Noise in electroanatomical signals

Abstract

In one exemplary aspect, a medical system includes a catheter configured to be inserted into a body part of a living subject and having a plurality of electrodes configured to contact tissue of the body part, a display, and a processing circuit configured to receive a signal from one of the electrodes, find a noise measurement of the signal, and render a dynamic representation of the noise measurement on the display.

Description

[Technical field]

[0001] The present disclosure relates to medical systems, particularly but not exclusively to catheter-based systems. [Background technology]

[0002] A wide range of medical procedures involve the placement of probes, such as catheters, inside a patient's body. Position sensing systems have been developed to track such probes. Magnetic position sensing is one method known in the art. In magnetic position sensing, magnetic field generators are typically placed at known locations outside the patient. A magnetic field sensor in the distal end of the probe generates electrical signals in response to these magnetic fields, and the electrical signals are processed to determine the coordinate position of the distal end of the probe. These methods and systems are described in U.S. Patent Nos. 5,391,199, 6,690,963, 6,484,118, 6,239,724, 6,618,612 and 6,332,089, International Publication No. WO 1996 / 005768, and U.S. Patent Application Publication Nos. 2002 / 0065455, 2003 / 0120150 and 2004 / 0068178, the disclosures of all of which are incorporated herein by reference. Position can also be tracked using impedance or current based systems.

[0003] One medical procedure in which these types of probes or catheters have proven extremely useful is in the treatment of cardiac arrhythmias, which remain particularly prevalent and dangerous medical ailments, especially in the elderly population.

[0004] The diagnosis and treatment of cardiac arrhythmias includes mapping the electrical properties of cardiac tissue, particularly the endocardium and cardiac volumes, and selectively ablating cardiac tissue by application of energy. Such ablation can stop or modify the propagation of undesired electrical signals from one part of the heart to another. The ablation process breaks the undesired electrical pathways by the formation of non-conducting foci. Various modes of energy delivery have been previously 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. In a two-stage procedure in which mapping is followed by ablation, electrical activity at points within the heart is typically sensed and measured by advancing a catheter containing one or more electrical sensors into the heart and acquiring data at multiple points. These data are then used to select an endocardial target area where ablation should be performed. [Brief description of the drawings]

[0005] The present disclosure will be understood from the following detailed description taken in conjunction with the accompanying drawings. [Figure 1] 1 is a schematic diagram of a medical treatment system constructed and operative in accordance with an exemplary aspect of the present disclosure. [Diagram 2] FIG. 2 is a schematic diagram of a catheter for use in the system of FIG. 1. [Diagram 3] 2 is a flow chart including steps in a method for providing noise levels for use in the system of FIG. 1. [Figure 4] FIG. 2 is a schematic diagram of noise level presentation in the system of FIG. 1. [Diagram 5] 2 is a flow chart including steps in a method for setting a noise level for selecting a signal in the system of FIG. 1. [Figure 6] 2 is a schematic diagram of a user interface screen used to set noise levels for selecting signals in the system of FIG. 1; [Figure 7]FIG. 2 is a schematic diagram of an electroanatomical map generated by the system of FIG. 1. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0006] overview Noise is added to intracardiac electrogram (IEGM) signals (captured by catheters) and electrocardiogram (ECG) signals (captured by body surface patches) in an electrophysiological (EP) lab from equipment in the EP lab as well as other sources such as signal processing circuitry, catheters, and position (e.g., magnetic) tracking systems. For example, as cardiac signals are carried in wires and cables from the catheters and / or body surface electrodes, they pick up noise generated in the EP lab. Each EP lab may have its own noise profile based on the equipment operating in the EP lab. The noise may distort the IEGM and / or ECG signals and prevent useful analysis and use of the signals.

[0007] Physicians generally do not want to use electrodes that are picking up too much noise for mapping. Electrodes may be selected by carefully examining the intracardiac signals (IEGMs) captured by the electrodes to determine if the electrodes are picking up too much noise. However, this is very time consuming, especially for catheters with dozens of electrodes. Additionally, the amount of noise being picked up by an electrode changes over time based on its location and other factors.

[0008] Exemplary aspects of the present disclosure solve at least some of the above problems by finding a noise measure for each signal captured by the electrodes, selecting signals having a noise measure below a given noise level, and rendering electroanatomical data (e.g., IEGM and / or ECG tracings and / or electroanatomical maps) on a display based on the selected signals, while noisier signals are not used to generate the displayed electroanatomical data. For example, an electroanatomical map may be generated from the selected signals and then rendered on a display.

[0009] In some exemplary aspects, a user interface is provided to receive user input of a noise level to be used to select the signal. In some exemplary aspects, the user interface includes a noise level selector slider to allow the user to select a given noise level by moving the slider to select the desired noise level. In some exemplary aspects, the user may include other mapping option selectors such as cycle length, pattern matching, positional stability, and local activation time (LAT) stability.

[0010] The noise measure may be calculated as a function of the magnitude of frequencies associated with the noise. For example, high frequency components of the signal captured by the catheter are likely to be of non-electroanatomical origin. For example, frequencies above 70 or 150 Hz (depending on the arrhythmia) are likely to be of non-electroanatomical origin. The noise measure may be based on an absolute measure of noise or as some kind of signal-to-noise ratio.

[0011] In some exemplary aspects, a dynamic display of the noise measurement of each signal, the changes of which are in real time, is rendered on the display so that the physician can easily see the noise level of each of the signals. In some exemplary aspects, the dynamic display is a graphical representation, such as a colored indicator that changes color in response to the respective level of the noise measurement of the signals. The colored indicator can be a colored line, for example, "green" for no noise, "yellow" for low noise, "orange" for medium noise, and "red" for high noise.

[0012] In some exemplary aspects, the catheter may include multiple splines with electrodes positioned along the splines. Graphical representations (e.g., colored lines) may be grouped according to the splines. For example, five colored vertical lines may be grouped together for five electrodes of one of the splines of the multi-spline mapping catheter. The display may include eight groups of five lines (labeled A-H) corresponding to the five electrodes of each of the eight splines (labeled A-H) of the mapping catheter.

[0013] System Description Reference is now made to Fig. 1, which is a schematic diagram of a medical procedure system 20 constructed and operative in accordance with an exemplary aspect of the present disclosure. Reference is also made to Fig. 2, which is a schematic diagram of a catheter 40 for use in the system 20 of Fig. 1.

[0014] The medical procedure system 20 is used to determine the position of a catheter 40, shown in inset 25 of Figure 1 and in more detail in Figure 2. The catheter 40 includes a shaft 22 and a plurality of deflectable arms 54 (only some of which are labeled for simplicity) for insertion into a body portion of a living subject. The deflectable arms 54 have respective proximal ends connected to a distal end of the shaft 22.

[0015] The catheter 40 includes a position sensor 53 disposed on the shaft 22 in a predetermined spatial relationship with respect to the proximal end of the deflectable arm 54. The position sensor 53 may include a magnetic sensor 50 and / or at least one shaft electrode 52. The magnetic sensor 50 may include at least one coil, for example, but not limited to, a biaxial or triaxial coil arrangement, to provide position and orientation position data, including roll. The catheter 40 includes a plurality of electrodes 55 (only some of which are labeled in FIG. 2 for simplicity) disposed at different respective positions along each of the deflectable arms 54. The electrodes 55 are configured to contact tissue of the body part. Typically, the catheter 40 may be used to map electrical activity in a heart of a living subject using the electrodes 55, or to perform any other suitable function in a body part of a living subject.

[0016] The medical procedure system 20 may determine the position and orientation of the shaft 22 of the catheter 40 based on signals provided by the magnetic sensor 50 and / or shaft electrodes 52 (proximal electrode 52a and distal electrode 52b) attached to the shaft 22 on either side of the magnetic sensor 50. At least some of the proximal electrode 52a, the distal electrode 52b, the magnetic sensor 50, and the electrodes 55 are connected to various driver circuits in the console 24 via the catheter connector 35 by wires extending through the shaft 22. In some exemplary embodiments, at least two of the electrodes 55 of each of the deflectable arms 54, the shaft electrodes 52, and the magnetic sensor 50 are connected to driver circuits in the console 24 via the catheter connector 35. In some exemplary embodiments, the distal electrode 52b and / or the proximal electrode 52a may be omitted.

[0017] The diagram shown in Figure 2 has been chosen purely for purposes of conceptual clarity. Other configurations of shaft electrode 52 and electrodes 55 are possible. Additional functionality may be included in position sensor 53. For clarity, elements not relevant to the disclosed exemplary aspects of the present disclosure, such as irrigation ports, have been omitted.

[0018] The physician 30 navigates the catheter 40 to a target location within a body part (e.g., the heart 26) of the patient 28 by manipulating the shaft 22 using a manipulator 32 near the proximal end of the catheter 40 and / or by deflection from the sheath 23. The catheter 40 is inserted through the sheath 23 with the deflectable arms 54 gathered together, and only after the catheter 40 is retracted from the sheath 23 can the deflectable arms 54 unfold and resume their intended functional shape. By housing the deflectable arms 54 together, the sheath 23 also serves to minimize vascular trauma during navigation to the target location.

[0019] The console 24 comprises processing circuitry 41, typically a general-purpose computer, and suitable front-end and interface circuitry 44 for generating signals at and / or receiving signals from body surface electrodes 49 attached to the chest and back, or any other suitable skin surface, of the patient 28 by wires extending through the cable 39.

[0020] The console 24 further comprises a magnetic sensing subsystem. The patient 28 is placed in a magnetic field generated by a pad including at least one magnetic field emitter 42, driven by a unit 43 located on the console 24. The magnetic field emitter 42 is configured to transmit an alternating magnetic field to a region where a body part (e.g., the heart 26) is located. The magnetic field generated by the magnetic field emitter 42 generates a directional signal in a magnetic sensor 50. The magnetic sensor 50 is configured to detect at least a portion of the transmitted alternating magnetic field and provide the directional signal as a corresponding electrical input to the processing circuit 41.

[0021] In some exemplary aspects, the processing circuitry 41 uses the position signals received from the shaft electrode 52, the magnetic sensor 50, and the electrodes 55 to estimate the position of the catheter 40 inside an organ, such as inside a heart chamber. In some exemplary aspects, the processing circuitry 41 correlates the position signals received from the electrodes 52, 55 with previously acquired magnetic position calibration position signals to estimate the position of the catheter 40 inside the heart chamber. Position coordinates of the shaft electrode 52 and the electrodes 55 may be determined by the processing circuitry 41 based on the impedance or current distribution ratios measured between the electrodes 52, 55 and the body surface electrodes 49, among other inputs. The console 24 drives a display 27 showing the distal end of the catheter 40 inside the heart 26.

[0022] Methods of position sensing using current distribution measurements and / or external magnetic fields have been used in various medical applications, e.g., by Biosense Webster et al. This technique has been implemented in a Carto® system manufactured by Intel Corporation of Irvine, California, and is described in detail in U.S. Pat. Nos. 5,391,199, 6,690,963, 6,484,118, 6,239,724, 6,618,612, 6,332,089, 7,756,576, 7,869,865, and 7,848,787, International Publication No. WO 96 / 05768, and U.S. Patent Application Publication Nos. 2002 / 0065455(A1), 2003 / 0120150(A1), and 2004 / 0068178(A1).

[0023] The Carto® 3 system applies an impedance-based position tracking method of Active Current Location (ACL). In some exemplary aspects using the ACL method, the processing circuitry 41 is configured to create a mapping (e.g., a current-position matrix (CPM)) between a representation of the electrical impedance and a position in the magnetic coordinate frame of the magnetic field emitter 42. The processing circuitry 41 estimates the position of the shaft electrode 52 and the electrodes 55 by performing a lookup in the CPM.

[0024] The processing circuitry 41 is typically programmed in software to carry out the functions described herein. The software may be downloaded to the computer in electronic form, for example over a network, or alternatively or additionally may be provided and / or stored on a non-transitory tangible medium, such as a magnetic, optical, or electronic memory.

[0025] For purposes of brevity and clarity, Figure 1 shows only those elements relevant to the disclosed technology. System 20 typically includes additional modules and elements that are not directly relevant to the disclosed technology and therefore have been purposely omitted from Figure 1 and the corresponding description.

[0026] The catheter 40 described above includes eight deflectable arms 54. Any suitable catheter may be used in place of catheter 40, such as, by way of example only, a catheter with a different number of flexible arms and / or multiple electrodes per arm, or a different probe geometry, such as a balloon probe or a lasso catheter.

[0027] The medical procedure system 20 may also perform ablation of cardiac tissue using any suitable catheter, for example, using the catheter 40 or a different catheter and any suitable ablation method. The console 24 may include an RF signal generator 34 configured to generate RF power applied by one or more electrodes of a catheter connected to the console 24 and one or more of the body surface electrodes 49 to perform ablation of the myocardium of the heart 26. The console 24 may include a pump (not shown) that pumps irrigation fluid into an irrigation channel to the distal end of the catheter performing the ablation. The catheter performing the ablation may also include a temperature sensor (not shown) that is used to measure the temperature of the myocardium during ablation and adjust the ablation power and / or the irrigation rate of pumping of the irrigation fluid according to the measured temperature.

[0028] Reference is now made to FIG. 3, which is a flow chart 300 including steps in a method of noise level indication for use in the system 20 of FIG.

[0029] Processing circuitry 41 is configured to receive a signal from one of the electrodes 55 (block 302), find a noise measurement for the signal (block 304), and render a dynamic display of the noise measurements on display 27 (block 306). In some example aspects, processing circuitry is configured to receive a respective signal from each of the electrodes 55 (e.g., receive a signal for each electrode 55), find a noise measurement for each signal (e.g., find a noise measurement for each signal), and render a dynamic display of the noise measurements on display 27 (e.g., render a dynamic display for each signal).

[0030] The noise measure may be calculated as a function of the magnitude of frequencies associated with the noise. For example, high frequency components of the signal captured by the catheter 40 are likely to be of non-electroanatomical origin. For example, frequencies above 70 or 150 Hz (or values ​​therebetween depending on the arrhythmia exhibited by the patient 28) are likely to be of non-electroanatomical origin and therefore noise. The noise measure may be based on an absolute measure of the noise (e.g., the magnitude of frequencies of non-electroanatomical origin) or as some kind of signal-to-noise ratio (described in more detail below). In some exemplary aspects, frequency cutoffs defining low and high frequencies may be set by the physician 30.

[0031] In some exemplary aspects, a Fourier transform of the signal is performed to provide a magnitude of high frequencies (e.g., noise, N) and a magnitude of low frequencies (e.g., fundamental signal, S). In some exemplary aspects, the magnitudes of high and low frequencies may be determined using a low pass and / or high pass filter. A measure of noise may be calculated based on N, or some kind of signal-to-noise ratio may be calculated as S / N or S / (S+N). The signal-to-noise ratio may be calculated by software and / or hardware (e.g., circuitry).

[0032] The noise measure is typically calculated over a time window of the signal, e.g., the most recent 100 milliseconds of the signal. The time window may slide as time progresses so that the calculated noise measure reflects the most recent noise of the signal. The window may have any suitable width, e.g., in the range of 100 milliseconds to 5 seconds.

[0033] Reference is now made to FIG. 4, which is a schematic diagram of a noise level presentation 400 in the system 20 of FIG.

[0034] 4 shows traces 404 of IEGMs captured by electrodes 55 of catheter 40. The traces 404 are grouped by splines (e.g., A-H) and ordered by electrode number within each spline. In some example aspects, the traces 404 are not displayed with the noise level presentation 400.

[0035] The noise level presentation 400 includes a dynamic display showing the noise measurements of each signal captured by the electrodes 55. In some exemplary aspects, each dynamic display is a graphical representation 402 (only some are labeled for simplicity). In some exemplary aspects, each graphical representation 402 includes a colored indicator that changes color in response to the level of the respective noise measurement of that signal. In other exemplary aspects, the graphical representation 402 may be a shaded or patterned representation that changes shade and / or pattern in response to the level of the respective noise measurement of each signal over time. In some exemplary aspects, the graphical representation 402 may change size over time according to the level of noise, for example, a bar graph may illustrate the noise of a signal where the height of each of the bars changes over time, with the respective heights being based on the noise measurements of the respective signal.

[0036] In some exemplary aspects, each colored indicator is a colored line as shown in FIG. 4. Any suitable color scheme may be used to indicate different levels of noise, such as "green" for no noise, "yellow" for low noise, "orange" for medium noise, and "red" for high noise. The line changes color as the noise level of the corresponding signal changes over time. The range of noise indicated by each color may be configurable by the user.

[0037] In some exemplary embodiments, catheter 40 includes a plurality of splines 54 (e.g., eight splines associated with spline markers A-H) with electrodes 55 positioned along splines 54 as shown in Figure 2. Processing circuitry 41 is configured to render on display 27 a graphical representation 402 grouped by splines (e.g., A-H), as shown in Figure 4.

[0038] The physician 30 may view the noise level presentation 400 and, if the noise level presentation 400 indicates that a particular electrode 55 is capturing a generally noisy signal (regardless of the position of the catheter 40), may decide to adjust the catheter 400 in the heart 26 to reduce noise or to replace the catheter 40.

[0039] Reference is now made to Figure 5, which is a flow chart 500 including steps in a method for setting a noise level for selecting a signal in the system 20 of Figure 1. Reference is also made to Figure 6, which is a schematic diagram of a user interface 600 screen used to set a noise level for selecting a signal in the system 20 of Figure 1.

[0040] Processing circuitry 41 is configured to provide user interface screen 600 and render user interface screen 600 on display 27 (block 502) to receive user input of a given noise level via user interface screen 600. In some exemplary aspects, user interface screen 600 includes a noise level selector slider 602 to allow a user to select a given noise level by moving the slider to select a desired noise level. Processing circuitry 41 is configured to receive a user selection of a given noise level (block 504), for example, via a user adjusting noise level selector slider 602. In some exemplary aspects, the noise level may be selected by a user entering a noise level using numbers in user interface screen 600, or by using keystrokes (e.g., up and down arrow keys), or foot pedal movements, or any other user interface interaction to adjust the noise level to the desired noise level.

[0041] In some exemplary aspects, the user interface screen 600 may include other mapping option selectors, such as a respiratory gating selector 604, a tissue proximity selector 606, a cycle length slider 608, a pattern matching slider 610, a positional stability slider 612, and a LAT stability slider 614.

[0042] The catheter 40 is inserted by the physician 30 into a body part (e.g., a chamber of the heart 26) of the patient 28, as described in more detail above with reference to FIG. 1. The catheter 40 is moved around the body part and the electrodes 55 capture electrical activity from tissue of the body part, e.g., as part of a mapping process. The processing circuitry 41 is configured to receive a respective signal from each of the electrodes 55 (e.g., one signal is received for each of the electrodes 55) (block 506) and find a noise measure for each signal (block 508). The noise measure may be found using any suitable method, for example, using one of the methods described with reference to the step of block 304 of FIG. 3. In some exemplary aspects, finding the noise measure is performed before other signal processing (e.g., to reduce signal noise).

[0043] In response to the found noise measurements, the processing circuitry 41 is configured to select (block 512) from each of the received signals those signals having a noise measurement below a given noise level (selected by a user, e.g., physician 30).

[0044] In some exemplary aspects, processing circuitry 41 is configured to flag signals of the received respective signals that have a noise measurement below a given noise level (block 510) and select the flagged signals (block 512). In other exemplary aspects, processing circuitry 41 is configured to flag signals of the received respective signals that have a noise measurement above a given noise level (block 510) and select non-flagged signals of the respective signals (block 512).

[0045] Reference is now made to FIG. 7, which is a schematic diagram of an electroanatomical map 700 generated by the system 20 of FIG. 1. Reference is also made to FIG. 5. In some exemplary aspects, the processing circuitry 41 is configured to generate (block 514) an electroanatomical map (such as the electroanatomical map 700) in response to a selected signal having a noise measurement below a given noise level. In other words, a signal having a noise measurement below a given noise level is used to generate the electroanatomical map 700. For example, any suitable electroanatomical map may be generated, such as one showing velocity vectors (as shown in FIG. 7) or showing a LAT map or a bipolar map. The processing circuitry 41 is configured to render (block 516) electroanatomical data (such as the electroanatomical map 700 and / or an IEGM trace (e.g., trace 404)) having sufficiently low noise (i.e., below a given noise level) on the display 27 in response to the selected signal.

[0046] In practice, some or all of the functions of the processing circuitry 41 may be combined in a single physical component, or alternatively, may be implemented using multiple physical components. These physical components may include hardwired or programmable devices, or a combination of the two. In some embodiments, at least some of the functions of the processing circuitry 41 may be performed by a programmable processor under the control of suitable software. This software may be downloaded to the device in electronic form, for example, over a network. Alternatively or additionally, the software may be stored in a tangible, non-transitory computer-readable storage medium, such as optical, magnetic, or electronic memory.

[0047] As used herein, the term "about" or "approximately" with respect to any numerical value or numerical range indicates a suitable dimensional tolerance that enables a portion of a component or a collection of components to function for its intended purpose as described herein. More specifically, "about" or "approximately" may refer to a range of values ​​of ±20% of the recited value, for example, "about 90%" may refer to a range of values ​​of 72% to 108%. EXAMPLES

[0048] Example 1: A medical system comprising: a catheter configured to be inserted into a body part of a living subject and comprising a plurality of electrodes configured to contact tissue of the body part; a display; and a processing circuit configured to receive a signal from one of the electrodes, find a noise measurement of the signal, and render a dynamic representation of the noise measurement on the display.

[0049] Example 2: The system of example 1, wherein the dynamic display is a graphical representation.

[0050] Example 3: The system of example 2, wherein the graphical representation includes a colored indicator that changes color in response to a level of the noise measurement.

[0051] Example 4: The system of example 3, wherein the colored indicator is a colored line.

[0052] Example 5: A system described in any of Examples 1 to 4, wherein the processing circuitry is configured to receive a respective signal from each of the electrodes, find a noise measurement for each signal, and render a dynamic representation of the noise measurements on the display.

[0053] Example 6: The system of example 5, wherein the dynamic display is a graphical representation.

[0054] Example 7: The system of example 6, wherein the graphical representation includes a colored indicator that changes color in response to a respective level of the noise measurement.

[0055] Example 8: The system of example 7, wherein the colored indicator is a colored line.

[0056] Example 9: A system described in any of Examples 1 to 8, wherein the catheter includes a plurality of splines, the electrodes are positioned between the splines, and the processing circuitry is configured to render a graphical representation grouped by the splines on the display.

[0057] Example 10: A system described in any of Examples 1 to 9, wherein the processing circuitry is configured to receive a respective signal from each of the electrodes, find a noise measurement for each signal, select from the respective signals a signal having a noise measurement below a given noise level, and render electroanatomical data on the display in response to the selected signal.

[0058] Example 11: The system of Example 10, wherein the processing circuit is configured to generate an electroanatomical map in response to selected signals having a noise measurement below a given noise level and render the electroanatomical map on a display.

[0059] Example 12: The system of example 10 or 11, wherein the processing circuitry is configured to provide a user interface screen for receiving user input of a given noise level.

[0060] Example 13: The system of example 12, wherein the user interface screen includes a noise level selector slider to allow a user to select a given noise level.

[0061] Example 14: A system described in any of Examples 10 to 13, wherein the processing circuit is configured to flag signals among the respective signals having a noise measurement value below a given noise level and select the flagged signals.

[0062] Example 15: A system described in any of Examples 10 to 13, wherein the processing circuitry is configured to flag signals among the respective signals that have a noise measurement equal to or greater than a given noise level, and to select signals among the respective signals that are not flagged.

[0063] Example 16: A medical method comprising: receiving a signal from an electrode of a catheter, the electrode being configured to contact tissue of a body part of a living subject; finding a noise measurement of the signal; and rendering a dynamic representation of the noise measurement on a display.

[0064] Example 17: A software product including a non-transitory computer-readable medium having program instructions stored thereon, which, when read by a central processing unit (CPU), cause the CPU to receive a signal from an electrode of a catheter, the electrode being configured to contact tissue of a body part of a living subject, find a noise measurement of the signal, and render a dynamic representation of the noise measurement on a display.

[0065] Example 18: A medical system comprising: a catheter configured to be inserted into a body part of a living subject and comprising a plurality of electrodes configured to contact tissue of the body part; a display; and a processing circuit configured to receive a respective signal from each of the electrodes, find a noise measurement for each signal, select from the respective signals a signal having a noise measurement below a given noise level, and render electroanatomical data on the display in response to the selected signal.

[0066] Example 19: The system described in Example 18, wherein the processing circuit is configured to generate an electroanatomical map in response to selected signals having a noise measurement below a given noise level and render the electroanatomical map on a display.

[0067] Example 20: A system described in example 18 or 19, wherein the processing circuit is configured to provide a user interface screen for receiving user input of a given noise level.

[0068] Example 21: The system of example 20, wherein the user interface screen includes a noise level selector slider to allow a user to select a given noise level.

[0069] Example 22: A system described in any of Examples 18 to 21, wherein the processing circuit is configured to flag signals among the respective signals having a noise measurement value below a given noise level and select the flagged signals.

[0070] Example 23: A system described in any of Examples 18 to 21, wherein the processing circuitry is configured to flag signals among the respective signals that have a noise measurement equal to or greater than a given noise level, and to select signals among the respective signals that are not flagged.

[0071] Example 24: A medical method comprising: receiving respective signals from respective electrodes of a catheter inserted into a body portion of a living subject; finding a noise measurement for each signal; selecting from the respective signals a signal having a noise measurement below a given noise level; and rendering electroanatomical data on a display in response to the selected signal.

[0072] Example 25: A software product including a non-transitory computer readable medium having program instructions stored thereon, which, when read by a central processing unit (CPU), cause the CPU to receive respective signals from respective electrodes of a catheter inserted into tissue of a body part of a living subject, find noise measurements for each signal, select from the respective signals signals having noise measurements below a given noise level, and render electroanatomical data on a display in response to the selected signals.

[0073] Various features of the present disclosure that are, for clarity, described in the context of a separate embodiment, may also be provided in combination in a single embodiment. Conversely, various features of the present disclosure that are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable subcombination.

[0074] The above-described embodiments are cited by way of example, and the disclosure is not limited to what has been specifically shown and described in the above specification. Rather, the scope of the disclosure includes both combinations and subcombinations of the various features described in the above specification, as well as variations and modifications thereof not disclosed in the prior art that would occur to one skilled in the art upon reading the above description.

[0075] [Embodiment] (1) A health care system, comprising: a catheter configured to be inserted into a body part of a living subject and comprising a plurality of electrodes configured to contact tissue of the body part; A display and A processing circuit, receiving a signal from one of the electrodes; Finding a noise measure of said signal; and processing circuitry configured to render a dynamic representation of the noise measurements on the display. (2) The system of embodiment 1, wherein the dynamic display is a graphical representation. (3) The system of claim 2, wherein the graphical representation includes a colored indicator that changes color in response to a level of the noise measurement. (4) The system of embodiment 3, wherein the colored indicator is a colored line. (5) The processing circuit, receiving a respective signal from each of the electrodes; Finding a noise measure for each of said signals; 2. The system of embodiment 1, configured to render a dynamic representation of the noise measurements on the display.

[0076] (6) The system of embodiment 5, wherein the dynamic display is a graphical representation. (7) The system of embodiment 6, wherein the graphical representation includes a colored indicator that changes color in response to a respective level of the noise measurement. (8) The system of embodiment 7, wherein the colored indicator is a colored line. (9) The catheter includes a plurality of splines, and the electrodes are disposed between the splines; 7. The system of claim 6, wherein the processing circuitry is configured to render the graphical representation grouped by the splines on the display. (10) The processing circuit, receiving a respective signal from each of the electrodes; Finding a noise measure for each of said signals; selecting from said respective signals those signals having a noise measurement below a given noise level; 2. The system of claim 1, configured to render electroanatomical data on the display in response to a selected one of the signals.

[0077] (11) The processing circuit, generating an electroanatomical map in response to the selected signals having noise measurements below the given noise level; 11. The system of claim 10, configured to render the electroanatomical map on the display. (12) The system of claim 10, wherein the processing circuitry is configured to provide a user interface screen for receiving user input of the given noise level. (13) The system of embodiment 12, wherein the user interface screen includes a noise level selector slider for enabling a user to select the given noise level. (14) The processing circuit, flagging signals of said respective signals having a noise measurement below said given noise level; 11. The system of embodiment 10, configured to select the flagged signal. (15) The processing circuit, flagging signals of said respective signals having a noise measurement equal to or greater than said given noise level; 11. The system of embodiment 10, configured to select unflagged signals from the respective signals.

[0078] (16) A medical method comprising the steps of: receiving a signal from an electrode of a catheter, the electrode configured to contact tissue of a body part of a living subject; Finding a noise measure of said signal; and rendering a dynamic representation of the noise measurements on a display. (17) A software product including a non-transitory computer-readable medium having program instructions stored thereon, the instructions, when read by a central processing unit (CPU), causing the CPU to: receiving a signal from an electrode of a catheter, the electrode configured to contact tissue of a body part of a living subject; Finding a noise measure of said signal; and rendering a dynamic representation of said noise measurements on a display. (18) A health care system, comprising: a catheter configured to be inserted into a body part of a living subject and comprising a plurality of electrodes configured to contact tissue of the body part; A display and A processing circuit, receiving a respective signal from each of the electrodes; Finding a noise measure for each of said signals; selecting from said respective signals those signals having a noise measurement below a given noise level; and processing circuitry configured to render electroanatomical data on the display in response to selected said signals. (19) The processing circuit, generating an electroanatomical map in response to the selected signals having noise measurements below the given noise level; 20. The system of claim 18, configured to render the electroanatomical map on the display. (20) The system of embodiment 18, wherein the processing circuitry is configured to provide a user interface screen for receiving user input of the given noise level.

[0079] (21) The system of embodiment 20, wherein the user interface screen includes a noise level selector slider for enabling a user to select the given noise level. (22) The processing circuit, flagging signals of said respective signals having a noise measurement below said given noise level; 20. The system of embodiment 18, configured to select the flagged signal. (23) The processing circuit, flagging signals of said respective signals having a noise measurement equal to or greater than said given noise level; 19. The system of embodiment 18, configured to select unflagged signals from among the respective signals. (24) A medical method comprising the steps of: receiving respective signals from respective electrodes of a catheter inserted into a body portion of a living subject; Finding a noise measure for each of said signals; selecting from said respective signals a signal having a noise measurement below a given noise level; and rendering electroanatomical data on a display in response to selected said signals. (25) A software product including a non-transitory computer-readable medium having program instructions stored thereon, the instructions, when read by a central processing unit (CPU), causing the CPU to: receiving respective signals from respective electrodes of a catheter inserted into a body portion of a living subject; finding a noise measure for each of said signals; selecting from said respective signals those signals having a noise measurement below a given noise level; A software product that causes the electroanatomical data to be rendered on a display in response to selected said signals.

Claims

1. 1. A health care system comprising: a catheter configured to be inserted into a body part of a living subject and comprising a plurality of electrodes configured to contact tissue of the body part; A display and A processing circuit, receiving a signal from one of the electrodes; Finding a noise measure of said signal; and processing circuitry configured to render a dynamic representation of the noise measurements on the display.

2. The system of claim 1 , wherein the dynamic display is a graphical representation.

3. The system of claim 2 , wherein the graphical representation includes a colored indicator that changes color in response to a level of the noise measurement.

4. The system of claim 3 , wherein the colored indicator is a colored line.

5. The processing circuitry comprises: receiving a respective signal from each of the electrodes; Finding a noise measure for each of said signals; The system of claim 1 , configured to render a dynamic representation of the noise measurements on the display.

6. The system of claim 5 , wherein the dynamic display is a graphical representation.

7. The system of claim 6 , wherein the graphical representation includes a colored indicator that changes color in response to a respective level of the noise measurement.

8. The system of claim 7 , wherein the colored indicator is a colored line.

9. the catheter includes a plurality of splines, the electrodes being disposed between the splines; The system of claim 6 , wherein the processing circuitry is configured to render the graphical representation grouped by the splines on the display.

10. The processing circuitry comprises: receiving a respective signal from each of the electrodes; Finding a noise measure for each of said signals; selecting from said respective signals those signals having a noise measurement below a given noise level; The system of claim 1 , configured to render electroanatomical data on the display in response to a selected one of the signals.

11. The processing circuitry comprises: generating an electroanatomical map in response to the selected signals having noise measurements below the given noise level; The system of claim 10 , configured to render the electro-anatomical map on the display.

12. The system of claim 10 , wherein the processing circuitry is configured to provide a user interface screen for receiving user input of the given noise level.

13. The system of claim 12 , wherein the user interface screen includes a noise level selector slider for allowing a user to select the given noise level.

14. The processing circuitry comprises: flagging signals of said respective signals having a noise measurement below said given noise level; The system of claim 10 configured to select the flagged signals.

15. The processing circuitry comprises: flagging signals of said respective signals having a noise measurement equal to or greater than said given noise level; The system of claim 10 configured to select non-flagged ones of the respective signals.

16. 1. A medical method comprising: receiving a signal from an electrode of a catheter, the electrode configured to contact tissue of a body part of a living subject; Finding a noise measure of said signal; and rendering a dynamic representation of the noise measurements on a display.

17. 1. A software product comprising a non-transitory computer readable medium having program instructions stored thereon, the instructions, when read by a central processing unit (CPU), causing the CPU to: receiving a signal from an electrode of a catheter, the electrode configured to contact tissue of a body part of a living subject; Finding a noise measure of said signal; and rendering a dynamic representation of said noise measurements on a display.

18. 1. A health care system comprising: a catheter configured to be inserted into a body part of a living subject and comprising a plurality of electrodes configured to contact tissue of the body part; A display and A processing circuit, receiving a respective signal from each of the electrodes; Finding a noise measure for each of said signals; selecting from said respective signals those signals having a noise measurement below a given noise level; and processing circuitry configured to render electroanatomical data on the display in response to selected said signals.

19. The processing circuitry comprises: generating an electroanatomical map in response to the selected signals having noise measurements below the given noise level; The system of claim 18 , configured to render the electro-anatomical map on the display.

20. 20. The system of claim 18, wherein the processing circuitry is configured to provide a user interface screen for receiving user input of the given noise level.

21. 21. The system of claim 20, wherein the user interface screen includes a noise level selector slider for allowing a user to select the given noise level.

22. The processing circuitry comprises: flagging signals of said respective signals having a noise measurement below said given noise level; 20. The system of claim 18 configured to select the flagged signals.

23. The processing circuitry comprises: flagging signals of said respective signals having a noise measurement equal to or greater than said given noise level; 20. The system of claim 18, configured to select non-flagged ones of the respective signals.

24. 1. A medical method comprising: receiving respective signals from respective electrodes of a catheter inserted into a body portion of a living subject; Finding a noise measure for each of said signals; selecting from said respective signals a signal having a noise measurement below a given noise level; and rendering electroanatomical data on a display in response to selected said signals.

25. 1. A software product comprising a non-transitory computer readable medium having program instructions stored thereon, the instructions, when read by a central processing unit (CPU), causing the CPU to: receiving respective signals from respective electrodes of a catheter inserted into a body portion of a living subject; finding a noise measure for each of said signals; selecting from said respective signals those signals having a noise measurement below a given noise level; A software product that causes the electroanatomical data to be rendered on a display in response to selected said signals.

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