Fast Anatomical Mapping (FAM) Reconstruction Using Surface Update Constraints

Abstract

To provide methods for fast anatomical mapping reconstruction.SOLUTION: A method includes presenting, on a display, an electroanatomical (EA) map of a surface of a cavity of an organ. Input is received from a user, and, in response to the user input, a region of the EA map is locked until subsequent updates.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates generally to electroanatomical (EA) mapping, and more specifically to compiling cardiac EA maps. [Background technology]

[0002] Software-based editing tools to aid in the analysis of electroanatomically mapped organs have been proposed in the patent literature before. For example, US Patent Application Publication No. 2017 / 0325891 describes a method aimed at generating a three-dimensional surface representation of an anatomical structure, such as a cardiac chamber. More specifically, the three-dimensional surface representation of the anatomical structure is constrained to one or more anchor portions that correspond to received input regarding the location of anatomical features of the anatomical structure. The resulting three-dimensional surface representation includes the salient features of the anatomical structure and thus may be useful as a visualization tool during any of a variety of different medical procedures, including, for example, cardiac ablation. Summary of the Invention [Means for solving the problem]

[0003] Certain embodiments of the invention described below provide a method that includes presenting, on a display, an electroanatomical (EA) map of a surface of an organ cavity, where input is received from a user and, in response to the user input, a region of the EA map is locked until a subsequent update.

[0004] In some embodiments, locking the region includes preventing subsequent manual editing of the EA map.

[0005] In some embodiments, locking a region includes ignoring subsequently acquired data points that belong to the region.

[0006] In other embodiments, locking the region includes preventing subsequent updates in a predetermined proximity of the anatomical feature in the EA map.

[0007] In one embodiment, the EA map includes an EA map of the left atrium and the anatomical feature is a pulmonary vein.

[0008] In another embodiment, locking the region is performed in response to determining that the data points within the region were acquired by the probe while applying excessive force to the surface.

[0009] In some embodiments, the method further includes manually editing the unlocked regions of the EA map to remove extraneous data points in the unlocked regions.

[0010] In some embodiments, the method further includes unlocking the locked region. The unlocked region of the EA map is manually edited to remove extraneous data points in the unlocked region, and the manually edited region is relocked.

[0011] According to another embodiment of the present invention, there is further provided a system including a display and a processor, the display configured to present an electroanatomical (EA) map of a surface of the organ cavity, the processor configured to receive input from a user and, in response to the user input, to lock a region of the EA map until a subsequent update. [Brief description of the drawings]

[0012] The invention will be more fully understood from consideration of the following detailed description taken in conjunction with the drawings, in which: [Figure 1] FIG. 1 is a schematic, depiction of a system for electroanatomical (EA) mapping, in accordance with an exemplary embodiment of the present invention. [Diagram 2] FIG. 2 is a schematic schematic illustration of a reconstructed electroanatomical (EA) map of the left atrium generated with surface update constraints, in accordance with an exemplary embodiment of the present invention; [Diagram 3]3 is a flow chart that generally illustrates a method for generating the reconstructed electroanatomical (EA) map of FIG. 2, in accordance with an exemplary embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0013] Overview The interior of a patient's organ, such as a heart chamber, may be mapped (e.g., electroanatomically mapped) using a mapping catheter having one or more suitable sensors attached to a distal end for mapping within the organ. Using position signals generated by the various sensors, a processor may calculate sensor locations within the organ (e.g., a heart chamber). Using the calculated locations, the processor may further derive an anatomical map of the cavity surface.

[0014] For example, in fast anatomical mapping (FAM) of the ventricle, point locations on the interior surface of the cavity are delineated using acquired electroanatomical (EA) data. However, undesired catheter locations may also be acquired and automatically added to the FAM-constructed cavity surface during FAM reconstruction. Examples of such undesired data points include distorted cavity wall locations due to being pushed outward by the catheter, incorrect wall locations due to respiratory-induced motion, locations erroneously measured inside the cavity instead of on the surface, and irrelevant catheter locations, e.g., locations outside the mapping area of ​​interest.

[0015] The accumulation of such undesired positions affects the accuracy of the reconstructed EA map. To address these inaccuracies, during or after acquisition, the physician, or a specialist assisting the physician, may manually edit the surface generated from the acquired points to correct the errors. This manual editing typically involves erasing data points and / or removing entire portions ("shaving") from the computed surface. However, this manual editing is a time-consuming process.

[0016] Exemplary embodiments of the invention described herein reduce the amount of manual editing required by "locking" regions (e.g., areas) of the surface of the EA map that are presented to a user so that these areas will not be further edited (e.g., to prevent automatic updates and / or manual editing of regions of the EA map).

[0017] In disclosed exemplary embodiments, a user interface is provided that allows a user to provide input to instruct the mapping system to, for example, lock areas of the EA map that are displayed on the display until a subsequent update. For example, in response to the user input, the system's processor ignores subsequently captured data points that belong to that area. In some exemplary embodiments, FAM-generated areas of the map that are deemed good enough are "locked" by the user so that they are not further automatically updated by the mapping application, thus preventing the accumulation of new errors in these areas.

[0018] Examples of areas that may be locked include: A surface part that has already been manually edited. Further auto capture in that area will be ignored, but the area can still be manually edited. Captured: the measured catheter contact force is deemed to be above a predefined threshold (indicating that the catheter is locally pressing the wall tissue into a distorted position). Captured points are ignored and not used to construct the surface. Specific areas on the map that are deemed to have a good representation of the anatomy after the initial FAM mapping. An example of such an area is around the pulmonary vein ostium in an EA map of the left atrium of the heart.

[0019] In some exemplary embodiments, the disclosed user interface includes a control configured to cancel an existing update restriction. For example, a special edit mode is activated (e.g., as a keyboard button) to allow data point updates even within a locked area, e.g., within a immediately adjacent locked area. The edit mode may also be provided as a new acquisition mode within the FAM tool user interface. As another example, a separate control (e.g., a computer mouse) may be actuated to manually select a "locked" area on the surface and disable ("unlock") its update restriction. An additional control knob, such as another keyboard button, may be used to toggle the entire update restriction mode on or off.

[0020] The disclosed FAM surface update limiting techniques may assist physicians in preparing EA maps, and thus may help facilitate, expedite, and improve the quality of complex diagnostic tasks performed during diagnostic catheterization procedures that rely on accurate EA maps generated during the procedure. Another advantage of the disclosed FAM surface update limiting techniques is that editing (e.g., shaving) time is reduced for the map, or for each portion of the supplemental data (e.g., volume) used to construct the map.

[0021] System Description FIGURE 1 is a schematic, pictorial diagram of a system 21 for electroanatomical (EA) mapping, in accordance with an exemplary embodiment of the present invention. FIGURE 1 shows a physician 27 using a Pentaray® EA mapping catheter 29 to perform EA mapping of a heart 23 of a patient 25. The catheter 29 comprises at its distal end one or more arms 20, which may be mechanically flexible, with one or more electrodes 22 coupled to each arm. During the mapping process, the electrodes 22 acquire and / or inject unipolar and / or bipolar signals from and / or to the tissue of the heart 23.

[0022] A processor 28 in the console 30 receives these signals via electrical interface 35 and uses the information contained in these signals to construct an EA map 40, which is stored by the processor 28 in memory 33. During and / or after the procedure, the processor 28 may display the EA map 40 on the display 26. User controls 32 of the user interface 100 allow the physician 27 to communicate with the processor 28 to lock portions of the EA map 40 to prevent further updates, as described above. The controls 32 may include, for example, a trackball and control knobs, as well as a keyboard. Other elements of the user interface 100 may include touch screen functionality of the display 26.

[0023] During the procedure, a tracking system can be used to track the location of each of the sensing electrodes 22, thereby associating each of the signals with the location where the signal was obtained. For example, the Active Current Location (ACL) system from Biosense-Webster (Irvine, California), described in U.S. Pat. No. 8,456,182, the disclosure of which is incorporated herein by reference, may be used. In the ACL system, a processor estimates the location of each of the electrodes based on the impedance measured between each of the sensing electrodes 22 and a number of surface electrodes 24 coupled to the skin of the patient 25. For example, three surface electrodes 24 may be coupled to the patient's chest and another three surface electrodes may be coupled to the patient's back. For ease of illustration, only one surface electrode 24 is shown in FIG. 1. A current is applied between the electrodes 22 and the surface electrodes 24 inside the heart 23 of the patient 25. The processor 28 calculates the estimated location of all the electrodes 22 within the patient's heart 23 based on the ratio between the current amplitudes (or between the impedances indicated by these amplitudes) measured at the surface electrodes 24 and the known locations of the electrodes 24 on the patient's body. In this way, processor 28 can associate any given impedance signal received from electrode 22 with the location at which the signal was obtained.

[0024] The illustration shown in FIG. 1 is chosen solely for the purpose of conceptual clarity. Other tracking methods may be used, such as methods based on measuring voltage signals. Other types of sensing catheters, such as the Lasso® catheter (Biosense Webster), may equally be employed. A contact sensor may be attached to the distal end of the EA mapping catheter 29. As mentioned above, other types of electrodes, such as electrodes used for ablation, may be attached to electrodes 22 for acquiring the required position data and utilized in a similar manner. Thus, in this case, the ablation electrodes used to collect the position data are considered to be the sensing electrodes. In an optional exemplary embodiment, the processor 28 is further configured to indicate the quality of physical contact between each of the electrodes 22 and the inner surface of the heart chamber during the measurement.

[0025] Processor 28 typically comprises a general-purpose computer with software programmed to carry out the functions described herein. In particular, processor 28 executes dedicated algorithms such as those disclosed herein, including in FIG. 3, that enable processor 28 to perform the disclosed steps, as further described below. The software may be downloaded in electronic form to the computer, for example over a network, or alternatively or additionally may be provided and / or stored on a non-transitory tangible medium, such as a magnetic, optical or electronic memory.

[0026] FAM reconstruction with surface update constraints 2 is a schematic diagram of a reconstructed electroanatomical (EA) map 40 of the left atrium generated with surface update constraints, according to an exemplary embodiment of the present invention. Map 40 includes various areas, some of which are amenable to automatic updates according to new data points captured during the mapping process shown in FIG. 1, such as the area within region 50. Area 60 of EA map 40 is deemed sufficiently representative of the anatomy, and therefore region 60, which is the EA mapping surface of the pulmonary vein ostium, is locked for further editing by the physician. Map 50 further includes area 55, which has been previously manually edited and subsequently locked.

[0027] As shown, areas having different status (e.g., locked or actively updated) may be graphically highlighted, for example with different shading or texture, so that the physician can easily follow the progress of the EA mapping.

[0028] 2 is for clarity of explanation only. In other exemplary embodiments, EA map 40 may include additional information, such as, for example, values ​​of electrophysiological potentials and cardiac activation times.

[0029] Figure 3 is a flow chart that generally illustrates a method for generating the reconstructed electroanatomical (EA) map 40 of Figure 2 (i.e., with surface update constraints) in accordance with an exemplary embodiment of the present invention. The algorithm, in accordance with the presented embodiment, performs a process that begins in step 70 with the processor 28 presenting to the user the EA map 40, which is also subject to automatic updating by the processor 28 as the processor analyzes newly acquired data points and adds them to the EP map 40.

[0030] In a manual editing step 72, using the user interface 100, the physician 27 edits a region of the map 40, for example, by erasing erroneous data points that distort the presented anatomical shape. Then, in a locking step 74, the physician 27 locks an edited area, such as area 55, to prevent it from being updated with newly captured erroneous data points. To lock a region, the physician 27 uses the control tools 32 of the user interface 100 to select the area and change its status.

[0031] In an additional locking step 76, the physician 27 examines the map area that is being actively updated. To avoid extensive manual editing to eliminate distorting data points (as is done in step 72), the physician locks areas until update with data points that the processor 28 determines are erroneous because they were acquired while the catheter was exerting excessive contact force on the wall tissue (e.g., force exceeding a pre-specified value was exerted on the cavity surface). Finally, in step 78, the physician 27 locks the edits in regions 60 proximate to the pulmonary vein ostium after determining that the additional data points in those regions are not significant enough to justify the potential need to manually edit those regions of the EA map.

[0032] The example flow chart shown in Figure 3 has been selected solely for the purposes of conceptual clarity, and in optional exemplary embodiments, various additional steps may be implemented, for example, to automatically register additional layers, such as medical images.

[0033] Although the embodiments described herein primarily address cardiac applications, the methods and systems described herein may also be used in other applications, such as anatomical mapping of cavities in other organs of the body. In general, the disclosed update constraining techniques may be used in any application that utilizes a geometric map reconstruction algorithm that is incremental, i.e., that supports local reconstruction updates.

[0034] It will therefore be understood that the above-described embodiments are cited by way of example, and that the present invention is not limited to what has been particularly shown and described above. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described in the above specification, 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 as part of this application, except that if any term is defined in these incorporated documents in a manner that is inconsistent with the definition expressly or impliedly given herein, then only the definition in this specification shall be considered.

[0035] [Embodiment] (1) A method for rapid anatomical mapping reconstruction, comprising: presenting on the display an electroanatomical (EA) map of a surface of the organ cavity; Receiving input from a user; and in response to the user input, locking a region of the EA map until a subsequent update. (2) The method of embodiment 1, wherein locking the region includes preventing subsequent manual editing of the EA map. (3) The method of claim 1, wherein locking the region includes ignoring subsequently acquired data points that belong to the region. (4) The method of embodiment 1, wherein locking the region includes preventing subsequent updates in a predetermined proximity to an anatomical feature in the EA map. (5) The method of embodiment 3, wherein the EA map includes an EA map of the left atrium and the anatomical feature is a pulmonary vein.

[0036] (6) The method of embodiment 1, wherein locking the region is performed in response to determining that data points within the region were acquired by the probe while applying excessive force to the surface. (7) The method of embodiment 1, comprising manually editing unlocked regions of the EA map to remove irrelevant data points within the unlocked regions. (8) unlocking the locked region; and manually editing the unlocked region of the EA map to remove extraneous data points within the unlocked region; and relocking the manually edited region. (9) A system for rapid anatomical mapping and reconstruction, comprising: a display configured to present an electroanatomical (EA) map of a surface of the organ cavity; a processor configured to receive input from a user and, in response to the user input, lock a region of the EA map until a subsequent update. (10) The system of embodiment 9, wherein the processor is configured to lock the region by preventing subsequent manual editing of the EA map.

[0037] (11) The system of embodiment 9, wherein the processor is configured to lock the region by ignoring subsequently acquired data points that belong to the region. (12) The system of embodiment 9, wherein the processor is configured to lock the region by preventing subsequent updates in a predetermined proximity to an anatomical feature in the EA map. (13) The system of embodiment 12, wherein the EA map includes an EA map of the left atrium and the anatomical feature is a pulmonary vein. (14) The system of claim 9, wherein the processor is configured to lock the region in response to determining that data points within the region were acquired by the probe while applying excessive force to the surface. (15) The system of embodiment 9, wherein the processor is configured to receive further user input to manually edit unlocked regions of the EA map to remove irrelevant data points within the unlocked regions.

[0038] (16) The processor, unlocking said locked region; receiving further user input to manually edit the unlocked region of the EA map to remove extraneous data points within the unlocked region; and relocking the manually edited region.

Claims

1. 1. A method of operating a system, including a processor, for rapid anatomical mapping reconstruction, comprising: the processor presenting on a display an electroanatomical (EA) map of a surface of the organ cavity; the processor receiving input from a user; the processor, in response to the user input, locking a region of the EA map until a subsequent update; and locking the region by the processor includes the processor preventing subsequent updates in a predetermined region proximate an anatomical feature in the EA map. The method, wherein the EA map includes an EA map of the left atrium and the anatomical feature is a pulmonary vein.

2. The method of claim 1, wherein the processor locking the region includes the processor preventing subsequent manual editing of the EA map.

3. The method of claim 1, wherein the processor locking the region includes the processor ignoring subsequently captured data points that belong to the region.

4. The method of claim 1, wherein the processor locks the region in response to the processor determining that data points within the region were acquired by the probe while applying excessive force to the surface.

5. The method of claim 1, further comprising: receiving a further user input from the processor to remove extraneous data points in an unlocked region of the EA map; and The method of claim 1 , further comprising the processor removing the extraneous data points.

6. The processor unlocking the locked region; and receiving further user input to remove extraneous data points within the unlocked region of the EA map; the processor removing the extraneous data points; The method of claim 1 , further comprising the processor relocking the unlocked region.

7. 1. A system for rapid anatomical mapping reconstruction, comprising: a display configured to present an electroanatomical (EA) map of a surface of the organ cavity; a processor configured to receive input from a user and, in response to the user input, lock a region of the EA map until a subsequent update; the processor is configured to lock a predetermined region proximate an anatomical feature in the EA map by preventing subsequent updates in the region; The EA map includes an EA map of a left atrium and the anatomical feature is a pulmonary vein.

8. The system of claim 7 , wherein the processor is configured to lock the region by preventing subsequent manual editing of the EA map.

9. The system of claim 7 , wherein the processor is configured to lock the region by ignoring subsequently acquired data points that belong to the region.

10. 8. The system of claim 7, wherein the processor is configured to lock the region in response to determining that data points within the region were acquired by the probe while applying excessive force to the surface.

11. 8. The system of claim 7, wherein the processor is configured to receive further user input to manually edit unlocked regions of the EA map to remove extraneous data points within the unlocked regions.

12. The processor, unlocking said locked region; receiving further user input to manually edit the unlocked region of the EA map to remove extraneous data points within the unlocked region; and re-locking the manually edited region.

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