Application of ablation signals to both sides of the tissue

Abstract

The system includes a display and a processor. The display is configured to display a map of an organ having a tissue including at least a first surface and a second surface facing each other. The processor is configured to: (i) receive a first position of a first lesion formed by ablating the first surface; (ii) calculate a second position on the second surface that faces the first position; and (iii) display, on the map, a marker indicating the second position for guiding the user to generate a second lesion in the tissue that faces the first lesion.

Description

Technical Field

[0001] The present disclosure generally relates to medical devices, and more particularly to methods and systems for assisting in the application of ablation signals to both sides of tissue.

Background Art

[0002] Various techniques for visualizing catheters and target tissue have been disclosed.

[0003] For example, U.S. Patent Application Publication No. 2021 / 0085387 describes a system including an interface and a processor. The interface is configured to receive data characterizing an initial ablation operation applied to a region of a patient's heart. The processor is configured to automatically identify a complementary ablation operation to be applied to the region based on the received data, if required.

Brief Description of the Drawings

[0004] The present disclosure will be more fully understood from the following detailed description of embodiments of the present disclosure in conjunction with the drawings.

Figure 1

Figure 2

Figure 3

Modes for Carrying Out the Invention

[0005] Overview Some tissue ablation procedures, such as ablation of the cardiac pericardium to treat arrhythmias, require the formation of one or more lesions through the entire thickness of the pericardium. In some cases, to form a lesion through the entire thickness of the pericardium, it is sufficient to apply an ablation signal to one side of the pericardium, for example, the endocardium or epicardium, using an ablation catheter. However, in other cases, the lesions formed in response to applying an ablation signal to one side (e.g., the endocardium) are incomplete and do not terminate the treated cardiac arrhythmia. In such cases, the physician must navigate the ablation catheter to apply an additional ablation signal to the epicardium at a position facing the lesion formed on the endocardium, but due to the three-dimensional (3D) structure of the heart, it can be difficult to determine such a position.

[0006] The embodiments of the present disclosure described below provide an improved technique for displaying to the user the following annotations: (i) a lesion formed on a first side of the tissue, and (ii) a proposed position on the second opposite side of the tissue facing the lesion formed on the first side.

[0007] In some embodiments, a system for treating arrhythmias comprises a suitable catheter having one or more ablation electrodes and one or more position sensors configured to generate a signal indicating the catheter position in a given XYZ coordinate system.

[0008] In some embodiments, the system comprises a display configured to display a map of an organ (e.g., a patient's heart) having tissue that includes at least a first surface and a second surface that face each other and further face the fluid of the organ. For example, in the heart, the first side and the second side of the pericardium include the endocardium and the epicardium, respectively. A given section of the endocardium and the epicardium face each other, the endocardium also faces the blood being pumped through the heart, and the epicardium faces the fluid surrounding the heart.

[0009] In some embodiments, the system includes a processor configured to receive one or more first positions of one or more respective first lesions formed on the endocardium. The processor is configured to calculate one or more second positions on the surface of the epicardium that face one or more respective first positions of the first lesions formed on the endocardium. In this embodiment, the processor is configured to calculate the projection of one or more first positions onto the surface of the epicardium. In the context of the present disclosure and the claims, the term "projection" refers to the shortest distance between each respective first position and second position on the endocardium and the epicardium, respectively. Note that, as described in detail below with reference to FIG. 2, the projection for each pair of first and second positions can be performed in any suitable direction in the XYZ coordinates of the heart.

[0010] The disclosed technique improves the quality of ablation procedures by assisting a physician in determining ablation sites on both sides of the tissue being ablated, thereby forming lesions through the entire thickness of the tissue to terminate an arrhythmia in a patient's heart.

[0011] Description of the System FIG. 1 is a schematic depiction of a catheter-based tracking and ablation system 20 according to an embodiment of the present disclosure.

[0012] In some embodiments, system 20 includes a catheter 22 configured to perform cardiac surgery and a control console 24. In the embodiments described herein, catheter 22 includes a focal catheter that can be used for any suitable therapeutic and / or diagnostic purpose, such as detecting electroanatomical signals and / or ablating tissue within heart 26, as described in detail below. In other embodiments, catheter 22 can include any other suitable type of catheter, including but not limited to a basket catheter, a lasso catheter, or a balloon catheter. In the context of the present disclosure and the claims, the term "ablation" refers to a radiofrequency (RF) ablation procedure or an irreversible electroporation (IRE) procedure. These procedures are intended to form lesions at one or more intended locations (also referred to herein as ablation sites) within heart 26, thereby applying one or more high-voltage monopolar or bipolar electrical signals (e.g., pulses) to one or more electrodes that contact the tissue intended to be ablated so as to treat cardiac arrhythmias. The formation of the lesions is described in more detail in FIG. 2 below.

[0013] In some embodiments, console 24 includes a processor 33 having suitable front-end and interface circuits that receive signals via catheter 22 and control other components of system 20 described herein, typically a general-purpose computer. Console 24 further includes a user display 35 configured to receive graphic and / or text display items, such as map 27 of heart 26, from processor 33 and display map 27 and, optionally, some annotations presented on map 27, as shown, for example, in FIG. 2 below.

[0014] In some embodiments, map 27 can include any suitable type of three-dimensional (3D) anatomical map generated using any suitable technique. For example, the anatomical map can be generated using anatomical images generated by using a suitable medical imaging system, or using the fast anatomical mapping (FAM) technique available in the CARTO™ system manufactured by Biosense Webster Inc. (Irvine, Calif.), or using any other suitable technique, or using any suitable combination of the above.

[0015] In some embodiments, console 24 includes a recording unit 38 configured to record in the event of a malfunction of the CARTO™ system and / or a malfunction of pacing of a particular electrode. Console 24 includes a patient interface unit (PIU) 44, which generates signals indicative of the location and electrocardiogram (ECG) signals to be acquired and processed, and is configured to exchange signals between console 24 and a plurality of entities of system 20, such as catheter 22.

[0016] Next, referring to insertion drawing 23, in some embodiments, prior to performing an ablation procedure, physician 30 inserts one or more catheters through the vasculature of patient 28 lying on table 29 so as to perform electro-anatomical (EA) mapping of the tissue of interest within heart 26. Based on the EA mapping, physician 30 plans an ablation or IRE procedure to be performed using focal catheter 22 or any other suitable catheter.

[0017] Next, refer to the inserted FIG. 42. In some embodiments, the catheter 22 comprises a distal-end assembly (DEA) 40 having one or more ablation electrodes 55 configured to apply an ablation signal to the tissue of the heart 26. The catheter 22 further comprises a position sensor 39, which is typically coupled to the distal end of the catheter 22 and is configured to generate a position signal indicative of the measured position of the ablation electrode 55 in the DEA 40, more specifically, in the XYZ coordinate system, as described in detail below.

[0018] In some embodiments, the DEA 40 comprises a contact force sensor, herein referred to as a force sensor 54, configured to measure the force applied by the DEA 40 of the catheter 22 to the endocardial tissue of the heart 26. The force sensor 54 is configured to generate a force signal indicative of the force applied by the DEA 40 to the endocardial tissue of the heart 26. In some embodiments, the force sensor may comprise a magnetic field transceiver connected to the DEA 40 by a spring and may generate an indication of the force based on the measurement of the deflection of the spring. Further details of this type of catheter and force sensor are described in the aforementioned U.S. Patent Application Publication Nos. 2009 / 0093806 and 2009 / 0138007. In other embodiments, the force sensor 54 may include any other suitable type of force sensor.

[0019] In this embodiment, the ablation electrode 55 is positioned at the tip of the DEA 40 and is arranged in contact with the endocardial tissue of the heart 26, such that the force signal indicates the force applied between the ablation electrode 55 and the endocardial tissue of the heart 26.

[0020] Next, refer again to the overall view of FIG. 1. In some embodiments, the PIU 44 is connected to a power source, such as a radio frequency (RF) generator 49, packaged within the housing of the PIU 44. In an alternative embodiment, the RF generator may be external to the housing of the PIU 44 and may be electrically connected to the PIU 44 using a suitable cable. The RF generator 49 is configured to apply a suitable RF ablation signal.

[0021] In some embodiments, the proximal end of the catheter 22 is connected to an interface circuit (not shown) of the PIU 44, among other things, to transfer an ablation signal from the PIU 44 to the electrode 55 and apply the ablation signal to the tissue of the heart 26. The interface circuit is further configured to conduct a position signal between the position sensor 39 and the processor 33.

[0022] In some embodiments, the system 20 includes a reference electrode 48, also referred to herein as a patch electrode, that is attached to the skin of the patient 28 (e.g., the back of the patient's torso) and electrically connected to the PIU 44 via the cable 21. In other embodiments, the system 20 may include any suitable number of skin patches configured to adhere to the skin of the patient 28, each with an electrode, e.g., about four or five electrodes.

[0023] In the context of the present disclosure and the claims, the term "about" or "approximately" used with any numerical value or range indicates a suitable dimensional tolerance that allows a component or a set of components to function for its intended purpose as described herein.

[0024] In some embodiments, the system 20 includes a handle 32 used by the physician 30 to navigate the DEA 40 into a target location within the heart 26 for performing ablation through the vasculature of the patient 28.

[0025] In some embodiments, the position of the distal assembly 40 within the vasculature and heart 26 of patient 28 is measured using the position sensor 39 of the magnetic position tracking system. In this embodiment, the console 24 includes a drive circuit 41 configured to drive a magnetic field generator 36 disposed external to patient 28, such as on table 29, at a known position external to the patient, for example, under the patient's torso. The position sensor is coupled to the distal end and is configured to generate a position signal in response to the sensed external magnetic field from the magnetic field generator 36. The position signal, also referred to herein as a position measurement, indicates the position of the DEA 40 in the XYZ coordinate system of the position tracking system.

[0026] This position sensing method is implemented in various medical applications, for example, in the CARTO™ system manufactured by Biosense Webster Inc., Irvine, Calif., and is described in detail 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. 96 / 05768; and U.S. Patent Application Publication Nos. 2002 / 0065455 (A1); 2003 / 0120150 (A1); and 2004 / 0068178 (A1).

[0027] In some embodiments, the coordinate system of the position tracking system is registered with the coordinate systems of the system 20 and the map 27, such that the processor 33 is configured to display the position of the distal assembly 40 on the anatomical or EA map (e.g., map 27).

[0028] In some embodiments, the processor 33 is programmed in software to perform the functions described herein. The software can be downloaded to the computer in electronic form, for example, via a network, or alternatively or additionally, provided and / or stored on a non-transitory tangible medium such as magnetic memory, optical memory, or electronic memory.

[0029] This particular configuration of system 20 is shown by way of example to illustrate the particular problems addressed by embodiments of the present disclosure and to demonstrate the application of these embodiments in improving the performance of such a system. However, embodiments of the present disclosure are in no way limited to this particular type of exemplary system, and the principles described herein may equally apply to other types of catheters and / or medical systems configured to be used in other types of tissue ablation procedures.

[0030] Display of a marker for a proposed ablation location on the tissue surface, calculated based on a lesion formed on the opposite side of the tissue FIG. 2 is a schematic depiction of a marker 77 indicating a proposed ablation location, displayed on the surface 64 of tissue 50 on map 27 and based on a lesion formed on the opposing surface 62 of tissue 50, according to an embodiment of the present disclosure.

[0031] In some cases, physician 30 applies an ablation signal to one side of tissues 50 and 80 of heart 26 using electrode 55 of catheter 22. In this embodiment, tissue 50 includes a septum between the left ventricle (LV) 60 and the right ventricle (RV) 70 of heart 26. Tissue 50 is defined between surfaces 62 and 64, which are the walls of LV 60 and RV 70, respectively. Similarly, tissue 80 includes the pericardium of heart 26, which is defined between surfaces 82 and 84, which are the endocardium and epicardium of the pericardium, respectively.

[0032] For example, an ablation signal is applied to the surface 82 to kill the cells of the tissue 80, thereby converting the live cells positioned between the surfaces 82 and 84 of the section 92 into a continuous damaged area. It should be noted that in order to prevent one or more electrophysiological (EP) waves from propagating through the section 92 of the tissue 80, it is intended to form a damaged area through the entire thickness of the tissue 80 (between the surfaces 82 and 84). In some cases, in order to form a desired continuous damaged area through the thickness of the tissue 80 (i.e., between the surfaces 82 and 84), it is sufficient to apply an ablation signal to one side of the tissue 80, for example, the surface 82, along the section 92.

[0033] However, in other cases, the damaged area formed in response to applying an ablation signal to one side (e.g., the surface 82) may be incomplete, and the EP wave may not be completely blocked from propagating through the section 92 of the tissue 80. In such cases, the physician 30 has to navigate the DEA 40 of the catheter 22 outside the heart 26 in order to apply an additional ablation signal to the surface 84 (i.e., the epicardium) at a position facing the damaged area formed on the surface 82 (i.e., the endocardium). It should be noted that due to the three-dimensional (3D) structure of the tissue 80, it is difficult to accurately determine the position intended to be ablated on the surface 84.

[0034] In some embodiments, the processor 33 is configured to display, on the map 27, markers 88 indicating the respective positions where an ablation signal is applied to the surface 82 and one or more damaged areas are formed.

[0035] In some embodiments, the processor 33 is configured to calculate the respective positions on the surface 84 facing the marker 88 by projecting the location of the marker 88 onto a surface 84 that typically faces the surface 82. Based on this projection, the processor 33 is configured to display a marker 99 indicating the calculated position on the map 27. In this embodiment, the marker 99 is shown as a dashed circle as the proposed location, and these circles are intended to guide the physician 30 to apply ablation pulses to the surface 84, thereby forming respective damaged areas facing the surface 82 and marked by the marker 88.

[0036] In some embodiments, the processor 33 is configured to calculate the distance 90 between each pair of markers 88 and 99. For example, the distance 90a between marker 88a and 99a, and the distance 90b between marker 88b and 99b. If the physician 30 accepts the proposed ablation location, and based on the calculated distance, the processor 33 and / or the physician 30 may determine one or more ablation parameters to obtain the desired continuous damaged areas of the section 92 in response to applying ablation pulses to the position of the marker 99. It should be noted that in this embodiment, the term "projection" refers to the shortest distance 90 between the respective markers 88 and 99 on the surfaces 82 and 84. In one embodiment, the processor 33 is configured to calculate a plurality of distances between the marker 88a and a plurality of locations on the surface 84, and determine the position of the marker 99a based on the distance 90a, which is the shortest distance among the calculated distances.

[0037] In an embodiment of section 92 of tissue 80, surfaces 82 and 84 face each other and are substantially parallel to each other, and thus, distances 90a and 90b are approximately equal. In an embodiment of tissue 50, surfaces 62 and 64 face each other, but are not parallel to each other due to the anatomical structures of LV60 and RV70. In the embodiment of FIG. 2, although LV60 has already been mapped and one or more ablation signals have already been applied to one or more tissues of the wall of LV60, it should be noted that RV70 may not yet have been mapped (e.g., using one or more ECG sensing electrodes of catheter 22 or any other suitable catheter).

[0038] In some embodiments, processor 33 is configured to display on map 27 a marker 66 indicating each position where an ablation signal has been applied to surface 62. In this embodiment, the ablation signals applied at the positions of marker 66 form one or more damaged portions within tissue 50 that are incomplete between surfaces 62 and 64. In other words, at least a portion of the EP wave can propagate through tissue 50, which does not achieve the purpose of the ablation treatment performed on tissue 50.

[0039] In some embodiments, processor 33 is configured to calculate each position on surface 64 that marker 66 faces by projecting the location of marker 66 onto surface 64, which typically faces surface 62. Based on the projection, processor 33 is configured to display on map 27 a marker 77 indicating the calculated positions. In this embodiment, marker 77 is shown as a dashed circle as the proposed location, and these circles are intended to guide physician 30 to apply ablation pulses to surface 64, thereby forming respective damaged portions that face the damaged portions formed on surface 62.

[0040] In some embodiments, the processor 33 is configured to calculate the distance 68 between each pair of markers 66 and 77. For example, the distance 68a between markers 66a and 77a, and the distance 68b between markers 66b and 77b. As described above with respect to the tissue 80, if the physician 30 accepts the proposed ablation location indicated as marker 77, based on the calculated distance 68, the processor 33 and / or the physician 30 may determine one or more ablation parameters for each location marked by the respective marker 77. In response to applying an ablation signal including the determined ablation parameters to the position of the marker 99, a desired continuous lesion is typically formed in the ablated section of the tissue 50.

[0041] In an embodiment of the tissue 50, the term "projection" refers to the shortest distance 68 between each pair of markers 66 and 77 displayed on the surfaces 62 and 64, respectively. It should be noted that in the ablated section, since the surfaces 62 and 64 are not parallel to each other, the orientation and the calculated distance may vary between pairs of markers 66 and 77.

[0042] For example, the size of the distance 68a and the orientation of the arrow indicating the distance 68a are different from those of the distance 68b. Thus, the physician 30 may determine to (i) use different ablation parameters for the ablation signals applied to the surface 64 at the positions of the markers 77a and 77b, and (ii) direct the DEA 40 in different directions, for example, towards the locations of the markers 77a and 77b, to obtain a continuous lesion in the ablated section between the surfaces 62 and 64. As explained above, the conversion of the tissue 50 into a continuous lesion between the surfaces 62 and 64 is intended to block the propagation of the EP wave through the septum between the LV 60 and the RV 70, thereby treating the arrhythmia of the heart 26.

[0043] In some embodiments, when implementing the above-described technique, at least one of markers 77 and 99 is displayed on map 27 to assist physician 30 in navigating DEA 40 to the position marked by the displayed marker. As described in FIG. 1 above, processor 33 is configured to continuously display on map 27 a given marker (not shown) indicating the position of DEA 40 within heart 26 based on the position signal of position sensor 39. In such an embodiment, physician 30 moves catheter 22 to position DEA 40 at one or more of the proposed ablation locations and then controls catheter 22 to apply a predetermined ablation signal to the tissue at the proposed position. For example, when the position of a given marker is integrated with the position of marker 77a, physician 30 may control catheter 22 to apply an ablation signal to form a continuous lesion between surfaces 62 and 64, at least between the positions of markers 66a and 77a.

[0044] In other embodiments, catheter 22 includes a basket catheter (not shown) having a plurality of ablation electrodes 55 (not shown). In such an embodiment, physician 30 moves catheter 22 such that the positions of the plurality of electrodes 55 of DEA 40 are integrated with the respective positions of markers 77, and then physician 30 may control catheter 22 to apply an ablation signal to surface 64 (using each ablation electrode 55) at the position marked by marker 77 to form a continuous lesion between surfaces 62 and 64.

[0045] The configurations of markers 66, 77, 88, and 99, and distances 68 and 90 are shown as examples for conceptual clarity. In other embodiments, the processor 33 is configured to use any other suitable calculations to determine (i) the position of one or more of these markers and / or distances, and (ii) the size, shape, and other parameters regarding the appearance of any suitable type of marker to assist the physician 30 in determining ablation of one or both of the tissues 50 and 80. For example, at least one of the distances 68 and 90 may be shown as a table presented as a text diagram, for example, on the map 27.

[0046] Note that in the embodiment of FIG. 2, the surfaces of the tissues 50 and 80 face each other and are in physical contact with the fluid within and surrounding the heart 26. For example, the surfaces 62 and 64 face each other and are in physical contact with the blood flowing through the LV 60 and RV 70. Similarly, the surfaces 82 and 84 face each other, the surface 82 is in physical contact with the blood flowing through the LV 60, and the surface 84 is in physical contact with the fluid surrounding the heart 26. In other embodiments, at least one of the surfaces 62, 64, 82, and 84 may be accessible to the DEA 40 through the patient 28's vasculature and / or through other (soft or hard) tissues of the patient for applying the techniques described above.

[0047] FIG. 3 is a flowchart schematically illustrating a method for displaying a marker 77 indicating a proposed ablation location calculated based on a lesion formed on the surface 62 of the tissue 50 on the surface 64 of the tissue 50 according to an embodiment of the present disclosure.

[0048] The method begins with a catheter insertion step 100 where the physician 30 inserts the DEA 40 of the catheter 22 into the patient 28's body, as described above with respect to FIGS. 1 and 2.

[0049] In the heart map display step 102, as described in FIG. 2 above, the processor 33 displays a map 27 showing the tissue 50 having the surface 62 of the left ventricle (LV) 60 and the surface 64 of the right ventricle (RV) 70 facing each other.

[0050] In the first ablation step 104, the physician 30 moves the catheter 22 into the LV and controls the system 20 to apply an ablation signal to the surface 62 to form a first lesion at one or more first positions on the surface 62, and the processor 33 stores the coordinates of the one or more first positions. In the embodiment of FIG. 2 above, the processor 33 uses the marker 66 to display the first positions on the surface 62.

[0051] In the calculation step 106, the processor 33 calculates one or more second positions on the surface 64 facing each of the one or more first positions by projecting the one or more first positions onto the surface 64 as described in detail in FIG. 2 above.

[0052] In the marker display step 108, the processor 33 displays one or more markers 77 on the map 27 indicating one or more second positions on the surface 64 and the distance 68 between each pair of the first and second positions. In the embodiment of FIG. 2, the distances 77 are respectively displayed between the markers 66 and 77 positioned on the surfaces 62 and 64.

[0053] In the second ablation step 110 to end the method, the physician 30 moves the catheter 22 into the RV 70 to position the DEA 40 at the second positions indicated by the markers 77. In this embodiment, the catheter 22 includes a focal catheter, and thus the physician 30 (i) continuously moves the DEA 40 to each of the second positions such that the position of the ablation electrode 55 is integrated with the position of each marker 77, and (ii) generates a plurality of second lesions (facing the first lesion indicated as the marker 66) at each of the positions of the markers 77 as described in detail in FIG. 2 above.

[0054] In some embodiments, physician 30 may perform a test to confirm the formation of a continuous lesion that blocks the propagation of the EP wave through tissue 30, which is the septum between LV 60 and RV 70.

[0055] In some embodiments, the method of FIG. 3 is applicable with the necessary modifications to generate a continuous lesion along section 92 between surfaces 82 and 84, as described in detail in FIG. 2 above.

[0056] In some embodiments, after obtaining and verifying the formation of one or more continuous lesions at the location intended to be ablated, physician 30 may withdraw catheter 22 from the body of patient 28.

[0057] The embodiments described herein are mainly directed to electrophysiological procedures (such as, but not limited to, RF ablation and / or IRE procedures) performed on a patient's heart 26. However, the methods and systems described herein can also be used in other applications, such as any catheter procedure performed on both sides of tissue within any suitable organ of a patient.

Example

[0058] System (20) includes a display (35) and a processor (33). The display (35) is configured to display at least a map (27) of an organ (26) having tissue (50) including a first surface (62) and a second surface (64) facing each other. The processor (33) is configured to: (i) receive a first position (66) of a first lesion formed by ablating the first surface (62); (ii) calculate a second position on the second surface (64) that faces the first position (66); and display a marker (77) indicating the second position for guiding user (30) to generate a second lesion in tissue (50) that faces the first lesion on the map (27).

Example

[0059] The system according to Example 1, wherein the processor is configured to calculate a second position by: (a) selecting two or more locations on a second surface; (b) calculating two or more distances between (i) a first position and (ii) each of the two or more locations, respectively; and (iii) selecting the second position from among the two or more locations based on a shortest distance selected from among the two or more distances.

Example

[0060] The system according to Example 1, wherein the processor is configured to calculate a second position by calculating a projection of the first position onto the second surface.

Example

[0061] The system according to Example 1, wherein the processor is configured to display an additional marker indicating a first damaged portion on a map.

Example

[0062] The system according to Examples 1 to 4, wherein the processor is configured to display a distance between the first position and the second position on a map.

Example

[0063] The system according to Example 5, wherein the processor is configured to set one or more ablation parameters for generating a second damaged portion based on a distance.

Example

[0064] The system according to Example 6, wherein the processor is configured to set one or more ablation parameters for converting tissue between the first position and the second position into a continuous damaged portion including the first damaged portion and the second damaged portion.

Example

[0065] The system according to any one of Examples 1 to 4, wherein the organ includes a heart and at least one of the first surface and the second surface includes the endocardium or epicardium of the heart.

Examples

[0066] The system according to any one of Examples 1 to 4, wherein one or both of the first surface and the second surface face a fluid located in one or both of (i) within the organ and (ii) around the organ.

Examples

[0067] The system according to Example 9, wherein the organ includes a heart, the first surface and the second surface respectively include the first wall and the second wall of the first chamber and the second chamber of the heart, and the fluid includes blood being pumped through the first chamber and the second chamber.

Examples

[0068] A method comprising: displaying a map (27) of an organ (26) having tissue (50) including at least a first surface (62) and a second surface (64) facing each other; receiving a first position (66) of a first lesion formed by ablating the first surface (62); calculating a second position on the second surface (64) facing the first position; displaying a marker (77) indicating the second position on the map (27) for guiding a user (30) to generate a second lesion in the tissue (50) facing the first lesion.

Examples

[0069] Calculating the second position includes: (a) selecting two or more locations on the second surface; (b) (i) calculating each of two or more distances between the first position and (ii) each of the two or more locations; and (iii) selecting the second position from among the two or more locations based on the shortest distance selected from the two or more distances. The method according to claim 11 of the embodiments.

Example

[0070] The method according to embodiment 11, wherein calculating the second position includes calculating a projection of the first position onto the second surface.

Example

[0071] The method according to embodiment 11, including displaying an additional marker indicating the first damaged part on the map.

Example

[0072] The method according to any one of embodiments 11 to 14, including displaying the distance between the first position and the second position on the map.

Example

[0073] The method according to embodiment 15, including setting one or more ablation parameters for generating a second damaged part based on the distance.

Example

[0074] The method according to embodiment 16, wherein one or more ablation parameters are set to convert the tissue between the first position and the second position into a continuous damaged part including the first damaged part and the second damaged part.

Example

[0075] The method according to embodiments 11 to 14, wherein the organ includes the heart, and at least one of the first surface and the second surface includes the endocardium or epicardium of the heart.

Example

[0076] The method according to any one of Examples 11 to 14, wherein one or both of the first surface and the second surface face a fluid positioned in one or both of (i) within an organ and (ii) around the organ.

Examples

[0077] The method according to Example 19, wherein the organ includes a heart, the first surface and the second surface respectively include the first wall and the second wall of the first chamber and the second chamber of the heart, and the fluid includes blood being pumped through the first chamber and the second chamber.

[0078] It should be understood that the above-described examples are given by way of example, and the present disclosure is not limited to those specifically illustrated and described hereinabove. Rather, the scope of the present disclosure includes both the various combinations and sub-combinations of functions described above, as well as those modifications and changes that would occur to those skilled in the art upon reading the foregoing description and that are not disclosed in the prior art. Documents incorporated by reference into this patent application should be regarded as an essential part of this application, provided that only the definitions in this specification are to be considered insofar as any terms are defined in these incorporated documents in a manner inconsistent with the definitions explicitly or implicitly made in this specification.

[0079] 〔Embodiments〕 (1) A system comprising: a display configured to display a map of an organ having a tissue including at least a first surface and a second surface facing each other; a processor, receiving a first position of a first damaged part formed by ablating the first surface; calculating a second position on the second surface facing the first position; A system comprising a processor configured to display, on the map, a marker indicating the second position for guiding a user to generate a second damaged part facing the first damaged part within the tissue. (2) The system according to embodiment 1, wherein the processor is configured to calculate the second position by: (a) selecting two or more locations on the second surface; (b) calculating two or more distances between (i) the first position and (ii) each of the two or more locations; and (iii) selecting the second position from among the two or more locations based on the shortest distance selected from the two or more distances. (3) The system according to embodiment 1, wherein the processor is configured to calculate the second position by calculating a projection of the first position onto the second surface. (4) The system according to embodiment 1, wherein the processor is configured to display, on the map, an additional marker indicating the first damaged part. (5) The system according to embodiment 1, wherein the processor is configured to display, on the map, the distance between the first position and the second position.

[0080] (6) The system according to embodiment 5, wherein the processor is configured to set one or more ablation parameters for generating the second damaged part based on the distance. (7) The system according to embodiment 6, wherein the processor is configured to set one or more ablation parameters for converting the tissue between the first position and the second position into a continuous damaged part including the first damaged part and the second damaged part. (8) The system according to embodiment 1, wherein the organ includes a heart, and at least one of the first surface and the second surface includes an endocardium or an epicardium of the heart. (9) The system according to embodiment 1, wherein one or both of the first surface and the second surface face a fluid positioned at one or both of (i) within the organ and (ii) around the organ. (10) The system according to embodiment 9, wherein the organ includes a heart, the first surface and the second surface each include a first wall and a second wall of a first chamber and a second chamber of the heart, respectively, and the fluid includes blood that is pumped through the first chamber and the second chamber.

[0081] (11) A method comprising: displaying a map of an organ having tissue including at least a first surface and a second surface facing each other; receiving a first position of a first lesion formed by ablating the first surface; calculating a second position on the second surface that faces the first position; displaying, on the map, a marker indicating the second position for guiding a user to generate a second lesion in the tissue that faces the first lesion. (12) The method according to embodiment 11, wherein calculating the second position includes: (a) selecting two or more locations on the second surface; (b) calculating two or more distances between (i) the first position and (ii) each of the two or more locations; and (iii) selecting the second position from among the two or more locations based on the shortest distance selected from the two or more distances. (13) The method according to embodiment 11, wherein calculating the second position includes calculating a projection of the first position onto the second surface. (14) The method according to embodiment 11, further comprising displaying an additional marker on the map indicating the first lesion. (15) The method according to embodiment 11, further comprising displaying a distance between the first position and the second position on the map.

[0082] (16) The method according to embodiment 15, comprising setting one or more ablation parameters for generating the second damaged portion based on the distance. (17) The method according to embodiment 16, wherein the one or more ablation parameters are set to convert the tissue between the first position and the second position into a continuous damaged portion including the first damaged portion and the second damaged portion. (18) The method according to embodiment 11, wherein the organ includes a heart, and at least one of the first surface and the second surface includes an endocardium or an epicardium of the heart. (19) The method according to embodiment 11, wherein one or both of the first surface and the second surface face a fluid positioned at one or both of (i) within the organ and (ii) around the organ. (20) The method according to embodiment 19, wherein the organ includes a heart, the first surface and the second surface respectively include a first wall and a second wall of a first chamber and a second chamber of the heart, and the fluid includes blood being pumped through the first chamber and the second chamber.

Claims

**Claim 1** A system comprising: a display configured to display a map of an organ having tissue including at least a first surface and a second surface facing each other; a processor, receiving a first position of a first lesion formed by ablating the first surface, calculating a second position on the second surface facing the first position, and a processor configured to display, on the map, a marker indicating the second position for guiding a user to generate a second lesion in the tissue facing the first lesion. **Claim 2** The system according to claim 1, wherein the processor is configured to calculate the second position by: (a) selecting two or more locations on the second surface; (b) (i) calculating two or more distances between the first position and (ii) each of the two or more locations; and (iii) selecting the second position from among the two or more locations based on a shortest distance selected from the two or more distances. **Claim 3** The system according to claim 1, wherein the processor is configured to calculate the second position by calculating a projection of the first position onto the second surface. **Claim 4** The system according to claim 1, wherein the processor is configured to display, on the map, an additional marker indicating the first lesion. **Claim 5** The system according to claim 1, wherein the processor is configured to display, on the map, a distance between the first position and the second position. **Claim 6** The system according to claim 5, wherein the processor is configured to set one or more ablation parameters for generating the second lesion based on the distance. **Claim 7** The system according to claim 6, wherein the processor is configured to set the one or more ablation parameters for converting the tissue between the first position and the second position into a continuous lesion including the first lesion and the second lesion. **Claim 8** The system according to claim 1, wherein the organ includes a heart, and at least one of the first surface and the second surface includes an endocardium or an epicardium of the heart.

9. The system according to claim 1, wherein one or both of the first surface and the second surface face a fluid positioned in one or both of (i) within the organ and (ii) around the organ.

10. The system according to claim 9, wherein the organ includes a heart, the first surface and the second surface each include a first wall and a second wall of a first chamber and a second chamber of the heart, and the fluid includes blood being pumped through the first chamber and the second chamber.

11. A method comprising: displaying a map of an organ having tissue including at least a first surface and a second surface facing each other; receiving a first position of a first lesion formed by ablating the first surface; calculating a second position on the second surface facing the first position; displaying, on the map, a marker indicating the second position for guiding a user to generate a second lesion in the tissue facing the first lesion.

12. Calculating the second position includes: (a) selecting two or more locations on the second surface; (b) (i) calculating two or more distances between the first position and (ii) each of the two or more locations; and (iii) selecting the second position from among the two or more locations based on a shortest distance selected from the two or more distances. The method according to claim 11.

13. The method according to claim 11, wherein calculating the second position includes calculating a projection of the first position onto the second surface.

14. The method according to claim 11, including displaying an additional marker indicating the first lesion on the map.

15. The method according to claim 11, including displaying a distance between the first position and the second position on the map.

16. The method according to claim 15, including setting one or more ablation parameters for generating the second lesion based on the distance.

17. The method according to claim 16, wherein the one or more ablation parameters are set to convert the tissue between the first position and the second position into a continuous damaged area including the first damaged area and the second damaged area. **Claim 18** The method according to claim 11, wherein the organ includes a heart, and at least one of the first surface and the second surface includes an endocardium or an epicardium of the heart. **Claim 19** The method according to claim 11, wherein one or both of the first surface and the second surface face a fluid positioned at one or both of (i) within the organ and (ii) around the organ. **Claim 20** The method according to claim 19, wherein the organ includes a heart, the first surface and the second surface each include a first wall and a second wall of a first chamber and a second chamber of the heart, and the fluid includes blood being pumped through the first chamber and the second chamber.

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