Enhanced Ultrasound Imaging

Abstract

In one exemplary aspect, a medical system includes an ultrasound probe configured to capture ultrasound images of at least a portion of a body part of a living subject, a display, and a processor configured to render on the display respective representations of respective electroanatomical data subsets superimposed on respective ultrasound images.

Description

[Technical field]

[0001] FIELD OF THE DISCLOSURE The present disclosure relates to medical systems and particularly, but not exclusively, to advanced imaging. [Background technology]

[0002] Various devices and methods for intracardiac ultrasound imaging are known in the art. For example, Biosense Webster Inc. (Irvine, California) offers the CartoSound™ software module and SoundStar™ catheter for generating 2D ultrasound images in real time. The SoundStar catheter, which is inserted into the heart through the vascular system, contains a phased array of position sensors and ultrasound transducers. The CartoSound software module processes signals from the position sensors and ultrasound transducers to generate a 3D image of the heart chambers.

[0003] U.S. Patent No. 8,075,486 to Tal describes the use of a specialized cardiac catheter for image acquisition, where cardiac features are readily identifiable on an ultrasound image based on a previously generated electrical activation map of the heart. The electrical activation map is automatically registered with the ultrasound image using information obtained from a position sensor in the catheter. Features identifiable on the electrical activation map, presented as points, tags, design lines, and text IDs, are projected in the plane of the ultrasound fan and overlaid on the ultrasound image, thereby clarifying features that are visible on the latter. [Brief description of the drawings]

[0004] The present disclosure will be understood from the following detailed description taken in conjunction with the accompanying drawings. [Figure 1] 1 is a schematic, pictorial illustration of a catheter-based system including ultrasound imaging, according to an exemplary aspect of the present disclosure. [Diagram 2]2 is a schematic side view of the distal end of a mapping catheter used in the system of FIG. 1. [Diagram 3] 2 is a schematic side view of the distal end of an ultrasound probe used in the system of FIG. 1. [Figure 4] 2 is a schematic diagram of an ultrasound image captured by an ultrasound probe of the system of FIG. 1. [Diagram 5] 2 is a flow chart including steps in a method of operation of the system of FIG. 1. [Figure 6] 1 is a schematic diagram of a 3D anatomical map and a 2D ultrasound image overlaid with a representation of electroanatomical data. [Figure 7] 1 is a schematic diagram of a 3D anatomical map and a 2D ultrasound image overlaid with different representations of electroanatomical data. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0005] overview An ultrasound scan (e.g., a two-dimensional (2D) or three-dimensional (3D) ultrasound image) allows a physician to view the motion of a heart cavity (or other body part) in real time. Electroanatomical data of the cavity (or other body part), such as local activation time (LAT), is typically presented (e.g., using an appropriate color scheme) as LAT values ​​overlaid on a 3D anatomical map of the cavity. However, the 3D electroanatomical map may not represent an image of the heart cavity and may not provide a real-time representation of the motion of the heart cavity. Currently, physicians often need to view both presentations, i.e., ultrasound and 3D electroanatomical map, separately and mentally formulate the relationship between the two presentations. This process requires mental energy and can lead to errors in judgment.

[0006] Exemplary aspects of the present disclosure solve the above problems by overlaying a representation of electroanatomical data on an ultrasound image captured by an ultrasound probe such that the electroanatomical data and real-time ultrasound images can be evaluated in a single view. The electroanatomical data may include LAT values, bipolar data, and / or propagation data such as velocity vectors. The electroanatomical data may be represented using colored or shaded lines or regions (e.g., to represent LAT values ​​or bipolar data), or arrows (e.g., to represent propagation data). The representation of the electroanatomical data may be overlaid on a 2D ultrasound image (e.g., a 2D ultrasound slice) or within (and / or on) a 3D ultrasound image.

[0007] The electroanatomical data included in each ultrasound image is selected based on electroanatomical data located in or within a threshold proximity to each ultrasound image with respect to 3D coordinate space. For example, data from a 3D electroanatomical map may be selected for overlay on each ultrasound image based on where each ultrasound image intersects with the 3D electroanatomical map in 3D coordinate space. For example, if the 3D electroanatomical map includes a particular distribution of colors representing LAT values ​​(or bipolar data), the coloring used in the 3D electroanatomical map at the intersection of the 3D electroanatomical map and the 2D ultrasound image is overlaid as one or more lines on the 2D ultrasound image to indicate the LAT values ​​(or bipolar data) associated with that 2D ultrasound image.

[0008] The display is dynamic, so that as the ultrasound probe is moved and captures different ultrasound images of the heart cavity, the representations of the electroanatomical data superimposed on the different ultrasound images change to reflect the new location of the different ultrasound images in 3D coordinate space and the new electroanatomical data contained within or within a given threshold proximity to the different ultrasound images. For example, as the ultrasound probe is moved, the LAT values ​​superimposed on the ultrasound images move and change to reflect the current LAT values ​​in the current region of 3D coordinate space occupied by the respective ultrasound image.

[0009] The representation of electroanatomical data superimposed on the ultrasound images need not be limited to the electroanatomical data included in the 3D electroanatomical map. Other electroanatomical data not used in the 3D electroanatomical map may be collected by the mapping catheter. For example, electroanatomical data captured from tissue of internal structures such as papillary muscles (e.g., bipolar data) may not be included in the 3D electroanatomical map. However, a representation of electroanatomical data captured from tissue of internal structures may be superimposed on the respective ultrasound images. In this way, electroanatomical data that is not normally seen by a physician (because it is excluded from the 3D electroanatomical map) becomes included in the respective ultrasound images.

[0010] In some exemplary aspects, the position of a distal end of a catheter inserted into a cavity of the heart may be tracked and a representation of the tracked distal end of the catheter may be superimposed on each ultrasound image.

[0011] System Description Reference is now made to Figure 1, which is a schematic, pictorial illustration of a catheter-based system 10 including ultrasound imaging, according to an exemplary embodiment of the present disclosure, and also to Figure 2, which is a schematic side view of the distal end of a mapping catheter 40 used in the system 10 of Figure 1.

[0012] System 10 is used to determine the position of a catheter 40, seen in inset 12 of Figure 1 and in more detail in Figure 2. Catheter 40 is a probe that includes a shaft 14 and multiple deflectable arms 16 (only some of which are labeled for simplicity) for insertion into a body portion of a living subject (e.g., a cavity of heart 18). Deflectable arms 16 have respective proximal ends connected to a distal end of shaft 14.

[0013] The catheter 40 includes a position sensor 20 disposed on the shaft 14 in a predefined spatial relationship with respect to the proximal end of the deflectable arm 16. The position sensor 20 may include a magnetic sensor 22 and / or at least one shaft electrode 24. The magnetic sensor 22 may include at least one coil, for example, but not limited to, a biaxial coil arrangement or a triaxial coil arrangement, to provide location and orientation position data, including roll. The catheter 40 includes a plurality of electrodes 26 (only some of which are labeled in FIG. 2 for simplicity) disposed at different respective locations along each of the deflectable arms 16. Typically, the catheter 40 may be used to map electrical activity within a heart of a living subject using the electrodes 26, or to perform any other suitable function within a body part of a living subject, for example, but not limited to, reversible and / or irreversible electroporation and / or RF ablation.

[0014] The medical procedure system 20 may determine the position and orientation of the shaft 14 of the catheter 40 based on signals provided by the magnetic sensor 22 and / or shaft electrodes 24 (proximal electrode 24a and distal electrode 24b) mounted on the shaft 14 on either side of the magnetic sensor 22. At least some of the proximal electrode 24a, distal electrode 24b, magnetic sensor 22, and electrodes 26 are connected to various driver circuitry in the console 28 by wires extending through the shaft 14. In some exemplary aspects, the distal electrode 24b and / or the proximal electrode 24a may be omitted.

[0015] The illustrative diagram shown in Figure 2 has been chosen purely for purposes of conceptual clarity. Other configurations of shaft electrode 24 and electrodes 26 are possible. Additional functionality may be included in position sensor 20. For clarity, elements not relevant to the disclosed exemplary aspects of the present disclosure, such as irrigation ports, have been omitted.

[0016] The physician 30 navigates the catheter 40 to a target location within a body part (e.g., the heart 18) of the patient 32 by manipulating the shaft 14 using a manipulator near the proximal end of the catheter 40 and / or by deflection from a sheath. The catheter 40 is inserted through the sheath with the deflectable arms 16 gathered together, and only after the catheter 40 is retracted from the sheath can the deflectable arms 16 spread apart and resume their intended functional shape. By housing the deflectable arms 16 together, the sheath also serves to minimize vascular trauma during navigation to the target location.

[0017] The console 28 comprises processing circuitry 34, typically a general-purpose computer, and suitable front-end and interface circuitry for generating signals at and / or receiving signals from body surface electrodes 36 which are attached to the chest and back, or any other suitable skin surface, of the patient 32 by wires (not shown) extending through a cable (not shown).

[0018] The console 28 further comprises a magnetic sensing subsystem. The patient 32 is placed in a magnetic field generated by a pad including at least one magnetic field emitter 38, which is driven by a unit 42 disposed on the console 28. The magnetic field emitter 38 is configured to transmit an alternating magnetic field to a region in which a body part (e.g., the heart 18) is located. The magnetic field generated by the magnetic field emitter 38 generates a directional signal in the magnetic sensor 22. The magnetic sensor 22 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 circuitry 34.

[0019] In some exemplary aspects, the processing circuitry 34 uses the position signals received from the shaft electrode 24, the magnetic sensor 22, and the electrodes 26 to estimate the position of the catheter 40 inside the organ, such as inside a heart chamber. In some exemplary aspects, the processing circuitry 34 correlates the position signals received from the electrodes 24 and 26 with previously acquired magnetic location calibration position signals to estimate the position of the catheter 40 within the organ. The position coordinates of the shaft electrodes 24 and 26 may be determined by the processing circuitry 34 based on the impedance or current distribution percentages measured between the electrodes 24, 26 and the body surface electrodes 36, among other inputs. The console 28 drives a display 44 that may show the distal end of the catheter 40 within the heart 18.

[0020] Position sensing methods using current distribution measurements and / or external magnetic fields have been used in various medical applications, e.g., by Biosense-Webster This technique is embodied in the Carto® system manufactured by Eppendorf Inc., Irvine, California, and 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, WO 96 / 05768, and U.S. Patent Application Publication Nos. 2002 / 0065455(A1), 2003 / 0120150(A1), and 2004 / 0068178(A1).

[0021] 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 34 is configured to create a mapping (e.g., a current-position matrix (CPM)) between measures of electrical impedance and positions in the magnetic coordinate frame of the magnetic field emitter 38. The processing circuitry 34 estimates the positions of the shaft electrode 24 and the electrodes 26 by performing a lookup in the CPM.

[0022] Other methods of determining the location of the distal end of the catheter 40 may be used, for example, using imaging techniques such as ultrasound, which may include placing a radiopaque tag on the catheter 40, based on an ultrasound transducer and receiver, or an MRI or CT scan.

[0023] The processing circuitry 34 is typically programmed in software to perform the functions described herein. The software may be downloaded to the computer in electronic form, for example over a network, or alternatively or additionally may be provided and / or stored on a non-transitory, tangible medium, such as magnetic, optical, or electronic memory.

[0024] For the sake of brevity and clarity, Figure 1 shows only those elements relevant to the disclosed technology. System 10 will typically include additional modules and elements that are not directly relevant to the disclosed technology and therefore have been intentionally omitted from Figure 1 and the corresponding description.

[0025] The catheter 40 described above includes eight deflectable arms 16 with six electrodes 26 per arm 16. Any suitable catheter may be used in place of catheter 40, such as, for example, a catheter with a different number of flexible arms and / or electrodes per arm, or a different probe geometry, such as, by way of example only, a balloon catheter, a basket catheter, or a lasso catheter.

[0026] System 10 may also perform electroporation or RF ablation (or other ablation techniques) of cardiac tissue using any suitable catheter, such as catheter 40 or a different catheter and any suitable ablation method. Console 28 may include a signal generator configured to generate an electrical signal that is applied by an electrode of a catheter (and, optionally, one or more of body surface electrodes 36) connected to console 28 to perform electroporation or RF ablation of the myocardium of heart 18. Console 28 may include a pump (not shown) that pumps irrigation fluid to an irrigation channel to a distal end of the catheter performing RF ablation. The catheter performing RF ablation may also include a temperature sensor (not shown) that is used to measure the temperature of the myocardium during RF ablation and adjust the ablation power and / or irrigation rate of pumping of irrigation fluid according to the measured temperature.

[0027] Reference is now made to Figure 3, which is a schematic side view of the distal end of an ultrasonic probe 46 used in the system 10 of Figure 1. Reference is also made to Figure 1.

[0028] The system 10 and ultrasound probe 46 are illustrated herein as illustrative examples to aid in understanding the ultrasound-based imaging methods described further below. However, these methods are not limited to catheter-based ultrasound sensing and may be similarly applied, mutatis mutandis, using 2D or 3D ultrasound images acquired by other types of probes, both inside and outside the body. Furthermore, these methods may be used for mapping other anatomical cavities, not just within the heart. The ultrasound probe 46 is configured to capture ultrasound images of at least a portion of a body part (e.g., heart 18) of a living subject (e.g., patient 32).

[0029] As shown in FIG. 1, a physician 30 inserts an ultrasound probe 46 into the body of a patient 32 such that the distal end of the ultrasound probe 46 passes through the vascular system and into the patient's heart 18. The ultrasound probe 46 is connected at its proximal end to a console 28. The processing circuitry 34 receives and processes signals from the ultrasound probe 46 as described below. The processing circuitry 34 may comprise a general-purpose computer processor that is programmed with software to perform the functions described herein. The software may be downloaded to the processor in electronic form, for example, over a network. Alternatively or additionally, the software may be stored in a tangible computer-readable storage medium, such as an optical, magnetic, or electronic storage medium. Additionally or alternatively, at least some of the functions of the processor may be performed by a digital signal processor (DSP) or by dedicated or programmable hardware logic circuitry.

[0030] Typically, the console 28 also allows a user to observe and adjust the functions of the ultrasound probe 46, and to view and edit images formed using the ultrasound probe 46. To these ends, the console 28 includes a display 44 and a user interface 48.

[0031] As shown in Figure 3, the distal end of the ultrasound probe 46 comprises an ultrasound imaging device 50 used to generate ultrasound images of the interior of the body. The device 50 typically comprises a phased array of transducers 52 that operate as known in the art to capture a two-dimensional (2D) "fan" image in the plane of a scanning ultrasound beam (referred to herein as the "beam plane" or "image plane") that includes the longitudinal axis of the ultrasound probe 46. The transducers 52 receive ultrasound waves reflected from objects in the beam plane and output signals responsive to the reflected waves. Typically, these signals are carried by wires 56 that extend through the ultrasound probe 46 to the console 28, which processes the signals to form and display ultrasound images, as described below.

[0032] The distal end of the ultrasound probe 46 further comprises a position sensor 54 that generates signals indicative of the position (location and orientation, including roll) of the catheter within the body. Based on these position signals, the console 28 determines the location and orientation of each fan image captured by the imaging device 50. Thus, the processing circuitry 34 can determine the coordinates of objects appearing in the fan images and the boundaries of the fan images.

[0033] In the depicted exemplary embodiment, the system 10 uses magnetic position sensing to determine position coordinates of the distal end of the ultrasound probe 46 within the heart 18. To determine the position coordinates, drive circuitry in the console 28 drives the magnetic field emitters 38 to generate magnetic fields within the body of the patient 32. Typically, the magnetic field emitters 38 comprise coils that are placed below the patient's torso and at known positions outside the body. These coils generate magnetic fields within a predefined working volume that includes the heart 18. The sensor 54 may include, for example, a magnetic position sensor that includes one or more coils in the distal end of the ultrasound probe 46, which generates electrical signals in response to these magnetic fields. The processing circuitry 34 processes these signals to determine the position (location and orientation) coordinates of the distal end of the ultrasound probe 46. The console 28 may use the coordinates in driving the display 44 to show the location and status of the ultrasound probe 46.

[0034] This method of position sensing and processing is implemented in the CARTO® 3 system manufactured by Biosense Webster Inc. This type of magnetic position sensing is described in detail, for example, in U.S. Patent No. 6,266,551. Other systems that combine ultrasound imaging with magnetic position sensing are described in U.S. Patent Nos. 6,690,963, 6,716,166, and 6,773,402.

[0035] Although FIG. 1 illustrates a particular system configuration, other system configurations may be used in alternative exemplary aspects of the disclosure. For example, the methods described below may be applied using other types of position transducers, such as impedance-based or ultrasonic position sensors. The term "position transducer" as used herein refers to an element mounted on or within the ultrasound probe 46 that causes the console 28 to receive a signal indicative of the coordinates of the element. Thus, a position transducer may comprise a receiver within the ultrasound probe 46, such as sensor 54, that generates a position signal to the control unit based on energy received by the transducer, or may include a transmitter that emits energy that is sensed by a receiver external to the probe. Furthermore, the methods described below may be similarly applied to mapping and imaging applications using catheter-type probes as well as other types of probes, as well as ultrasound probes external to the body, both within the heart and other body organs and regions.

[0036] Reference is now made to FIG. 4, which is a schematic illustration of an ultrasound image 60 captured by the ultrasound probe 46 of the system 10 of FIG.

[0037] The image has the form of a 2D fan with its apex at the imaging device 50. As described above, the console 28 can determine the location of the apex in 3D space and the orientation of the fan (including the fan's boundaries) based on signals received from the position sensor 54. The dark areas 62, 64 in the image correspond to areas such as the heart chambers that are filled with blood and therefore have low reflectivity. The lighter areas generally represent tissue such as the inner and outer heart walls.

[0038] As previously mentioned, the physician 30 may manipulate the ultrasound probe 46 within the heart 18 to capture images from different locations and different orientations. The reflections that make up the image may come not only from the heart chamber in which the distal tip of the ultrasound probe 46 is located, but also from other heart chambers and anatomical structures. Thus, for example, the ultrasound probe 46 may be inserted into the right atrium (where access is relatively easy via the vena cava) and capture images from the right atrium of the left atrium and possibly the ventricles.

[0039] Reference is now made to FIG. 5, which is a flow chart 100 including steps in a method of operation of the system 10 of FIG.

[0040] The mapping catheter 40 is configured to be inserted into the body part. The mapping catheter 40 includes electrodes 26 configured to capture electrical activity from tissue of the body part (e.g., a cavity of the heart 18) at respective locations within the body part over time. In some exemplary embodiments, the mapping catheter 40 may include one or more electrodes for capturing electrical activity from tissue of the body part. The mapping catheter 40 is moved around the body part (e.g., around the cavity of the heart 18) to collect electrical activity at different respective locations.

[0041] The system 10 includes at least one position sensor (e.g., position sensor 20, electrode 26, magnetic sensor 22, shaft electrode 24, position sensor 54, and / or body surface electrode 36) configured to provide at least one signal indicative of the position of the ultrasound probe 46 and the location of each of the electrodes 26 of the mapping catheter 40 over time. The positions may be disposed on the ultrasound probe 46 and / or the mapping catheter 40, and / or on another probe inside or outside the body. In some exemplary aspects, the position sensor includes a magnetic sensor 22 disposed on the mapping catheter 40 and a (magnetic) position sensor 54 disposed on the ultrasound probe 46. In some exemplary aspects, the position sensor may include an ultrasound transducer.

[0042] The processing circuitry 34 is configured to calculate respective locations of the electrodes 26 in a 3D coordinate frame in response to signals provided by the position sensors (e.g., the position sensor 20, the electrodes 26, the magnetic sensor 22, the shaft electrodes 24, and / or the body surface electrodes 36) (block 102). The calculated respective locations of the electrodes 26 are locations where tissue electrical activity is captured (e.g., for inclusion in a 3D anatomical map). The respective locations may be calculated based on magnetic tracking, impedance-based tracking, a combination of magnetic and impedance-based tracking, ultrasound tracking, or any suitable tracking modality, as described in more detail above with reference to FIG. 1.

[0043] Processing circuitry 34 is configured to calculate electroanatomical data (included in an electroanatomical data set) in response to the captured electrical activity and to calculate corresponding positions of the electroanatomical data (e.g., in a 3D coordinate frame) in response to each calculated location (block 104). The electroanatomical data may include any one or more of local activation time data, bipolar data, propagation data, and velocity vectors.

[0044] The ultrasound probe 46 is inserted into the body part and maneuvered around the body part as needed. The processing circuitry 34 is configured to calculate a position of the ultrasound probe 46 in response to signals provided by a position sensor (e.g., position sensor 54 and / or body surface electrodes 36 or any suitable sensor or transducer) (block 106), as described in more detail with reference to FIG. 3. The processing circuitry 34 is configured to calculate the position (e.g., boundary) of each ultrasound image captured at each calculated position of the ultrasound probe 46, as described in more detail with reference to FIGS. 3 and 4.

[0045] The processing circuitry 34 is configured to find (block 108) respective electroanatomical data subsets from the electroanatomical data set (calculated in the step of block 104) having electroanatomical data positioned in three-dimensional (3D) coordinate space for each of the ultrasound images and / or within a given threshold for each of the ultrasound images (e.g., based on the location of the electroanatomical data in the 3D coordinate space and the location (e.g., boundary) of each of the ultrasound images in the 3D coordinate space). In other words, for each ultrasound image, the processing circuitry 34 is configured to find electroanatomical data subsets from the electroanatomical data set having electroanatomical data positioned in that ultrasound image or within a given threshold for that ultrasound image in the 3D coordinate space. The threshold may be set to any suitable default value, for example, within a range of 0.5 mm to 2 mm, for any adjustment by a physician. The electroanatomical data subsets may include any one or more of local activation time data, bipolar data, propagation data, and velocity vectors. In some exemplary aspects, each ultrasound image is a two-dimensional (2D) slice. In some exemplary aspects, each ultrasound image is a three-dimensional (3D) image.

[0046] Reference is now made to Figure 6, which is a schematic illustration of a 3D anatomical map 90 and a 2D ultrasound image 94 overlaid with a representation of electroanatomical data 92. Reference is also made to Figure 5.

[0047] 6 shows a 2D ultrasound image 94 captured by the ultrasound probe 46. The representation 92 of the electroanatomical data may be colored and / or shaded and / or patterned to reflect different values ​​of the electroanatomical data (e.g., LAT values ​​or bipolar data values).

[0048] In some exemplary embodiments, data from the 3D electroanatomical map may be selected for overlay on the 2D ultrasound image 94 based on where the 2D ultrasound image 94 intersects with the 3D electroanatomical map in 3D coordinate space. For example, if the 3D electroanatomical map includes a particular distribution of colors representing LAT values ​​(or bipolar data), the coloring used in the 3D electroanatomical map at the intersection of the 3D electroanatomical map with the 2D ultrasound image 94 (in 3D coordinate space) is superimposed as one or more lines 92-1 on the 2D ultrasound image 94 to indicate the LAT value (or bipolar data) associated with the 2D ultrasound image 94. The lines may be thicker than the corresponding coloring on the 3D electroanatomical map at the intersection of the 3D electroanatomical map with the 2D ultrasound image 94.

[0049] As the ultrasound probe 46 is moved to capture different ultrasound images of the cavities of the heart 18, the representations of the electroanatomical data superimposed on the different ultrasound images change to reflect the new locations of the different ultrasound images being displayed and the new electroanatomical data that becomes contained within or within a given threshold value proximate to the different ultrasound images. For example, as the ultrasound probe 46 is moved, the LAT values ​​superimposed on the ultrasound images move and change to reflect the current LAT values ​​in the current region of the 3D coordinate space occupied by the respective ultrasound image.

[0050] The representation 92 of electroanatomical data superimposed on the ultrasound image 94 need not be limited to electroanatomical data included in the 3D electroanatomical map. Other electroanatomical data not used in the 3D electroanatomical map may be collected by the mapping catheter. For example, electroanatomical data (e.g., bipolar data) captured from tissue of an internal structure 98, such as the papillary muscles, may not be included in the 3D electroanatomical map. However, the representation 92-2 of electroanatomical data captured from tissue of an internal structure 98 may be superimposed on the 2D ultrasound image 94, as shown in FIG. 6. In this way, electroanatomical data that is not normally seen by a physician (because it is excluded from the 3D electroanatomical map) is included in each ultrasound image.

[0051] In some exemplary embodiments, the position of a distal end of a catheter inserted into a cavity of the heart 18 may be tracked (as described in more detail with reference to FIG. 1 ) and a representation 96 of the tracked distal end of the catheter may be overlaid on the 2D ultrasound image 94.

[0052] Thus, the processing circuitry 34 is configured to render on the display 44 the respective representations 92 of the respective electroanatomical data subsets superimposed on the respective ultrasound images 94 (block 110) (in other words, each ultrasound image 94 has its own representation 92 of its own corresponding electroanatomical data subset superimposed thereon). The respective positions of the representations 92 in the respective ultrasound images 94 are calculated based on the corresponding positions of the electroanatomical data that the representations 92 represent. In some exemplary aspects, the processing circuitry 34 is configured to render on the display 44 the respective representations 92 of the respective electroanatomical data subsets and a representation 96 of the distal end of the catheter superimposed on the respective ultrasound images 94. The respective representations 92 may include respective multi-colored lines or regions. The multi-colored lines or regions represent local activation times or bipolar data.

[0053] In some exemplary embodiments, the processing circuitry 34 is configured to render on the display 44 representations 92 of each electroanatomical data subset superimposed on a 2D ultrasound image 94 including internal structures 98 of the cavities of the heart 18, with at least some of the representations 92 showing electroanatomical data (e.g., bipolar data) of the internal structures 98 (e.g., papillary muscles).

[0054] The left side of the display 44 shows a 3D anatomical map 90 (e.g., generated from points captured by the mapping catheter 40 or from data captured by the ultrasound probe 46). The 3D anatomical map 90 may be calculated using any suitable map generation method, such as fast anatomical mapping (FAM) to form a smooth shell as described in U.S. Pat. No. 10,918,310 to Cohen et al. from points captured by the mapping catheter 40, or fast anatomical mapping using ultrasound images as described in U.S. Pat. No. 10,835,207 to Altmann et al. from data captured by the ultrasound probe 46. A 2D ultrasound image 94 is also shown intersected with the 3D anatomical map 90. The 2D ultrasound image 94 is positioned relative to the 3D anatomical map 90 according to the respective positions of the 3D anatomical map 90 and the 2D ultrasound image 94 in 3D coordinate space according to positions provided by the position sensor 54 and an associated position tracking system. The 2D ultrasound image 94 is shown as being partially transparent, so that the orientation of the 2D ultrasound image 94 relative to the 3D anatomical map 90 can be clearly seen. In some exemplary embodiments, the 2D ultrasound image 94 is shown as being opaque on top of the 3D anatomical map 90. In some exemplary embodiments, the 3D anatomical map 90 is shown without the 2D ultrasound image 94 overlaying the 3D anatomical map 90.

[0055] Reference is now made to Figure 7, which is a schematic diagram of a 3D anatomical map 90 and a 2D ultrasound image 88 overlaid with different representations 86 of electroanatomical data (only some of which are labeled for simplicity). Each representation 86 includes a respective number of arrows, each of which represents a velocity vector or other propagation data.

[0056] 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

[0057] Example 1: A medical system comprising an ultrasound probe configured to capture ultrasound images of at least a portion of a body part of a biological subject, a display, and a processor configured to render on the display respective representations of respective electroanatomical data subsets superimposed on each of the ultrasound images.

[0058] Example 2: The system of example 1, wherein each representation includes a respective multi-colored line or region.

[0059] Example 3: The system described in Example 2, wherein the multi-colored lines or areas represent local activation times or bipolar data.

[0060] Example 4: The system of any of Examples 1 to 3, wherein each representation includes a respective plurality of arrows.

[0061] Example 5: The system of example 4, wherein each of the multiple arrows represents a velocity vector.

[0062] Example 6: A system described in any of Examples 1 to 5, wherein each electroanatomical data subset includes any one or more of local activation time data, bipolar data, propagation data, and velocity vectors.

[0063] Example 7: A system as described in any of Examples 1 to 6, wherein the processor is configured to render on a display one of the respective representations of one of the respective electroanatomical data subsets superimposed on one of the ultrasound images including an internal structure of a cavity of the heart, with one of the respective representations showing electroanatomical data of the internal structure.

[0064] Example 8: The system of Example 7, wherein the internal structure is a papillary muscle.

[0065] Example 9: A system described in example 7 or 8, wherein the electroanatomical data of the internal structures includes bipolar data.

[0066] Example 10: A system described in any of Examples 1 to 9, wherein the processor is configured to render on a display a representation of each of the electroanatomical data subsets superimposed on each of the ultrasound images and a representation of the distal end of the catheter.

[0067] Example 11: A system described in any of Examples 1 to 10, wherein the processor is configured to find respective electroanatomical data subsets from an electroanatomical data set having electroanatomical data positioned in three-dimensional (3D) coordinate space within each of the ultrasound images or within a given threshold value of each of the ultrasound images.

[0068] Example 12: The system described in Example 11, further comprising a mapping catheter configured to be inserted into a body part, the mapping catheter having at least one electrode configured to capture electrical activity from tissue of the body part at a respective location within the body part over time, and at least one position sensor configured to provide at least one signal indicative of a position of the ultrasound probe and a respective location of the at least one electrode of the mapping catheter, wherein the processor is configured to calculate the respective locations of the at least one electrode and the position of the ultrasound probe in response to the at least one signal provided by the at least one position sensor, and to calculate electroanatomical data of an electroanatomical dataset and corresponding positions of the electroanatomical data in a 3D coordinate frame in response to the captured electrical activity and the calculated respective locations.

[0069] Example 13: The system described in Example 12, wherein the at least one position sensor includes at least one first magnetic position sensor disposed on the mapping catheter and at least one second magnetic position sensor disposed on the ultrasound probe.

[0070] Example 14: A system described in any of Examples 11 to 13, wherein each of the ultrasound images is a respective two-dimensional (2D) slice.

[0071] Example 15: A system according to any of Examples 11 to 13, wherein each respective one of the ultrasound images is a respective three-dimensional (3D) image.

[0072] Example 16: A medical method comprising: capturing ultrasound images of at least a portion of a body part of a living subject; and rendering on a display respective representations of respective electroanatomical data subsets superimposed on respective ultrasound images.

[0073] Example 17: The method of example 16, wherein each representation comprises a respective multi-colored line or region.

[0074] Example 18: The method of Example 17, wherein the multicolored lines or areas represent local activation times or bipolar data.

[0075] Example 19: The method of example 16 or 17, wherein each representation includes a respective plurality of arrows.

[0076] Example 20: The method of example 19, wherein each of the multiple arrows represents a velocity vector.

[0077] Example 21: A system described in any of Examples 16 to 20, wherein each electroanatomical data subset includes any one or more of local activation time data, bipolar data, propagation data, and velocity vectors.

[0078] Example 22: A method as described in any of Examples 16 to 21, wherein the rendering includes rendering on a display one of the respective representations of one of the respective electroanatomical data subsets superimposed on one of the ultrasound images including an internal structure of a cavity of the heart, with one of the respective representations showing electroanatomical data of the internal structure.

[0079] Example 23: A method as described in any of Examples 16 to 22, wherein the rendering includes rendering on a display a representation of each of the electroanatomical data subsets and a representation of the distal end of the catheter superimposed on each of the ultrasound images.

[0080] Example 24: A method as described in any of Examples 16 to 23, further comprising finding a respective electroanatomical data subset from the electroanatomical data set having electroanatomical data positioned in three-dimensional (3D) coordinate space within each of the ultrasound images or within a given threshold value of each of the ultrasound images.

[0081] 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.

[0082] The above-described embodiments are cited by way of example, and the disclosure is not limited to what has been particularly 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.

[0083] [Embodiment] (1) A health care system, comprising: an ultrasound probe configured to capture an ultrasound image of at least a portion of a body part of a living subject; A display and and a processor configured to render on the display a respective representation of each of the electroanatomical data subsets superimposed on each of the ultrasound images. (2) The system of claim 1, wherein each of the representations includes a respective multi-colored line or multi-colored region. (3) The system of embodiment 2, wherein the multicolored lines or regions represent local excitation time or bipolar data. (4) The system of claim 1, wherein each of the representations includes a respective plurality of arrows. (5) The system of embodiment 4, wherein each of the arrows represents a velocity vector.

[0084] (6) The system of embodiment 1, wherein each of the electroanatomical data subsets includes any one or more of local activation time data, bipolar data, propagation data, and velocity vectors. (7) The system of embodiment 1, wherein the processor is configured to render on the display one of the respective representations of one of the respective electroanatomical data subsets superimposed on one of the ultrasound images including an internal structure of a heart cavity, with the one of the respective representations showing electroanatomical data of the internal structure. (8) The system of embodiment 7, wherein the internal structure is a papillary muscle. (9) The system of embodiment 8, wherein the electroanatomical data of the internal structures includes bipolar data. (10) The system of embodiment 1, wherein the processor is configured to render on the display the respective representations of the respective electroanatomical data subsets superimposed on the respective ultrasound images and a representation of a distal end of the catheter.

[0085] (11) The system of claim 1, wherein the processor is configured to find the respective electroanatomical data subsets from an electroanatomical data set having electroanatomical data positioned in three-dimensional (3D) coordinate space within the respective ultrasound images or within a given threshold of the respective ultrasound images. (12) a mapping catheter configured to be inserted into the body part and comprising at least one electrode configured to capture electrical activity from tissue of the body part at respective locations within the body part over time; and at least one position sensor configured to provide at least one signal indicative of a position of the ultrasound probe and the respective location of the at least one electrode of the mapping catheter, wherein the processor: calculating the respective locations of the at least one electrode and the position of the ultrasound probe in response to the at least one signal provided by the at least one position sensor; The system of embodiment 11, configured to calculate the electroanatomical data of the electroanatomical data set and a corresponding position of the electroanatomical data within the 3D coordinate frame in response to the captured electrical activity and the calculated respective locations. (13) The system of embodiment 12, wherein the at least one position sensor includes at least one first magnetic position sensor disposed on the mapping catheter and at least one second magnetic position sensor disposed on the ultrasound probe. (14) The system of claim 11, wherein each of the respective ones of the ultrasound images is a respective two-dimensional (2D) slice. (15) The system of claim 11, wherein each of the respective ones of the ultrasound images is a respective three-dimensional (3D) image.

[0086] (16) A medical method comprising the steps of: Capturing an ultrasound image of at least a portion of a body part of a living subject; and rendering on a display a respective representation of each of the electroanatomical data subsets superimposed on each of said ultrasound images. 17. The method of claim 16, wherein the respective representations include respective multi-colored lines or regions. (18) The method of embodiment 17, wherein the multicolored lines or regions represent local activation times or bipolar data. (19) The method of claim 16, wherein each of the representations includes a respective plurality of arrows. (20) The method of claim 19, wherein each of the plurality of arrows represents a velocity vector.

[0087] (21) The method of embodiment 16, wherein each of the electroanatomical data subsets includes any one or more of local activation time data, bipolar data, propagation data, and velocity vectors. (22) The method of embodiment 16, wherein the rendering includes rendering on the display one of the respective representations of one of the respective electroanatomical data subsets superimposed on one of the ultrasound images including an internal structure of a heart cavity, with the one of the respective representations showing electroanatomical data of the internal structure. (23) The method of embodiment 16, wherein the rendering includes rendering on the display the respective representations of the respective electroanatomical data subsets and a representation of a distal end of the catheter superimposed on the respective ultrasound images. (24) The method of embodiment 16, further comprising finding the respective electroanatomical data subsets from an electroanatomical data set having electroanatomical data positioned in three-dimensional (3D) coordinate space within the respective ultrasound images or within a given threshold of the respective ultrasound images.

Claims

1. It is a medical system, A mapping catheter configured to be inserted into a body part of a living organism, comprising at least one electrode configured to capture electrical activity from the tissue of the body part at each location over time, An ultrasound probe configured to capture an ultrasound image of at least a portion of the body when inserted into the body of the biological target, At least one position sensor configured to generate at least one signal indicating the position of the ultrasound probe and the position of at least one electrode of the mapping catheter, The display and It is a processor, In response to the at least one signal generated by the at least one position sensor, the position of the ultrasound probe and the position of the at least one electrode of the mapping catheter are determined in real time within a common three-dimensional (3D) coordinate frame. Rendering each representation of electroanatomical data obtained from a 3D electroanatomical map onto the display, wherein the representation is superimposed on a corresponding two-dimensional (2D) ultrasound image, and the 2D ultrasound image represents a slice passing through the 3D electroanatomical map. In response to the movement of the ultrasound probe, the superimposed representation is continuously updated in real time, so that the displayed electroanatomical data remains spatially aligned with the anatomical structures depicted in the ultrasound image. Displaying color-encoded lines or regions corresponding to local excitation time (LAT) data or bipolar data within the superimposed representation, A medical system comprising a processor configured to perform the following.

2. The system according to claim 1, wherein each of the aforementioned expressions includes each of the plurality of arrows.

3. The system according to claim 2, wherein each of the aforementioned multiple arrows represents a velocity vector.

4. The system according to claim 1, wherein the processor is configured to render on the display each representation of an electroanatomical data subset superimposed on one of the ultrasound images including the internal structure of the cavity of the heart, such that one of the representations shows the electroanatomical data of the internal structure.

5. The system according to claim 4, wherein the internal structure is a papillary muscle.

6. The system according to claim 5, wherein the electroanatomical data of the internal structure includes bipolar data.

7. The system according to claim 1, wherein the processor is configured to render to the display the respective representations of the subset of electroanatomical data superimposed on each of the ultrasound images and the representation of the distal end of the catheter.

8. The system according to claim 1, wherein the at least one position sensor includes at least one first magnetic position sensor disposed on the mapping catheter and at least one second magnetic position sensor disposed on the ultrasound probe.

9. The system according to claim 1, wherein each of the ultrasound images is a two-dimensional (2D) slice.

10. The system according to claim 1, wherein each of the ultrasound images is a three-dimensional (3D) image.

11. A method for operating a medical system, wherein the medical system includes a processor, and the method is The processor captures ultrasound images of at least a portion of the body parts of a biological object, The processor renders each representation of electroanatomical data from a three-dimensional (3D) electroanatomical map to a display, wherein the rendering includes superimposing each representation of the electroanatomical data on a two-dimensional (2D) slice of the ultrasound image in a region within the two-dimensional slice that corresponds to the location of the electroanatomical data in the electroanatomical map. Each of the aforementioned representations includes a multicolor line or multicolor region corresponding to the color coding of the electroanatomical data in the electroanatomical map, wherein the color coding represents local excitation time (LAT) data or bipolar data. A method wherein each of the representations superimposed on the two-dimensional slices moves dynamically and changes shape to reflect current LAT data or bipolar data at the location, and the location changes in response to the movement of an ultrasound probe within the body part.

12. The method according to claim 11, wherein each of the aforementioned expressions includes each of the multiple arrows.

13. The method according to claim 12, wherein each of the aforementioned multiple arrows represents a velocity vector.

14. The method according to claim 11, wherein the subset of electroanatomical data includes one or more of the following: local excitation time data, bipolar data, propagation data, and velocity vectors.

15. The method according to claim 11, wherein rendering includes rendering on a display one of the respective representations of one of the subsets of the electroanatomical data superimposed on one of the ultrasound images including the internal structure of the cavity of the heart, such that one of the respective representations shows the electroanatomical data of the internal structure.

16. The method according to claim 11, wherein rendering includes rendering on the display the respective representations of the respective subsets of the electroanatomical data superimposed on the respective ultrasound images and the representation of the distal end of the catheter.

17. The method according to claim 11, further comprising the processor finding a subset of electroanatomical data from an electroanatomical dataset having electroanatomical data positioned in a three-dimensional (3D) coordinate space within each of the ultrasound images or within a given threshold of each of the ultrasound images.

18. A medical imaging system, A position-tracking ultrasound probe configured to capture ultrasound images of the internal body region of a target, A data interface configured to receive electroanatomical data acquired from one or more electrodes placed within the internal body region, It is a processor, The spatial relationship between the ultrasound probe and the electroanatomical data within a common three-dimensional coordinate frame is determined in real time. A composite image is rendered on a display, which includes one or more graphic representations of the electroanatomical data that are automatically updated in real time in response to the movement of the ultrasound probe, and the ultrasound image. The graphic representation is encoded using colors or motion cues that indicate local excitation time or bipolar signal amplitude. A medical imaging system comprising a processor configured as follows.

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