generate minimal 3D images cannot provide detailed cardiac vein ablation visualization.

[0005] For example, pulmonary vein (PV) isolation is a type of cardiac ablation procedure to treat aFib. A catheter can provide one-shot PV ablation using an ablation surface (e.g., circular or spherical). The ablation surface is sized to fully contact the inner circumference of the PV wall to form an ablation ring. However, in PV isolation, approaching the PV with a catheter having such an ablation surface requires an expert's understanding of 3D modeling due to the roughness of these 3D images. In other words, since conventional systems and methods generate such rough 3D images, it is very difficult for medical professionals to understand the 3D positioning of the circular or spherical ablation surface relative to the inside of the PV. Furthermore, as the catheter approaches the PV, the catheter may provide an overload of data to conventional systems and methods. This overload of data is very difficult to process by conventional systems and methods, blurring the 3D image and further increasing the difficulty of the desired catheter placement in relation to the PV. In addition, the 3D image can include annotations of the ablated region (e.g., purple spheres or VISITAGS™). The annotations may generate more visual confusion than visual clarity, further compromising the medical professional's understanding of the 3D positioning of the ablation plane. Summary of the Invention [Means for solving the problem]

[0006] According to one or more embodiments, a computing system is provided. The computing system includes a memory storing processor executable code. The computing system includes at least one processor that executes the code. The code causes the computing system to generate a graphical user interface including one or more topological maps constructed from a three-dimensional anatomical model of a portion of an anatomical feature. The one or more topological maps include at least one internal map view of the portion of the anatomical feature from the perspective of a device inserted into a patient. The code causes the computing system to generate a device icon on each of the one or more topological maps. The device icon presents a real-time location of an ablation surface of the device in relation to each map view of the one or more topological maps. According to one or more embodiments, the exemplary computing system embodiments described above can be implemented as an apparatus, a method, and / or a computer program product.

[0007] According to one or more embodiments, a mapping engine is provided that is implemented in processor executable code of a medical device device. The medical device device includes a memory that stores the processor executable code and at least one processor that executes the processor executable code. The mapping engine is executed to generate a graphical user interface. The graphical user interface includes an interior map view that presents a three-dimensional anatomical model of the interior of the heart. The interior map presents textures and includes lines or shading that indicate depth within the interior. The graphical user interface includes a device icon that presents a real-time position of a catheter in relation to the interior of the heart. According to one or more embodiments, the exemplary mapping system embodiments described above can be implemented as an apparatus, a computing system, and / or a computer program product. [Brief description of the drawings]

[0008] 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 numbers indicate similar elements and in which: [Figure 1] 1 illustrates a diagram of an example system in which one or more features of the subject matter of this disclosure can be implemented, in accordance with one or more embodiments. [Diagram 2] 1 illustrates a system according to one or more embodiments. [Diagram 3] 1 illustrates a method according to one or more embodiments. [Figure 4] 1 illustrates an interface in accordance with one or more embodiments. [Diagram 5] 1 illustrates an interface in accordance with one or more embodiments. [Figure 6] 1 illustrates an interface in accordance with one or more embodiments. [Figure 7] 1 illustrates an interface in accordance with one or more embodiments. [Figure 8] 1 illustrates an interface in accordance with one or more embodiments. [Figure 9] 1 illustrates an interface in accordance with one or more embodiments. [Figure 10] 1 illustrates an interface in accordance with one or more embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0009] Disclosed herein are systems and methods generally related to signal processing. According to one or more embodiments, the systems and methods herein provide a mapping engine that generates detailed cardiac vein ablation visualizations by extracting and analyzing cardiac electrical activity and by analyzing internal and / or external 3D maps of the heart. By way of example, the mapping engine may be processor executable code or software that is implemented during processing operations by and within a processing hardware of a medical device apparatus (e.g., a catheter and a computer system connected thereto). The mapping engine performs multi-stage manipulation of cardiac electrical activity during processing operations by the medical device apparatus to generate detailed cardiac vein ablation visualizations that address the visual clutter caused by the roughness of conventional 3D images and annotations thereon. One or more advantages, technical effects, and / or benefits of the mapping engine, multi-stage manipulation of electrical activity, and detailed cardiac vein ablation visualizations include providing medical professionals with improved understanding of more accurate electrophysiology that promotes the efficiency and success of cardiac procedures.

[0010] 1 is a diagram of an example system (e.g., a medical device instrument and / or a catheter-based electrophysiological mapping and ablation system) in which one or more features of the subject matter herein may be implemented in accordance with one or more embodiments, shown as system 10. All or a portion of system 10 may be used to collect information (e.g., biometric data and / or a training data set) and / or may be used to implement a mapping engine 101 as described herein. The system 10 includes 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 (or medical professional or clinician), a location pad 25, an electrode 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 (including at least one processor 61 and at least one memory 62 having a mapping engine 101 stored therein). It should be noted that each element and / or item of the system 10 is representative of one or more of that element and / or item. The example system 10 shown in FIG. 1 can be modified to implement the embodiments disclosed herein. The embodiments of the present disclosure can be similarly applied using other system components and configurations. Additionally, system 10 may include additional components, such as elements for sensing electrical activity and / or physiological signals, wired or wireless connectors, processing devices, and display devices. For ease of explanation, mapping engine 101 is described herein with respect to mapping heart 12. However, any anatomical structure, body part, organ, or portion thereof may be targeted for mapping by mapping engine 101 as described herein.

[0011] The system 10 includes multiple catheters 14 that are percutaneously inserted by a physician 24 through the vascular system of a patient 23 into a chamber or vasculature of the heart 12. Typically, a delivery sheath catheter (one example of a catheter 14) is inserted into the left or right atrium near a desired location in the heart 12. The multiple catheters 14 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 shown herein. The physician 24 brings a distal tip 28 of the catheter 14 into contact with the heart wall to sense a target site of the heart 12. For ablation, the physician 24 similarly brings a distal end of an ablation catheter to a target site for ablation.

[0012] Catheter 14 is an exemplary catheter that includes one, and preferably multiple, electrodes 26, optionally distributed across multiple splines 22 at distal tip 28, and configured to sense IEGM signals. Catheter 14 may further include a sensor 29 embedded in or near distal tip 28 for tracking the position and orientation of distal tip 28. Optionally and preferably, position sensor 29 is a magnetic-based position sensor including three magnetic coils for sensing three-dimensional (3D) position and orientation.

[0013] 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 end 28 of the catheter 14 may be tracked based on the magnetic field generated by the location pad 25 and sensed by the sensor 29. Details of magnetic-based position sensing 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.

[0014] The system 10 includes one or more electrode patches 38 placed on the patient 23 for skin contact to establish a position reference for the location pads 25 and impedance-based tracking of the electrodes 26. For impedance-based tracking, a current is directed to the electrodes 26 and sensed at the patch 38, so that the location of each electrode can be triangulated via the patch 38. Details of impedance-based position tracking technology are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182, each of which is incorporated herein by reference.

[0015] Recorder 11 displays electrograms 21 captured by electrodes 18 (e.g., surface electrocardiogram (ECG) electrodes) and IEGMs captured by 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.

[0016] 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 generated by the ablation energy generator 50 may include, but is not limited to, radio frequency (RF) energy or pulsed field ablation (PFA) energy, including monopolar or bipolar high voltage DC pulses such as may be used to effect irreversible electroporation (IRE), or combinations thereof.

[0017] The patient interface unit (PIU) 30 is an interface configured to establish electrical communication between the catheters, the electrophysiological equipment, a power source, and a workstation 55 that controls the operation of the system 10. The electrophysiological equipment of the system 10 may include, for example, a number of catheters 14, location pads 25, body surface ECG electrodes 18, electrode patches 38, an ablation energy generator 50, and a recorder 11. Optionally and preferably, the PIU 30 additionally includes processing capabilities for implementing real-time calculations of the catheter positions and performing ECG calculations.

[0018] The workstation 55 includes a processor unit 61 having a memory 62, a memory 62 or storage device loaded with suitable operating software, and user interface functionality, as described further herein. The workstation 55 may optionally provide multiple functions, including: (1) modeling the endocardial anatomical structures in three dimensions (3D) and rendering a model or anatomical map 20 for display on the display device 27; (2) 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; (3) displaying real-time positions and orientations of multiple catheters within the cardiac chambers; and (5) 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, commercially available from Biosense Webster, Inc., 31A Technology Drive, Irvine, Calif., 92618.

[0019] The system 10 can be used to detect, diagnose, and / or treat cardiac conditions (e.g., using the mapping engine 101). Cardiac diseases, such as cardiac arrhythmias, persist as common and dangerous medical disorders, especially in the geriatric population. For example, the system 10 can be part of a surgical system (e.g., a CARTO® system sold by Biosense Webster) configured to obtain biometric data (e.g., anatomical and electrical measurements of a patient's organs, such as the heart 12, as described herein) and perform cardiac ablation procedures. More specifically, the treatment of cardiac diseases, such as cardiac arrhythmias, often requires obtaining detailed mapping of cardiac tissue, chambers, veins, arteries, and / or electrical pathways. For example, as a prerequisite for successful catheter ablation (as described herein), the source of the cardiac arrhythmia may be precisely localized in the chambers of the heart 12. Such localization may be performed by electrophysiological studies during which spatially resolved electrical potentials are detected by a mapping catheter (e.g., catheter 14) introduced into the chambers of the heart 12. This electrophysiological study, also called electroanatomical mapping, provides 3D mapping data that can be displayed on the display device 27. Often, the mapping and therapy functions (e.g., ablation) are provided by a single catheter or a group of catheters, with the mapping catheter also simultaneously acting as the therapy (e.g., ablation) catheter. According to one or more embodiments, the mapping engine 101 can be stored and executed directly by the catheter 14.

[0020] According to one or more embodiments, the mapping engine 101 performs an electrocardiogram and / or intracardiac electrogram (ECG / ICEG). ECG / ICEG is a process of decomposing / analyzing / recording the electrical activity of the heart 12 using physiological signals of multiple electrodes 18 and electrodes 26 (e.g., in ICEG, at least one of the electrodes 26 is inside the heart 12). That is, to help the system 10 detect, diagnose, and / or treat cardiac disease, the physician 24 can guide one or more catheters 14 into the heart 12 of the patient 23. The multiple electrodes 18 and electrodes 26 then detect and provide signals (aka physiological signals) that the mapping engine 101 uses to identify small electrical changes resulting from the myocardial electrophysiological pattern of depolarization between each heartbeat. The ECG / ICEG can be performed over a period of time, such as, for example, 10 seconds. This allows the entire magnitude and direction of the electrical depolarization of the heart 12 to be captured at each instant throughout the cardiac cycle. ECG / ICEG can be recorded during diagnostic or therapeutic procedures, the duration of which can vary from tens of minutes to several hours. During each therapeutic procedure, there are usually several dozen ablation sessions, each lasting, for example, from a few seconds up to about a minute.

[0021] According to one or more embodiments, the ECG / ICEG conveys a great deal of information to the physician 24 regarding the structure of the heart 12 and the function of its electrical conduction system. During each heartbeat, a healthy heart undergoes a regular progression of depolarizations. This regular pattern of depolarizations gives rise to a characteristic ECG / ICEG tracing. Additionally, among other things, the ECG / ICEG can be used to measure the rate and rhythm of the heartbeat, the size and location of the heart chambers, the presence of damage to the myocytes or conduction system of the heart 12, the effects of cardiac medications, and the function of implanted pacemakers. The mapping engine 101 provides the technical effects, advantages, and benefits of ECG / ICEG signal interpretation that aid in a fundamental understanding of the electrical conduction system of the heart 12, as normal conduction initiates and propagates in a predictable pattern, and deviations from this pattern may be normal variations or may be pathological. It is noted that the mapping engine 101 may be considered an electrocardiograph, while the tests and outputs by the mapping engine 101 may be considered electrocardiogram tests and electrocardiograms (i.e., graphs of voltage versus time), respectively. For ease of explanation, electrocardiography, electrocardiograph, and electrocardiogram may all be referred to herein as ECG, and may also be referred to as EKG.

[0022] According to one or more embodiments, the mapping engine 101 may be applied to IRE such as PFA, where the catheter 14 must be properly positioned within the vein of the atrium of the heart 14 .

[0023] In a patient (e.g., patient 23) having normal sinus rhythm (NSR), the heart (e.g., heart 12), including the atria, ventricles, and excitable conductive tissue, is electrically excited to beat in a synchronous, patterned manner, which can be detected, such as in intracardiac electrocardiogram (IC ECG) data.

[0024] According to one or more embodiments, in patients (e.g., patient 23) with cardiac arrhythmias (e.g., aFib), the abnormal regions of cardiac tissue do not follow the synchronous beating cycle associated with normal conductive tissue, in contrast to patients with NSR. In contrast, the abnormal regions of cardiac tissue conduct abnormally to adjacent tissue, which disrupts the cardiac cycle and results in an asynchronous cardiac rhythm. It should be noted that this asynchronous cardiac rhythm can also be detected as IC ECG data. Such abnormal conduction has previously been known to occur in various regions of the heart 12, such as, for example, in the region of the sinoatrial (SA) node along the conduction pathway of the atrioventricular (AV) node, or in the myocardial tissue forming the walls of the ventricles and atria. Other conditions, such as atrial flutter, exist in which abnormal conductive tissue patterns lead to reentry pathways, causing the heart chambers to beat in a regular pattern that can be multiples of the sinus rhythm.

[0025] As an example, to assist system 10 in detecting, diagnosing, and / or treating cardiac disease, physician 24 may guide catheter 14 into heart 12 of patient 23 lying in bed. For example, physician 24 may insert a shaft through a sheath while manipulating the distal end of the shaft using a manipulator near the proximal end of catheter 14 and / or a deflection from the sheath. According to one or more embodiments, catheter 14 may be attached to the distal end of the shaft. Catheter 14 may be inserted through the sheath in a collapsed state and then expanded within heart 12.

[0026] In general, electrical activity at a point within the heart 12 can typically be measured by advancing a catheter 14 containing an electrical sensor (e.g., sensor 29) at or near its distal tip (e.g., at least one electrode 26) to the point within the heart 12, contacting tissue with the electrical sensor, and acquiring data at the point. One difficulty with mapping a heart chamber using a catheter type containing only a single distal tip electrode is that a long time may be required to collect data for each point over the necessary number of points required for a detailed map of the heart chamber as a whole. Therefore, multi-electrode catheters (e.g., catheter 14) have been developed to simultaneously measure electrical activity at multiple points within the heart chamber.

[0027] The catheter 14, which may include at least one electrode 26 and a catheter needle coupled on its body, may be configured to obtain biometric data, such as electrical signals, of a body organ (e.g., the heart 12) and / or ablate a tissue region thereof (e.g., a chamber of the heart 12). It is noted that the electrode 26 is representative of any similar element, such as a tracking coil, a piezoelectric transducer, an electrode, or a combination of elements configured to ablate a tissue region or obtain biometric data. According to one or more embodiments, the catheter 14 may include one or more position sensors that are used to determine trajectory information. This trajectory information may be used to infer motion characteristics, such as tissue contractility.

[0028] 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, and the like. 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 may be measured based on one or more thresholds and may be sensed and / or enhanced based on signal-to-noise ratio and / or other filters. Topology may correspond to the physical structure of the body part or a portion of the body part, and may correspond to changes in the physical structure for different parts 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 the body part and may be different in different parts of the same body part. For example, the dominant frequency of the PVs of the heart may be different from the dominant frequency of the right atrium of the same heart. Impedance may be a resistance measurement in a particular region of the body part.

[0029] Examples of biometric data include, but are not limited to, patient identification data, IC ECG data, bipolar intracardiac reference signals, anatomical and electrical measurements, trajectory information, body surface (BS) ECG data, historical data, brain biometric measurements, blood pressure data, ultrasound signals, radio signals, audio signals, two-dimensional or three-dimensional (3D) image data, blood glucose data, temperature data, other electrical activity and / or physiological signals. The biometric data may generally 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., diabetes mellitus type I and type II). It is noted that BS ECG data may include data and signals collected from electrodes on the patient's surface, IC ECG data may include data and signals collected from electrodes inside the patient's body, and ablation data may include data and signals collected from ablated tissue. Additionally, the BS ECG data, IC ECG data, and ablation data may be derived from one or more procedure records along with catheter electrode position data.

[0030] For example, the catheter 14 may use the electrodes 26 to perform intravascular ultrasound and / or MRI catheterization to image the heart 12 (e.g., acquire and process biometric data). The catheter 14 is shown in an enlarged view within a chamber of the heart 12. It will be understood that any shape that includes one or more electrodes 26 may be used to implement the embodiments disclosed herein.

[0031] Examples of catheter 14 include, but are not limited to, a straight catheter with multiple electrodes, a balloon catheter including electrodes distributed on multiple spines forming a balloon, a lasso, a catheter with multiple electrodes in a grid shape or a loop catheter with multiple electrodes, a high density catheter, or any other applicable shape or combination. The straight catheter may be fully or partially elastic so that it can twist, bend, and / or otherwise change its shape based on received signals and / or based on the action of an external force (e.g., cardiac tissue) on the straight catheter. The balloon catheter is designed to hold its electrodes in intimate contact against the endocardial surface when deployed within the patient's body. As an example, the balloon catheter may be inserted into a lumen such as a pulmonary vein (PV). The balloon catheter may be inserted into the PV in a deflated state, such that the balloon catheter does not occupy its maximum volume while inserted into the PV. The balloon catheter may be expanded while inside the PV, such that the electrodes on the balloon catheter contact the entire circular portion of the PV. Such contact with the entire circular portion of the PV or any other lumen allows for efficient imaging and / or ablation. According to one or more embodiments, the catheter 14 may be a high-density mapping catheter having electrodes (e.g., at least three) arranged in any combination of pairs. For example, the catheter 14 may include at least five arms, and possibly eight or more, and the electrodes may include 20 or 48 monopolar electrodes arranged in pairs or coupled one or two millimeters apart from each other (e.g., high density improves performance). Examples of high-density mapping catheters include, but are not limited to, the Constellation catheter, the OCTARAY™ Mapping Catheter, and / or the PENTARAY® NAV ECO High Density Mapping Catheter (by Biosense Webster®).

[0032] According to another example, a body patch and / or body surface electrodes (e.g., one or more electrode patches 38) may be placed on or adjacent to the body of the patient 23. A catheter 14 having one or more electrodes 26 may be placed within the body (e.g., within the heart 12), and the position of the catheter 14 may be determined by the 100 system based on signals transmitted and received between the one or more electrodes 26 of the catheter 14 and the body patch and / or body surface electrodes. Additionally, the electrodes 26 may sense biometric data from within the body of the patient 23, such as within the heart 12 (e.g., the electrodes 26 sense tissue electrical potentials in real time). The biometric data may be correlated with the determined position of the catheter 14, such that a rendering of the patient's body part (e.g., the heart 12) may be displayed showing the biometric data superimposed on the shape of the body part.

[0033] As a further example, the catheter 14 and other items of the system 10 may be connected to a workstation 55. The workstation 55 may include any computing device that employs ML / AI algorithms (which may be included in the mapping engine 101). According to an exemplary embodiment, the workstation 55 includes one or more processors 61 (any computing hardware) and memory 62 (any non-transitory tangible medium), where the one or more processors 61 execute computer instructions for the mapping engine 101 and the memory 62 stores these instructions for execution by the one or more processors 61. For example, the workstation 55 may be configured to receive and process biometric data to determine whether a particular tissue region conducts electricity. In some embodiments, the workstation 55 may be further programmed by the mapping engine 101 (in software) to perform functions of an ablation procedure guidance method. For example, the workstation 55 may be further programmed by the mapping engine 101 (in software) to perform functions of generating a graphical user interface that presents one or more topological maps constructed from a 3D anatomical model of a portion of an anatomical feature (e.g., a vein of an atrium of the heart 12). The one or more topological maps may include at least one internal map view of the portion of the anatomical feature from the perspective of the device (e.g., the catheter 14 inserted into the patient 23). Additionally, the workstation 55 may be programmed (in software) by the mapping engine 101 to perform the function of generating a device icon for each of the one or more topological maps. The catheter icon may indicate the real-time location of the ablation surface of the device in relation to each map view of the one or more topological maps. According to one or more embodiments, the mapping engine 101 may be external to the workstation 55, e.g., located in the catheter 14, in an external device, in a mobile device, in a cloud-based device, or may be a stand-alone processor.In this regard, the mapping engine 101 may be transferable / downloadable in electronic form over a network.

[0034] By way of example, the workstation 55 may be any computing device described herein including software (e.g., mapping engine 101) and / or hardware (e.g., processor 61 and memory 62), such as a general-purpose computer with appropriate front-end and interface circuitry for transmitting and receiving signals to and from the catheter 14 and controlling other components of the system 10. For example, the front-end and interface circuitry may include an input / output (I / O) communication interface that allows the workstation 55 to receive signals from at least one electrode 26 and / or transmit signals to at least one electrode 111. The workstation 55 may include real-time noise reduction circuitry, typically configured as a field programmable gate array (FPGA). The real-time noise reduction circuitry is followed by an analog-to-digital (A / D) ECG or electrocardiogram / electromyogram (EMG) signal conversion integrated circuit. The workstation 55 may communicate signals from the A / D ECG or EMG circuitry to another processor and / or may be programmed to perform one or more functions disclosed herein.

[0035] A display device 27, which may be any electronic device for visually presenting biometric data, is connected to the workstation 55. According to an exemplary embodiment, during a procedure, the workstation 55 may facilitate the presentation of a rendering of the body part to the physician 24 on the display device 27 and store data representative of the rendering of the body part in memory 62. For example, a map indicative of motion characteristics may be rendered / constructed based on trajectory information sampled at a sufficient number of points within the heart 12. By way of example, the display device 27 may include a touch screen that may be configured to receive input from the physician 24 in addition to presenting the rendering of the body part.

[0036] In some embodiments, physician 24 may use one or more input devices, such as a touchpad, mouse, keyboard, gesture recognizer, etc., to manipulate the renderings of elements of system 10 and / or body parts. For example, the input devices may be used to change the position of catheter 14 so that the renderings are updated. Note that display device 27 may be located at the same location or at a remote location, such as another hospital or another healthcare provider network.

[0037] According to one or more embodiments, the system 10 can also obtain biometric data using ultrasound, computed tomography (CT), MRI, or other medical imaging techniques utilizing the catheter 14 or other medical equipment. For example, the system 10 can obtain ECG data and / or anatomical and electrical measurements (e.g., biometric data) of the heart 12 using one or more catheters 14 or other sensors. More specifically, the workstation 55 can be connected by a cable to BS electrodes including adhesive skin patches affixed to the patient 23. The BS electrodes can acquire / generate biometric data in the form of BS ECG data. For example, the processor 61 can determine position coordinates of the catheter 14 within the body part (e.g., the heart 12) of the patient 23. The position coordinates can be based on impedance or electromagnetic fields measured between the body surface electrodes and the electrodes 26 of the catheter 14 or other electromagnetic components. Additionally or alternatively, the location pads generating the magnetic fields used for steering can be located on the surface of the bed (or table) and can be separate from the bed. The biometric data can be transmitted to the workstation 55 and stored in the memory 62. Alternatively, or additionally, the biometric data may be transmitted to a server, which may be local or remote, using a network as described further herein.

[0038] According to one or more embodiments, the catheter 14 may be configured to ablate a tissue region of a chamber of the heart 12. For example, the catheter 14 is shown in an expanded view within a chamber of the heart 12. Additionally, an ablation electrode, such as at least one electrode 26, may be configured to apply energy to a tissue region of an internal organ (e.g., the heart 12). The energy may be thermal energy and may cause damage to the tissue region starting from a surface of the tissue region and extending through a thickness of the tissue region. Biometric data related to the ablation procedure (e.g., ablated tissue, ablation location, etc.) may be considered ablation data.

[0039] According to one or more embodiments, the mapping engine 101 can utilize biometric data to perform cardiac mapping. Cardiac mapping by the mapping engine 101 can be performed using one or more techniques. In general, mapping of cardiac regions, such as the cardiac regions, tissues, veins, arteries, and / or electrical pathways of the heart 12 can lead to identification of problem areas, such as scar tissue, arrhythmia sources (e.g., electrical rotors), healthy regions, and the like. The cardiac regions can be mapped such that a visual rendering of the mapped cardiac regions is provided using a display, as further disclosed herein. Additionally, cardiac mapping (which is an example of cardiac imaging) can include mapping based on one or more modalities, such as, but not limited to, LAT, regional activation rate, electrical activity, topology, bipolar mapping, dominant frequency, or impedance. Data (e.g., biometric data) corresponding to multiple modalities may be acquired using a catheter (e.g., catheter 14) inserted into the patient's body and may be provided for rendering at the same time or at different times based on corresponding settings and / or physician 24 preferences.

[0040] As an example of the first technique, cardiac mapping by the mapping engine 101 may be performed by sensing electrical properties of cardiac tissue, such as LAT, as a function of precise location within the heart 12. Corresponding data (e.g., biometric data) may be acquired by one or more catheters (e.g., catheter 14) advanced into the heart 12 and having electrical and position sensors (e.g., electrodes 26) at their distal tips. As a specific example, location and electrical activity may be initially measured at about 10 to about 20 points on the inner surface of the heart 12. These data points may generally be sufficient for the mapping engine 101 to generate a preliminary reconstruction or map of the cardiac surface with satisfactory quality. The preliminary map may often be combined by the mapping engine 101 with data measured at additional points to generate a more comprehensive map of the cardiac electrical activity. In clinical practice, it is not uncommon to collect data from 100 or more sites (e.g., several thousand) to generate a detailed comprehensive map of the electrical activity of the heart chambers. The detailed maps generated can then serve as the basis for making decisions about a course of therapeutic action, such as tissue ablation as described herein, to alter the propagation of the heart's electrical activity and restore normal cardiac rhythm.

[0041] Furthermore, cardiac mapping by the mapping engine 101 can be generated based on detection of intracardiac potential fields (e.g., examples of IC ECG data and / or bipolar intracardiac reference signals). Non-contact methods can be implemented to simultaneously acquire large amounts of cardiac electrical information. For example, a catheter type having a distal end portion can be provided with a series of sensor electrodes distributed over its surface and connected to insulated conductors for connection to signal sensing and processing means. The size and shape of the end portion can be such that the electrodes are spaced apart from the wall of the cardiac chamber by a large distance. The intracardiac potential fields can be detected during one cardiac beat. According to one example, the sensor electrodes can be distributed on a series of circumferences located in planes spaced apart from one another. These planes can be perpendicular to the long axis of the end portion of the catheter. At least two further electrodes can be disposed adjacent to both ends of the long axis of the end portion. As a more specific example, the catheter 14 can include four circumferences with eight electrodes equiangularly spaced apart on each circumference. Thus, in this particular implementation, the catheter can include at least 34 electrodes (32 circumferential electrodes and 2 end electrodes). As another more specific example, the catheter 14 can include other multi-spline catheters, such as a five soft flexible branch, eight radial splines, or a turner-type with parallel splines (e.g., any of which can have a total of 42 electrodes).

[0042] As an example of electrical or cardiac mapping, electrophysiological cardiac mapping systems and techniques based on non-contact and non-expandable multi-electrode catheters (e.g., catheter 14) can be implemented. ECGs may be acquired using one or more catheters 14 with multiple electrodes (e.g., 42-122 electrodes, etc.). This implementation allows knowledge of the relative geometry of the probe and endocardium to be obtained by an independent imaging modality, such as transesophageal echocardiography. After independent imaging, non-contact electrodes can be used to measure cardiac surface potentials and a map can be constructed from the surface potentials (e.g., possibly using a bipolar intracardiac reference signal). This technique can include the following steps (after the independent imaging step): (a) measuring potentials using multiple electrodes placed on a probe placed within the heart 12; (b) determining the geometric relationship of the probe surface to the endocardial surface and / or other fiducials; (c) generating a matrix of coefficients representing the geometric relationship of the probe surface to the endocardial surface; and (d) determining the endocardial potentials based on the electrode potentials and the matrix of coefficients.

[0043] As another example of electrical or cardiac mapping, techniques and devices can be implemented for mapping the electrical potential distribution of a heart chamber. An intracardiac multi-electrode mapping catheter assembly can be inserted into the heart 12. The mapping catheter (e.g., catheter 14) assembly can include a multi-electrode array having one or more integral reference electrodes (e.g., one or more electrodes 26) or a companion reference catheter.

[0044] According to one or more embodiments, the electrodes may be deployed in a generally spherical array that may be spatially referenced to points on the endocardial surface by a reference electrode or by a reference catheter that is brought into contact with the endocardial surface. A preferred electrode array catheter may have a large number of individual electrode sites (e.g., at least 24). In addition, this exemplary technique may be implemented with knowledge of the location of each of the electrode sites on the array and with knowledge of the cardiac geometry. These locations are preferably determined by impedance plethysmography.

[0045] From an electrical or cardiac mapping perspective, and according to another example, the catheter 14 may be a cardiac mapping catheter assembly that may include an electrode array that defines multiple electrode sites. The cardiac mapping catheter assembly also includes a lumen for receiving a reference catheter having a distal tip electrode assembly that may be used to probe the heart wall. The cardiac mapping catheter assembly may include a braid of insulated wires (e.g., having 24-64 wires in the braid), each of which may be used to form an electrode site. The cardiac mapping catheter assembly may be readily positionable within the heart 12 to be used to obtain electrical activity information from a first set of non-contact electrode sites and / or a second set of contact electrode sites.

[0046] Moreover, according to another example, a catheter 14 capable of performing mapping of electrophysiological activity within the heart 12 can include a distal tip adapted to deliver stimulation pulses for pacing the heart 12, or an ablation electrode for ablating tissue in contact with the tip. The catheter 14 can further include at least a pair of orthogonal electrodes for generating a differential signal indicative of local cardiac electrical activity in the vicinity of the orthogonal electrodes.

[0047] As described herein, system 10 may be used to detect, diagnose, and / or treat cardiac conditions. In an exemplary operation, a process may be performed by system 10 for measuring electrophysiological data within a heart chamber. This process may include, in part, placing a set of active and passive electrodes within heart 12, supplying electrical current to the active electrodes thereby generating an electric field within the heart chamber, and measuring the electric field at the passive electrode sites. The passive electrodes are included in an array disposed on an inflatable balloon of a balloon catheter. In a preferred embodiment, the array is said to have 60-64 electrodes.

[0048] As another exemplary operation, cardiac mapping may be performed by the system 10 using one or more ultrasound transducers. The ultrasound transducers may be inserted into the patient's heart 12 and may collect multiple ultrasound slices (e.g., two-dimensional or three-dimensional slices) at various locations and orientations within the heart 12. The location and orientation of a particular ultrasound transducer may be known, and the collected ultrasound slices may be stored so that they can be displayed at a later time. One or more ultrasound slices corresponding to the location of a catheter 14 (e.g., a treatment catheter) may be displayed later, and the catheter 14 may be superimposed on the one or more ultrasound slices.

[0049] Considering the system 10, it can be seen that cardiac arrhythmias, including atrial arrhythmias, can be of the multiwavelet-reentrant type, characterized by multiple asynchronous loops of electrical impulses that scatter and often self-propagate around the atria (e.g., another example of IC ECG data). Alternatively or in addition to the multiwavelet-reentrant type, cardiac arrhythmias can also have focal sources of excitation, such as when isolated regions of atrial tissue are excited autonomously in a rapid and repetitive manner (e.g., another example of IC ECG data). Ventricular tachycardia (V-tach or VT) is a tachycardia or fast heart rhythm that originates from one of the ventricles. It is a potentially fatal arrhythmia, as it can lead to ventricular fibrillation and sudden death.

[0050] For example, aFib occurs when the normal electrical impulses generated by the sinoatrial node (e.g., another example of IC ECG data) are overwhelmed by chaotic electrical impulses (e.g., signal interference) originating in the atrial veins and PVs, conducting irregular impulses to the ventricles. The result is an irregular heartbeat that may persist for minutes to weeks or even years. In many cases, aFib is a chronic condition that often carries a small increase in the risk of death from stroke. The treatment approach for aFib is medication to reduce the heart rate or return the heart rhythm to normal. Furthermore, patients with aFib are often given anticoagulants to protect against the risk of stroke. The use of such anticoagulants carries its own risks, internal bleeding. In some patients, medication is not sufficient and the patient's aFib is determined to be drug refractory, i.e., untreatable by standard pharmacological interventions. Synchronized electrical cardioversion can also be used to convert aFib to a normal heart rhythm. Alternatively, patients with aFib may be treated with catheter ablation.

[0051] Catheter ablation-based therapy may include mapping electrical properties of cardiac tissue, particularly the endocardium and cardiac volumes, and selectively ablating cardiac tissue by application of energy. Electrical or cardiac mapping (e.g., performed by any of the electrophysiological cardiac mapping systems and techniques described herein) includes creating an electrical potential map (e.g., voltage map) of wave propagation along cardiac tissue, or a map of arrival times (e.g., LAT map) to points located within various tissues. Electrical or cardiac mapping (e.g., cardiac map) can be used to detect localized cardiac tissue dysfunction. Ablation, such as cardiac mapping-based ablation, can stop or change the propagation of unwanted electrical signals from one portion of the heart 12 to another.

[0052] Ablation techniques disrupt undesirable electrical pathways by creating non-conductive lesions. Various energy delivery modalities have been disclosed to create lesions, including the use of microwave, laser, and more generally radio frequency energy to create a conduction block along the cardiac tissue wall. Another example of an energy delivery technique is irreversible electroporation (IRE), which applies a high electric field that damages cell membranes. For example, the system 10 estimates the intensity in the vicinity of the ablation based on IRE, which may have a more localized effect than RF. In a two-stage procedure (mapping followed by ablation), electrical activity at points within the heart 12 is typically sensed and measured by advancing a catheter 14 containing one or more electrical sensors (e.g., electrodes 26) into the heart 12 and acquiring / capturing data (e.g., generally as biometric data or specifically as ECG data) at multiple points. The ECG data is then used to select a target region of the endocardium where ablation will be performed.

[0053] Cardiac ablation and other cardiac electrophysiology procedures are becoming increasingly complex as physicians treat challenging conditions such as atrial fibrillation and ventricular tachycardia. Treatment of refractory arrhythmias can now rely on the use of 3D mapping systems to reconstruct the anatomy of the targeted heart chamber. In this regard, the mapping engine 101 used by the system 10 herein manipulates and evaluates biometric data in general, or ECG data in particular, to generate improved tissue data that enables more accurate diagnosis, images, scans, and / or maps for treating abnormal heart rhythms or arrhythmias. For example, cardiologists rely on software such as the Complex Fractionated Atrial Electrograms (CFAE) module of the CARTO® 3 3D mapping system manufactured by Biosense Webster, Inc. (Diamond Bar, Calif.) to generate and analyze ECG data. The mapping engine 101 of the system 10 enhances this software to generate and analyze improved biometric data, which further provides multiple pieces of information regarding the electrophysiological properties of the heart 12 (including scar tissue) that are representative of the cardiac substrate (anatomical and functional) of the aFib.

[0054] Thus, the system 10 can implement a 3D mapping system, such as the CARTO® 3 3D mapping system, to locate potential arrhythmogenic substrates of cardiomyopathies in terms of detection of abnormal ECG. Substrates related to these cardiac diseases have been associated with the presence of delayed ECG and fragmentation of the endocardial and / or epicardial layers of the ventricular chambers (right and left). For example, areas of low or medium voltage may indicate ECG fragmentation and delayed activity. Furthermore, areas of low or medium voltage during sinus rhythm may correspond to critical isthmus identified in sustained coherent ventricular arrhythmias (e.g., in non-permissive ventricular tachycardia, as well as in the atrium). In general, abnormal tissue is characterized by low voltage ECG. However, early clinical experience with endocardial-epicardial mapping has shown that areas of low voltage are not always present as the only arrhythmogenic mechanism in such patients. Indeed, areas of low or medium voltage may show ECG fragmentation and delayed activity during sinus rhythm, which corresponds to the critical isthmus identified during sustained coherent ventricular arrhythmias (e.g., only applicable to non-permissive ventricular tachycardia). Moreover, in many cases, ECG fragmentation and delayed activity are observed in areas showing normal or near-normal voltage amplitudes (>1-1.5 mV). The latter areas can be evaluated according to voltage amplitudes, but are not considered normal according to the intracardiac signal and therefore represent true arrhythmogenic substrates. 3D mapping allows to localize arrhythmogenic substrates on the endocardial and / or epicardial layers of the right / left ventricle, whose distribution may vary depending on the evolution of the primary disease.

[0055] As another exemplary operation, cardiac mapping may also be performed by the system 10 using one or more multi-electrode catheters (e.g., catheter 14). Multi-electrode catheters are used to stimulate and map electrical activity within the heart 12 and to ablate sites of abnormal electrical activity. In use, the multi-electrode catheter is inserted into a major vein or artery, such as the femoral vein, and then guided into a chamber of the heart 12 of interest. A typical ablation procedure involves inserting the catheter 14, having at least one electrode 26 at its distal end, into the heart chamber. A reference electrode is provided by taping to the patient's skin or by a second catheter placed in or near the heart, or by selecting from one or the other electrodes 26 of the catheter 14. RF current is applied to the tip electrode 26 of the ablation catheter 14, and current flows through the medium (i.e., blood and tissue) surrounding the tip electrode toward the reference electrode. The current distribution is determined by the amount of electrode surface in contact with tissue compared to blood, which is more conductive than tissue. Heating of the tissue occurs due to its electrical resistance. When the tissue is heated sufficiently, cell destruction is induced in the cardiac tissue, resulting in the formation of electrically non-conductive lesions in the cardiac tissue. This process also results in heating of the tip electrode 26 by conduction from the heated tissue to the electrode itself. When the temperature of the electrode becomes high enough, possibly exceeding 60° C., a thin, transparent film of dehydrated blood proteins may form on the surface of the electrode 26. As the temperature continues to increase, this dehydrated layer may gradually thicken, causing blood to coagulate on the electrode surface. Because dehydrated biological material has a higher electrical resistance than endocardial tissue, the impedance to the flow of electrical energy into the tissue also increases. When the impedance becomes high enough, an impedance rise occurs and the catheter 14 must be withdrawn from the body and the tip electrode 26 must be cleaned.

[0056] According to one example, with respect to acquiring biometric data, a multi-electrode catheter (e.g., catheter 14) can be advanced into a chamber of heart 12. Anterior-posterior (AP) and lateral fluoroscopic pictures can be acquired to establish the position and orientation of each of the electrodes. An ECG can be recorded from each of the electrodes 26 in contact with the cardiac surface relative to a time reference, such as the occurrence of P waves in sinus rhythm from a BS ECG and / or a signal from an electrode 26 of catheter 14 positioned within the coronary sinus. The system 10 as further disclosed herein can distinguish between electrodes that record electrical activity and electrodes that do not record electrical activity because they are not in close proximity to the endocardial wall. After an initial ECG is recorded, the catheter can be repositioned and fluoroscopic pictures and ECGs can be recorded again. An electrical map (e.g., via cardiac mapping) can then be constructed from an iteration of the above process.

[0057] Referring now to Figure 2, a diagram of a system 200 capable of implementing one or more features of the subject matter of the present disclosure is illustrated, according to one or more exemplary embodiments. The system 200 includes an apparatus 204, a local computing device 206, a remote computing system 208, a first network 210, and a second network 211 in association with a patient 202 (e.g., an example of the patient 23 of Figure 1). Additionally, the apparatus 204 may include a biometric sensor 221 (e.g., an example of the catheter 14 of Figure 1), a processor 222, a user input (UI) sensor 223, a memory 224, and a transceiver 225. It should be noted that the mapping engine 101 of Figure 1 is reused in Figure 2 for ease of explanation and brevity.

[0058] According to an embodiment, the device 204 may be an example of the system 10 of FIG. 1, where the device 204 may include both components internal to the patient 202 and components external to the patient 202. According to another embodiment, the device 204 may be an external device to the patient 202, including an attachable patch (e.g., attached to the patient's skin). According to another embodiment, the device 204 may be internal to the body of the patient 202 (e.g., subcutaneously implantable), where the device 204 may be inserted into the body of the patient 202 by any applicable method, including oral infusion, surgical insertion via a vein or artery, endoscopic surgery, or laparoscopic surgery. According to one embodiment, although a single device 204 is shown in FIG. 2, an exemplary system may include multiple devices.

[0059] Thus, the apparatus 204, the local computing device 206, and / or the remote computing system 208 may be programmed to execute computer instructions for the mapping engine 101. By way of example, the memory 224 stores these instructions for the processor 222 to execute such that the apparatus 204 can receive and process biometric data via the biometric sensor 201. In this manner, the processor 222 and the memory 224 are representative of the processor and memory of the local computing device 206 and / or the remote computing system 208.

[0060] The apparatus 204, the local computing device 206, and / or the remote computing system 208 can be any combination of software (e.g., processor executable code) and / or hardware that individually or collectively stores, executes, and performs the mapping engine 101 and its functions. Furthermore, the apparatus 204, the local computing device 206, and / or the remote computing system 208 can be an electronic computer framework that includes and / or uses any number and combination of computing devices and networks utilizing various communication technologies, as described herein. The apparatus 204, the local computing device 206, and / or the remote computing system 208 can be easily scalable, extensible, and modular, capable of being tailored for different services or reconfigured with some functions independent of others.

[0061] Networks 210 and 211 may be wired networks, wireless networks, or may include one or more wired and wireless networks. According to one embodiment, network 210 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 apparatus 204 and local computing device 206 over short-range network 210 using any one of a variety of short-range wireless communication protocols, such as Bluetooth, Wi-Fi, Zigbee, Z-Wave, near field communication (NFC), Ultraband, Zigbee, or infrared (IR). Furthermore, network 211 is an example of one or more of 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 local computing device 206 and remote computing system 208. Information may be transmitted over network 211 using any one of a variety of long-range wireless communication protocols (e.g., TCP / IP, HTTP, 3G, 4G / LTE, or 5G / New Radio). Note that the wired connections of networks 210 and 211 may be implemented using Ethernet, Universal Serial Bus (USB), RJ-11, or any other wired connection, and the wireless connections may be implemented using Wi-Fi, WiMAX, Bluetooth, infrared, cellular networks, satellite communications, or any other wireless connection methodology.

[0062] In operation, the device 204 may continuously or periodically acquire, monitor, store, process, and communicate biometric data associated with the patient 202 via the network 210. Additionally, the device 204, the local computing device 206, and / or the remote computing system 208 communicate via the networks 210 and 211 (e.g., the local computing device 206 may be configured as a gateway between the device 204 and the remote computing system 208). For example, the device 204 may be an example of the system 10 of FIG. 1 configured to communicate with the local computing device 206 via the network 210. The local computing device 206 may be, for example, a fixed / standalone device, a base station, a desktop / laptop computer, a smartphone, a smartwatch, a tablet, or any other device configured to communicate with other devices via the networks 211 and 210. A remote computing system 208, implemented as a physical server on or connected to the network 211 or as a virtual server within a public cloud computing provider of the network 211 (e.g., Amazon Web Services (AWS)®), can be configured to communicate with the local computing device 206 over the network 211. Thus, biometric data related to the patient 202 can be communicated throughout the system 200.

[0063] The elements of device 204 are now described. Biometric sensor 221 may include, for example, one or more transducers configured to convert one or more environmental conditions into electrical signals such that different types of biometric data may be observed / obtained / obtained. For example, biometric sensor 221 may include one or more of an electrode (e.g., electrodes 18 and 26 of FIG. 1), a temperature sensor (e.g., a thermocouple), a blood pressure sensor, a blood glucose sensor, a blood oxygen sensor, a pH sensor, an accelerometer, and a microphone.

[0064] In executing the mapping engine 101, the processor 222 can be configured to receive, process, and manage biometric data acquired by the biometric sensor 221, and communicate the biometric data to the memory 224 for storage and / or across the network 210 via the transceiver 225. Biometric data from one or more other devices 204 may also be received by the processor 222 via the transceiver 225. Also, as described in more detail below, the processor 222 can be configured to selectively respond to different tapping patterns (e.g., single tap or double tap) received from the UI sensor 223 such that different tasks of the patch (e.g., acquiring, storing, or transmitting data) are initiated based on the detected pattern. In some embodiments, the processor 222 can generate audible feedback regarding detection of the gesture.

[0065] The UI sensor 223 includes a piezoelectric or capacitive sensor configured to receive user input, such as, for example, a tap or touch. For example, the UI sensor 223 may be controlled to perform capacitive coupling in response to the patient 202 tapping or touching the surface of the device 204. Gesture recognition may be performed by any one of a variety of capacitive types, such as resistive capacitive, surface capacitive, projected capacitive, surface ultrasonic, piezoelectric, and infrared touch. The capacitive sensor may be positioned over a small area or length of the surface such that a tap or touch on the surface activates the monitoring device.

[0066] The memory 224 may be any non-transitory tangible medium, such as magnetic, optical, or electronic memory (e.g., any suitable volatile and / or non-volatile memory, such as a random access memory or a hard disk drive). The memory 224 stores computer instructions that are executed by the processor 222.

[0067] The transceiver 225 may include a separate transmitter and a separate receiver, or, alternatively, the transceiver 225 may include a transmitter and receiver integrated into a single device.

[0068] During operation, the device 204 utilizing the mapping engine 101 observes / acquires biometric data of the patient 202 via the biometric sensor 221, stores the biometric data in memory, and shares this biometric data throughout the system 200 via the transceiver 225. The mapping engine 101 can then utilize models, neural networks, and ML / AI algorithms to extract and analyze electrical activity to provide medical professionals with detailed cardiac vein ablation visualization using at least 3D maps of the interior and exterior of the heart that are not currently available otherwise and improve the efficiency and success of cardiac procedures.

[0069] Referring now to FIG. 3, a method 300 (e.g., performed by the mapping engine 101 of FIG. 1 and / or FIG. 2) is illustrated according to one or more exemplary embodiments. According to one or more embodiments, the method 300 performed by the mapping engine 100 (i.e., during the process operation of the system 10 of FIG. 1 and / or the system 200 of FIG. 2) performs a multi-stage manipulation of electrical activity (of the heart 12 of FIG. 1 or the patient 202 of FIG. 2) to generate detailed cardiac vein ablation visualization that addresses the visual clutter of conventional 3D images and annotations thereon. One or more advantages, technical effects, and / or benefits of the method 300 include providing medical professionals with improved understanding of more accurate electrophysiology that promotes efficiency and success of cardiac procedures. According to one or more embodiments, the method 300 may be implemented by the mapping engine 101 with any IRE, such as PFA.

[0070] The method begins at block 305 with the mapping engine 101 acquiring biometric data. The biometric data may be acquired by the mapping engine 101 in real time. The biometric data may be acquired by the mapping engine 101 from a device. The device may be any medical or surgical device, such as the catheter 14. In this regard, the biometric data may be acquired by the mapping engine 101 in real time from the catheter 14 as it advances into the heart 12. Electrical signals may be generated by one or more distal tips, one or more proximal ends, and electrical and positional sensors therebetween (e.g., electrodes 26). Additionally, the biometric data may be acquired by the mapping engine 101 based on detection of intracardiac potential fields (e.g., IC ECG data and / or bipolar intracardiac reference signals) and / or non-contact techniques that simultaneously acquire large amounts of cardiac electrical information. The biometric data may also be acquired from historical data of past procedures stored in the memory 62 or in a database connected to the workstation 55.

[0071] At block 310, the mapping engine 101 analyzes and evaluates the biometric data. According to one or more embodiments, the mapping engine 101 utilizes the biometric data to generate one or more 3D anatomical models. The one or more 3D anatomical models may be at least a portion of an anatomical feature. The anatomical feature may include the heart 12. The portion of the anatomical feature may include an atrium vein of the heart 12. The one or more 3D anatomical models are generated from one or more electrical layers constructed from iterations of advancing the catheter 14 (e.g., constructed by cardiac mapping), as described in block 305.

[0072] According to one or more embodiments, the mapping engine 101 generates a 3D anatomical model. Additionally, the mapping engine 101 may also generate one or more topological maps. The one or more topological maps may include a topographical view of the 3D anatomical model. The one or more topological maps may be from one or more distances and / or one or more perspectives. The one or more perspectives include a view from the exterior of the atria and / or veins of the heart 12. The one or more perspectives include a view from the proximal end to the distal end. The one or more perspectives include a view from the distal end to the proximal end. The one or more topographic maps include at least one external map view.

[0073] According to one or more embodiments, the mapping engine 101 includes and utilizes models, neural networks, and ML / AI algorithms to analyze and evaluate biometric data to generate and refine one or more 3D anatomical models. The mapping engine 101 generates 3D data based on an ultrasound-based localization system, catheter positions, or imported CT, and uses the 3D data to refine one or more 3D anatomical models. For example, the mapping engine 101 runs ML / AI algorithms with neural networks inside. In general, a neural network is a network or circuit of neurons, or in the modern sense, an artificial neural network (ANN) composed of artificial neurons or nodes or cells. According to one or more embodiments, the neural network may implement a long-short-term memory neural network architecture, a convolutional neural network (CNN) architecture, or the like. The neural network may be configurable with respect to a number of layers, a number of connections (e.g., encoder / decoder connections), regularization techniques (e.g., dropout), and optimization features.

[0074] At block 320, the mapping engine 101 generates a graphical user interface (GUI). The GUI may be in the form of a user interface that allows a user to interact with the biometric data via graphical icons, audio indicators, 3D anatomical models, etc. According to one or more embodiments, the mapping engine 101 generates output to the GUI. The GUI may include one or more frames, windows, portions, each of which may operate simultaneously or independently to present output. The output may include one or more topological maps. The mapping engine 101 performs multi-stage manipulation of cardiac electrical activity, biometric data, ultrasound-based localization system, catheter position, and imported CT to generate detailed cardiac vein ablation visualization within the GUI that provides medical professionals with an improved understanding of more accurate electrophysiology that promotes efficiency and success of cardiac procedures.

[0075] According to one or more embodiments, the GUI may include one or more frames providing one or more topological maps constructed from a 3D anatomical model of the portion of the anatomical feature. The one or more topological maps may include at least one internal map view of the portion of the anatomical feature from a device perspective. The device perspective includes a perspective of the catheter 14. The device perspective includes a perspective from a proximal end to a distal end of the catheter 14. The device perspective includes a perspective from a distal end to a proximal end of the catheter 14. The one or more topological maps may include at least one external map view.

[0076] Referring to FIG. 4, an interface 400 is shown according to one or more embodiments. The interface 400 is an example of a GUI generated by the mapping engine 101. The interface 400 shows an external view 410 and an internal view 420 of a 3D anatomical model with interface elements therein. Note that there are three external views 410 showing different perspectives of the 3D anatomical model. Additionally, note that the internal view 420 can be a topological view from within the atrium. According to one or more embodiments, the device icon 430, cloud 440, color 450, and identifier 460 of the interface 400 are examples of interface elements of a GUI. Each of these examples can be color coded, include transparency variations, associated with lines or texture gradients, etc., to distinguish and / or indicate one or more topological aspects. According to one or more embodiments, the internal view 420 is shown in a black and white example 499, further depicting shading, texture, etc. The example 499 can also be generated in color by the mapping engine 101.

[0077] Returning to FIG. 3, in block 330, the mapping engine 101 generates a device icon. The mapping engine 101 utilizes IRE, such as PFA, to generate the device icon. The mapping engine 101 presents the device icon on each of the one or more topological maps. The device icon presents a real-time location of the ablation surface of the device (i.e., catheter 14) in relation to each map view of the one or more topological maps. The device icon may include, but is not limited to, an interface element identifier in the shape of the catheter 14 having a boundary (i.e., identifier 460) representing the electrodes 26. As shown in FIG. 4, the interface 400 presents a device icon 430, which may be a three-dimensional representation of the catheter (i.e., a replica corresponding to the size and shape) or a catheter icon. For example, the boundary or identifier 460 for each of the one or more electrodes 25 may be a highlighted region along the representation of the device icon 430.

[0078] In block 340, the mapping engine 101 generates a cloud. The cloud may be generated on each of the one or more topological maps. The cloud is indicative of at least one ablation region based on a position of the ablation surface. For example, the cloud is a real-time representation of at least one ablation region based on a real-time position of the ablation surface. As shown in FIG. 4, the interface 400 presents a cloud 440 that may indicate an affected region.

[0079] At block 350, the mapping engine 101 generates colors in the cloud. The colors indicate one or more parameters. According to one or more embodiments, the one or more parameters can include at least the intensity of the ablation (e.g., the intensity can be calculated by the mapping engine 101) or the number of ablations delivered. According to one or more embodiments, the colors are generated by various ablation parameters, including but not limited to the distance from the ablation source, the ablation duration, the number of ablations in the same region, the intensity of the ablation, and a tissue proximity indicator (TPI) value. The TPI value is the result of a computational decision (TIP algorithm, impedance-based decision, etc.) by the mapping engine 101 to detect the proximity of the catheter to the tissue. As shown in FIG. 4, the interface 400 presents colors 450 in the cloud 440. It should be noted that the colors can be a color mix with white to increase lightness or black to increase darkness, both of which affect the relative saturation of the resulting color mix.

[0080] In block 360, the mapping engine 101 generates an identifier. For example, in real time, the mapping engine 101 generates an identifier for each electrode of a plurality of electrodes (e.g., electrode 26) that is in contact with tissue of the portion of the anatomical feature. For example, the contact can be effective contact. Effective contact can include actual physical contact with tissue. Effective contact can further include proximity to tissue. According to one or more embodiments, the mapping engine 101 can utilize a TPI algorithm to generate the proximity of the vein to tissue. The TPI algorithm indicates whether the electrode 26 is in contact with tissue according to impedance changes and is incorporated into the mapping engine 101 and / or adds an indication to the GUI for the electrode 26 or the catheter shaft. As shown in FIG. 4, the interface 400 includes an identifier 460.

[0081] In block 370, the mapping engine 101 presents a GUI on the display device 27. For example, the interface 400 may be shown by the display device 27.

[0082] In block 380, the mapping engine 101 monitors the location of the ablation surface of the device. The mapping engine 101 monitors the real-time location of the ablation surface of the catheter 14.

[0083] At block 390, the mapping engine 101 updates one or more topological maps based on the position. The mapping engine 101 updates the one or more topological maps in real-time based on the real-time position of the ablation surface of the catheter 14. For example, color can be updated in real-time during ablation.

[0084] FIG 5 illustrates a method 500 according to one or more embodiments. FIGs 6-10 present interfaces 600, 700, 800, 900, and 1000, which depict a catheter 601 (i.e., catheter 14) moving into a vein 602 (i.e., of the heart 12), according to one or more embodiments. Method 500 describes the operation of mapping engine 101 with respect to interfaces 600, 700, 800, 900, and 1000. FIGs 5-10 are described in conjunction.

[0085] In block 525, the mapping engine 101 detects the topology of the catheter 14 and the heart 12. The mapping engine 101 presents the catheter 14 and the topology in the GUI accordingly. FIG. 6 is a snapshot showing the catheter 601 in the vein 620 relative to the ablation target 610 and the topological maps 620, 630, 640, and 650. For example, each of the topological maps 620, 630, 640, and 650 may be in the frame of the interface 600. Each of the topological maps 620, 630, 640, and 650 may be independently manipulated. All of the topological maps 620, 630, 640, and 650 may be collectively manipulated. Additionally, the movement of any interface element of the interface 600 can be synchronized with the topological map 620, the topological map 630, the topological map 640, and the topological map 650. The topological map 620 shows the interior of the vein 602. That is, the topological map 620 presents an interior view of the 3D anatomical model of the vein 602 (i.e., directly showing the inner wall 661 of the working location, i.e., the ablation target 610). The topological map 620 provides texture and indicates depth via shading 662, lines 663, boundaries, etc. on the inner wall as the catheter 14 moves into the vein 602. For example, based on the signal from the catheter 14 and the topology of the heart 12, the mapping engine 101 can place a first line 663a at a predetermined distance from a second line 663b. Additionally, the contrast of the shading 662 may indicate slope or depth, and / or one or more boundaries or lines 663 may be added at predetermined distances, such as 0.5 millimeter intervals, to indicate depth. Topological map 630, topological map 640, and topological map 650 show the outer surface of vein 602.In this regard, topological map 630, topological map 640, and topological map 650 present external views of the same 3D anatomical model from different perspectives (i.e., through a wall to a working position).

[0086] Each of the different views for each of topological map 630, topological map 640, and topological map 650 may be separated by one or more values ​​(e.g., 120 degrees) and combined to show a complete exterior view (e.g., 360 degrees) of vein 602 across one or more axes (e.g., horizontal and / or vertical axes). Note that the interior view of topological map 620 may be from the perspective of a device within patient 23, such as catheter 601. By way of example, the interior view of topological map 620 shows the perspective of catheter 601 from the proximal end to the distal end.

[0087] At block 535, the mapping engine 101 detects the catheter 14 as it moves towards the ablation target. The mapping engine 101 accordingly presents the detected motion in the GUI. With reference to FIG. 7, the interface 700 shows further motion 710 of the catheter 601 into the vein 602 (e.g., in a direction from the proximal end to the distal end). Note that as the motion 710 is shown in the topological map 620, the other topological maps 630, 640, and 650 move accordingly.

[0088] At block 545, the mapping engine 101 detects the alignment of the catheter 14 with respect to the ablation target. The mapping engine 101 accordingly presents the detected alignment in the GUI. With reference to Figure 8, the interface 800 further illustrates the alignment 810 of the catheter 601 with the ablation target 610. Note how the periphery of the catheter 601 is within the ablation target 610.

[0089] At block 555, the mapping engine 101 detects ablation of the catheter 14 against the ablation target. The mapping engine 101 accordingly presents the detected movement in the GUI. With reference to FIG. 9, the interface 900 further illustrates a cloud 910 within the working position. The cloud 910 illustrates at least one ablation region in real time based on the real time position of the ablation surface.

[0090] At block 565, the mapping engine 101 presents in the GUI the intensity of the ablation by the catheter 14. The mapping engine 101 presents the intensity in the GUI accordingly. With reference to Figure 10, the interface 1000 further shows a cloud 1010, including a color based on ablation intensity, aligned with the ablation target 610 in the topological map 620. Note that this cloud 1010 may be shown as a purple cloud with a color based on ablation intensity.

[0091] In accordance with one or more embodiments, a computing system is provided. The computing system includes a memory that stores processor-executable code. The computing system includes at least one processor that executes the code. The code causes the computing system to generate a graphical user interface including one or more topological maps constructed from a three-dimensional anatomical model of a portion of an anatomical feature. The one or more topological maps include at least one internal map view of the portion of the anatomical feature from the perspective of a device inserted into a patient. The code causes the computing system to generate a device icon on each of the one or more topological maps. The device icon presents a real-time location of an ablation surface of the device in relation to each map view of the one or more topological maps.

[0092] According to one or more embodiments or any of the computing system embodiments herein, the one or more topological maps may include at least one or more external map views.

[0093] According to one or more embodiments or any of the computing system embodiments herein, at least one processor executes code to cause the computing system to generate a cloud for each of one or more topological maps indicating at least one ablation region in real time based on the real-time position of the ablation surface.

[0094] According to one or more embodiments or any of the computing system embodiments herein, at least one processor can execute code to cause the computing system to generate a color in the cloud that is indicative of one or more parameters.

[0095] According to one or more embodiments or any of the computing system embodiments herein, the one or more parameters may include an intensity of the ablation.

[0096] According to one or more embodiments or any of the computing system embodiments herein, the color can be updated in real-time during ablation.

[0097] In accordance with one or more embodiments or any of the computing system embodiments herein, the device may include a catheter with a plurality of electrodes, and at least one processor executes code to cause the computing system to generate, in real time, an identifier for each electrode of the plurality of electrodes that is in contact with tissue of the portion of the anatomical feature.

[0098] According to one or more embodiments or any of the computing system embodiments herein, at least one processor can execute code to cause the computing system to monitor a real-time position of the ablation surface of the device and update one or more topological maps in real-time based on the real-time position.

[0099] According to one or more embodiments or any of the computing system embodiments herein, the device perspective may include a view from the proximal end to the distal end, or a view from the distal end to the proximal end.

[0100] According to one or more embodiments or any of the computing system embodiments herein, at least one internal map view may include shading, lines, or borders to indicate texture and depth.

[0101] According to one or more embodiments, a mapping engine is provided implemented in processor executable code of a medical device device. The medical device device includes a memory that stores the processor executable code and at least one processor that executes the processor executable code. The mapping engine is executed to generate a graphical user interface. The graphical user interface includes an interior map view that presents a three-dimensional anatomical model of the interior of the heart. The interior map presents textures and includes lines or shading to indicate depth within the interior. The graphical user interface includes a device icon that presents a real-time position of a catheter in relation to the interior of the heart.

[0102] According to one or more embodiments or any of the computing system embodiments herein, the graphical user interface can include one or more topological maps, each presenting an external map view of the heart.

[0103] According to one or more embodiments or any of the computing system embodiments herein, the internal map view can provide a perspective from a catheter inserted into the heart.

[0104] According to one or more embodiments or any of the computing system embodiments herein, the graphical user interface may include a cloud internal map view showing at least one ablation region in real time based on the real-time position of the catheter.

[0105] According to one or more embodiments or any of the computing system embodiments herein, the graphical user interface may include a color in the cloud that indicates one or more parameters that correspond to the intensity of the ablation.

[0106] According to one or more embodiments or any of the computing system embodiments herein, the graphical user interface can include colors in the cloud that are updated in real time during ablation.

[0107] According to one or more embodiments or any of the computing system embodiments herein, the catheter may be a straight catheter. According to one or more embodiments or any of the computing system embodiments herein, the device icon may include an identifier for each electrode of the plurality of electrodes.

[0108] According to one or more embodiments or any of the computing system embodiments herein, the mapping engine can monitor the real-time position of the catheter and update the internal map view in real-time based on the real-time position.

[0109] According to one or more embodiments or any of the computing system embodiments herein, the internal map view may present a view from a proximal end to a distal end, or a view from a distal end to a proximal end.

[0110] According to one or more embodiments or any of the computing system embodiments herein, the internal map view may present one or more lines at a predetermined distance that indicate depth.

[0111] According to one or more embodiments, a computing system is provided herein. The computing system includes a memory storing processor executable code. The computing system also includes at least one processor. The at least one processor executes the code to cause the computing system to generate a graphical user interface including one or more topological maps constructed from a three-dimensional anatomical model of a portion of an anatomical feature. The one or more topological maps include at least one internal map view of the portion of the anatomical feature from the perspective of a device inserted into a patient. The at least one processor executes the code to cause the computing system to generate a device icon on each of the one or more topological maps. The device icon presents a real-time location of an ablation surface of the device in relation to each map view of the one or more topological maps.

[0112] According to one or more embodiments or any of the computing system embodiments herein, the anatomical structure may include a heart.

[0113] According to one or more embodiments or any of the computing system embodiments herein, the portion may include a vein of an atrium of the heart.

[0114] According to one or more embodiments or any of the computing system embodiments herein, the one or more topological maps may include at least one or more external map views.

[0115] According to one or more embodiments or any of the computing system embodiments herein, at least one processor executes code to cause the computing system to generate a cloud for each of one or more topological maps indicating at least one ablation region in real time based on the real-time position of the ablation surface.

[0116] According to one or more embodiments or any of the computing system embodiments herein, at least one processor can execute code to cause the computing system to generate a color in the cloud that is indicative of one or more parameters.

[0117] According to one or more embodiments or any of the computing system embodiments herein, the one or more parameters may include an intensity of the ablation.

[0118] According to one or more embodiments or any of the computing system embodiments herein, the color can be updated in real-time during ablation.

[0119] According to one or more embodiments or any of the computing system embodiments herein, the device may include a catheter that may include multiple electrodes.

[0120] According to one or more embodiments or any of the computing system embodiments herein, at least one processor can execute code to cause the computing system to generate, in real time, an identifier for each electrode of a plurality of electrodes that is in effective contact with tissue of the portion of the anatomical feature.

[0121] According to one or more embodiments or any of the computing system embodiments herein, effective contact can include physical contact or proximity.

[0122] According to one or more embodiments or any of the computing system embodiments herein, the identifier may include a highlighted region.

[0123] According to one or more embodiments or any of the computing system embodiments herein, at least one processor can execute code to cause the computing system to monitor a real-time position of the ablation surface of the device and update one or more topological maps in real-time based on the real-time position.

[0124] According to one or more embodiments or any of the computing system embodiments herein, the device perspective may include a view from the proximal end to the distal end, or a view from the distal end to the proximal end.

[0125] In accordance with one or more embodiments, computing system embodiments herein may be implemented as apparatus, methods, and / or computer program products.

[0126] The flowcharts and block diagrams in the figures illustrate the structure, functionality, and operation of possible implementations of systems, methods, and computer program products according to various embodiments of the present invention. In this regard, each block in the flowcharts or block diagrams may represent a module, segment, or portion of instructions that includes one or more executable instructions for implementing the illustrated logical function. In some alternative implementations, the functions shown in the blocks may occur in an order other than that shown in the figures. For example, two blocks shown in succession may in fact be executed substantially simultaneously, or the blocks may sometimes 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 flow diagrams, and combinations of blocks in the block diagrams and / or flow diagrams, may be implemented by a dedicated hardware-based system that performs the specified function or operation, or may operate or execute a combination of dedicated hardware and computer instructions.

[0127] Although the features and elements have been described above in a particular combination, those skilled in the art will understand that each of the features or elements can be used alone or in combination with other features and elements. In addition, the methods described herein can be implemented in a computer program, software, or firmware that is embodied in a computer-readable medium for execution on a computer or processor. As used herein, a computer-readable medium should not be construed as being a signal that is itself ephemeral, such as an electric wave or other freely propagating electromagnetic wave, an electromagnetic wave propagating through a wave guide or other transmission medium (e.g., a light pulse passing through a fiber optic cable), or an electric signal transmitted through a flow line.

[0128] 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 such as internal hard disks and removable disks, magneto-optical media, optical media such as compact disks (CDs) and digital versatile disks (DVDs), random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), static random access memory (SRAM), and memory sticks. The processor can be used with software to implement a radio frequency transceiver for use in a terminal, a base station, or any host computer.

[0129] 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 unless the context clearly indicates otherwise. It is further to be understood that the terms "comprise" and / or "comprising," as 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.

[0130] The description of different embodiments herein is presented for illustrative purposes, but is not intended to be exhaustive or limited to the disclosed embodiments. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the described embodiments. The terms used in this specification are selected to best explain the principles, practical applications, or technical improvements of the embodiments compared to the art found in the market, or to enable those skilled in the art to understand the embodiments disclosed herein.

[0131] [Embodiment] (1) A computing system comprising: a memory for storing processor executable code; and at least one processor, the processor executing the code to provide the computing system with: generating a graphical user interface including one or more topological maps constructed from a three-dimensional anatomical model of a portion of an anatomical feature, the one or more topological maps including at least one internal map view of the portion of the anatomical feature from a perspective of a device inserted into a patient; generating a device icon on each of the one or more topological maps, the device icon indicating a real-time location of an ablation surface of the device in relation to a map view of each of the one or more topological maps. (2) The computing system of embodiment 1, wherein the one or more topological maps include at least one external map view. (3) The computing system of embodiment 1, wherein the at least one processor executes the code to cause the computing system to generate a cloud on each of the one or more topological maps indicating at least one ablation region in real time based on the real-time position of the ablation surface. (4) The computing system of embodiment 3, wherein the at least one processor executes the code to cause the computing system to generate colors within the cloud indicative of one or more parameters. (5) The computing system of embodiment 4, wherein the one or more parameters include ablation intensity.

[0132] (6) The computing system of embodiment 4, wherein the color is updated in real time during ablation. (7) The computing system of embodiment 1, wherein the device comprises a catheter having a plurality of electrodes, and the at least one processor executes the code to cause the computing system to generate in real time an identifier for each electrode of the plurality of electrodes that is in contact with tissue of the portion of the anatomical feature. (8) The computing system of embodiment 1, wherein the at least one processor executes the code to cause the computing system to monitor the real-time position of the ablation surface of the device and update the one or more topological maps in real-time based on the real-time position. (9) The computing system of embodiment 1, wherein the viewpoint of the device includes a view from a proximal end to a distal end, or a view from the distal end to the proximal end. (10) The computing system of embodiment 1, wherein the at least one internal map view includes shading, lines, or boundaries to indicate texture and depth.

[0133] (11) A mapping engine implemented in processor executable code of a medical device, the medical device comprising: a memory for storing the processor executable code; and at least one processor for executing the processor executable code, the mapping engine executing to generate a graphical user interface, the graphical user interface comprising: an internal map view presenting a three-dimensional anatomical model of the interior of the heart, said internal map presenting texture and including lines or shading indicating depth of said interior; a device icon indicating a real-time position of a catheter in relation to the interior of the heart. (12) The mapping engine of embodiment 11, wherein the graphical user interface includes one or more topological maps, each of which presents an external map view of the heart. (13) The mapping engine of embodiment 11, wherein the internal map view provides a perspective from the catheter inserted into the heart. (14) The mapping engine of embodiment 11, wherein the graphical user interface includes a cloud of the internal map view showing at least one ablation region in real time based on the real-time position of the catheter. (15) The mapping engine of embodiment 11, wherein the graphical user interface includes a color within a cloud indicating one or more parameters corresponding to ablation intensity.

[0134] (16) The mapping engine of embodiment 11, wherein the graphical user interface includes a color in the cloud that is updated in real time during ablation. (17) The mapping engine of embodiment 11, wherein the catheter comprises a plurality of electrodes, and the device icon comprises an identifier for each electrode of the plurality of electrodes. (18) The mapping engine of embodiment 11, wherein the mapping engine monitors the real-time position of the catheter and updates the internal map view in real-time based on the real-time position. (19) The mapping engine of embodiment 11, wherein the internal map view presents a view from a proximal end to a distal end or a view from the distal end to the proximal end. (20) The mapping engine of embodiment 11, wherein the internal map view presents one or more lines at a predetermined distance indicating depth.

Claims

1. 1. A computing system comprising: a memory for storing processor executable code; and at least one processor, the processor executing the code to provide the computing system with: generating a graphical user interface including one or more topological maps constructed from a three-dimensional anatomical model of a portion of an anatomical feature, the one or more topological maps including at least one internal map view of the portion of the anatomical feature from a perspective of a device inserted into a patient; generating a device icon on each of the one or more topological maps, the device icon indicating a real-time location of an ablation surface of the device in relation to a map view of each of the one or more topological maps.

2. The computing system of claim 1 , wherein the one or more topological maps include at least one external map view.

3. 2. The computing system of claim 1, wherein the at least one processor executes the code to cause the computing system to generate a cloud on each of the one or more topological maps indicating at least one ablation region in real time based on the real-time position of the ablation surface.

4. The computing system of claim 3 , wherein the at least one processor executes the code to cause the computing system to generate colors within the cloud that are indicative of one or more parameters.

5. The computing system of claim 4 , wherein the one or more parameters include an intensity of ablation.

6. The computing system of claim 4 , wherein the color is updated in real time during ablation.

7. 2. The computing system of claim 1, wherein the device comprises a catheter comprising a plurality of electrodes, and the at least one processor executes the code to cause the computing system to generate, in real time, an identifier for each electrode of the plurality of electrodes in contact with tissue of the portion of the anatomical feature.

8. 2. The computing system of claim 1, wherein the at least one processor executes the code to cause the computing system to monitor the real-time position of the ablation surface of the device and to update the one or more topological maps in real-time based on the real-time position.

9. The computing system of claim 1 , wherein the viewpoint of the device includes a view from a proximal end to a distal end or a view from the distal end to the proximal end.

10. The computing system of claim 1 , wherein the at least one internal map view includes shading, lines, or boundaries that indicate texture and depth.

11. A mapping engine implemented in processor executable code of a medical device device, the medical device device comprising: a memory for storing the processor executable code; and at least one processor for executing the processor executable code, the mapping engine executing to generate a graphical user interface, the graphical user interface comprising: an internal map view presenting a three-dimensional anatomical model of the interior of the heart, said internal map presenting texture and including lines or shading indicating depth of said interior; a device icon indicating a real-time position of a catheter in relation to the interior of the heart.

12. The mapping engine of claim 11 , wherein the graphical user interface includes one or more topological maps, each presenting an external map view of the heart.

13. The mapping engine of claim 11 , wherein the internal map view provides a perspective from the catheter inserted into the heart.

14. The mapping engine of claim 11 , wherein the graphical user interface includes a cloud of the internal map view showing at least one ablation region in real time based on the real-time position of the catheter.

15. The mapping engine of claim 11 , wherein the graphical user interface includes a color in a cloud that indicates one or more parameters that correspond to an intensity of ablation.

16. The mapping engine of claim 11 , wherein the graphical user interface includes a color in a cloud that is updated in real time during ablation.

17. The mapping engine of claim 11 , wherein the catheter comprises a plurality of electrodes, and the device icon comprises an identifier for each electrode of the plurality of electrodes.

18. The mapping engine of claim 11 , wherein the mapping engine monitors the real-time position of the catheter and updates the internal map view in real-time based on the real-time position.

19. The mapping engine of claim 11 , wherein the internal map view presents a view from a proximal end to a distal end or from the distal end to the proximal end.

20. The mapping engine of claim 11 , wherein the internal map view presents one or more lines at a predetermined distance that indicate depth.

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