Real-time evaluation of rejection filters during cardiac mapping.

Abstract

To provide a cardiac diagnostic and therapeutic system.SOLUTION: A system includes a display and a processor. The processor is configured to (a) receive multiple electrophysiological (EP) signals acquired by multiple electrodes of a multi-electrode catheter that are in contact with tissue of a cardiac chamber, (b) reject one or more of the EP signals using a set of rejection criteria, and further process the EP signals that are not rejected, and visualize to a user, on the display, (i) a current setting of the rejection criteria, and (ii) a rejection effectiveness of each of the rejection criteria in the current setting.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates generally to cardiac electrophysiological (EP) mapping, and more particularly to a graphical user interface (GUI) for cardiac EP mapping. [Background technology]

[0002] Various techniques for visually analyzing EP data have been reported in the patent literature. For example, U.S. Pat. No. 8,478,393 describes a method for visualization of electrophysiological data representing electrical activity on the surface of an organ over a period of time. An interval within this period is selected according to a user's selection. In response to the user's selection of the interval, a visual representation of the physiological information for the user-selected interval is generated by applying at least one method to the data. This visual representation is spatially represented on a graphical representation of a predetermined region of the organ's surface. Summary of the Invention [Means for solving the problem]

[0003] Embodiments of the invention described below provide a system including a display and a processor configured to (a) receive a plurality of electrophysiological (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a cardiac chamber, (b) reject one or more of the EP signals using a set of rejection criteria, further process EP signals that are not rejected, and visualize to a user on the display (i) the current settings of the rejection criteria, and (ii) the rejection effectiveness of each of the rejection criteria at the current settings.

[0004] In some embodiments, the system further comprises an input device, and the processor is configured to receive user input via the input device to reconfigure the settings of one or more of the rejection criteria in response to the visualized rejection effectiveness.

[0005] In some embodiments, the processor is configured to visualize the rejection effectiveness by plotting at least a portion of the EP signals and marking rejected EP signals with a mark indicating the rejection criteria used to reject the EP signals.

[0006] In some embodiments, the processor is configured to visualize the rejection effectiveness by graphically depicting multiple electrodes of the multi-electrode catheter, and for rejected EP signals, is configured to mark the electrodes used to acquire the rejected EP signal with a mark indicating the rejection criteria used to reject the EP signal.

[0007] In some embodiments, the processor is further configured to graphically indicate the orientation of the plurality of electrodes relative to the anatomy of the heart chamber.

[0008] In some embodiments, the processor is configured to visualize the rejection effectiveness in real time, hi some embodiments, the processor is configured to visualize a given rejection criterion and the rejection effectiveness of a given rejection criterion using the same graphical features.

[0009] In one embodiment, the graphical features include one or more of a color and a pattern.

[0010] According to another embodiment of the present invention, there is additionally provided a method including receiving a plurality of electrophysiological (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a cardiac chamber, rejecting one or more of the EP signals using a set of rejection criteria, and further processing the EP signals that are not rejected, and visualizing to the user on a display (i) the current settings of the rejection criteria, and (ii) the rejection effectiveness of each of the rejection criteria at the current settings.

[0011] According to another embodiment of the present invention, there is further provided a computer software product, the product including a tangible, non-transitory computer-readable medium having stored thereon program instructions that, when read by a processor in a computer system, cause the processor to (a) receive a plurality of electrophysiological (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a cardiac chamber; (b) reject one or more of the EP signals using a set of rejection criteria and further process the EP signals that are not rejected; and visualize to a user on a display (i) the current settings of the rejection criteria and (ii) the rejection effectiveness of each of the rejection criteria at the current settings. [Brief explanation of the drawings]

[0012] The present invention will be more fully understood from the following detailed description taken in conjunction with the drawings, in which: [Figure 1] 1 is a schematic, pictorial illustration of an electrophysiology (EP) mapping system including different possible multi-electrode catheters, in accordance with an exemplary embodiment of the present invention. [Figure 2] 2 is a schematic diagram of a graphical user interface (GUI) of the electrophysiology (EP) mapping system of FIG. 1, in accordance with an exemplary embodiment of the present invention. [Figure 3] 3 is a flowchart that schematically illustrates a method for differentiating filters in real time using the graphical user interface (GUI) of FIG. 2, in accordance with an exemplary embodiment of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0013] Overview Probe-based (e.g., catheter-based) cardiac diagnostic and therapeutic systems may measure multiple intracardiac electrophysiological (EP) signals, such as electrograms (EGMs), during invasive procedures. Such systems acquire multiple intracardiac signals using multiple electrodes (hereinafter also referred to as "distal electrodes") attached to the distal end of a probe. Analysis of the acquired EP signals is most often performed in a continuous mode (automatically) to allow for processing of vast amounts of EP information.

[0014] Automation of analysis often involves automatically applying rejection criteria at any given time (e.g., using automatic "filtering" (e.g., irrelevant, too noisy) to avoid using "wrong" channels). The physician performing the procedure must therefore set "good" filtering criteria to analyze only "good" (e.g., relevant and stable) channels. The measured and filtered signals may be analyzed in real time to provide the physician with visual cardiac information, such as 3D mapping of the source of pathological electrical patterns within the patient's heart. The 3D mapping may be used to support corrective medical procedures, such as in-situ ablation (e.g., using the same catheter). Additionally, or alternatively, the measured and filtered signals may then be analyzed, for example, offline.

[0015] More specifically, to acquire EGM signals of a heart chamber, for example, a catheter carrying a large number of electrodes (e.g., 256), such as a basket catheter, may be used to reduce the time required to EP map the heart chamber. The acquired signals are typically subjected to rejection criteria to remove signals that may be inaccurate (e.g., unstable) or irrelevant (e.g., acquired from the blood pool instead of the heart chamber surface). With a large number of electrodes, applying the rejection criteria may be performed automatically by setting individual filter scale levels shown on the display. However, it can be difficult for a physician to tell whether the filter setting levels are appropriate or whether too many signals are being rejected.

[0016] The embodiments of the present invention described below provide a visual, real-time assessment of the effectiveness of rejection criteria. In some embodiments, a graphical user interface (GUI) provides a preference window showing different rejection criteria (e.g., filters with scales that can be adjusted by a dial) that can be adjusted by the physician. Another GUI window shows the EP signals acquired by each electrode of a multi-electrode catheter. Whenever a filter rejects an acquired EP signal, the signal is marked with a distinct graphic (e.g., color) of the scale of the filter that rejected it.

[0017] In another embodiment, a third window of the GUI shows the electrodes relative to the anatomical surface being mapped. The electrodes are patterned (e.g., colored) by the disclosed GUI with the same distinctive graphic as the filter and the respective rejected EP signal. In other words, if a filter rejects an acquired EP signal, the electrode used to acquire the signal is marked with a distinct graphic of the filter that rejected the signal.

[0018] Further alternatively, the rejection validity of the rejection criteria can be visualized to the physician in any other suitable manner.

[0019] All or some of the above visualization methods allow the physician to inspect and change the filter scale (e.g., dial in the level) to easily optimize the filter settings. Thus, the disclosed techniques allow visualization of how each filter criterion affects the signals used for mapping, as well as the signals not used, all in real time.

[0020] In some embodiments, the rejection criteria (e.g., filter scale limits) can be modified by dialing in a threshold or dialing in a range (e.g., by dialing in lower and upper limits) to generate criteria for signal rejection. The processor of the mapping system functions to compare the real-time value of each data point (e.g., annotated signal) to the dialed-in criteria and reject or accept the data point accordingly.

[0021] For example, in one embodiment, any acquired data points having bipolar voltage amplitude values ​​below a dialed-in signal amplitude threshold (e.g., less than 0.1 mV) are filtered out (i.e., rejected), and the acquired electrode pair, channel, and waveform are given the same color of the respective filter. In a second embodiment, any acquired data points having cycle lengths outside a dialed-in range (e.g., between 600 mS and 900 mS) are filtered out, and the electrode, channel, and waveform are given the same color of the filter.

[0022] In a third embodiment, any acquired data point using the dialed-in criteria is considered an outlier (e.g., not within a dialed-in range of a predetermined parameter from the surrounding electrode data points) and is filtered out, and the electrode, channel, and waveform are given the same color of their respective filters. In a fourth embodiment, the current position of any acquired data point whose position is greater than a dialed-in value (e.g., 2 mm) from the previous position of the electrode is filtered out, and the acquiring electrode, channel, and waveform are given the same color of their respective filters.

[0023] Other rejection (e.g., filter) criteria may also be used to reject data points in real time using similar visualization for rejection. Such additional filter criteria include unstable local activation time (LAT) values, weak physical contact between the electrode and tissue, and low measured impedance (e.g., of blood instead of tissue). After rejection, the respective electrode and signal are given the same color as the rejection filter.

[0024] In one embodiment, the disclosed GUI visualizes to the user on the display (i) the current settings of the rejection criteria and (ii) the rejection effectiveness of each of the rejection criteria at the current settings. The processor may visualize the rejection effectiveness by plotting at least a portion of the EP signals and marking rejected EP signals with a mark indicating the rejection criteria used to reject the EP signals. Similarly, the processor may be configured to visualize the rejection effectiveness by graphically depicting multiple electrodes of a multi-electrode catheter and, for rejected EP signals, marking the electrodes used to acquire the rejected EP signals with a mark indicating the rejection criteria used to reject the EP signals.

[0025] For example, icons within the GUI summarize the actions of different filters, e.g., using a "funnel" icon where filter statistics are "poured" (e.g., into a "measuring tube" icon). Information about the effectiveness of the funnel icon is coded into two parts, one of which indicates to the user how many channels are being filtered by the filter (represented by the colored part of the funnel, which is graphically coded to the respective filter color), and the other of which indicates the dominant filter by using enclosed coded text of the channels that have been filtered out.

[0026] In another embodiment, a color bar on the GUI indicates the percentage of data points of each filter type that pass a given filter, using the same graphic (eg, color) of the filter.

[0027] In some embodiments, the physician uses an input device such as a computer mouse to reconfigure the settings of one or more of the rejection criteria in response to the visualized rejection effectiveness, for example by changing the range within the signal on a filter scale, which is accepted and further processed in response to the visualized rejection effectiveness.

[0028] By providing a GUI with a set of filter scales that can be adjusted (e.g., dialed) in real time, the physician can optimize the quality of the analysis on the fly (during EP mapping), thereby improving the diagnostic quality of the invasive procedure.

[0029] System Description FIG. 1 is a schematic, pictorial illustration of an electrophysiology (EP) mapping system 10 including different possible multi-electrode catheters, according to an exemplary embodiment of the present invention. System 10 can be configured to analyze virtually any physiological parameter or combination of such parameters. Herein, by way of example, the analyzed signal is assumed to be an intracardiac electrogram potential-time relationship. To fully characterize such a relationship, the signals must be referenced in time to one another at various locations, as is done, for example, during LAT map generation. This time referencing is achieved by measuring relative to a reference time (e.g., a point in time), such as the onset of each QRS complex (i.e., the start of each heartbeat) of an ECG reference signal. Methods for generating LAT maps are described in the aforementioned U.S. Pat. No. 9,050,011.

[0030] As mentioned above, system 10 includes a multi-electrode catheter, which may be a basket catheter 14 or a multi-arm catheter 114 (e.g., a PentaRay™ catheter), among many possible options, both of which are shown in inset 37. The following description will collectively refer to the above catheter options as "catheter 14 / 114," meaning that the embodiments described below apply to either of these multi-electrode catheter types.

[0031] The multi-electrode catheter 14 / 114 is inserted by a physician 32 through the patient's vascular system into a chamber or vasculature of the heart 12. The physician 32 brings the distal tip 18 / 118 of the catheter into contact with the wall tissue 19 of the heart chamber 21 at the EP mapping target tissue site (e.g., by pushing the tip distally). The catheter typically includes a handle 20 with suitable controls to enable the physician 32 to steer, position, and orient the distal end of the catheter as needed for EP mapping.

[0032] The multi-electrode catheter 14 / 114 is coupled to a console 24 that allows a physician 32 to observe and adjust catheter function. To assist the physician 32, the distal portion of the catheter may include various sensors, such as contact force sensors (not shown) and magnetic sensors 33 / 133, that provide position, direction, and orientation signals to a processor 22 located within the console 24. The processor 22 may perform several processing functions, as described below. In particular, electrical signals may be transmitted from electrodes 16 / 116 located at or near the distal tip 18 / 118 of the catheter 14 / 114 to and from the heart 12 via the cable 31 to the console 24. Pacing and other control signals may be transmitted from the console 24 via the cable 31 and the electrodes 16 / 116 to the heart 12.

[0033] The console 24 includes a monitor 29 driven by the processor 22. Signal processing circuitry within the electrical interface 34 typically receives, amplifies, analog filters, and digitizes signals from the catheter 14 / 114 to generate a plurality of digital signals, including signals generated by the plurality of sensing electrodes 16 / 116 described above. The digitized signals are received by the console 24 and a positioning system and used to calculate the position and orientation of the catheter 14 / 114 and to analyze the EP signals from the electrodes 16 / 116, as described in more detail below.

[0034] During an EP mapping procedure, a tracking system can be used to track the intracardiac location of the distal electrodes 16 / 116, thereby associating each acquired EP signal with a known intracardiac location. One example of such a tracking system is Active Current Location (ACL), which is described in U.S. Pat. No. 8,456,182, which is assigned to the assignee of the present patent application and whose disclosure is incorporated herein by reference. In the ACL system, a processor estimates the location of each of the distal electrodes 16 / 116 based on the impedance measured between each of the distal electrodes 16 / 116 and a plurality of surface electrodes 30 coupled to the patient's skin and wired (35) to the console 24. The processor can then associate any electrophysiological signals received from the distal electrodes 16 / 116 with the location at which the signal was acquired.

[0035] In an alternative embodiment, position measurements may be made by applying a voltage gradient between a pair of surface electrodes 30 and measuring the resulting potential gradient at the distal electrode 16 / 116.

[0036] In some embodiments, the system 10 includes, in addition to or instead of the ACL tracking subsystem, a magnetic position tracking subsystem that determines the position and orientation of a magnetic sensor 33 at the distal end of the catheter 14 / 114 by generating magnetic fields within a predetermined working volume and sensing these fields at the catheter using field generating coils 28. Because the electrodes 16 / 116 have known positions on the arms 15 / 115 and known relationships to each other, when the catheter 14 / 114 is magnetically tracked within the heart, the position of each electrode 16 / 116 within the heart becomes known. Suitable magnetic position tracking subsystems are described in U.S. Patent Nos. 7,756,576 and 7,536,218, which are assigned to the assignee of the present patent application and whose disclosures are incorporated herein by reference.

[0037] Based on the EP signals from the electrodes 16 / 116 having tracked positions, an electrical activation map can be generated according to the methods disclosed in U.S. Patent Nos. 6,226,542, 6,301,496, and 6,892,091, which are assigned to the assignee of the present patent application and whose disclosures are incorporated herein by reference.

[0038] Processor 22 operates system 10 using software stored in memory 25. The software may be downloaded to processor 22 in electronic form, for example, over a network; alternatively or additionally, the software may be provided and / or stored on a non-transitory, tangible medium, such as magnetic, optical, or electronic memory. In particular, processor 22 executes the dedicated algorithms disclosed herein, included in FIG. 3, which enable processor 22 to perform the disclosed steps, as further described below.

[0039] The processor 22 includes a signal processing unit 42 configured to digitally filter the multi-channel signal and extract respective annotation parameters from the signal. As seen in Figure 2, the digital filter of unit 42 can be dialed in using an input device, such as one of a computer mouse 43, a keyboard, and a touch display, using a graphical user interface (GUI) 44 to accept or reject the electrogram signal based on the dialed level of the digital filter. Examples of dialed filter levels include cycle length, LAT stability, and minimum signal voltage, to name a few.

[0040] The illustration shown in Figure 1 has been chosen solely for conceptual clarity. Other types of EP sensing configurations can also be employed, such as a balloon catheter with electrode segments, as described in U.S. Patent Application No. 16 / 708,285, filed December 9, 2019, entitled "Catheter with Plurality of Sensing Electrodes Used as Ablation Electrodes," the disclosure of which is incorporated herein by reference.

[0041] Other types of catheters, such as a Lasso® catheter (manufactured by Biosense Webster), may equally be employed. Other types of electrodes, such as those used for ablation, may also be utilized at electrode 16 / 116 to acquire electrophysiological signals within the heart.

[0042] System 10 typically includes additional modules and elements not directly relevant to the disclosed technology and therefore intentionally omitted from Figure 1 and the corresponding description. The elements of system 10 and the methods described herein may be further applied, for example, to control the ablation of tissue in heart 12.

[0043] Distinguishing Between Filters During Real-Time Cardiac Mapping 2 is a schematic diagram of a graphical user interface (GUI) 44 of the electrophysiology (EP) mapping system 10 of FIG. 1, in accordance with an embodiment of the present invention. In the illustrated embodiment, GUI 44 includes a filter scale 55 that can be adjusted by a user during EP mapping.

[0044] In the illustrated embodiment, GUI 44 displays three windows (52, 54, 56). Window 52 shows basket catheter 14 within heart chamber 21, where the catheter is being used for EP mapping of wall tissue of heart chamber 21, for example, to detect arrhythmogenic tissue. The catheter is shown with the orientation of its multiple electrodes relative to the anatomy of the heart chamber. As can be seen, some of the electrodes on the catheter are coded with unique graphics that are the same codes used by the filter in window 54.

[0045] Window 54 shows a user settings menu with different filter scales 55, with each filter name displayed to the left. Respective checkboxes allow the user to activate or deactivate each filter.

[0046] Each enabled filter has a color-coded name (51) and a unique graphic associated with it (e.g., codes 540, 542, 544, and 546). Electrodes whose signals have been filtered out are coded with the filter's characteristic graphic (e.g., codes 520, 522, 524, and 526), ​​as will be seen in the following examples.

[0047] Electrodes coded by graphic 520 have their acquired signals rejected by the minimum voltage filter coded 540.

[0048] Electrodes coded with graphic 522 have their acquired signals rejected by the cycle length range filter coded 542.

[0049] Electrodes coded with graphic 524 have their acquired signals rejected by the unstable LAT value filter coded 544.

[0050] Electrodes coded by graphic 526 have their acquired signals rejected by the unstable electrode position filter coded 546.

[0051] Window 56 displays the acquired electrogram (66) and the filtered-out electrograms, which are given the same graphic code as the filter by which they were rejected (e.g., codes 560, 562, 564, and 566). As can be seen in window 56, the electrograms are annotated with a graphic-coded dot at the location on the portion of the electrogram where the analysis was performed, typically at or near the QRST complex of the cardiac cycle captured by the electrogram.

[0052] In one embodiment, the user receives a summary of the filter's performance at any given time in the form of icon 57, which is selected by pressing icon 67 in the preferences menu. As can be seen, icon 67 has a funnel icon 68 into which filter statistical data is "poured" (into a measuring tube icon, not shown). The information in funnel icon 68 is coded in two parts: the first indicates to the user how many channels have been filtered by which filter, indicated by the amount of colored portion of the funnel (two shown, 69a, 69b) coded with the same graphic as the respective filter; and the second indicates the dominant filter, indicated by accompanying coded text, e.g., "LAT Stability," which filters the dominant portion of the filtered-out channels 69b.

[0053] 2 is an example provided solely for purposes of illustrating embodiments. An actual GUI is typically much more elaborate and includes, for example, numerous icons and graphics that are omitted here for ease of presentation. As another example, GUI 44 typically includes various types of menus and overlaid information that are omitted here for ease of presentation.

[0054] Figure 3 is a flowchart that generally illustrates a method for differentiating filters in real time using the graphical user interface (GUI) 44 of Figure 2, in accordance with an embodiment of the present invention. While the flowchart describes a workflow that involves dialing in the scale of a given filter, it should be understood that a user can adjust several filters while exploring the relative contribution of each filter to the total number of channels being filtered out.

[0055] According to the presented embodiment, the algorithm executes a process that begins after the physician 32 delivers the basket catheter 14 to the target tissue location within the heart chamber 21, and in GUI operation step 80, the physician 32 opens the preference window 54 on the display 29.

[0056] Next, physician 32 checks whether the required filters are enabled in a check filter menu step 82. If the filters are not enabled, physician 32 enables them by selecting them (e.g., by clicking a checkbox) in a filter enable step 84. Depending on the type of filter (e.g., threshold or tolerance-based filtering), physician 32 adjusts one or more limits (e.g., dials) in a filter scale dial adjustment step 86.

[0057] The physician 32 then examines the filtering results in a channel filter check step 88. The physician can, for example, examine the tissue location and number of channels affected by the filtering action.

[0058] For example, in an electrode filter removal check step 90, the physician inspects the identity (e.g., location) of electrodes that have been filtered out by a given filter in window 52 of GUI 44. These electrodes are easily identified because they are coded with the same graphic code (e.g., color) of the filter, as described in FIG.

[0059] If the physician 32 discovers by viewing the window 52 that at least some of the filtered-out electrodes are in fact correctly positioned and are likely obtaining valid signals, the physician adjusts one or more limits of the filter scale to make the filter less aggressive, in a scale adjustment step 94.

[0060] However, if the physician identifies on window 52 that the filtered out electrodes are in the correct filtered out position (e.g., they are immersed in blood), the process proceeds to step 92. In channel filter removal check step 92, the physician checks the absolute number or percentage of electrodes that have been filtered out by the filter.

[0061] If the physician 32 finds, by looking at the icon 67 or by looking at the window 56, that at least some of the filtered out channels are too large and / or the waveform is valid, the physician adjusts one or more limits of the filter scale to make the filter less aggressive, in a scale adjustment step 94.

[0062] The process then returns to step 90 for the physician to verify that the adjusted filter scale did not adversely affect the filtering out of the electrode.

[0063] The process ends when the physician finds that the identity of the filtered out electrodes and the number of channels (eg, number of electrodes) are sufficiently optimal.

[0064] The exemplary flowchart of Figure 3 has been chosen purely for purposes of conceptual clarity. In alternative embodiments, for example, the physician may adjust the scale of at least one additional filter and examine the cumulative filtering effect of the two filters.

[0065] It will be understood that the above-described embodiments are given by way of example, and that the present invention is not limited to what is specifically shown and described hereinabove. 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 an integral part of this application, except that if any term is defined in these incorporated documents in a way that contradicts the definition given herein, either expressly or impliedly, then only the definition given herein shall be considered.

[0066] [Embodiment] (1) A cardiac diagnostic and therapeutic system, comprising: The display and 1. A processor, comprising: receiving a plurality of electrophysiology (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a cardiac chamber; rejecting one or more of the EP signals using a set of rejection criteria and further processing the EP signals that are not rejected; On said display, visualizing to the user (i) the current settings of said rejection criteria, and (ii) the rejection effectiveness of each of said rejection criteria at said current settings. The processor and A cardiac diagnostic and therapeutic system comprising: (2) The system of embodiment 1, further comprising an input device, wherein the processor is configured to receive user input via the input device to reconfigure the settings of one or more of the rejection criteria in accordance with the visualized rejection effectiveness. (3) The system of embodiment 1, wherein the processor is configured to visualize the rejection effectiveness by plotting at least a portion of the EP signals and mark rejected EP signals with a mark indicating the rejection criteria used to reject the EP signals. (4) The system of embodiment 1, wherein the processor is configured to visualize the rejection effectiveness by graphically illustrating the plurality of electrodes of the multi-electrode catheter, and for rejected EP signals, to mark the electrodes used to acquire the rejected EP signal with a mark indicating the rejection criteria used to reject the EP signal. (5) The system of embodiment 4, wherein the processor is further configured to graphically indicate the orientation of the plurality of electrodes relative to the anatomical structure of the heart chamber.

[0067] (6) The system of embodiment 1, wherein the processor is configured to visualize the rejection effectiveness in real time. (7) The system of embodiment 1, wherein the processor is configured to visualize a given rejection criterion and the rejection effectiveness of the given rejection criterion using the same graphical features. (8) The system of embodiment 6, wherein the graphic features include one or more of color and pattern. (9) A method for cardiac diagnosis and treatment, comprising: receiving a plurality of electrophysiology (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a heart chamber; rejecting one or more of the EP signals using a set of rejection criteria and further processing the EP signals that are not rejected; visualizing to the user on a display (i) the current settings of said rejection criteria, and (ii) the rejection effectiveness of each of said rejection criteria at said current settings; A method comprising: (10) The method of embodiment 9, comprising receiving a user input via an input device to reconfigure the settings of one or more of the rejection criteria in accordance with the visualized rejection effectiveness.

[0068] (11) The method of embodiment 9, wherein visualizing the rejection effectiveness includes plotting at least a portion of the EP signals and marking rejected EP signals with a mark indicating the rejection criteria used to reject the EP signals. (12) The method of embodiment 9, wherein visualizing the rejection effectiveness includes graphically illustrating the plurality of electrodes of the multi-electrode catheter and, for rejected EP signals, marking the electrodes used to acquire the rejected EP signal with a mark indicating the rejection criteria used to reject the EP signal. (13) The method of embodiment 12, wherein illustrating the plurality of electrodes includes illustrating an orientation of the plurality of electrodes relative to an anatomical structure of the heart chamber. (14) The method of embodiment 9, wherein visualizing the rejection efficacy comprises visualizing the rejection efficacy in real time. (15) The method of embodiment 9, wherein visualizing the rejection effectiveness includes visualizing a given rejection criterion and the rejection effectiveness of the given rejection criterion using the same graphical feature.

[0069] (16) The method of claim 15, wherein the graphic features include one or more of a color and a pattern. (17) A computer software product, said product including a tangible, non-transitory computer-readable medium having stored thereon program instructions, said instructions, when read by a processor in a computer system, causing said processor to: receiving a plurality of electrophysiology (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a cardiac chamber; rejecting one or more of the EP signals using a set of rejection criteria and further processing the EP signals that are not rejected; A computer software product that allows a user to visualize on a display (i) the current settings of said rejection criteria, and (ii) the rejection effectiveness of each of said rejection criteria at said current settings.

Claims

1. 1. A cardiac diagnostic and therapeutic system comprising: The display and 1. A processor, comprising: receiving a plurality of electrophysiological (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a heart chamber; rejecting one or more of the EP signals using a set of filtering criteria for the EP signals and further processing the EP signals that are not rejected; On the display, (i) the current setting of the filtering criteria, and (ii) the rejection effectiveness of each of the filtering criteria at the current setting, are visualized to the user. The processor and A cardiac diagnostic and therapeutic system comprising:

2. 2. The system of claim 1, further comprising an input device, wherein the processor is configured to receive user input via the input device to reconfigure the settings of one or more of the filtering criteria in response to the visualized rejection effectiveness.

3. 2. The system of claim 1, wherein the processor is configured to visualize the rejection effectiveness by plotting at least a portion of the EP signals and marking rejected EP signals with a mark indicating the filtering criteria used to reject the EP signals.

4. 2. The system of claim 1, wherein the processor is configured to visualize the rejection effectiveness by graphically depicting the plurality of electrodes of the multi-electrode catheter, and for rejected EP signals, marking the electrodes used to acquire the rejected EP signal with a mark indicating the filtering criteria used to reject the EP signal.

5. The system of claim 4 , wherein the processor is further configured to graphically indicate the orientation of the plurality of electrodes relative to the anatomy of the heart chamber.

6. The system of claim 1 , wherein the processor is configured to visualize the rejection effectiveness in real time.

7. The system of claim 1 , wherein the processor is configured to visualize a given filtering criterion and the rejection effectiveness of the given filtering criterion using the same graphical features.

8. The system of claim 6 , wherein the graphical features include one or more of a color and a pattern.

9. 1. A method of operating a cardiac diagnostic and therapy system for cardiac diagnosis and therapy, comprising: the cardiac diagnostic and therapeutic system includes a display and a processor; receiving, by the processor, a plurality of electrophysiology (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a heart chamber; the processor rejecting one or more of the EP signals using a set of filtering criteria for the EP signals and further processing the EP signals that are not rejected; the processor visualizing to the user on the display (i) the current setting of the filtering criteria, and (ii) the rejection effectiveness of each of the filtering criteria at the current setting; A method of operating a cardiac diagnostic and therapeutic system, comprising:

10. The cardiac diagnostic and therapeutic system further comprising an input device; 10. The method of claim 9, further comprising: receiving, via the input device, a user input for reconfiguring the settings of one or more of the filtering criteria in response to the visualized rejection effectiveness.

11. A method of operating a cardiac diagnostic and therapeutic system as described in claim 9, wherein the processor visualizing the rejection effectiveness includes the processor plotting at least a portion of the EP signal and the processor marking rejected EP signals with a mark indicating the filtering criteria used to reject the EP signal.

12. A method of operating a cardiac diagnostic and therapeutic system as described in claim 9, wherein the processor visualizing the rejection effectiveness includes the processor graphically illustrating the plurality of electrodes of the multi-electrode catheter, and, for rejected EP signals, the processor marking the electrodes used to acquire the rejected EP signal with a mark indicating the filtering criteria used to reject the EP signal.

13. A method of operating a cardiac diagnostic and therapeutic system as described in claim 12, wherein the processor illustrating the plurality of electrodes includes the processor illustrating the orientation of the plurality of electrodes relative to the anatomical structure of the cardiac chamber.

14. A method of operating a cardiac diagnostic and treatment system as described in claim 9, wherein the processor visualizing the rejection effectiveness includes the processor visualizing the rejection effectiveness in real time.

15. A method of operating a cardiac diagnostic and treatment system as described in claim 9, wherein the processor visualizing the rejection effectiveness includes the processor visualizing a given filtering criterion and the rejection effectiveness of the given filtering criterion using the same graphical feature.

16. 16. The method of operating a cardiac diagnostic and therapeutic system of claim 15, wherein the graphical features include one or more of a color and a pattern.

17. 1. A computer software product, the computer software product comprising a tangible, non-transitory computer-readable medium having stored thereon program instructions, the program instructions, when read by a processor in a computer system, causing the processor to: receiving a plurality of electrophysiological (EP) signals acquired by a plurality of electrodes of a multi-electrode catheter in contact with tissue of a heart chamber; rejecting one or more of the EP signals using a set of filtering criteria for the EP signals and further processing the EP signals that are not rejected; A computer software product that allows a user to visualize on a display (i) the current settings of said filtering criteria, and (ii) the rejection effectiveness of each of said filtering criteria in said current settings.

Images