Incorporating confidence levels into electrophysiological (EP) maps

Abstract

To visualize a cardiac electrophysiological map.SOLUTION: A method includes receiving (i) a modeled surface of at least a portion of a heart and (ii) multiple EP values measured at multiple respective positions in the heart. Multiple regions are defined on the modeled surface and, for each region, a confidence level is estimated for the EP values whose positions fall in the region. The modeled surface is presented to a user, including (i) the EP values overlaid on the modeled surface, and (ii) the confidence level graphically visualized in each region of the modeled surface.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates generally to electrophysiological mapping, and more particularly to visualization of cardiac electrophysiological maps. [Background technology]

[0002] In electrophysiological (EP) cardiac mapping, visualization methods previously proposed in the patent literature can be used to facilitate interpretation of EP maps. For example, U.S. Patent No. 9,532,725 describes an exemplary medical device that can include a catheter shaft to which multiple electrodes are coupled and a processor coupled to the catheter shaft. The processor can collect a set of signals from the multiple electrodes and generate a dataset from at least one of the sets of signals. The dataset can include at least one known data point and one or more unknown data points. The processor can also interpolate at least one of the unknown data points by adjusting the dataset, assign an interpolated value to at least one of the unknown data points, and assign a confidence level to the interpolated value. To communicate the reliability of the interpolated data, the derived confidence level can take the form of a confidence map, thereby displaying the confidence level of the interpolated data.

[0003] As another example, U.S. Patent No. 6,301,496 describes a method for diagnosing cardiac arrhythmias, including measuring a physiological response, calculating a vector function associated with the response, displaying a representation of the vector function, and inferring an abnormal condition from the representation. The physiological response is a voltage from which a local activation time (LAT) is estimated, and the vector function is the gradient of the local activation time, specifically, conduction velocity. Measurement data may be displayed on a map using a pseudocolor scale when a certain value represents measurement data with a defined confidence level, thereby allowing the measurement data to be placed directly on the pseudocolor map. Alternatively, when a certain value represents measurement data with a low confidence level, the measurement data may be displayed in a different color or transparency, thereby allowing the measurement data to be displayed in a different color or transparency. In the latter case, the practitioner is guided to obtain more samples.

[0004] U.S. Patent Application Publication No. 2016 / 0038047 describes a method that includes recording parameters characteristic of ablation performed at one or more sites in a region of a human heart and receiving a set of electrophysiological signals indicative of waves of electrical activation flowing through the region. The method further includes identifying locations within the region where wave flow is inhibited and estimating a confidence level for wave inhibition at those locations responsive to the signals and the parameters. The method also includes displaying a map of the human heart that includes an indication of the confidence levels.

[0005] U.S. Patent No. 10,588,531 describes a system and method for determining the prevalence of a cardiac phenomenon based on electrophysiological (EP) data from bodily tissue. One system includes an electronic control unit communicatively coupled to a display device, configured to detect, for each of a plurality of locations, whether a cardiac phenomenon occurs at the location based on the EP data at each of a plurality of discrete times occurring during a predetermined time period, determine a prevalence of the cardiac phenomenon based on the detection, and display information on the display device indicative of the determined prevalence of the cardiac phenomenon. A confidence score associated with the prevalence value may also be determined and displayed. Generally, the longer the predetermined time period and the higher the sampling frequency, the higher the confidence score.

[0006] U.S. Patent No. 9,629,567 describes software and apparatus for automatically detecting and mapping regions of complex fractionated electrograms within the ventricles. Electrogram signals are analyzed to measure the number of complexes whose amplitudes and peak-to-peak intervals meet certain criteria. Functional maps showing the mean complex interval, shortest complex interval, and confidence level are generated for display. For example, confidence level tags corresponding to the percentage of times complex fractionated electrograms occur at a given location during the study are displayed. Summary of the Invention [Means for solving the problem]

[0007] Embodiments of the invention described below provide a method that includes receiving (i) a modeled surface of at least a portion of a heart and (ii) a plurality of EP values ​​measured at a plurality of respective locations within the heart, defining a plurality of regions on the modeled surface, and for each region, estimating a confidence level for EP values ​​whose locations fall within the region, and presenting the modeled surface to a user, including (i) the EP values ​​overlaid on the modeled surface and (ii) a graphically visualized confidence level within each region of the modeled surface.

[0008] In some embodiments, estimating the confidence level includes calculating the confidence level as a function of the number of EP values ​​that fall in the region. In some embodiments, estimating the confidence level of a region includes calculating the confidence level as an increasing function of the number of EP values ​​that fall in the region. In other embodiments, estimating the confidence level of a region includes calculating the confidence level as a decreasing function of the variance of the distribution of EP values ​​that fall in the region.

[0009] In one embodiment, receiving the EP values ​​includes obtaining the EP values ​​using a catheter.

[0010] In another embodiment, the modeled surface is a surface generated by fast anatomical mapping (FAM).

[0011] In some embodiments, the EP value is one of a local activation time (LAT), a bipolar potential, and a unipolar potential.

[0012] In some embodiments, the EP value within a region is the median EP value within that region.

[0013] In one embodiment, graphically visualizing the confidence levels includes presenting respective icons in areas, the size of the icons being an increasing function of the respective confidence levels.

[0014] In another embodiment, the method further includes, in response to detecting that the confidence level of a region is lower than a predetermined confidence level threshold, receiving one or more additional EP values ​​for the region and re-estimating the confidence level for EP values ​​that fall in the region including the one or more additional EP values.

[0015] In some embodiments, receiving EP values ​​for a region includes projecting a plurality of positions onto a plurality of locations within the region and assigning the EP values ​​at those locations to each location.

[0016] In some embodiments, the regions comprise polygons within a polygon mesh of the modeled surface, while in other embodiments, one or more of the regions is a circular region having a predetermined radius.

[0017] According to another embodiment of the present invention, there is additionally provided a system including an interface and a processor. The interface is configured to receive (i) a modeled surface of at least a portion of a heart and (ii) a plurality of EP values ​​measured at a plurality of respective locations within the heart. The processor is configured to define a plurality of regions on the modeled surface, estimate for each region a confidence level for EP values ​​whose locations fall within the region, and display the modeled surface to a user, including (i) overlaying the EP values ​​on the modeled surface and (ii) graphically visualizing the confidence level within each region of the modeled surface. [Brief explanation of the drawings]

[0018] 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 a system for electrophysiological (EP) mapping, in accordance with an exemplary embodiment of the present invention; [Figure 2A]1A and 1B are schematic representations of a volume rendering of an EP map of the right atrium overlaid with original EP values ​​and a reconstructed EP map of the right atrium overlaid with graphically visualized EP values, respectively, according to an exemplary embodiment of the present invention. [Figure 2B] 1A and 1B are schematic representations of a volume rendering of an EP map of the right atrium overlaid with original EP values ​​and a reconstructed EP map of the right atrium overlaid with graphically visualized EP values, respectively, according to an exemplary embodiment of the present invention. [Figure 3] 2C is a flow chart that schematically illustrates a method for estimating and graphically visualizing EP values ​​on the EP map of FIG. 2B, according to an exemplary embodiment of the present invention; and [Figure 4] 2C is a flow chart that schematically illustrates a method for projecting and graphically visualizing EP values ​​onto the EP map of FIG. 2B, according to another exemplary embodiment of the present invention; DETAILED DESCRIPTION OF THE INVENTION

[0019] Overview Catheter-based electrophysiological (EP) mapping techniques can create various types of EP maps of organs such as the left atrium of the heart. Cardiac EP maps, such as local activation time (LAT) maps, bipolar potential maps, or unipolar potential maps, are created by acquiring electrograms from locations on the surface of the ventricles. EP values, such as LATs (or potentials), are then derived from the electrograms at these locations. Such locations and their respective EP values, hereafter referred to as "data points," are then overlaid, typically as colors, on a 3D map of the ventricles.

[0020] However, EP maps, which are typically obtained by interpolating EP values, do not provide an indication of the quality of the EP values ​​shown. For example, the color of a particular cardiac region may be generated by interpolating the LAT of several locations relatively far from the region, or by interpolating the LAT of multiple locations near or within the region, or by finding the LAT of just one location.

[0021] Specifically, a large number of data points can be acquired in a short period of time, especially when using automated acquisition with a multi-electrode catheter, resulting in many of the data points subsequently projecting onto the same surface area. One existing mapping technique for avoiding such a large number of local acquisition points is to use a density filter. A second technique involves the processor using only the nearest local acquisition points to color the map. Neither technique uses all of the captured data and therefore cannot prevent outlying EP values ​​from being incorporated into the EP map.

[0022] The embodiments of the present invention described below provide methods and systems for improving map quality in multi-electrode catheter systems that acquire large numbers of data points in short periods of time. To this end, techniques are provided for increasing the confidence level of the EP values ​​(e.g., LAT values) shown in the maps.

[0023] In one embodiment, a processor receives a modeled surface of at least a portion of the heart and a plurality of EP values ​​measured at a plurality of respective locations within the heart. The processor defines a plurality of regions (e.g., triangles of a triangular mesh) on the modeled surface and, for each region, estimates a confidence level for EP values ​​whose locations fall within the region. The processor displays the modeled surface to a user, including (i) overlaying the EP values ​​on the modeled surface and (ii) graphically visualizing the confidence level within each region of the modeled surface. In another embodiment, the processor is configured to estimate the confidence level based on the number of EP values ​​that fall within the region.

[0024] For example, the processor can calculate an EP value for a given region by averaging the number of measured locations within that region. A region can be a polygon in a polygon map mesh in a fast anatomical map (FAM) of the ventricle. An example of a polygon is a triangle in a triangular mesh. In another embodiment, a region may be defined as a circle with a preselected radius.

[0025] In another embodiment, the processor receives all measurements (e.g., LAT values). When multiple locations are projected onto the same surface area on the map, the processor may calculate the median EP (or possibly the mean EP) of the set of EP values ​​to minimize errors in the EP values ​​therein and avoid outliers. Thus, estimating a confidence level for an EP value whose location falls within the area may include projecting multiple locations onto multiple locations within the area and calculating a confidence level according to the number of EP values ​​that fall within the area and the EP values ​​projected onto the area.

[0026] The user can also identify map areas that have a lower confidence level and update the map by acquiring more data points at locations within these areas using a multi-electrode catheter processed in a manner similar to that described above, thereby increasing the confidence level within this region.

[0027] In some embodiments, a method is provided for displaying to the user a confidence level that increases with the total number of acquired data points within the same region (i.e., the sum of data points already located and projected within the region). Alternatively, the confidence level is calculated as the inverse of the variance (e.g., median) of the EP values ​​used. In an alternative embodiment, if the variance of EP values ​​within a region is high, the processor may assign a low confidence level to, for example, the median EP value.

[0028] However, typically, a larger number of EP values ​​per region results in a higher confidence level because the variance in the distribution of EP values ​​among data points within a region is smaller.

[0029] Confidence levels are presented by overlaying icons (e.g., hexagonal relief, diamond) on surface locations on the map, where different sized icons (e.g., circles with different radii) correspond to the counted number of locations used to generate the EP value. For example, confidence levels may be grouped into high, medium, and low categories by representing them as large circles, medium points, and small circles, respectively.

[0030] Typically, the processor is programmed with software containing specific algorithms that enable the processor to perform each of the processor-related steps and functions outlined above.

[0031] By increasing the confidence level of EP values ​​and displaying the confidence level on the map using graphical means, the disclosed technology can assist physicians in interpreting EP maps, thus facilitating and improving the quality of complex diagnostic tasks such as those required for diagnostic catheterization.

[0032] System Description FIG. 1 is a schematic, pictorial illustration of a system 21 for electrophysiological (EP) mapping, according to one embodiment of the present invention. FIG. 1 shows a physician 27 using a mapping Pentaray® catheter 29 to perform EP mapping of a heart 23 of a patient 25. The catheter 29 includes one or more arms 20, which may be mechanically flexible, at its distal end, with one or more electrodes 22 coupled to each arm. During the mapping process, the electrodes 22 acquire and / or inject unipolar and / or bipolar signals from and / or into tissue of the heart 23. A processor 28 receives these signals via an electrical interface 35 and uses information contained in these signals to construct an EP map 31, which is stored by the processor 28 in memory 33. During and / or following the procedure, the processor 28 can display the EP map 31 on the display 26.

[0033] The EP map 31 can be a LAT map, a bipolar potential map, or another map type. As illustrated in Figures 2A, 2B, and 3, the EP map 31 has improved quality using the disclosed techniques for deriving and presenting confidence levels on the map.

[0034] A tracking system can be used to track the location of each of the sensing electrodes 22 during the procedure, thereby associating each signal with the location where it was acquired. For example, the Active Catheter Location (ACL) system manufactured by Biosense-Webster (Irvine, California), described in U.S. Patent No. 8,456,182, the disclosure of which is incorporated herein by reference, may be used. In the ACL system, a processor estimates the location of each of the sensing electrodes 22 based on the impedance measured between each of the sensing electrodes 22 and multiple surface electrodes 24 coupled to the skin of the patient 25. For example, three surface electrodes 24 may be coupled to the patient's chest and three surface electrodes 24 may be coupled to the patient's back. (For ease of illustration, only one surface electrode is shown in FIG. 1.) Currents are passed between the electrodes 22 and 24 within the patient's heart 23. The processor 28 calculates the estimated locations of all of the electrodes 22 within the patient's heart based on the ratio between the current amplitudes (or the impedances indicated by these amplitudes) measured at the surface electrodes 24 and the known locations of the electrodes 24 on the patient's body. In this way, the processor can associate any given impedance signal received from the electrodes 22 with the location where the signal was obtained.

[0035] The illustration shown in Figure 1 is chosen solely for the purposes of conceptual clarity. Other tracking methods can be used, such as methods based on measuring voltage signals. Other types of detection catheters, such as the Lasso® catheter (manufactured by Biosense Webster) or basket catheters, may equally be used. Physical contact sensors may be attached to the distal end of the mapping catheter 29 to estimate the contact quality between each of the electrodes 22 and the inner surface of the ventricle during measurement.

[0036] Processor 28 typically comprises a general-purpose computer with software programmed to perform the functions described herein. Specifically, processor 28 executes the dedicated algorithms disclosed herein, included in Figure 3, which enable processor 28 to perform the steps of the present disclosure, as further described below. The software may be downloaded to the computer in electronic form, for example over a network, or alternatively or additionally, may be provided and / or stored on a non-transitory, tangible medium, such as magnetic, optical, or electronic memory.

[0037] Overlaying confidence levels onto the EP map 2A and 2B are schematic volume renderings of an EP map 40 of the right atrium overlaid with original EP values ​​42 and a reconstructed EP map 44 of the right atrium overlaid with graphically visualized EP values ​​(45, 47, 49), respectively, according to one embodiment of the present invention.

[0038] In the map 40, the EP values ​​42 may fall in the same or very similar places, and existing methods, as discussed above, do not utilize this information to increase the reliability of the map.

[0039] In the disclosed technique, the EP map 44 is generated using the median EP values ​​in the surface region, taking into account the number of data points per region to increase the reliability of the map.

[0040] In the illustrated map 44, EP values ​​of three possible confidence levels are assigned to surface regions. As can be seen, EP values ​​with a high confidence level are marked by a large sized icon 49, EP values ​​with a medium confidence level are marked by a medium sized icon 47, and EP values ​​with a low confidence level are marked by a small sized icon 45.

[0041] As can be seen, the reconstructed EP map 44 also has modified contours 46 compared to contours 43 of EP map 40. The new contours reflect modified interpolated EP values ​​that are derived using the assigned data points (e.g., using EP values ​​that may be the median of the EP values ​​per region or per location).

[0042] 2A / B show confidence levels in the form of different relief hexagon sizes, the confidence levels may be presented by other graphical means, such as color coding. Additionally, while FIGS. 2A / 2B show two-layer EP maps, the disclosed technology may overlay confidence levels on multi-layer maps, at least one of which may be an EP map, e.g., a map of ventricular wall thickness.

[0043] Figure 3 is a flow chart that schematically illustrates a method for estimating and graphically visualizing EP values ​​on the EP map of Figure 2B, according to one embodiment of the present invention. The algorithm according to the presented embodiment executes a process that begins with processor 28 receiving a modeled surface (e.g., an anatomical map) of at least a portion of the heart in a model receiving step 302.

[0044] The processor defines a number of regions (eg, triangles) on the modeled surface in a region definition step 304 .

[0045] In a data point receiving step 306, the processor retrieves a plurality of data points including EP values ​​measured at a plurality of respective locations associated with the modeled surface. Step 306 may include all or part of the separate steps of acquiring electrograms using a multi-electrode catheter and processor 28 analyzing the electrograms to derive EP values, such as LAT values.

[0046] Next, in an EP value calculation step 308, processor 28 calculates the median EP value in each region.

[0047] Processor 28 uses the number of median EP values ​​in each region to estimate a confidence level for the median EP value in each region, in a confidence level estimation step 310 .

[0048] In an EP map presentation step 312, processor 28 presents the modeled surface with the median EP values ​​overlaid and with the confidence level in each region graphically visualized, for example, by overlaying an icon in the region, the icon graphic (e.g., size) indicating the confidence level within the region.

[0049] In an EP map update step, a user or processor can identify areas of the map that have a lower confidence level and update the map. In a map check step 314, a user identifies areas of the map that have a confidence level below, for example, a predefined threshold level.

[0050] If the user (or processor) finds a region with a confidence level below a predetermined threshold level, the user can use the mapping system to acquire more data points with a multi-electrode catheter at locations within the region in an additional acquisition step 316.

[0051] Additional data points acquired at locations associated within these regions are added to the available data points and reprocessed by the algorithm by returning to step 308 .

[0052] As above, the data points can be projected onto a surface to add reliability and remove outliers.

[0053] 4 is a flow chart that schematically illustrates a method for projecting and graphically visualizing EP values ​​onto the EP map of FIG. 2B, according to another embodiment of the present invention. The algorithm according to the presented embodiment executes a process that begins with processor 28 receiving a modeled surface (e.g., an anatomical map) of at least a portion of the heart in a model receiving step 402.

[0054] The processor defines a number of regions (eg, triangles) on the modeled surface in a region definition step 404 .

[0055] In a data point receiving step 406, the processor retrieves a plurality of data points including EP values ​​measured at a plurality of respective locations associated with the modeled surface. Step 406 may include all or part of the separate steps of acquiring electrograms using a multi-electrode catheter and processor 28 analyzing the electrograms to derive EP values, such as LAT values.

[0056] Processor 28 then projects the plurality of respective positions onto a plurality of locations on the modeled surface in a data point projection step 408. For data points that are already on the surface, no actual projection occurs.

[0057] Next, in an EP value calculation step 410, processor 28 calculates the median EP value in each region.

[0058] Processor 28 uses the number of median EP values ​​in each region to estimate a confidence level for the median EP value in each region, at a confidence level estimation step 412 .

[0059] In an EP map presentation step 414, processor 28 presents the modeled surface with the median EP values ​​overlaid and with the confidence level in each region graphically visualized, for example, by overlaying an icon in the region, the icon graphic (e.g., size) indicating the confidence level within the region.

[0060] In an EP map update step, a user or processor can identify areas of the map that have a lower confidence level and update the map. In a map check step 416, a user identifies areas of the map that have a confidence level below, for example, a predefined threshold level.

[0061] If the user (or processor) finds a region with a confidence level below a predetermined threshold level, the user can use the mapping system to acquire more data points with a multi-electrode catheter at locations within the region in an additional acquisition step 418.

[0062] Any additional data points acquired at locations associated with these regions are added to the available data points and reprocessed by the algorithm by returning to step 408.

[0063] The exemplary flowcharts shown in Figures 3 and 4 have been chosen purely for purposes of conceptual clarity. In optional embodiments, various additional steps may be performed, for example, to automatically align additional layers, such as medical images, and to generate a display that can toggle between all layers.

[0064] Although the embodiments described herein are primarily directed to cardiac applications, the methods and systems described herein can also be used in other applications, such as electroanatomical mapping of the brain.

[0065] Accordingly, it will be understood that the above-described embodiments are cited by way of example, and that the present invention is not limited to what has been particularly shown and described in the foregoing specification. 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 not disclosed in the prior art that would occur to one skilled in the art upon reading the foregoing description. Documents incorporated by reference into this patent application are to be deemed an integral part of this application, except that if any term is defined in these incorporated documents in a way that contradicts the definition expressly or impliedly given herein, then only the definition in this specification shall be considered.

[0066] [Embodiment] (1) A method for incorporating a confidence level into an electrophysiological map, comprising: receiving (i) a modeled surface of at least a portion of a heart, and (ii) a plurality of EP values ​​measured at a plurality of respective locations within the heart; defining a plurality of regions on the modeled surface and for each region estimating a confidence level of the EP value that the location of the EP value falls within the region; displaying the modeled surface to a user, including (i) overlaying the EP values ​​on the modeled surface, and (ii) graphically visualizing the confidence level within each region of the modeled surface; A method comprising: (2) The method of embodiment 1, wherein estimating the confidence level includes calculating the confidence level according to the number of the EP values ​​that fall within the region. (3) The method of embodiment 1, wherein estimating the confidence level for a region includes calculating the confidence level as an increasing function of the number of EP values ​​that fall in the region. (4) The method of embodiment 1, wherein estimating the confidence level for a region includes calculating the confidence level as a decreasing function of the variance of the distribution of the EP values ​​that fall within the region. (5) The method of embodiment 1, wherein receiving the EP value includes obtaining the EP value using a catheter.

[0067] (6) The method of embodiment 1, wherein the modeled surface is a surface generated by fast anatomical mapping (FAM). (7) The method described in embodiment 1, wherein the EP value is one of local excitation time (LAT), bipolar potential, and unipolar potential. (8) The method of embodiment 1, wherein the EP value within a region is the median of the EP values ​​within the region. (9) The method of embodiment 1, wherein graphically visualizing the confidence levels includes presenting respective icons in the region, the size of the icons being an increasing function of the respective confidence levels. (10) The method of embodiment 1, comprising, in response to detecting that the confidence level of a region is lower than a predetermined confidence level threshold, receiving one or more additional EP values ​​for the region and re-estimating the confidence level for the EP values ​​that fall in the region including the one or more additional EP values.

[0068] (11) The method of embodiment 1, wherein receiving the EP value for an area includes projecting a plurality of positions onto a plurality of locations within the area and assigning the EP value at the position to each of the locations. (12) The method of embodiment 1, wherein the region comprises a polygon within a polygon mesh of the modeled surface. (13) The method of embodiment 1, wherein one or more of the regions is a circular region having a predetermined radius. (14) A system for incorporating a confidence level into an electrophysiological map, comprising: an interface configured to receive (i) a modeled surface of at least a portion of a heart, and (ii) a plurality of EP values ​​measured at a plurality of respective locations within the heart; 1. A processor, comprising: defining a plurality of regions on the modeled surface, and for each region, estimating a confidence level of the EP value that the location of the EP value falls within the region; displaying the modeled surface to a user, including (i) overlaying the EP values ​​on the modeled surface, and (ii) graphically visualizing the confidence level within each region of the modeled surface; a processor configured to: Including, the system. (15) The system of embodiment 14, wherein the processor is configured to estimate the confidence level by calculating the confidence level according to the number of the EP values ​​that fall within the region.

[0069] (16) The system of embodiment 14, wherein the processor is configured to estimate the confidence level for the region by calculating the confidence level as an increasing function of the number of EP values ​​that fall into a region. (17) The system of embodiment 14, wherein the processor is configured to estimate the confidence level for the region by calculating the confidence level as a decreasing function of the variance of the distribution of the EP values ​​that fall within the region. (18) The system described in embodiment 14, wherein the interface is configured to receive the EP value from a catheter. (19) The system described in embodiment 14, wherein the modeled surface is a surface generated by fast anatomical mapping (FAM). (20) The system described in embodiment 14, wherein the EP value is one of a local excitation time (LAT), a bipolar potential, and a unipolar potential.

[0070] (21) The system of embodiment 14, wherein the EP value within a region is the median of the EP values ​​within the region. (22) The system of embodiment 14, wherein the processor is configured to graphically visualize the trust levels by presenting respective icons in the region, the size of the icons being an increasing function of the respective trust levels. (23) The system of embodiment 14, wherein the interface is further configured to receive one or more additional EP values ​​for a region in response to detecting that the confidence level of the region is lower than a predetermined confidence level threshold, and the processor is configured to re-estimate the confidence level for the EP values ​​that fall in the region including the one or more additional EP values. (24) The system of embodiment 14, wherein the processor is further configured to project a plurality of positions onto a plurality of locations within the region and assign the EP values ​​at the positions to the respective locations. (25) The system of embodiment 14, wherein the region comprises a polygon within a polygon mesh of the modeled surface.

[0071] (26) The system of embodiment 14, wherein one or more of the regions is a circular region having a predetermined radius.

Claims

1. 1. A system for incorporating a confidence level into an electrophysiological map, comprising: an interface configured to (i) receive a modeled surface of at least a portion of a heart; and (ii) receive a plurality of EP values ​​measured at a plurality of respective locations within the heart; 1. A processor, comprising: defining a plurality of regions on the modeled surface, and for each region estimating a confidence level of the EP value that the location of the EP value falls within the region; displaying the modeled surface to a user, including (i) overlaying the EP values ​​on the modeled surface, and (ii) graphically visualizing the confidence level within each region of the modeled surface; a processor configured to: Including, the interface is further configured to receive one or more additional EP values ​​for a region in response to detecting that the confidence level of the region is lower than a predetermined confidence level threshold, and the processor is configured to re-estimate the confidence level for the EP values ​​falling in the region including the one or more additional EP values. system.

2. The system of claim 1 , wherein the processor is configured to estimate the confidence level by calculating the confidence level as a function of the number of the EP values ​​that fall in the region.

3. The system of claim 1 , wherein the processor is configured to estimate the confidence level for a region by calculating the confidence level as an increasing function of the number of the EP values ​​that fall into the region.

4. The system of claim 1 , wherein the processor is configured to estimate the confidence level for a region by calculating the confidence level as a decreasing function of the variance of the distribution of the EP values ​​that fall within the region.

5. The system of claim 1 , wherein the interface is configured to receive the EP value from a catheter.

6. The system of claim 1 , wherein the modeled surface is a surface generated by fast anatomical mapping (FAM).

7. The system of claim 1 , wherein the EP value is one of a local excitation time (LAT), a bipolar potential, and a unipolar potential.

8. The system of claim 1 , wherein the EP value within a region is the median of the EP values ​​within the region.

9. 2. The system of claim 1, wherein the processor is configured to graphically visualize the confidence levels by presenting respective icons in the region, the size of the icons being an increasing function of the respective confidence levels.

10. The system of claim 1 , wherein the processor is further configured to project a plurality of positions onto a plurality of locations within the region and assign the EP value at the position to the respective positions.

11. The system of claim 1 , wherein the region comprises a polygon within a polygon mesh of the modeled surface.

12. The system of claim 1 , wherein one or more of the regions is a circular region having a predetermined radius.

13. 1. A program for incorporating a confidence level into an electrophysiological map, the program, when loaded into a processor, comprising: (i) receiving a modeled surface of at least a portion of a heart; (ii) receiving a plurality of EP values ​​measured at a plurality of respective locations within the heart; defining a plurality of regions on the modeled surface and for each region estimating a confidence level of the EP value that the location of the EP value falls within the region; displaying the modeled surface to a user, including (i) overlaying the EP values ​​on the modeled surface, and (ii) graphically visualizing the confidence level within each region of the modeled surface; In response to detecting that the confidence level of a region is lower than a predetermined confidence level threshold, receiving one or more additional EP values ​​for the region and re-estimating the confidence level for the EP values ​​falling in the region including the one or more additional EP values. program.

14. The program of claim 13 , wherein estimating the confidence level comprises calculating the confidence level as a function of the number of the EP values ​​that fall within the region.

15. The program of claim 13 , wherein estimating the confidence level for a region comprises calculating the confidence level as an increasing function of the number of the EP values ​​that fall in the region.

16. The program of claim 13 , wherein estimating the confidence level for a region comprises calculating the confidence level as a decreasing function of the variance of the distribution of the EP values ​​that fall in the region.

17. The program of claim 13 , wherein the EP value comprises an EP value received from a catheter.

18. The program of claim 13 , wherein the modeled surface is a surface generated by fast anatomical mapping (FAM).

19. 14. The program of claim 13, wherein the EP value is one of a local excitation time (LAT), a bipolar potential, and a unipolar potential.

20. The program according to claim 13 , wherein the EP value within a region is the median of the EP values ​​within the region.

21. 14. The program of claim 13, wherein the graphical visualization of the confidence levels comprises presenting respective icons in the regions, the size of the icons being an increasing function of the respective confidence levels.

22. 14. The program of claim 13, wherein receiving the EP values ​​for an area includes projecting a plurality of positions onto a plurality of locations within the area and assigning the EP values ​​at the positions to the respective positions.

23. The program of claim 13 , wherein the region comprises a polygon within a polygon mesh of the modeled surface.

24. The computer program product of claim 13 , wherein one or more of the regions is a circular region having a predetermined radius.

25. A system for incorporating confidence levels into electrophysiological maps, comprising: an interface configured to (i) receive a modeled surface of at least a portion of a heart; and (ii) receive a plurality of EP values ​​measured at a plurality of respective locations within the heart; 1. A processor, comprising: defining a plurality of regions on the modeled surface, and for each region estimating a confidence level of the EP value that the location of the EP value falls within the region; displaying the modeled surface to a user, including (i) overlaying the EP values ​​on the modeled surface, and (ii) graphically visualizing the confidence level within each region of the modeled surface; a processor configured to: Including, The system, wherein the processor is configured to graphically visualize the trust levels by presenting respective icons in the region, the size of the icons being an increasing function of the respective trust levels.

26. A program for incorporating a confidence level into an electrophysiological map, the program, when loaded into a processor, comprising: (i) receiving a modeled surface of at least a portion of a heart; (ii) receiving a plurality of EP values ​​measured at a plurality of respective locations within the heart; defining a plurality of regions on the modeled surface and for each region estimating a confidence level of the EP value that the location of the EP value falls within the region; displaying the modeled surface to a user, including (i) overlaying the EP values ​​on the modeled surface, and (ii) graphically visualizing the confidence level within each region of the modeled surface; Run The program, wherein graphically visualizing the confidence levels includes presenting respective icons in the region, the size of the icons being an increasing function of the respective confidence levels.

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