Gesture-Based Selection of Catheter Portions

Abstract

To provide a medical system.SOLUTION: In one embodiment, a medical system includes a catheter configured to be inserted into a body part of a living subject, a display configured to provide a view of at least a part of a hand of a user, and a processor. The processor is configured to track a position of the catheter in the body part, render to the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter inside the anatomical map responsively to the tracked position, while the display is providing the view of the at least a part of the hand of the user, recognize a gesture of the at least the part of the hand of the user selecting a portion of the catheter, and perform an action responsively to recognizing selection by the user of the portion of the catheter.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to medical devices, particularly but not exclusively to catheter devices. [Background technology]

[0002] A wide range of medical procedures involve the placement of probes, such as catheters, within a patient's body. Position sensing systems have been developed to track such probes. Magnetic position sensing is one method known in the art. In magnetic position sensing, magnetic field generators are typically placed at known locations external to the patient. A magnetic field sensor in the distal end of the probe generates electrical signals in response to these magnetic fields, and these signals are processed to determine the coordinate position of the distal end of the probe. These methods and systems are described in U.S. Patent Nos. 5,391,199, 6,690,963, 6,484,118, 6,239,724, 6,618,612, and 6,332,089, WO 1996 / 005768, and U.S. Patent Application Publication Nos. 2002 / 0065455, 2003 / 0120150, and 2004 / 0068178. Position may also be tracked using impedance or current-based systems.

[0003] One medical procedure in which these types of probes or catheters have proven extremely useful is in the treatment of cardiac arrhythmias, which, and atrial fibrillation in particular, persist as a common and dangerous condition, especially in the aging population.

[0004] Diagnosis and treatment of cardiac arrhythmias involve mapping the electrical properties of cardiac tissue, particularly the endocardium, and selectively ablating the cardiac tissue through the application of energy. Such ablation can stop or modify the propagation of unwanted electrical signals from one part of the heart to another. The ablation process disrupts unwanted electrical pathways by creating non-conductive lesions. Various energy delivery modalities have been previously disclosed for creating lesions, including the use of microwave, laser, and more commonly, radiofrequency energy to create conduction blocks along cardiac tissue walls. In a two-step mapping-then-ablation procedure, electrical activity at each point within the heart is typically sensed and measured by advancing a catheter containing one or more electrical sensors into the heart and acquiring data at multiple points. These data are then used to select a target region of the endocardium for this ablation.

[0005] Electrode catheters have been commonly used in medical practice for many years. They are used to stimulate and map electrical activity within the heart and to ablate sites of abnormal electrical activity. In use, an electrode catheter is inserted into a major vein or artery, such as the femoral vein, and then guided into the heart chamber of interest. A typical ablation procedure involves inserting a catheter with one or more electrodes at its distal end into a heart chamber. A reference electrode is typically taped to the patient's skin or may be provided by a second catheter placed in or near the heart. Radio frequency (RF) current is applied through the tip electrode of the ablation catheter, and the current flows through the medium surrounding the tip electrode, i.e., blood and tissue, between the tip electrode and an indifferent electrode. The distribution of the current depends on the amount of electrode surface in contact with the tissue compared to blood, which has a higher electrical conductivity than tissue. Tissue heating occurs due to the electrical resistance of the tissue. Sufficient tissue heating can cause cell destruction in the cardiac tissue, resulting in the formation of a non-conductive lesion within the cardiac tissue.

[0006] Therefore, when an ablation catheter or other catheter is placed within the body, particularly near endocardial tissue, it is desirable to have the distal tip of the catheter in direct contact with the tissue. This contact can be confirmed, for example, by measuring contact between the distal tip and the body tissue. U.S. Patent Application Publication Nos. 2007 / 0100332, 2009 / 0093806, and 2009 / 0138007 describe methods for detecting contact pressure between the distal tip of a catheter and tissue within a body cavity using a force sensor embedded within the catheter.

[0007] Several references, including U.S. Patent Nos. 5,935,079, 5,891,095, 5,836,990, 5,836,874, 5,673,704, 5,662,108, 5,469,857, 5,447,529, 5,341,807, 5,078,714, and Canadian Patent Application No. 2,285,342, report methods for determining electrode-tissue contact. Some of these references, such as U.S. Patent Nos. 5,935,079, 5,836,990, and 5,447,529, determine electrode-tissue contact by measuring impedance between the tip and return electrodes. As disclosed in the '529 patent, it is generally known that the impedance through blood is lower than the impedance through tissue, and therefore tissue contact is detected by comparing the impedance value across a set of electrodes to previously measured impedance values ​​when one electrode is known to be in contact with tissue and when one electrode is known to be in contact with only blood. Summary of the Invention [Means for solving the problem]

[0008] According to yet another embodiment of the present disclosure, there is provided a medical system comprising: a catheter configured to be inserted into a body part of a living subject; a display configured to provide a view of at least a portion of a user's hand; and a processor configured to: track a position of the catheter within the body part; render on the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked position while the display provides a view of at least a portion of the user's hand; recognize a gesture of at least a portion of the user's hand to select a portion of the catheter; and perform an action in response to recognizing the user's selection of the portion of the catheter.

[0009] Further, according to one embodiment of the present disclosure, the system includes a camera configured to capture an image of at least a portion of the user's hand, and the processor is configured to recognize a gesture of at least a portion of the user's hand that selects a portion of the catheter in response to the tracked position of the catheter and the captured image.

[0010] Still further, in accordance with one embodiment of the present disclosure, the system comprises a head-mounted device configured to be worn by a user and including a display, the head-mounted device configured to simultaneously render on the display a three-dimensional view of an interior of an anatomical map of the body part, a representation of the catheter within the anatomical map in response to the tracked position, and an image of at least a portion of the user's hand captured by the camera.

[0011] Additionally, according to one embodiment of the present disclosure, a system includes a head-mounted device configured to be worn by a user and including a display, the head-mounted device comprising an optical see-through display configured to provide a view of at least a portion of the user's hand visible through the display while augmenting the display with virtual objects including an internal three-dimensional view of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked position.

[0012] Further, according to one embodiment of the present disclosure, the catheter includes a plurality of electrodes, the processor is configured to track the positions of the electrodes, and the processor is configured to recognize a gesture of at least a portion of a user's hand that selects one of the electrodes of the catheter.

[0013] Further, according to one embodiment of the present disclosure, one electrode is configured to sense electrical activity from tissue of the body part, and the processor is configured to render an intracardiac electrogram on the display in response to recognizing the sensed electrical activity and a gesture selecting the one electrode.

[0014] Still further, according to an embodiment of the present disclosure, one of the electrodes is configured to sense electrical activity from tissue of the body part, and the processor is configured to generate an electro-anatomical map in response to the sensed electrical activity and recognizing a gesture selecting one of the electrodes.

[0015] Additionally, according to one embodiment of the present disclosure, the gestures include any one or more of the following: a pinch gesture, a pointing gesture, or a touch gesture.

[0016] Further, according to one embodiment of the present disclosure, the system includes a head-mounted device configured to be worn by a user and including a display, and the processor is configured to receive user input to operate a virtual camera in response to movement of the head-mounted device, and to render on the display a three-dimensional view of the interior of an anatomical map of the body part as seen from the virtual camera and a representation of the catheter within the anatomical map, while the display provides a view of at least a portion of the user's hand.

[0017] Further, according to one embodiment of the present disclosure, the catheter comprises an expandable distal tip assembly and a plurality of electrodes disposed on the expandable distal tip assembly, and the processor is configured to render on the display a three-dimensional view of the interior of an anatomical map of the body part as seen from a virtual camera disposed within the expandable distal tip assembly and a representation of the catheter within the anatomical map, while the display provides a view of at least a portion of a user's hand.

[0018] According to another embodiment of the present disclosure, there is also provided a medical method including: providing a view of at least a portion of a user's hand on a display; tracking a position of a catheter within a body part of a living subject; rendering on the display, while the display provides a view of at least a portion of the user's hand, a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked position; recognizing a gesture of at least a portion of the user's hand to select a portion of the catheter; and performing an action in response to recognizing the user's selection of the portion of the catheter.

[0019] Still further, in accordance with one embodiment of the present disclosure, the method includes capturing an image of at least a portion of a user's hand, and recognizing includes recognizing a gesture of at least a portion of the user's hand that selects a portion of the catheter in response to the tracked position of the catheter and the captured image.

[0020] Additionally, according to one embodiment of the present disclosure, the display is included in a head-mounted device worn by the user, and the rendering includes rendering on the display a three-dimensional view of an interior of an anatomical map of the body part, a representation of the catheter within the anatomical map in response to the tracked position, and a captured image of at least a portion of the user's hand.

[0021] Further, according to one embodiment of the present disclosure, providing includes providing a view of at least a portion of the user's hand viewable through an optical see-through display included in a head-mounted device worn by the user while augmenting the display with virtual objects including an internal three-dimensional view of an anatomical map of the body part and a representation of the catheter within the anatomical map responsive to the tracked position.

[0022] Further, according to one embodiment of the present disclosure, the method includes tracking positions of electrodes of the catheter, and the recognizing includes recognizing a gesture of at least a portion of a user's hand selecting one of the electrodes of the catheter.

[0023] Still further, according to an embodiment of the present disclosure, the method includes sensing electrical activity from tissue of the body part with one electrode, and rendering includes rendering an intracardiac electrogram on a display in response to the sensed electrical activity and recognizing a gesture selecting the one electrode.

[0024] Additionally, according to one embodiment of the present disclosure, a method includes sensing electrical activity from tissue of a body part with an electrode, and generating an electro-anatomical map in response to the sensed electrical activity and recognizing a gesture selecting the electrode.

[0025] Furthermore, according to one embodiment of the present disclosure, the gestures include any one or more of the following: a pinch gesture, a pointing gesture, or a touch gesture.

[0026] Further, according to one embodiment of the present disclosure, the method includes receiving user input to manipulate a virtual camera in response to movement of a head-mounted device worn by the user, and rendering includes rendering on the display a three-dimensional view of the interior of an anatomical map of the body part as seen from the virtual camera and a representation of the catheter within the anatomical map, while the display provides a view of at least a portion of the user's hand.

[0027] Still further, according to one embodiment of the present disclosure, the rendering includes rendering on the display a three-dimensional view of the interior of the anatomical map of the body part as seen from a virtual camera disposed within the expandable distal tip assembly of the catheter and a representation of the catheter within the anatomical map, while the display provides a view of at least a portion of the user's hand.

[0028] Also provided according to yet another embodiment of the present disclosure is a software product including a non-transitory computer-readable medium having stored thereon program instructions that, when read by a central processing unit (CPU), cause the CPU to: track a position of a catheter within a body part of a living subject; render on the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked position, while the display provides a view of at least a portion of a user's hand; recognize a gesture of at least a portion of the user's hand to select a portion of the catheter; and perform an action in response to recognizing the user's selection of the portion of the catheter. [Brief explanation of the drawings]

[0029] The present invention will be understood from the following detailed description taken in conjunction with the drawings. [Figure 1] 1 is a schematic illustration of a medical system constructed and operative in accordance with an embodiment of the present invention. [Figure 2] 2 is a schematic diagram showing a catheter within a body part for use in the system of FIG. 1. [Figure 3] 3 is a schematic diagram of a display providing a view of a hand performing a gesture and rendering the interior of an anatomical map of a body part and a representation of the catheter of FIG. 2 within the anatomical map. [Figure 4] 2 is a flow chart including steps in a method of operating the system of FIG. 1. DETAILED DESCRIPTION OF THE INVENTION

[0030] Overview As previously mentioned, in a two-step mapping-then-ablation procedure, a catheter equipped with one or more electrodes is typically advanced into the heart to sense and measure electrical activity at each point within the heart by acquiring data at multiple points, which are then used to select a target region where ablation will be performed.

[0031] Specifically, the electrical activity can be displayed as an intracardiac electrogram (IEGM) trace for analysis by a physician to find the source of the arrhythmia. Catheter electrodes that are not in contact with tissue within the heart typically measure some electrical and far-field signals from the cardiac tissue. When a catheter electrode is in contact with cardiac tissue, the signal amplitude is primarily based on the tissue's conductivity, and the far-field is small. Therefore, physicians typically focus on analyzing the IEGM trace of electrodes that are in contact with tissue.

[0032] For focal catheters with one or more electrodes, typically only one IEGM trace is displayed for analysis by the physician. The physician can quickly determine whether the catheter electrode supplying the signal is in contact with tissue based on the signal morphology. However, multi-electrode catheters that simultaneously capture electrical activity from various tissue locations may simultaneously display data from multiple IEGM traces on a single display. In some cases, the number of IEGM traces may be so large that the physician cannot easily determine which IEGM traces are supplied by electrodes in contact with tissue and which are not.

[0033] An example of a multi-electrode catheter is the Octaray® catheter, which includes 48 or more electrodes and is manufactured by Biosense Webster Inc. of Irvine, California. The Octaray includes eight deflectable arms located at the distal end of the shaft, each of which includes six electrodes. Some catheters, such as basket catheters, may include many more electrodes, including, but not limited to, 120 electrodes.

[0034] In addition to the need to determine electrode contact during mapping as described above, physicians performing ablation procedures monitor electrode-tissue contact because effective ablation generally requires sufficient contact between the ablation electrode and the tissue. When the number of electrodes is small, contact monitoring can be accomplished by displaying a numerical or graphical representation of the degree of contact, such as the impedance observed at the electrode or the force applied to the electrode. However, as the number of active electrodes used in an ablation procedure increases, it becomes increasingly difficult for physicians to monitor any parameter of each individual electrode. In the case of electrode contact, this problem is exacerbated by the fact that, in most cases, the parameter measuring contact also changes as the contact changes.

[0035] Embodiments of the present invention solve the above problems by providing a user interface in which a user views a three-dimensional (3D) representation of a catheter and its electrodes within an anatomical map of a body part, such as a cardiac chamber, during a medical procedure, such as a mapping or ablation procedure. The anatomical map may include structural features and / or tags that identify information, such as previous ablation points or electrical activation information. The user can then easily view the catheter relative to the body part (and its features), such as, for example, which electrodes are in sufficient contact with the tissue of the body part. The user's hand or hands (or portions thereof) may also be shown on the screen (by using a see-through display in a head-mounted display (HMD), described in more detail below, or via capturing an image of the hand with a camera mounted in the room or on the HMD) along with the representation of the catheter and the anatomical map, so that the user can make hand gestures (recognized by software) to select portions of the catheter, such as one or more of the electrodes. An action associated with the selection, such as displaying IEGMs sensed by the selected electrodes or capturing electrical activity from the selected electrodes into the electroanatomical map, can then be performed. Different gesture types can be used to perform different actions, for example, a user can point to an electrode to see the IEGM associated with that electrode, or pinch an electrode to select it for mapping.

[0036] In some embodiments, a user wears an HMD that includes an eye-level video display screen and a forward-facing camera. The camera captures an image of the user's hand (or a portion thereof) and displays the image of the hand (or portion thereof) on the eye-level video display screen along with an internal 3D view of a 3D catheter representation and an anatomical map. The image of the hand and / or the catheter representation are appropriately scaled so that one or more of the user's fingers can easily select a single electrode, while the fingers can easily move around to select any electrode on the catheter. In some embodiments, the interior of the catheter representation and anatomical map can be viewed from the perspective of a virtual camera that the user can manipulate by, for example, moving the HMD to different orientations and / or positions. In some embodiments, the virtual camera can be disposed within an expandable distal end assembly (e.g., a basket) of the catheter.

[0037] In some embodiments, the HMD includes an optical see-through display that provides a view of the hand (or portion thereof) as seen through the display while augmenting the display with virtual objects including a 3D representation of the catheter and an internal 3D view of an anatomical map of the body part in response to the tracked position of the catheter.

[0038] In some embodiments, the view of the hand, the representation of the catheter, and the interior of the anatomical map may be displayed on a display monitor, a tablet, or any suitable display device.

[0039] System Description Reference is now made to FIG. 1, which is a schematic illustration of a medical system 20 constructed and operative in accordance with an embodiment of the present invention. System 20 includes a catheter 40 configured to be inserted into a body portion of a living subject (e.g., patient 28). A physician 30 navigates catheter 40 (e.g., a basket catheter manufactured by Biosense Webster, Inc., Irvine, California, USA) to a target location in heart 26 of patient 28 by manipulating elongated, deflectable element 22 of catheter 40 using a manipulator 32 near the proximal end of catheter 40 and / or deflection from a sheath 23. In the illustrated embodiment, physician 30 uses catheter 40 to perform electroanatomical mapping of heart cavities and ablation of cardiac tissue.

[0040] The catheter 40 includes an expandable distal tip assembly 35 (e.g., a basket assembly) that is inserted through the sheath 23 in a collapsed configuration, and only after the catheter 40 exits the sheath 23 does the distal tip assembly 35 resume its intended functional shape. By housing the distal tip assembly 35 in a collapsed configuration, the sheath 23 also serves to minimize vascular trauma en route to the target location.

[0041] The catheter 40 includes a plurality of electrodes 48 disposed on the expandable distal tip assembly 35 for sensing electrical activity and / or applying ablation power to ablate tissue in the body portion. The catheter 40 may also include a proximal electrode 21 disposed on the deflectable element 22 proximal to the expandable distal tip assembly 35. The catheter 40 may incorporate a magnetic position sensor (not shown) at the distal edge of the deflectable element 22 (i.e., at the proximal edge of the distal tip assembly 35). Typically, but not necessarily, the magnetic sensor is a single-axis sensor (SAS). A second magnetic sensor (not shown) may be included in any suitable location on the assembly 35. The second magnetic sensor may be a triple-axis sensor (TAS) or a dual-axis sensor (DAS), or an SAS, by way of example, depending on, for example, size considerations. The magnetic sensor, proximal electrode 21 and electrode 48 disposed on assembly 35 are connected to various drive circuits within console 24 by wires that extend through deflectable element 22 .

[0042] In some embodiments, system 20 includes a magnetic sensing subsystem that estimates the ellipticity and extension / retraction state of basket assembly 35 of catheter 40 within a cardiac cavity of heart 26 by estimating the extension of basket assembly 35 from the distance between magnetic sensors. Patient 28 is placed in a magnetic field generated by a pad including one or more magnetic field generator coils 42 driven by unit 43. The magnetic field generated by coils 42 transmits an alternating magnetic field to the region where the body part is located. The transmitted alternating magnetic field generates signals in the magnetic sensors that indicate position and / or orientation. The generated signals are transmitted to console 24 and become corresponding electrical inputs to processor 41.

[0043] Position and / or orientation sensing methods using external magnetic fields and magnetic sensors have been implemented in various medical applications, for example, in the CARTO® system manufactured by Biosense-Webster, and are described in U.S. Pat. Nos. 5,391,199, 6,690,963, 6,484,118, 6,239,724, 6,618,612, and 6,332,089, WO 96 / 05768, and U.S. Patent Application Publication Nos. 2002 / 0065455(A1), 2003 / 0120150(A1), and 2004 / 0068178(A1).

[0044] Processor 41, which is typically part of a general-purpose computer, is further connected through suitable front-end and interface circuitry 44 to receive signals from body surface electrodes 49. Processor 41 is connected to body surface electrodes 49 by wires that extend through cable 39 to the chest of patient 28.

[0045] In one embodiment, the processor 41 renders a representation 31 of at least a portion of the catheter 40 and a mapped body part (e.g., an anatomical or electroanatomical map) on the display 27 in response to the calculated position coordinates of the catheter 40.

[0046] The processor 41 is typically programmed with software to perform the functions described herein. The software may be downloaded to the computer in electronic form, for example over a network. Alternatively or additionally, the software may be provided on and / or stored on a non-transitory tangible medium, such as magnetic, optical, or electronic memory.

[0047] The medical system 20 may also include an ablation power generator 69 (e.g., an RF signal generator) connected to the catheter 40 and configured to apply an electrical signal between one or more of the electrodes 48 and the proximal electrode 21. The medical system 20 may also include an irrigation reservoir 71 configured to store irrigation fluid, and a pump 73 configured to connect to the irrigation reservoir 71 and the catheter 40 and configured to pump the irrigation fluid from the irrigation reservoir 71, through the irrigation tubing, and through the irrigation lumen of the catheter 40.

[0048] The illustration of the embodiment shown in Figure 1 has been chosen solely for purposes of conceptual clarity. For simplicity and clarity, Figure 1 shows only elements relevant to the disclosed technique. System 20 typically includes additional modules and elements that are not directly related to the disclosed technology and thus have been intentionally omitted from Figure 1 and the corresponding description. The elements of system 20 and the methods described herein may be further applied, for example, to control the ablation of tissue in heart 26.

[0049] Catheter 40 is described herein as a basket catheter. Expandable distal tip assembly 35 may include any suitable number of splines, any suitable number of electrodes, and any suitable number of electrodes per spline. Catheter 40 may be implemented as any suitable catheter type, such as a balloon catheter, a lasso catheter, a grid catheter, or a flexible spline catheter in which the distal ends of the flexible splines are not connected together.

[0050] Reference is now made to Figure 2, which is a schematic diagram showing a catheter 40 within a body part, such as the heart 26, for use in the system 20 of Figure 1. Figure 2 shows that some of the electrodes 48 on the expandable distal tip assembly 35 (visible in Figure 2 - for simplicity, only some are labeled) are not in contact with tissue of the heart 26, while other electrodes 48 (not visible in Figure 2, but indicated using arrows 75) are in contact with tissue of the heart 26. The position (location and orientation) of the catheter 40 and electrodes 48 may be tracked using any suitable tracking method, such as the method described above with reference to Figure 1.

[0051] The physician 30 or another user of the medical system 20 can view the position of the catheter 40 and electrodes 48 relative to the body part using a display, such as the display 27 (FIG. 1), or a head-mounted device 79 (e.g., a head-mounted display (HMD)) that includes a display screen 81. The catheter 40, electrodes 48, and the interior of the body part can be viewed from a virtual camera 83 that is substantially positioned within the body part and / or within the expandable distal tip assembly 35 (as shown in FIG. 2) and can be operated by the physician 30. The virtual camera 83 can be operated using a user interface (e.g., a joystick) and / or by moving the head-mounted device 79. FIG. 2 shows a dotted line 85 that indicates the field of view of the virtual camera 83.

[0052] Physician 30 may use hand gestures to select a portion of catheter 40 that includes one or more of electrodes 48. As described in more detail below with reference to FIG. 3, physician 30's hand (or portion thereof) (or an image of the hand) may also be shown on display 81 (or other suitable display) so that physician 30 can see a representation of catheter 40 and his or her hand relative to electrodes 48 on display 81.

[0053] Hand gestures may be tracked by analyzing images captured by camera 77. Camera 77 may be disposed in the room where the medical procedure is being performed, on the front of head-mounted device 79, or in any suitable location. Alternatively or additionally, hand gestures may be tracked using any suitable tracking technology, such as glove-based technology that uses a virtual reality glove with sensors within the glove to track the hand and finger movements of physician 30 while wearing the glove. Sensors may include one or more of the following sensors: mechanical, piezoresistive, or fiber optic sensors to measure finger bending. Other sensors include gyroscopes, accelerometers, and / or magnetometers to track hand movements. Signals from the glove are sent to processor 41 and processed by software to identify hand movements and / or gestures.

[0054] Head-mounted device 79 is configured to be worn by physician 30 (or any suitable user). It should be noted that when physician 30 is described herein as performing a task, the task may also be performed by any suitable user. In some embodiments, display 81 comprises an optical see-through display that allows physician 30 to view his or her hand (or a portion thereof) through display 81 when the physician's hand is positioned in front of him or her. In other embodiments, display 81 is an eye-level video display on which an image (e.g., video) of the hand (or a portion thereof) captured by camera 77 is shown, as described in more detail with reference to FIG. 3 .

[0055] Reference is now made to Figure 3, which is a schematic diagram of a display 81 providing a view 87 of a hand performing a gesture, a rendering of the interior of an anatomical map 89 of a body part, and a rendering of a representation 91 of the catheter 40 of Figure 2 within the anatomical map 89. See also Figure 2.

[0056] FIG. 3 shows the inside of the expandable distal tip assembly 35 with the electrodes 48 of the expandable distal tip assembly 35 hidden from view because the electrodes 48 face toward the tissue of the body part (i.e., toward the page of the drawing in FIG. 3). To allow the physician 30 to see and select the “hidden” electrodes 48, the locations of the electrodes 48 are shown on representation 91 as representation 93 (only some are labeled for simplicity). FIG. 3 shows a hand (view 87) performing a pinching action on one of the representations 93. The corresponding electrode 48 is then selected. In the example of FIG. 3, the pinching action causes a display of the IEGM 95 sensed by the selected electrode 48. In some embodiments, representation 91 may show the catheter 40 using semi-transparent rendering to view the locations of the “hidden” electrodes 48.

[0057] In embodiments in which the display 81 of the head-mounted device 79 comprises an optical see-through display, the view 87 seen on the display 81 is of the actual hand of the physician 30 positioned in front of him or her. The anatomical map 89 and representation 91 (including representation 93) are then augmented on the display 81 so that the hand is seen along with the anatomical map 89 and representation 91 of the catheter 40. The hand movements may be registered to a coordinate frame used to track the catheter 40 based on images captured by the camera 77, or using a tracking glove worn by the physician 30, or any suitable method. The size of the representation 91 and anatomical map 89 is scaled according to the size of the hand seen on the display 81 (either based on an actual captured image of the hand or based on an estimated size of the hand) so that gestures such as pointing with one finger or pinching with two fingers may be used to easily select a single electrode.

[0058] In embodiments in which the display 81 of the head-mounted device 79 is an eye-level video display, the view 87 includes an image (e.g., video) of the hand (or portion thereof) captured by the camera 77. The view 87, the anatomical map 89, and the representation 91 (including the representation 93) are rendered on the display 81 by the processor 41. The hand movements may be registered to a coordinate frame used to track the catheter 40 based on the image captured by the camera 77, or using a tracking glove worn by the physician 30, or any suitable method. The size of the view 87 and / or representation 91 of the hand, and the anatomical map 89 may be scaled to allow for easy selection of a single electrode using gestures such as pointing with one finger or pinching with two fingers.

[0059] Reference is now made to Figure 4, which is a flowchart 100 including steps in a method of operating the system 20 of Figure 1. Reference is also made to Figure 2. The steps described below with reference to flowchart 100 may be performed in any suitable order, and some of the steps may be performed simultaneously, unless the steps require a given processing order.

[0060] The catheter 40 is configured to be inserted into a body part (e.g., a chamber of the heart 26) of a living subject. The electrodes 48 of the catheter 40 are configured to sense electrical activity from tissue in the body part. The processor 41 (FIG. 1) is configured to track (block 102) the position (e.g., position, orientation, and roll) of the catheter 40 within the body part. In some embodiments, the processor is configured to track the position of the electrodes 48 of the catheter 40. Any suitable tracking method may be used, such as the tracking methods described above with reference to FIG. 1.

[0061] In embodiments that include a camera 77, the camera 77 is configured to capture at least one image (eg, video) of the hand (or portion thereof) of the physician 30 (block 104).

[0062] Display 81 is configured to provide (block 106) a view 87 ( FIG. 3 ) of physician 30's hand (or portion thereof). In embodiments in which display 81 of head-mounted device 79 comprises an optical see-through display, view 87 seen on display 81 is of physician 30's actual hand positioned in front of him / her. In embodiments in which display 81 of head-mounted device 79 is an eye-level video display, view 87 includes an image (e.g., video) of the hand (or portion thereof) captured by camera 77, and processor 41 is configured to render the image of the hand (or portion thereof) on display 81.

[0063] The processor 41 is configured to render (block 108) on the display 81 a three-dimensional view of the interior of the anatomical map 89 of the body part and a representation 91 of the catheter 40 within the anatomical map 89 (and a representation 93 of the electrodes 48) responsive to the tracked position of the catheter 40, while the display 81 provides a view 87 of the hand (or portion thereof) of the physician 30. In some embodiments, the processor 41 is configured to render on the display 81 a three-dimensional view of the interior of the anatomical map 89 of the body part and a representation 91 of the catheter 40 within the anatomical map 89 (and a representation 93 of the electrodes 48) as seen from a virtual camera 83, while the display 81 provides a view 87 of the hand (or portion thereof) of the physician 30. The virtual camera 83 is optionally disposed within the expandable distal end assembly 35 of the catheter 40.

[0064] In some embodiments where display 81 is a video display included in head-mounted device 79, display 81 is configured to simultaneously render (block 110) on display 81 a three-dimensional view of the interior of an anatomical map 89 of the body part, and, responsive to the tracked position of catheter 40, a representation 91 of catheter 40 (and a representation 93 of electrodes 48) within anatomical map 89, and a view 87 of physician 30's hand (or portion thereof) included in an image (e.g., video) captured by camera 77. In some embodiments, processor 41 may be configured to generate view 87 based on a virtual reality glove worn by physician 30.

[0065] In some embodiments in which the display 81 is included in the head-mounted device 79 and includes an optical see-through display, the optical see-through display is configured to provide a view of the physician's 30's hand (or portion thereof) visible through the display 81 while augmenting the display 81 with virtual objects including a three-dimensional view of the interior of an anatomical map 89 of the body part and, in response to the tracked position of the catheter 40, a representation 91 of the catheter 40 within the anatomical map 89 (and a representation 93 of the electrodes 48).

[0066] In some embodiments, processor 41 is configured to receive user input (block 114) to manipulate virtual camera 83 in response to movement of head-mounted device 79 or any suitable user interface (such as a joystick). In response to movement of virtual camera 83, the view of representation 91 and anatomical map 89 shown in display 81 changes.

[0067] The processor 41 is configured to recognize (block 116) a gesture of the physician 30's hand (or a portion thereof) that selects a portion of the catheter 40 and / or one of the electrodes 48 of the catheter 40. The processor 41 may recognize the gesture based on analysis of images captured by the camera 77, and / or analysis of images displayed on the display 81, and / or other gesture tracking methods, such as, for example, tracking glove movement. The proximity of the hand or finger to a portion of the catheter 40 or one of the electrodes 48 may be determined from analysis of the images displayed on the display 81 and / or the tracked position of the catheter 40 and / or electrode 48 relative to the tracked position of the hand or finger. The gesture may include any one or more of the following, by way of example: a pinch gesture, a pointing gesture, or a touching gesture.

[0068] The processor 41 is configured to perform an action (block 118) in response to recognizing a selection of a portion of the catheter 40 (or one of the electrodes 48) by the physician 30. Exemplary actions follow: In some embodiments, the processor 41 is configured to render an IEGM 95 on the display 81 in response to recognizing the sensed electrical activity of the selected electrode 48 and a gesture to select that electrode 48. In some embodiments, the processor 41 is configured to generate an electroanatomical map in response to recognizing the sensed electrical activity of the selected electrode 48 and a gesture to select that electrode 48.

[0069] As used herein, the term "about" or "approximately" in connection with any numerical value or range of values ​​indicates a suitable dimensional tolerance that enables a portion of a component or a collection of components to function in accordance with its intended purpose as described herein. More specifically, "about" or "approximately" may refer to a range of values ​​of ±20% of the recited value, for example, "about 90%" may refer to a range of values ​​of 72% to 108%.

[0070] Various features of the invention, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention, which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable subcombination.

[0071] The above-described embodiments are cited by way of example, and the present invention is not limited to that particularly shown and described in the foregoing specification. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described in the foregoing specification, as well as variations and modifications thereof not disclosed in the prior art that will occur to those skilled in the art upon reading the above description.

[0072] [Embodiment] (1) A health care system: a catheter configured to be inserted into a body part of a living subject; a display configured to provide a view of at least a portion of a user's hand; 1. A processor, comprising: tracking the position of the catheter within the body part; rendering on the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked positions while the display provides the view of the at least part of the hand of the user; Recognizing a gesture of the at least a portion of the user's hand that selects a portion of the catheter; and a processor configured to perform an action in response to recognizing a selection of the portion of the catheter by the user. (2) The system of embodiment 1, further comprising a camera configured to capture an image of at least a portion of the user's hand, and the processor configured to recognize the gesture of at least a portion of the user's hand that selects the portion of the catheter in response to the tracked position of the catheter and the captured image. (3) The system of embodiment 2, further comprising a head-mounted device configured to be worn by the user and including the display, wherein the head-mounted device is configured to simultaneously render on the display the three-dimensional view of the interior of the anatomical map of the body part, the representation of the catheter within the anatomical map in response to the tracked position, and the image of at least a portion of the user's hand captured by the camera. (4) The system of embodiment 1 further comprises a head-mounted device configured to be worn by the user and including the display, the head-mounted device comprising an optical see-through display configured to provide the view of at least a portion of the user's hand visible through the display while augmenting the display with virtual objects including the three-dimensional view of the interior of the anatomical map of the body part and the representation of the catheter within the anatomical map in response to the tracked position. (5) the catheter includes a plurality of electrodes; the processor is configured to track the position of the electrodes; The system of embodiment 1, wherein the processor is configured to recognize the gesture of at least a portion of the user's hand that selects one of the electrodes of the catheter.

[0073] (6) the one electrode is configured to sense electrical activity from tissue of the body part; The system of embodiment 5, wherein the processor is configured to render an intracardiac electrogram on the display in response to recognizing the sensed electrical activity and the gesture selecting the one electrode. (7) the one of the electrodes is configured to sense electrical activity from tissue of the body part; The system of embodiment 5, wherein the processor is configured to generate an electroanatomical map in response to recognizing the sensed electrical activity and the gesture selecting the one electrode. (8) The system of embodiment 5, wherein the gesture includes any one or more of the following: a pinch gesture, a pointing gesture, or a touch gesture. (9) The method further includes a head-mounted device configured to be worn by the user and including the display, wherein the processor: receiving user input to manipulate a virtual camera in response to movement of the head-mounted device; The system of embodiment 1, configured to render on the display the three-dimensional view of the interior of the anatomical map of the body part as seen from the virtual camera and the representation of the catheter within the anatomical map, while the display provides the view of at least a portion of the user's hand. (10) The catheter comprises an expandable distal end assembly and a plurality of electrodes disposed on the expandable distal end assembly; The system of embodiment 1, wherein the processor is configured to render on the display the three-dimensional view of the interior of the anatomical map of the body part as seen from a virtual camera disposed within the expandable distal end assembly and the representation of the catheter within the anatomical map, while the display provides the view of at least a portion of the user's hand.

[0074] (11) A medical method comprising: providing a view of at least a portion of a user's hand on a display; Tracking the position of a catheter within a body part of a living subject; rendering on the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked positions while the display provides the view of the at least part of the hand of the user; Recognizing a gesture of the at least a portion of the user's hand that selects a portion of the catheter; and performing an action in response to recognizing a selection of the portion of the catheter by the user. (12) The method of embodiment 11, further comprising capturing an image of at least a portion of the user's hand, and wherein the recognizing comprises recognizing a gesture of at least a portion of the user's hand that selects the portion of the catheter in response to the tracked position of the catheter and the captured image. (13) The display is included in a head-mounted device worn by the user; The method of embodiment 12, wherein the rendering includes rendering on the display the three-dimensional view of the interior of the anatomical map of the body part, the representation of the catheter within the anatomical map in response to the tracked position, and the captured image of at least a portion of the user's hand. (14) The method of embodiment 11, wherein the providing includes providing the view of at least a portion of the user's hand viewable through an optical see-through display included in a head-mounted device worn by the user while augmenting the display with virtual objects including the three-dimensional view of the interior of the anatomical map of the body part and the representation of the catheter within the anatomical map in response to the tracked position. (15) The method of embodiment 11, further comprising tracking the position of electrodes of the catheter, and wherein the recognizing comprises recognizing the gesture of the at least a portion of the user's hand that selects one of the electrodes of the catheter.

[0075] (16) The method of embodiment 15, further comprising sensing electrical activity from tissue of the body part by the one electrode, and wherein the rendering comprises rendering an intracardiac electrogram on the display in response to the sensed electrical activity and the recognizing the gesture selecting the one electrode. (17) sensing electrical activity from tissue of the body part with the one electrode; 16. The method of claim 15, further comprising generating an electroanatomical map in response to the sensed electrical activity and the recognizing the gesture selecting the one electrode. (18) The method of embodiment 15, wherein the gesture includes any one or more of the following: a pinch gesture, a pointing gesture, or a touch gesture. (19) The method of embodiment 11, further comprising receiving user input to operate a virtual camera in response to movement of a head-mounted device worn by the user, and wherein the rendering comprises rendering on the display the three-dimensional view of the interior of the anatomical map of the body part and the representation of the catheter within the anatomical map as seen from the virtual camera while the display provides the view of the at least a portion of the user's hand. (20) The method of embodiment 11, wherein the rendering includes rendering on the display the three-dimensional view of the interior of the anatomical map of the body part and the representation of the catheter within the anatomical map as seen from a virtual camera disposed within an expandable distal end assembly of the catheter, while the display provides the view of the at least a portion of the user's hand.

[0076] (21) A software product including a non-transitory computer-readable medium having stored thereon program instructions, the instructions, when read by a central processing unit (CPU), causing the CPU to: Tracking the position of a catheter within a body part of a living subject; rendering on the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked positions, while the display provides a view of at least a portion of the user's hand; Recognizing a gesture of the at least a portion of the user's hand that selects a portion of the catheter; and performing an action in response to recognizing a selection of the portion of the catheter by the user.

Claims

1. 1. A health care system comprising: a catheter configured to be inserted into a body part of a living subject; a display configured to provide a view of at least a portion of a user's hand; 1. A processor, comprising: tracking the position of the catheter within the body part; a processor configured to render on the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked positions while the display provides the view of the at least part of the hand of the user; the catheter includes a plurality of electrodes; the processor is configured to track positions of the plurality of electrodes; the processor is configured to recognize a gesture of the at least a portion of the user's hand that selects one electrode of the plurality of electrodes of the catheter; the one electrode is configured to sense electrical activity from tissue of the body part; the processor is configured to render an intracardiac electrogram on the display or generate an electroanatomical map in response to the sensed electrical activity and recognizing the gesture selecting the one electrode.

2. 2. The system of claim 1, further comprising a camera configured to capture an image of the at least a portion of the user's hand, and wherein the processor is configured to recognize the gesture of the at least a portion of the user's hand that selects the one electrode in response to the tracked position of the catheter and the captured image.

3. 3. The system of claim 2, further comprising a head-mounted device configured to be worn by the user and including the display, the head-mounted device configured to simultaneously render on the display the three-dimensional view of the interior of the anatomical map of the body part, the representation of the catheter within the anatomical map in response to the tracked position, and the image of the at least a portion of the user's hand captured by the camera.

4. 2. The system of claim 1, further comprising: a head-mounted device configured to be worn by the user and including the display, the head-mounted device comprising an optical see-through display configured to provide the view of the at least a portion of the user's hand visible through the display while augmenting the display with virtual objects including the three-dimensional view of the interior of the anatomical map of the body part and the representation of the catheter within the anatomical map in response to the tracked position.

5. The system of claim 1 , wherein the gestures include any one or more of the following: a pinch gesture, a pointing gesture, or a touch gesture.

6. a head-mounted device configured to be worn by the user and including the display, the processor: receiving user input to manipulate a virtual camera in response to movement of the head-mounted device; 2. The system of claim 1, wherein the system is configured to: render on the display the three-dimensional view of the interior of the anatomical map of the body part as seen from the virtual camera and the representation of the catheter within the anatomical map, while the display provides the view of the at least a portion of the hand of the user.

7. the catheter comprising an expandable distal tip assembly and a plurality of electrodes disposed on the expandable distal tip assembly; 2. The system of claim 1, wherein the processor is configured to render on the display the three-dimensional view of the interior of the anatomical map of the body part and the representation of the catheter within the anatomical map as seen from a virtual camera disposed within the expandable distal tip assembly, while the display provides the view of the at least a portion of the user's hand.

8. 1. A method of operating a medical system, comprising: the medical system comprising a catheter configured to be inserted into a body part of a living subject, a display, and a processor; the processor providing a view of at least a portion of a user's hand on the display; the processor tracks the position of the catheter within the body part of the living subject; the processor rendering on the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked positions while the display provides the view of the at least part of the hand of the user; the catheter includes a plurality of electrodes; the processor tracks the positions of the plurality of electrodes; the processor recognizing a gesture of the at least a portion of the user's hand that selects one electrode of the plurality of electrodes of the catheter; the one electrode sensing electrical activity from tissue of the body part; 10. A method of operating a medical system, wherein the processor, in response to recognizing the sensed electrical activity and the gesture selecting the one electrode, renders an intracardiac electrogram on the display or generates an electroanatomical map.

9. The medical system further comprising a camera configured to capture an image of the at least a portion of the hand of the user; 9. The method of claim 8, wherein the processor is configured to recognize the gesture of the at least a portion of the user's hand that selects the one electrode in response to the tracked position of the catheter and the captured image.

10. The display is included in a head-mounted device worn by the user.

9. The method of operating a medical system according to claim 8.

11. A method of operating a medical system as described in claim 8, wherein the processor provides the view of at least a portion of the user's hand visible through an optical see-through display included in a head-mounted device worn by the user while augmenting the display with virtual objects including the three-dimensional view of the interior of the anatomical map of the body part and the representation of the catheter within the anatomical map in response to the tracked position.

12. The method of claim 8 , wherein the gestures include any one or more of the following: a pinch gesture, a pointing gesture, or a touch gesture.

13. A method of operating a medical system as described in claim 8, wherein the processor receives user input to operate a virtual camera in response to movement of a head-mounted device worn by the user.

14. A method of operating a medical system as described in claim 8, wherein the processor renders on the display the three-dimensional view of the interior of the anatomical map of the body part as seen from a virtual camera disposed within an expandable distal end assembly of the catheter and the representation of the catheter within the anatomical map, while the display provides the view of at least a portion of the user's hand.

15. 1. A software product including a non-transitory computer-readable medium having stored thereon program instructions, the program instructions, when read by a central processing unit (CPU), causing the CPU to: Tracking the position of a catheter within a body part of a living subject; rendering on the display a three-dimensional view of an interior of an anatomical map of the body part and a representation of the catheter within the anatomical map in response to the tracked positions, while the display provides a view of at least a portion of the user's hand; Recognizing a gesture of the at least a portion of the user's hand that selects one electrode of a plurality of electrodes of the catheter; and in response to recognizing the electrical activity sensed by the one electrode and the gesture selecting the one electrode, rendering an intracardiac electrogram on the display or generating an electroanatomical map.

Images