Multi-electrode catheter and three-dimensional display of signals acquired over time

Abstract

The system includes an interface and a processor. The interface is configured to receive first and second signals from at least first and second electrodes, respectively, of a catheter acquired at an organ of a patient over at least a time interval by the at least first and second electrodes. The processor is configured to generate a three-dimensional (3D) representation of at least a portion of the catheter and first and second traces corresponding to the first and second signals, the first and second traces being displayed in 3D space relative to the physical locations of the first and second electrodes on the catheter, respectively.

Description

[Technical Field]

[0001] FIELD OF THE DISCLOSURE The present disclosure relates generally to medical devices, and more particularly to methods and systems for improving the presentation and visualization of signals acquired by multi-electrode catheters. [Background technology]

[0002] Various techniques for presenting electroanatomical (EA) signals have been published, one of the challenges being to visualize signals acquired over time using catheters with multiple electrodes.

[0003] The present disclosure will be more fully understood from the following detailed description of the embodiments thereof, taken in conjunction with the drawings in which: [Brief explanation of the drawings]

[0004] [Figure 1] FIG. 1 is a schematic, pictorial illustration of a catheter-based system for electrophysiological mapping and ablation, according to one embodiment of the present disclosure. [Figure 2] 1 is a schematic, pictorial illustration of a multi-electrode catheter and EA signals acquired over time, in accordance with an example of the present disclosure. [Figure 3] 1 is a schematic, pictorial illustration of a multi-electrode catheter and EA signals acquired over time, in accordance with an example of the present disclosure. [Figure 4] 3 is a flow chart that schematically illustrates a method for displaying at least a portion of the catheter of FIG. 2 and signals acquired by electrodes over time, according to an example of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0005] overview The embodiments of the present disclosure described below provide techniques for improving the presentation of multiple signals acquired in a patient's organ using multiple electrodes (e.g., a diagnostic catheter may include 48 or more electrodes to obtain a high-resolution electroanatomical map).

[0006] Electroanatomical (EA) mapping of an organ such as the heart may involve (i) moving the distal tip of a catheter within the interior volume of the heart, (ii) acquiring electrophysiological (EP) signals on the surface of the heart, and (iii) presenting the signals to a user, for example, on a three-dimensional (3D) map of the catheter and heart.

[0007] In some cases, a physician performing EA mapping may use one or more catheters with a large number of electrodes, such as Biosense Webster's OctaRay® or OPTRELL® catheters, each with approximately 48 mapping electrodes. The use of such catheters can result in an overwhelming number of signals and data for a user to interpret during an EA mapping procedure. More specifically, (i) the user must capture and analyze a large amount of data in real time, (ii) the signals presented to the user are not correlated with their location on the catheter, and (iii) conditioning and / or filtering specific signals can be time-consuming.

[0008] In some examples, such a multi-electrode catheter (e.g., an OctaRay® or OPTRELL® catheter) and a system for displaying signals acquired by the catheter over time includes an interface, a processor, and a display device, also referred to herein as a display for simplicity.

[0009] In some examples, the interface is configured to receive first and second signals from at least a first and second of the electrodes, respectively, acquired by the first and second electrodes of the catheter within the heart during a time interval.

[0010] In some examples, the processor is configured to generate a three-dimensional (3D) representation of (i) at least a portion of the catheter including at least a first electrode and a second electrode, and (ii) a first trace and a second trace corresponding to the first signal and the second signal.

[0011] In this example, the first and second traces are displayed on a display device in 3D space relative to the physical locations of the first and second electrodes on the catheter, respectively.

[0012] In some examples, the electrodes are coupled to splines on the catheter, for example, an OPTRELL® catheter has approximately six splines and approximately eight electrodes coupled to each spline. Additionally, first and second traces corresponding to the first and second signals are displayed on respective time axes that are orthogonal to the first and second electrodes, in this example.

[0013] In some examples, the processor is also configured to display at least a portion of the spline in the 3D representation and to rotate the 3D representation in response to commands received from a user (e.g., a physician wishing to view the electrodes and / or traces from different orientations). Furthermore, the processor is configured to display a plurality of selectable elements corresponding to (i) one or more splines of the catheter and (ii) at least one of the first electrode and the second electrode. When the user selects one or more of the selectable elements, the processor is configured to toggle the display of the trace (and optionally the spline and / or electrode) corresponding to the selectable element in the 3D representation. Example implementations of all of these techniques are described in detail in Figures 2 and 3 below.

[0014] In some examples, the system may provide the user with both the 3D representation described above and a two-dimensional display of an electrocardiogram (ECG) signal as known in the art. In such examples, the processor may be configured to activate or deactivate the display of traces in the 3D representation, and optionally in the 2D display of the ECG signal, in response to selecting or deselecting splines or individual electrodes in the 3D representation. In other words, the user may simultaneously turn selected signals on and off in the 3D representation and / or the 2D display of the ECG signal.

[0015] The disclosed techniques provide the user with customized presentation of any desired combination of splines, electrodes, and signals of interest, thereby allowing the user to focus on structures of interest while analyzing multiple signals acquired within a patient's organ.

[0016] System Description FIG. 1 is a schematic, pictorial illustration of a catheter-based electrophysiological mapping and ablation system 10, according to one embodiment of the present disclosure.

[0017] In some embodiments, the system 10 includes multiple catheters that are percutaneously inserted by the physician 24 through the patient's vascular system into the cavities or vasculature of the heart 12. Typically, a delivery sheath catheter is inserted into the left or right atrium near the desired location of the heart 12. One or more catheters may then be inserted into the delivery sheath catheter to reach the desired location within the heart 12. The multiple catheters may include catheters dedicated to sensing intracardiac electrogram (IEGM) signals, catheters dedicated to ablation, and / or catheters adapted for both sensing and ablation. An exemplary catheter 14 configured for sensing IEGMs is illustrated herein. In some embodiments, the physician 24 may position a distal tip 28 of the catheter 14 adjacent to or in contact with tissue of the heart wall to sense a target site in the heart 12. Additionally or alternatively, to perform ablation, the physician 24 similarly positions the distal tip 28 of an ablation catheter in contact with the target site to ablate the tissue to be ablated.

[0018] Reference is now made to inset 34, which illustrates the distal tip 28. In this example, the distal tip 28 of the catheter 14 comprises a representative (and non-limiting example) multi-spline and multi-electrode catheter, such as the OPTRELL® catheter, having approximately six splines 22, each spline having approximately eight electrodes 26 distributed along its respective spline 22. Thus, the distal tip 28 includes approximately 48 electrodes 26 configured to sense IEGM signals. The catheter 14 may additionally include a position sensor 29 embedded in or near the distal tip 28 to track the position and orientation of the distal tip 28. Optionally and preferably, the position sensor 29 is a magnetic-based position sensor including three magnetic coils for sensing three-dimensional (3D) position and orientation.

[0019] Referring again to the overall view of Figure 1, in some embodiments, the magnetic-based position sensor 29 may operate in conjunction with a location pad 25 that includes multiple (e.g., three) magnetic coils 32 configured to generate multiple (e.g., three) magnetic fields within a predetermined workspace. The real-time position of the distal tip 28 of the catheter 14 may be tracked based on the magnetic fields generated by the location pad 25 and sensed by the magnetic-based position sensor 29. Details of magnetic-based position sensing techniques are described, for example, in U.S. Patent Nos. 5,391,199, 5,443,489, 5,558,091, 6,172,499, 6,239,724, 6,332,089, 6,484,118, 6,618,612, 6,690,963, 6,788,967, and 6,892,091.

[0020] In some embodiments, system 10 includes one or more electrode patches 38 that are placed on patient 23 in skin contact to establish a location reference for location pads 25 and for impedance-based tracking of electrodes 26. For impedance-based tracking, current is directed to electrodes 26 and sensed at electrode skin patches 38, allowing the location of each electrode to be triangulated via electrode patches 38. This technique is also referred to herein as advanced current localization (ACL), and details of impedance-based location tracking techniques are described in U.S. Patent Nos. 7,536,218, 7,756,576, 7,848,787, 7,869,865, and 8,456,182. In some embodiments, magnetic-based position sensing and ACL may be applied simultaneously to improve the position sensing of, for example, one or more electrodes coupled to a flexible arm or spline on the shaft of a rigid catheter or the distal tip of another type of catheter, such as, for example, a PentaRay® or OPTRELL® catheter available from Biosense Webster, Inc. (31A Technology Drive, Irvine, CA 92618).

[0021] In some embodiments, recorder 11 displays electrograms 21 captured by body surface ECG electrodes 18 and intracardiac electrograms (IEGMs) captured by electrodes 26 on catheter 14. Recorder 11 may include pacing capability for pacing the cardiac rhythm and / or may be electrically connected to a stand-alone pacer.

[0022] In some examples, system 10 may include an ablation energy generator 50 adapted to deliver ablation energy to one or more electrodes at the distal tip of a catheter configured to ablate tissue of heart 12. The energy generated by ablation energy generator 50 may include, but is not limited to, pulse trains of radiofrequency (RF) energy or pulsed-field ablation (PFA) energy, including unipolar or bipolar high-voltage direct current pulses such as may be used to effect irreversible electroporation (IRE), or combinations thereof. In this example, catheter 14 does not include an ablation electrode, although, as described above, system 10 may include an ablation catheter (not shown) configured to apply pulse trains of RF energy and / or PFA energy to tissue in the wall of heart 12.

[0023] In some embodiments, patient interface unit (PIU) 30 is an interface configured to establish electrical communication between catheters, electrophysiology equipment, a power source, and workstation 55 to control operation of system 10. The electrophysiology equipment of system 10 may include, for example, multiple catheters, location pads 25, body surface ECG electrodes 18, electrode patches 38, ablation energy generator 50, and recorder 11. Optionally and preferably, PIU 30 additionally includes processing capabilities for implementing real-time calculations of catheter location and performing ECG calculations.

[0024] In some embodiments, the workstation 55 includes a storage device, a processor 77 with suitable random access memory or a storage device having suitable operating software stored thereon, an interface 56 configured to exchange data signals (e.g., between the processor 77 and another entity in the system 10), and user interface capabilities. The workstation 55 may optionally provide multiple functions, including: (1) modeling intracardiac anatomical structures in three dimensions (3D) and rendering a model or anatomical map 20 for display on the display device 27; (2) displaying activation sequences (or other data) compiled from recorded electrograms 21 in a representative visual display or image superimposed on the rendered anatomical map 20 on the display device 27; (3) displaying real-time positions and orientations of multiple catheters within the cardiac chambers; and (4) displaying sites of interest, such as locations where ablation energy is being or is intended to be applied, on the display device 27. In some examples, the processor 77 is configured to receive position signals from at least one of the position sensor 29 and the ACL. Based on this position signal, processor 77 is configured to track the position of distal tip 28 and display the position of distal tip 28 on map 20. One commercially available product embodying elements of system 10 is available as the CARTO™ 3 system, commercially available from Biosense Webster, Inc. (31A Technology Drive, Irvine, CA 92618).

[0025] Reference is now made to inset 31, which illustrates an example of electrograms 21 displayed on display device 27. In some examples, processor 77 is configured to display electrograms using any suitable configuration. In the example of inset 31, processor 77 presents approximately six sets 35a, 35b, 35c, 35d, 35e, and 35f of electrograms 21, each set having approximately seven electrograms 21 of bipolar signals sensed between seven respective pairs of adjacent electrodes 26 along a respective spline 22. For example, set 35a includes (i) a first electrogram 21 representing a bipolar signal measured between a first electrode 26 and a second electrode 26 along a particular spline 22, and (ii) six more electrograms 21 representing signals measured between other adjacent pairs of electrodes along the same particular spline 22. In this example, the seventh electrogram 21 represents a bipolar signal measured between the seventh electrode 26 and the eighth electrode 26, the last pair of electrodes 26 located along the same particular spline 22.

[0026] As the heart 12 beats, electrophysiological (EP) waves propagate along portions of the heart 12 to pace the heartbeat. In some examples, the processor 77 is configured to display annotations 36 on each electrogram 21 indicating the time at which an EP wave propagating due to a bipolar signal sensed between each pair of electrodes 26 was sensed.

[0027] In the example shown in inset 31, processor 77 presents physician 24 with approximately 42 electrograms 21 and approximately 42 respective annotations 36, which may be an overwhelming amount of data for physician 24 to interpret in order to identify one or more regions and / or sources of arrhythmia in heart 12. More generally, multiple electrogram traces and annotations may be displayed to physician 24 using different presentation formats that may improve physician 24's (and other users of system 10's) ability to navigate and interpret the large amounts of data collected generally by the electrodes at distal tip 28. Examples of the present disclosure, shown in Figures 2, 3, and 4 below, may provide users of system 10 with improved techniques for visualizing and analyzing data (e.g., multiple electrogram traces and annotations), thereby helping users to improve their interpretation of the data.

[0028] Display of signal traces on a 3D map of a multi-electrode catheter 2 is a schematic depiction of distal tip 28 and 3D map 40 presenting trace 33, according to one example of the present disclosure. In some examples, processor 77 is configured to present map 40 in place of map 20 shown in FIG. 1 above, such that both map 40 and electrogram 21 (of FIG. 1 above) are presented simultaneously on display device 27. In other examples, map 40 may replace electrogram 21 shown in inset 31 of FIG. 1 above.

[0029] In the example of Figure 2, trace 33 corresponds to an electrogram signal (also referred to herein for simplicity as a signal) acquired over time by electrodes 26. In the example of Figure 1 above, the signal includes a bipolar signal presented as an electrogram 21, whereas in the example of Figure 2, the signal may include (i) a unipolar signal acquired between electrode 26 and a reference electrode (e.g., body surface ECG electrode 18), or (ii) a bipolar signal acquired between any suitable pair of electrodes 26 at distal tip 28. Note that the techniques described below in Figures 2 and 3 are applicable to both unipolar and bipolar signals.

[0030] In some examples, interface 56 is configured to receive signals acquired at heart 12 from some or each of electrodes 26 during a time interval 44 depicted in map 40 along a time axis t that is typically orthogonal to each electrode 26. More specifically, during time interval 44, interface 56 may receive at least a first signal and a second signal from at least electrode 26a and electrode 26b, respectively.

[0031] In some examples, the processor 77 is configured to generate a map 40 that is a 3D representation of at least a portion of the distal tip 28, including at least electrodes 26a and 26b, and optionally selected splines 22 of the distal tip 28. In the example of FIG. 2 , the map 40 includes all splines 22 and electrodes 26 of the distal tip 28, and the processor 77 is configured to present a plurality of traces 33, including at least traces 33a and 33b (also referred to herein as first traces and second traces) corresponding to first and second signals, respectively. Note that the traces 33 are displayed on the display device 27 in 3D space relative to the physical locations of the respective electrodes 26 from which the signals were acquired. More specifically, the traces 33a and 33b are displayed in 3D space on the map 40 relative to the respective physical locations of the electrodes 26a and 26b on the splines 22 of the distal tip 28.

[0032] In some examples, the processor 77 is configured to display a plurality of selectable elements 41 and 42 within the map 40, corresponding to the selection and deselection of splines 22 and electrodes 26, respectively, of the distal tip 28. More specifically, the map 40 includes (i) selectable elements 41 for selecting and deselecting columns of electrodes 26 distributed along each spline 22, and (ii) selectable elements 42 for selecting and deselecting rows of electrodes 26 distributed across the splines 22. For example, the physician 24 can activate selectable element 41 a to select an electrode 26 distributed along spline 22 a and can deactivate selectable element 41 b to deselect an electrode 26 distributed along spline 22 b. Similarly, the physician 24 can activate selectable element 42 b to select electrode 26 b (even though spline 22 b has been deselected as described above) and can deactivate selectable element 42 a to deselect electrode 26 c.

[0033] In some examples, based on selections made by physician 24, processor 77 is configured to toggle the display of traces 33 corresponding to splines and / or electrodes selected by physician 24. For example, traces 33a and 33b corresponding to signals received from electrodes 26a and 26b, respectively, are presented on map 40, while in response to deselection of electrode 26c, processor 77 does not present the corresponding trace 33 on map 40. Additionally, processor 77 is configured to present annotations 36 on at least some of the selected traces 33.

[0034] In this example, the annotation 36 descends along the virtual vector 37. In some examples, based on presentation of the annotation 36 and the virtual vector 37, the processor 77 is configured to present, for example, on a map of the distal tip 28, a vector 39 that is approximately parallel to the virtual vector 37 and indicates the direction of propagation of the EP wave relative to the splines 22 and electrodes 26 of the distal tip 28.

[0035] In some examples, processor 77 is configured to display a tag indicating vector 39 on map 20 (shown in FIG. 1 above) of heart 12 based on the position and orientation of distal tip 28 (obtained using the position signals described in FIG. 1 above). Additionally or alternatively, processor 77 may present map 20 and map 40 overlaid on one another to correlate the position and orientation of vector 39 with the position of distal tip 28 within heart 12.

[0036] 3 is a schematic depiction of a 3D map 60 presenting distal tip portion 28 and trace 33, according to another example of the present disclosure. Map 60 can replace, for example, at least one of map 40 of FIG. 2 above, map 20 of FIG. 1 above, and electrogram 21 shown in inset 31 of FIG. 1 above.

[0037] In the context of this disclosure and in the claims, map 20 (of FIG. 1), map 40 (of FIG. 2), and map 60 (of FIG. 3) are also referred to herein as 3D representations of at least one of traces 33, electrodes 26, and splines 22.

[0038] In some examples, the processor 77 is configured to rotate the 3D representation, which may include at least a portion of the splines 22, electrodes 26, and optionally corresponding traces 33 and annotations 36, in response to commands received from the physician 24 (or any other user). For example, the physician 24 can use a suitable input device, such as a mouse, trackball, or keyboard(s), to rotate the distal tip 28 and corresponding traces 33 and annotations 36 to view particular electrodes 26, traces 33, and annotations 36 from a different orientation (e.g., compared to that shown in FIG. 2 above). Rotation can occur in a direction 46 about a vertical axis 45, a direction 48 about a horizontal axis 47, and combinations of directions 46 and 48.

[0039] Additionally or alternatively, in response to commands received from physician 24 (or any other user), processor 77 is configured to perform various operations, such as, but not limited to, (i) displaying selected portions of one or more traces 33 (e.g., using checkboxes), (ii) adjusting the amplitude of selected traces 33, (iii) zooming in and / or out on particular portions of distal tip 28 and traces 33, and (iv) removing and / or adjusting the position of selected annotations 36. For example, physician 2 may adjust the amplitude of a signal received from at least one of electrodes 26, and in response, processor 77 is configured to adjust the amplitude of at least one of traces 33 corresponding to the adjusted signal(s).

[0040] In some examples, processor 77 is configured to simultaneously display (i) a 3D representation (e.g., map 40 or map 60) and (ii) a 2D display of the electrogram signal, such as the display of electrogram 21 shown in inset 31 of FIG. 1 above. In such examples, processor 77 is configured to activate or deactivate the display of each trace 33 in the 3D representation (as described in FIG. 2 above) and, optionally, in the 2D display of electrogram 21 of FIG. 1 above, in response to physician 24 selecting or deselecting splines 22 or individual electrodes 26 in the 3D representation. In other words, physician 24 can simultaneously turn on and off selected ones of (i) traces 33 in the 3D representation and (ii) electrograms 21 in the 2D display.

[0041] FIG. 4 is a flowchart that schematically illustrates a method for displaying at least a portion of a distal tip 28 and a trace 33 showing signals acquired by corresponding electrodes 26 over a time interval 44, according to an example of the present disclosure.

[0042] The method begins at step 100, where processor 77 receives signals acquired from electrodes 26 during time interval 44, as described in detail above in FIG.

[0043] In a 3D view generation step 102, the processor 77 generates a map 40 including a 3D representation of at least a portion of the distal tip 28 having at least electrodes 26a and 26b and at least traces 33a and 33b corresponding to signals received from electrodes 26a and 26b, respectively, as described in detail in FIG. 2 above.

[0044] In a display step 104, which concludes the method, the processor 77 displays, for example on the display device 27, at least traces 33a and 33b in 3D space for the respective physical positions of at least electrodes 26a and 26b, as described in detail in Figure 2 above.

[0045] In some examples, the processor 77 is configured to display annotations 36 and vectors 39 indicating the direction of EP wave propagation relative to the splines 22 and electrodes 26 of the distal tip 28, as shown and described above in Figure 2. Additionally, the processor 77 is configured to display selectable elements 41 and 42 corresponding to the selection and deselection, respectively, of the splines 22 and electrodes 26 of the distal tip 28, thereby allowing the physician 24 to select or deselect the traces 33 they wish to view in the map 40, as described above in Figure 2.

[0046] In some examples, in response to commands received from the physician 24 (or any other user), the processor 77 may perform various operations, such as, but not limited to, (i) displaying selected portions of one or more traces 33 (e.g., using checkboxes), (ii) adjusting the amplitude of selected traces 33, (iii) zooming in and / or out on particular portions of the distal tip 28 and traces 33, (iv) removing and / or adjusting the position of selected annotations 36, and (v) rotating the 3D representation of the distal tip 28, traces 33, and annotations 36 in three dimensions, as described in detail in FIG. 3 above.

[0047] While the examples described herein primarily relate to techniques for dynamically varying the transparency level of sub-volumes within a patient's heart during an electrophysiology (EP) procedure, the methods and systems described herein may also be used in other applications, such as dynamically displaying the interior volume or surface of any other suitable organ of a patient. [Example]

[0048] The system 10 includes an interface 56 and a processor 77. The interface is configured to receive first and second signals from at least first and second electrodes 26 a, 26 b, respectively, acquired over at least an interval 44 by at least first and second electrodes of a catheter 14 at an organ 12 of a patient 23. The processor is configured to generate a three-dimensional (3D) representation 40 of at least a portion of the catheter and first and second traces 33 a, 33 b corresponding to the first and second signals, the first and second traces being displayed in 3D space relative to the physical locations of the first and second electrodes 26 a, 26 b on the catheter. [Example]

[0049] 2. The system of example 1, wherein a first trace and a second trace corresponding to the first signal and the second signal, respectively, are displayed on respective time axes orthogonal to the first electrode and the second electrode. [Example]

[0050] A system described in any of Examples 1 and 2, wherein the processor is configured to display one or more splines of a catheter including at least a first electrode and a second electrode in the 3D representation. [Example]

[0051] 4. The system of example 3, wherein the processor is configured to rotate the 3D representation in response to instructions received from a user. [Example]

[0052] The system of Example 3, wherein the processor is configured to display (i) one or more splines and (ii) a plurality of selectable elements corresponding to at least one of the first electrode and the second electrode, and the processor is configured to switch the display of (i) the one or more splines and (ii) at least one of the first electrode and the second electrode corresponding to the selectable elements in the 3D representation in response to a user selection of one or more of the plurality of selectable elements. [Example]

[0053] The system of Example 5, wherein the processor is configured to switch the display of at least one of the first trace and the second trace in response to a user selection, respectively, to switch the display of at least one of the first electrode and the second electrode. [Example]

[0054] The system of Example 6, wherein the processor is configured to generate two-dimensional (2D) representations of at least a first electrogram and a second electrogram showing at least the first signal and the second signal, and the processor is configured to switch the display of at least one of the first electrogram and the second electrogram in response to a selection by a user, respectively, to switch the display of at least one of the first trace and the second trace. [Example]

[0055] 3. The system of any of Examples 1 and 2, wherein the time interval includes a first time and a second time during which an electrophysiological (EP) wave propagates through the tissue and is sensed by the first electrode and the second electrode, respectively, and wherein the processor is configured to display at least a first annotation and a second annotation on the first trace and the second trace, respectively, indicating the first time and the second time. [Example]

[0056] The system of Example 8, wherein the processor is configured to display on the 3D display a vector indicating the direction of the EP wave propagating through the tissue between at least the first electrode and the second electrode based on at least the first annotation and the second annotation. [Example]

[0057] 2. The system of claim 1, wherein the processor is configured to adjust a trace amplitude of at least one of the first trace and the second trace in response to receiving an adjustment of the signal amplitude of at least one of the first signal and the second signal, respectively. [Example]

[0058] receiving first and second signals from at least a first electrode and a second electrode (26a, 26b), respectively, acquired over at least a time interval (44) by at least a first electrode and a second electrode of a catheter (14) at an organ (12) of a patient (23); generating a three-dimensional (3D) representation (40) of at least a portion of the catheter and first and second traces (33a, 33b) corresponding to the first and second signals; and displaying the first and second traces (33a, 33b) in 3D space relative to the physical locations of the first and second electrodes (26a, 26b) on the catheter, respectively.

[0059] It will be understood that the above-described embodiments are given by way of example, and that the present disclosure is not limited to what is particularly shown and described hereinabove. Rather, the scope of the present disclosure includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that would occur to one 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 are to be considered an integral part of this application, provided that, to the extent that any term in these incorporated documents is defined in a manner that contradicts a definition expressly or implicitly made herein, only the definition herein shall be considered.

[0060] [Embodiment] (1) an interface configured to receive first and second signals from at least a first electrode and a second electrode of a catheter, respectively, acquired over at least a certain time interval by the at least a first electrode and a second electrode of the catheter in an organ of a patient; and a processor configured to generate a three-dimensional (3D) representation of at least a portion of the catheter and a first trace and a second trace corresponding to the first signal and the second signal, wherein the first trace and the second trace are displayed in 3D space relative to the physical positions of the first electrode and the second electrode on the catheter, respectively. (2) The system described in embodiment 1, wherein the first trace and the second trace corresponding to the first signal and the second signal are displayed on respective time axes perpendicular to the first electrode and the second electrode, respectively. (3) The system of embodiment 1, wherein the processor is configured to display one or more splines of the catheter including at least the first electrode and the second electrode in the 3D representation. (4) The system of embodiment 3, wherein the processor is configured to rotate the 3D representation in response to an instruction received from a user. (5) The system of embodiment 3, wherein the processor is configured to display a plurality of selectable elements corresponding to (i) the one or more splines and (ii) at least one of the first electrode and the second electrode, and wherein the processor is configured to switch display of (i) the one or more splines and (ii) at least one of the first electrode and the second electrode corresponding to the selectable elements in the 3D representation in response to a selection of one or more of the plurality of selectable elements by the user.

[0061] (6) The system of embodiment 5, wherein the processor is configured to switch the display of at least one of the first trace and the second trace in response to the selection by the user, and to switch the display of at least one of the first electrode and the second electrode, respectively. (7) The system of embodiment 6, wherein the processor is configured to generate two-dimensional (2D) representations of at least a first electrogram and a second electrogram showing at least the first signal and the second signal, and wherein the processor is configured to switch the display of at least one of the first electrogram and the second electrogram in response to the selection by the user, respectively, to switch the display of at least one of the first trace and the second trace. (8) The system of embodiment 1, wherein the time interval includes a first time and a second time during which an electrophysiological (EP) wave propagates through tissue and is sensed by the first electrode and the second electrode, respectively, and the processor is configured to display at least a first annotation and a second annotation on the first trace and the second trace, respectively, indicating the first time and the second time. (9) The system described in embodiment 8, wherein the processor is configured to display on the 3D display a vector indicating the direction of the EP wave propagating through tissue between at least the first electrode and the second electrode based on at least the first annotation and the second annotation. (10) The system of embodiment 1, wherein the processor is configured to adjust a trace amplitude of at least one of the first trace and the second trace in response to receiving an adjustment of the signal amplitude of at least one of the first signal and the second signal, respectively.

[0062] (11) receiving first and second signals from at least a first electrode and a second electrode of a catheter, respectively, acquired over at least a certain time interval by the at least a first electrode and a second electrode of the catheter in an organ of the patient; generating a three-dimensional (3D) representation of at least a portion of the catheter and first and second traces corresponding to the first and second signals; and displaying the first trace and the second trace, respectively, in 3D space relative to the physical locations of the first electrode and the second electrode on the catheter. (12) The method of embodiment 1, wherein displaying the first trace and the second trace corresponding to the first signal and the second signal includes displaying the first trace and the second trace, respectively, on respective time axes orthogonal to the first electrode and the second electrode. (13) The method of embodiment 11, further comprising displaying one or more splines of the catheter including at least the first electrode and the second electrode in the 3D representation. (14) The method of embodiment 13, wherein displaying the first trace and the second trace includes rotating the 3D representation in response to a command received from a user. (15) A method as described in embodiment 13, comprising: displaying a plurality of selectable elements corresponding to (i) the one or more splines and (ii) at least one of the first electrode and the second electrode; and switching the display of (i) the one or more splines and (ii) at least one of the first electrode and the second electrode corresponding to the selectable elements in the 3D representation in response to the user selecting one or more of the plurality of selectable elements.

[0063] (16) The method of embodiment 15, comprising switching the display of at least one of the first trace and the second trace in response to switching the display of at least one of the first electrode and the second electrode, respectively, in response to the selection by the user. (17) The method of embodiment 16, comprising generating two-dimensional (2D) representations of at least a first electrogram and a second electrogram showing at least the first signal and the second signal, and switching the display of at least one of the first electrogram and the second electrogram in response to the selection by the user, respectively, of at least one of the first trace and the second trace. (18) The method of embodiment 11, wherein the time interval includes a first time and a second time during which an electrophysiological (EP) wave propagates through tissue and is sensed by the first electrode and the second electrode, respectively, and further comprising displaying at least a first annotation and a second annotation on the first trace and the second trace, respectively, indicating the first time and the second time. (19) The method described in embodiment 18, comprising displaying on the 3D display a vector indicating the direction of the EP wave propagating through tissue between at least the first electrode and the second electrode based on at least the first annotation and the second annotation. (20) The method of embodiment 11, wherein displaying the first trace and the second trace includes adjusting a trace amplitude of at least one of the first trace and the second trace in response to receiving an adjustment of a signal amplitude of at least one of the first signal and the second signal.

Claims

1. an interface configured to receive first and second signals from at least a first electrode and a second electrode of a catheter, respectively, acquired at an organ of a patient by the at least a first electrode and a second electrode of the catheter over at least a certain time interval; and a processor configured to generate a three-dimensional (3D) representation of at least a portion of the catheter and a first trace and a second trace corresponding to the first signal and the second signal, wherein the first trace and the second trace are displayed in 3D space relative to the physical positions of the first electrode and the second electrode on the catheter, respectively.

2. 2. The system of claim 1, wherein the first trace and the second trace corresponding to the first signal and the second signal, respectively, are displayed on respective time axes orthogonal to the first electrode and the second electrode.

3. The system of claim 1 , wherein the processor is configured to display one or more splines of the catheter including at least the first electrode and the second electrode in the 3D representation.

4. The system of claim 3 , wherein the processor is configured to rotate the 3D representation in response to instructions received from a user.

5. 4. The system of claim 3, wherein the processor is configured to display a plurality of selectable elements corresponding to (i) the one or more splines and (ii) at least one of the first electrode and the second electrode, and wherein the processor is configured to toggle display of (i) the one or more splines and (ii) at least one of the first electrode and the second electrode corresponding to the selectable elements in the 3D representation in response to a selection of one or more of the plurality of selectable elements by the user.

6. 6. The system of claim 5, wherein the processor is configured to switch the display of at least one of the first trace and the second trace in response to the selection by the user and to switch the display of at least one of the first electrode and the second electrode, respectively.

7. 7. The system of claim 6, wherein the processor is configured to generate two-dimensional (2D) representations of at least a first electrogram and a second electrogram representing at least the first signal and the second signal, and wherein the processor is configured to switch the display of at least one of the first electrogram and the second electrogram in response to the selection by the user, respectively, to switch the display of at least one of the first trace and the second trace.

8. 8. The system of claim 1, wherein the time interval includes a first time and a second time during which an electrophysiological (EP) wave propagates through tissue and is sensed by the first electrode and the second electrode, respectively, and wherein the processor is configured to display at least first and second annotations on the first and second traces, respectively, indicating the first and second times.

9. 9. The system of claim 8, wherein the processor is configured to display, on the 3D display, a vector indicating a direction of the EP wave propagating through tissue between at least the first electrode and the second electrode based on at least the first annotation and the second annotation.

10. 8. The system of claim 1, wherein the processor is configured to adjust a trace amplitude of at least one of the first trace and the second trace in response to receiving an adjustment of a signal amplitude of at least one of the first signal and the second signal, respectively.

11. receiving first and second signals from at least a first electrode and a second electrode of a catheter, respectively, acquired at an organ of a patient by the at least a first electrode and a second electrode of the catheter over at least a certain time interval; generating a three-dimensional (3D) representation of at least a portion of the catheter and first and second traces corresponding to the first and second signals; and displaying the first trace and the second trace, respectively, in 3D space relative to the physical locations of the first electrode and the second electrode on the catheter.

12. 12. The method of claim 11 , wherein displaying the first trace and the second trace corresponding to the first signal and the second signal comprises displaying the first trace and the second trace, respectively, on respective time axes orthogonal to the first electrode and the second electrode.

13. The method of claim 11 , comprising displaying one or more splines of the catheter including at least the first electrode and the second electrode in the 3D representation.

14. The method of claim 13 , wherein displaying the first trace and the second trace comprises rotating the 3D representation in response to commands received from a user.

15. 14. The method of claim 13, comprising: displaying a plurality of selectable elements corresponding to (i) the one or more splines and (ii) at least one of the first electrode and the second electrode; and, in response to the user selecting one or more of the plurality of selectable elements, toggling display of (i) the one or more splines and (ii) at least one of the first electrode and the second electrode that correspond to the selectable elements in the 3D representation.

16. 16. The method of claim 15, comprising switching the display of at least one of the first trace and the second trace in response to switching the display of at least one of the first electrode and the second electrode in response to the selection by the user, respectively.

17. 17. The method of claim 16, comprising generating two-dimensional (2D) representations of at least a first electrogram and a second electrogram indicative of at least the first signal and the second signal, and switching the display of at least one of the first electrogram and the second electrogram in response to the selection by the user, respectively, of at least one of the first trace and the second trace.

18. 18. The method of claim 11, wherein the time interval comprises a first time and a second time during which an electrophysiological (EP) wave propagates through tissue and is sensed by the first electrode and the second electrode, respectively, and further comprising displaying at least first and second annotations on the first and second traces, respectively, indicating the first and second times.

19. 20. The method of claim 18, comprising displaying on the 3D display a vector indicating a direction of the EP wave propagating through tissue between at least the first electrode and the second electrode based on at least the first annotation and the second annotation.

20. 18. The method of claim 11, wherein displaying the first trace and the second trace comprises adjusting a trace amplitude of at least one of the first trace and the second trace in response to receiving an adjustment of a signal amplitude of at least one of the first signal and the second signal, respectively.

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