Signal processing of velocity streams of signal flow for coherent mapping of anatomical structures

Abstract

To provide signal correction processing of velocity streams of a signal flow for coherent mapping of an anatomical structure.SOLUTION: A method is provided. The method is implemented by a mapping engine stored as a program code on a memory and executed by a processor. The method includes subdividing an anatomical mesh of a part of an anatomical structure into one or more other meshes of the anatomical structure. The one or more other meshes are more granular than the anatomical mesh. The method includes interpolating local activation time values and velocity values for the one or more other meshes, and tracing a path of velocity vectors on the one or more other meshes in accordance with the interpolation of the local activation time values and velocity values. The method also includes projecting the path on the anatomical mesh to provide enhanced visualization of the anatomical structure.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present invention relates to signal processing. More specifically, the present invention relates to signal correction processing of a velocity stream of a signal flow for coherent mapping of an anatomical structure.

Background Art

[0002] In medical procedures such as mapping the electrical activity of an organ (e.g., the heart), a physician uses a current medical mapping system to measure and track the flow and progression of signals around the heart.

[0003] Generally, when mapping electrical activity, current medical mapping systems show the correspondence between a set of local activation times (LATs) and a group of spatial map elements such as triangles (e.g., as discussed in U.S. Patent Application No. 2020 / 0146579, which is incorporated herein by reference. The LAT is an indication of the flow of electrical activity through the heart wall related to the heartbeat. The spatial map elements (e.g., triangles, etc.) may be generated from the measured positions of the heart wall. It should be noted that current medical mapping systems can show the correspondence between the LAT and the mesh-shaped triangles superimposed on the graphical representation of the heart wall as mapping. To refine this mesh form and mapping, current medical mapping systems perform interpolation by calculating the velocity vectors of the electrical waves on the mesh form (e.g., for each triangle, the signal arrival time and signal velocity are calculated) with respect to the mesh form given to the heart wall.

[0004] Specifically, coherent mapping features in current medical mapping systems present a clear visualization of signal flow within the heart based on a color-coded display of signal progression. Coherent mapping features also provide the time and velocity of signals around the heart, particularly the movement of periodic arrhythmias. However, when physicians attempt to understand the flow of arrhythmias, they must analyze the velocity vectors of any given triangle, which can be difficult to interpret because the coarseness of the mesh from which the velocity vectors are determined can make the progression of activation appear discontinuous even if it is smooth. [Overview of the project] [Means for solving the problem]

[0005] According to one embodiment, a method is provided. The method is implemented by a mapping engine, which is stored as program code in memory and executed by a processor. The method comprises subdividing an anatomical mesh of a portion of an anatomical structure into one or more other meshes of the anatomical structure, one or more of which have a finer granularity than the anatomical mesh. The method comprises interpolating local activation time values ​​and velocity values ​​of one or more of the other meshes, and tracing the paths of velocity vectors on one or more of the other meshes according to the interpolation of local activation time values ​​and velocity values. The method also comprises projecting the paths onto the anatomical mesh to provide an improved visualization of the anatomical structure.

[0006] According to one or more embodiments, embodiments of the above method may be implemented as an apparatus, system, and / or computer program product. [Brief explanation of the drawing]

[0007] A more detailed understanding can be obtained from the following explanation, which is provided as an example in conjunction with the attached drawings, where similar reference numbers in the drawings indicate similar elements. [Figure 1]The diagram shows an exemplary system in which one or more embodiments can implement one or more features of the subject matter of this disclosure. [Figure 2] A block diagram of an exemplary system for signal correction processing of a velocity stream of signal flow for organ coherent mapping according to one or more embodiments is shown. [Figure 3] Exemplary methods according to one or more embodiments are shown. [Figure 4] Geometric diagrams of one or more embodiments are shown. [Figure 5] Geometric diagrams of one or more embodiments are shown. [Figure 6] Geometric diagrams of one or more embodiments are shown. [Figure 7] An exemplary interface according to one or more embodiments is shown. [Figure 8] Exemplary methods according to one or more embodiments are shown. [Modes for carrying out the invention]

[0008] This specification discloses signal processing and methods. More specifically, the present invention relates to signal correction processing of velocity streams of signal flow for coherent mapping of anatomical structures (or parts thereof), or to the interpolation of any vector field on a surface (e.g., weather maps, wind speed, airflow around an wing, the Earth's magnetic field on a surface for navigation, and depiction of vortices in fluid dynamics). The signal correction processing is processor-executable code or software necessarily rooted in process operations by medical device equipment and processing of the hardware of medical device equipment. For ease of explanation, the signal correction processing is described herein in relation to mapping at least a part of an anatomical structure such as a human organ (e.g., a heart). However, any anatomical structure, body part, and / or organ or part thereof can be targeted for mapping by the signal and correction processing described herein. According to exemplary embodiments, the signal correction processing is implemented by a mapping engine.

[0009] For example, the mapping engine provides enhanced visualization of the flow or progression of the complete velocity stream around the entire heart by providing time, difference, and velocity, as well as verifying the start and end points. Particularly for periodic arrhythmias, and in relation to enhanced visualization of the flow (of signals within the heart) to understand the time and velocity of signal movement around the heart, the mapping engine analyzes the signal along a time interval (e.g., 5 milliseconds or other intervals) as a measurement of the velocity of the signal over time. Such an approach is sometimes called a signal stream or velocity stream.

[0010] The advantages, technical effects, and benefits of a mapping engine may include, at a minimum, providing cardiologists and healthcare professionals with a visualization of signal flow to verify the global correlation between velocity vector solutions and LAT value solutions. Therefore, the mapping engine may, in particular, utilize and transform medical devices and equipment to enable / implement improved visualizations that are otherwise not currently available or performed by cardiologists and healthcare professionals (for example, given that current medical mapping systems use mesh-based approximations of anatomical forms when presenting any map, and current cardiologists and healthcare professionals have a need to understand the flow of arrhythmias).

[0011] Figure 1 is a schematic diagram of a system 100 (e.g., a medical device) in which one or more features of the subject matter herein may be implemented according to one or more embodiments. All or part of system 100 may be used to collect information (e.g., biometric data and / or training data sets) and / or to implement machine learning and / or artificial intelligence algorithms (e.g., mapping engine 101) as described herein. The system 100 shown in the figure includes a probe 105 with a catheter 110 (including at least one electrode 111), a shaft 112, a sheath 113, and a manipulator 114. The system 100 shown in the figure also includes a physician 115 (or medical professional or clinician), a heart 120, a patient 125, and a bed 130 (or table). Note that inserts 140 and 150 show the heart 120 and catheter 110 in more detail. System 100 also includes a console 160 (including one or more processors 161 and memory 162) and a display 165, as shown in the figure. Furthermore, note that each element and / or item of System 100 represents one or more of those elements and / or items. The examples of System 100 shown in Figure 1 can be modified to implement the embodiments disclosed herein. Embodiments of this disclosure can also be applied in a similar manner using other system components and settings. Furthermore, System 100 may include further components such as elements for sensing electrical activity, wired or wireless connectors, processing and display devices.

[0012] System 100 can be used to detect, diagnose, and / or treat cardiac conditions (for example, using the mapping engine 101). Cardiac conditions such as cardiac arrhythmias remain common and dangerous medical conditions, particularly in the elderly population. For example, System 100 can be part of a surgical system (e.g., the CARTO® system sold by Biosense Webster) configured to acquire biometric data (e.g., anatomical and electrical measurements of a patient's organs, such as the heart 120) and perform cardiac ablation procedures. More specifically, in the treatment of cardiac diseases such as cardiac arrhythmias, it is often necessary to obtain detailed mapping of cardiac tissue, cardiac chambers, veins, arteries, and / or electrical pathways. For example, as a prerequisite for successful catheter ablation (as described herein), the cause of the cardiac arrhythmia may be precisely localized in the cardiac chambers of the heart 120. Such localization can be performed by electrophysiological examination, during which spatially resolved potentials can be detected by a mapping catheter (e.g., catheter 110) introduced into the cardiac chambers of the heart 120. Therefore, this electrophysiological examination, so-called electroanatomical mapping, provides 3D mapping data that can be displayed on a monitor. In many cases, the mapping function and the therapeutic function (e.g., ablation) are provided by a single catheter or a group of catheters, and the mapping catheter also operates simultaneously as a therapeutic (e.g., ablation) catheter. In this case, the mapping engine 101 can be directly stored and executed by the catheter 110.

[0013] In patients with normal sinus rhythm (NSR) (e.g., patient 125), the heart (e.g., heart 120), including the atria, ventricles, and excitatory conduction tissue, is electrically excited and beats in a synchronized, patterned manner. It should be noted that this electrical excitation can be detected as intracardiac electrocardiogram (IC ECG) data, etc.

[0014] In patients with cardiac arrhythmias (e.g., atrial fibrillation or aFib) (e.g., patient 125), abnormal areas of cardiac tissue do not follow the synchronized beating cycle associated with normal conductive tissue, in contrast to patients with NSR. Instead, abnormal conduction occurs in adjacent tissues within the abnormal areas of cardiac tissue, disrupting the cardiac cycle and resulting in an asynchronous rhythm. It should be noted that this asynchronous rhythm can also be detected as IC ECG data. Such abnormal conduction is known to occur in various regions of the heart 120, such as the sinoatrial (SA) node region along the conduction pathway of the atrioventricular (AV) node, or the myocardial tissue forming the walls of the ventricles and atria. Other conditions exist, such as atrial flutter, in which patterns of abnormally conductive tissue lead to re-entry pathways, causing the cardiac chambers to beat in a regular pattern that can be several times more frequent than the sinus rhythm.

[0015] To assist the system 100 in detecting, diagnosing, and / or treating the condition of the heart, a physician 115 can guide the probe 105 into the heart 120 of a patient 125 lying on a bed 130. For example, the physician 115 can insert the shaft 112 through the sheath 113 while manipulating the distal end of the shaft 112 using a manipulator 114 and / or deflection from the sheath 113 near the proximal end of the catheter 110. The catheter 110 can be attached to the distal end of the shaft 112 as shown in inset 140. The catheter 110 can be inserted through the sheath 113 in a folded state and then expanded within the heart 120.

[0016] Generally, electrical activity at a point within the heart 120 can usually be measured by advancing a catheter 110 (e.g., at least one electrode 111) containing an electrical sensor at or near its distal tip into that point within the heart 120, bringing the tissue into contact with the sensor, and acquiring data at that point. One difficulty associated with mapping the cardiac chambers using catheter types containing only a single distal tip electrode is that it can take a long time to collect data point by point across the required number of points for a detailed map of the entire cardiac chamber. Therefore, multi-electrode catheters (e.g., catheter 110) have been developed to simultaneously measure electrical activity at multiple points within the cardiac chambers.

[0017] A catheter 110, which may include at least one electrode 111 and a catheter needle connected to its body, can be configured to obtain biometric data, such as electrical signals, from an internal organ (e.g., the heart 120) and / or to ablate a tissue area (e.g., the cardiac chambers of the heart 120). Note that the electrode 111 may represent any similar element, such as a tracking coil, a piezoelectric transducer, an electrode, or a combination of elements configured to ablate a tissue area or obtain biometric data. According to one or more embodiments, the catheter 110 may include one or more position sensors used to determine trajectory information. This trajectory information can be used to infer kinetic properties, such as tissue contractility.

[0018] Biometric data (e.g., patient biometrics, patient data, or patient biometric data) may include one or more of the following: local time activation (LAT), electrical activity, topology, bipolar mapping, reference activity, ventricular activity, dominant frequency, impedance, etc. LAT may be a time point of threshold activity corresponding to local activation, calculated based on a normalized initial starting point. Electrical activity may be any applicable electrical signal that can be measured based on one or more thresholds and may be detected and / or augmented based on signal-to-noise ratio and / or other filters. Topology may correspond to the physical structure of a body part or part of a body part, or to variations in the physical structure of different parts of a body part or different parts of a body part. Dominant frequency may be a frequency or range of frequencies commonly found in a part of a body part and may differ in different parts of the same body part. For example, the dominant frequency of the PV in the heart may differ from the dominant frequency of the right atrium of the same heart. Impedance may be a resistance measurement in a particular region of a body part.

[0019] Examples of biometric data, but not limited to these, include patient identification data, IC ECG data, bipolar intracardiac reference signals, anatomical and electrical measurements, trajectory information, body surface (BS) ECG data, historical data, brain biometrics, blood pressure data, ultrasound signals, radio signals, voice signals, two-dimensional or three-dimensional image data, blood glucose data, and temperature data. Biometric data can generally be used to monitor, diagnose, and treat any number of different diseases, such as cardiovascular diseases (e.g., arrhythmias, cardiomyopathy, and coronary artery disease) and autoimmune diseases (e.g., type 1 and type 2 diabetes). Note that BS ECG data may include data and signals collected from electrodes on the patient's surface, IC ECG data may include data and signals collected from electrodes inside the patient's body, and ablation data may include data and signals collected from ablated tissue. Furthermore, BS ECG data, IC ECG data, and ablation data can be derived from one or more procedure records, along with catheter electrode position data.

[0020] For example, catheter 110 can implement intravascular ultrasound and / or MRI catheter methods using electrode 111 to image the heart 120 (e.g., acquire and process biometric data). Insertion diagram 150 shows an enlarged view of catheter 110 within the cardiac chamber of heart 120. Although catheter 110 is shown as a point catheter, it will be understood that any shape including one or more electrodes 111 can be used to implement the embodiments disclosed herein.

[0021] Examples of catheter 106 include, but are not limited to, a linear catheter having multiple electrodes, a balloon catheter including electrodes dispersed on multiple spines forming a balloon, a lasso catheter or loop catheter having multiple electrodes, or any other applicable shape. The linear catheter can be fully or partially elastic so that it can change its shape by twisting, bending, and / or otherwise based on the received signal and / or the action of an external force (e.g., heart tissue) on the linear catheter. The balloon catheter can be designed to hold its electrodes in close contact with the endocardial surface when deployed within the patient's body. As an example, the balloon catheter can be inserted into a lumen such as a pulmonary vein (PV). The balloon catheter can be inserted into the PV in a contracted state, such that the balloon catheter does not occupy its maximum volume while inserted into the PV. The balloon catheter can expand while inside the PV, such that the electrodes on the balloon catheter contact the entire circular portion of the PV. Such contact with the entire circular portion of the PV or any other lumen enables efficient imaging and / or ablation.

[0022] According to other examples, a body patch and / or body surface electrodes can also be disposed on or proximate to the body of patient 125. A catheter 110 having one or more electrodes 111 can be disposed within the body (e.g., within the heart 120) of the patient, and the position of the catheter 110 can be determined by the system 100 based on signals transmitted and received between one or more electrodes 111 of the catheter 110 and the body patch and / or body surface electrodes. Further, the electrodes 111 can sense biometric measurement data from within the body of patient 125, such as within the heart 120 (e.g., the electrodes 111 can sense the potential of tissue in real time). The biometric measurement data can be associated with the determined position of the catheter 110, thereby displaying a rendering of a body part (e.g., the heart 120) of the patient and showing the biometric measurement data superimposed on the shape of the body part.

[0023] The probe 105 and other items of the system 100 can be connected to the console 160. The console 160 may include any computing device that employs machine learning and / or artificial intelligence algorithms (represented as the mapping engine 101). According to one embodiment, the console 160 includes one or more processors 161 (any computing hardware) and memory 162 (any non-temporary tangible medium), where one or more processors 161 execute computer instructions with respect to the mapping engine 101 (e.g., its coherent mapping algorithm), and the memory 162 stores these instructions for execution by one or more processors 161. For example, the console 160 may be configured to receive and process biometric data to determine whether a particular tissue region conducts electricity. In some embodiments, the console 160 can be further programmed by the mapping engine 101 (software) to perform the function of subdividing an anatomical mesh of a portion of an anatomical structure into one or more other meshes of the anatomical structure, interpolating local activation time values ​​and velocity values ​​of one or more other meshes, tracing the path of velocity vectors on one or more other meshes according to the interpolation of local activation time values ​​and velocity values, and projecting the path onto the anatomical mesh to provide improved visualization of the anatomical structure. It should be noted that while the improved visualization and meshing of the heart are typically of individual cardiac chambers, the system 100 can display two or more cardiac chambers at a time. According to one or more embodiments, the mapping engine 101 may be external to the console 160, for example, located within a catheter 110, in an external device, in a mobile device, in a cloud-based device, or as a standalone processor. In this regard, the mapping engine 101 can be transferred / downloaded in electronic form over a network.

[0024] For example, console 160 may be any computing device described herein, including hardware such as a general-purpose computer (e.g., processor 161 and memory 162) with software (e.g., mapping engine 101) and / or suitable front-end and interface circuits for transmitting and receiving signals to and from probe 105, and for controlling other components of system 100. For example, the front-end and interface circuits include an input / output (I / O) communication interface that enables console 160 to receive signals from and / or transfer signals to at least one electrode 111. Console 160 may typically include real-time noise reduction circuitry configured as an analog-to-digital (A / D) ECG or electromyogram (EMG) signal conversion integrated circuit following a field programmable gate array (FPGA). Console 160 can transmit signals from an A / D ECG or EMG circuit to another processor and / or can be programmed to perform one or more of the functions disclosed herein.

[0025] A display 165, which may be any electronic device for visually presenting biometric data, is connected to the console 160. According to one embodiment, during a procedure, the console 160 can facilitate the presentation of a rendering of a body part to the physician 115 on the display 165 and store data representing the rendering of the body part in memory 162. For example, a map showing motor characteristics can be rendered / constructed based on trajectory information sampled at a sufficient number of points within the heart 120. As an example, the display 165 may include a touchscreen that, in addition to presenting a rendering of a body part, can be configured to receive input from the medical professional 115.

[0026] In some exemplary embodiments, the physician 115 may use one or more input devices, such as a touchpad, mouse, keyboard, or gesture recognition device, to manipulate the rendering of elements and / or body parts of the system 100. For example, the input device may be used to change the position of the catheter 110 so that the rendering is updated. Note that the display 165 may be located in the same location or in a remote location, such as another hospital or another healthcare provider network.

[0027] According to one or more embodiments, the system 100 may also obtain biometric data using ultrasound, computed tomography (CT), MRI, or other medical imaging techniques utilizing the catheter 110 or other medical devices. For example, the system 100 may use one or more catheters 110 or other sensors to obtain ECG data and / or anatomical and electrical measurements (e.g., biometric data) of the heart 120. More specifically, the console 160 may be connected by cable to a BS electrode, which includes an adhesive skin patch attached to the patient 125. The BS electrode can acquire / generate biometric data in the form of BS ECG data. For example, the processor 161 may determine the position coordinates of the catheter 110 within a body part of the patient 125 (e.g., the heart 120). The position coordinates may be based on impedance or electromagnetic fields measured between a body surface electrode and an electrode 111 of the catheter 110 or other electromagnetic component. In addition to or instead of the above, a position pad that generates a magnetic field used for navigation may be placed on the surface of the bed 130, or it may be placed separately from the bed 130. Biometric data can be transmitted to the console 160 and stored in memory 162. Alternatively or additionally, biometric data may be transmitted to a server, which may be local or remote, using a network as further described herein.

[0028] According to one or more embodiments, the catheter 110 may be configured to ablate tissue areas in the cardiac chambers of the heart 120. Insertion figure 150 shows a magnified view of the catheter 110 within the cardiac chambers of the heart 120. For example, an ablation electrode, such as at least one electrode 111, may be configured to deliver energy to a tissue area in an organ within the body (e.g., the heart 120). The energy may be thermal energy and may cause damage to the tissue area, starting from the surface of the tissue area and extending to the thickness of the tissue area. Biometric data relating to the ablation procedure (e.g., ablated tissue, ablation location, etc.) may be considered ablation data.

[0029] For example, with respect to acquiring biometric data, a multi-electrode catheter (e.g., catheter 110) can be advanced into the cardiac chambers of the heart 120. To establish the position and orientation of each electrode, anterior-posterior (AP) and lateral fluorescence images can be acquired. The ECG can be recorded from each of the electrodes 111 that are in contact with the cardiac surface relative to a time reference, such as the generation of P waves in the sinus rhythm from the BS ECG and / or signals from the electrodes 111 of catheter 110 positioned in the coronary sinus. Systems further disclosed herein can distinguish between electrodes that record electrical activity and electrodes that do not record electrical activity because they are not in close proximity to the endocardial wall. After the initial ECG is recorded, the catheter can be repositioned and fluorescence images and ECGs can be recorded again. An electrical map can then be constructed (e.g., via cardiac mapping) from iterations of the above process.

[0030] Cardiac mapping can be performed using one or more techniques. Generally, mapping of cardiac regions of the heart 120, such as cardiac areas, tissues, veins, arteries, and / or electrical pathways, can lead to the identification of problem areas such as scar tissue, sources of arrhythmias (e.g., electrical rotors), and healthy areas. Cardiac regions can be mapped so that a visual rendering of the mapped cardiac regions is provided using a display, as further disclosed herein. Furthermore, cardiac mapping (e.g., cardiac imaging) may include mapping based on one or more modalities, such as but not limited to local activation time (LAT), electrical activity, topology, bipolar mapping, dominant frequency, or impedance. Data corresponding to multiple modalities (e.g., biometric data) can be acquired using a catheter inserted into the patient's body (e.g., catheter 110) and can be provided for rendering simultaneously or at different times, based on the corresponding settings and / or the preference of the physician 115.

[0031] As an example of the first technique, cardiac mapping can be performed by sensing the electrical properties of cardiac tissue, e.g., LAT, as a function of precise location within the heart 120. Corresponding data (e.g., biometric data) can be acquired by one or more catheters (e.g., catheter 110) that are advanced into the heart 120 and have electrical and position sensors (e.g., electrode 111) at their distal tip. Specifically, location and electrical activity can be initially measured at approximately 10 to 20 points on the inner surface of the heart 120. These data points are generally sufficient to generate a preliminary reconstruction or map of the cardiac surface with satisfactory quality. The preliminary map can often be combined with data measured at further points to generate a more comprehensive map of the cardiac electrical activity. In clinical settings, it is not uncommon to accumulate data at more than 100 sites to generate a detailed and comprehensive map of the electrical activity of the cardiac chambers. The resulting detailed map can then serve as a basis for determining therapeutic action strategies to alter the propagation of cardiac electrical activity and restore normal rhythm, e.g., tissue ablation as described herein.

[0032] Furthermore, cardiac mapping can be generated based on the detection of intracardiac potential fields (e.g., IC ECG data and / or bipolar intracardiac reference signals). Non-contact methods can be employed to simultaneously acquire a large amount of cardiac electrical information. For example, a catheter type with a distal end portion may be equipped with a series of sensor electrodes distributed across its surface and connected to an insulating conductor for connection to signal sensing and processing means. The size and shape of the end portion may be such that the electrodes are positioned at a large distance from the walls of the cardiac chambers. The intracardiac potential field can be detected during a single heartbeat. In one example, the sensor electrodes may be distributed on a series of circles located in planes spaced apart from each other. These planes may be perpendicular to the long axis of the end portion of the catheter. At least two additional electrodes may be arranged adjacent to both ends of the long axis of the end portion. In a more specific example, the catheter may include four circumferences, each having eight electrodes spaced equally apart on each circumference. Thus, in this particular implementation, the catheter may include at least 34 electrodes (32 circumferential electrodes and 2 end electrodes). As another, more specific example, the catheter may include other multi-spline catheters such as a flip-type catheter with five flexible branches, eight radial splines, or parallel splines (for example, each of which may have a total of 42 electrodes).

[0033] As an example of electrical or cardiac mapping, electrophysiological cardiac mapping systems and techniques based on non-contact and non-expandable multi-electrode catheters (e.g., catheter 110) can be implemented. ECG can be obtained using one or more catheters 110 having multiple electrodes (e.g., 42 to 122 electrodes). This implementation allows insights into the relative geometric shape of the probe and endocardium to be obtained by an independent imaging modality such as transesophageal echocardiography. After independent imaging, cardiac surface potentials can be measured using non-contact electrodes, and a map can be constructed from these surface potentials (e.g., using bipolar intracardiac reference signals in some cases). This technique may include the following steps (after the independent imaging step): (a) measuring potentials using multiple electrodes placed on a probe placed in the heart 120; (b) determining the geometric relationship between the probe surface and the endocardial surface and / or other references; (c) generating a matrix of coefficients representing the geometric relationship between the probe surface and the endocardial surface; and (d) determining the endocardial potential based on the electrode potentials and the matrix of coefficients.

[0034] As another example of electrical or cardiac mapping, techniques and apparatus for mapping the potential distribution of cardiac chambers can be implemented. An intracardiac multi-electrode mapping catheter assembly can be inserted into the heart 120. The mapping catheter (e.g., catheter 110) assembly may include a multi-electrode array or companion reference catheter having one or more integrated reference electrodes (e.g., one or electrode 111).

[0035] According to one or more embodiments, the electrodes can be deployed in the form of a substantially spherical array, which can be spatially referenced to a point on the endocardial surface by a reference electrode or by a reference catheter in contact with the endocardial surface. A preferred electrode array catheter may have a number of individual electrode sites (e.g., at least 24). In addition, this exemplary technique can be carried out by knowing the position of each electrode site on the array and the geometric shape of the heart. These positions are preferably determined by impedance plethysmography.

[0036] From an electrical or cardiac mapping perspective, and according to another example, the catheter 110 may also be a cardiac mapping catheter assembly that may include an electrode array defining a number of electrode sites. This cardiac mapping catheter assembly also has a lumen for receiving a reference catheter having a distal tip electrode assembly that can be used to puncture the cardiac wall. The mapping cardiac mapping catheter assembly may include a braid of insulated wires (e.g., having 24 to 64 wires in the braid), each of which can be used to form an electrode site. The cardiac mapping catheter assembly is readily deployable within the heart 120 for use in acquiring electrical activity information from a first set of non-contact electrode sites and / or a second set of contact electrode sites.

[0037] Furthermore, according to another example, a catheter 110 capable of performing electrophysiological activity mapping within the heart may include a distal tip adapted to supply stimulation pulses for pacing the heart, or an ablation electrode for ablating tissue in contact with the tip. The catheter 110 may further include at least a pair of orthogonal electrodes for generating a differential signal indicating local cardiac electrical activity in the vicinity of the orthogonal electrodes.

[0038] As described herein, the system 100 can be used to detect, diagnose, and / or treat cardiac conditions. In exemplary operation, the system 100 can perform a process for measuring electrophysiological data within the cardiac chambers. This process may include, in part, placing a set of active and passive electrodes within the heart 120, supplying current to the active electrodes to generate an electric field within the cardiac chambers, and measuring the electric field at the passive electrode sites. The passive electrodes are contained in an array placed on an inflatable balloon of a balloon catheter. In a preferred embodiment, the array is said to have 60 to 64 electrodes.

[0039] As another exemplary operation, cardiac mapping may also be performed by system 100 using one or more ultrasound transducers. The ultrasound transducers can be inserted into the patient's heart 120 and can collect multiple ultrasound slices (e.g., two-dimensional or three-dimensional slices) at various positions and orientations within the heart 120. The position and orientation of a particular ultrasound transducer may be known, and the collected ultrasound slices can be stored so that they can be viewed later. One or more ultrasound slices corresponding to the position of probe 105 (e.g., a therapeutic catheter shown as catheter 110) can be displayed, and probe 105 can be superimposed on one or more ultrasound slices.

[0040] Considering System 100, cardiac arrhythmias, including atrial arrhythmias, can be of the multi-wavelet reentrant type, characterized by multiple asynchronous loops of electrical impulses that scatter around the atria and often self-propagate (e.g., another example of IC ECG data). Alternatively, or in addition to the multi-wavelet reentrant type, cardiac arrhythmias can also have focal sources of excitation, such as when isolated areas of atrial tissue are rapidly and repeatedly excited autonomously (e.g., another example of IC ECG data). Ventricular tachycardia (V-tach or VT) is a tachycardia or rapid heart rhythm originating from one of the ventricles. It is a potentially fatal arrhythmia because it can lead to ventricular fibrillation and sudden death.

[0041] For example, aFib occurs when the normal electrical impulses generated by the sinoatrial node (e.g., another example of IC ECG data) are overwhelmed by disordered electrical impulses (e.g., signal interference) occurring in the atrial veins and PV, causing irregular impulses to be conducted to the ventricles. This results in an irregular heartbeat, which can last from minutes to weeks, or even years. Often, aFib is a chronic condition that frequently slightly increases the risk of death from stroke. The treatment strategy for aFib is medication to reduce heart rate or restore a normal rhythm. Furthermore, patients with aFib are often given anticoagulants to protect against the risk of stroke. The use of such anticoagulants carries its own risk of internal bleeding. In some patients, medication is insufficient, and their aFib is deemed drug-refractory, i.e., untreatable with standard pharmacological interventions. Synchronized electrical cardioversion can also be used to convert aFib back to a normal rhythm. Alternatively, patients with aFib may also be treated with catheter ablation.

[0042] Catheter ablation-based therapies may include mapping the electrical properties of cardiac tissue, particularly the endocardium and cardiac volume, and selectively ablating cardiac tissue by applying energy. Electrical or cardiac mapping (e.g., performed by any electrophysiological cardiac mapping systems and techniques described herein) includes creating potential maps of wave propagation along cardiac tissue (e.g., voltage maps) or maps of arrival times (e.g., LAT maps) to points located within various tissues. Electrical or cardiac mapping (e.g., cardiac maps) can be used to detect localized cardiac tissue dysfunction. Ablation, such as cardiac mapping-based ablation, can stop or alter unwanted electrical signals from propagating from one part of the heart 120 to another.

[0043] Ablation is a method that disrupts undesirable electrical pathways by forming non-conductive damaged areas. Various energy delivery methods have been disclosed to date for the purpose of forming damaged areas, including the use of microwaves, lasers, and more generally radiofrequency energy to create conduction blocks along the cardiac tissue wall. Another example of an energy delivery method is irreversible electroporation (IRE), which applies a high electric field to damage cell membranes. In a two-step procedure (mapping followed by ablation), a catheter 110 containing one or more electrical sensors (e.g., electrodes 111) is typically advanced into the heart 120, and electrical activity at points within the heart 120 is sensed and measured by acquiring data at multiple points (e.g., generally as biometric data, or specifically as ECG data). The ECG data is then used to select target regions of the endocardium to be ablated.

[0044] Cardiac ablation and other cardiac electrophysiological procedures are becoming increasingly complex when physicians treat difficult conditions such as atrial fibrillation and ventricular tachycardia. Treatment of refractory arrhythmias can now rely on the use of three-dimensional (3D) mapping systems to reconstruct the anatomical morphology of the target cardiac chambers. In this regard, the mapping engine 101 used by system 100 herein manipulates and evaluates biometric data, or specifically ECG data, to generate improved tissue data that enables more accurate diagnosis, imaging, scanning, and / or mapping for treating abnormal heartbeats or arrhythmias. For example, cardiologists rely on software such as the Complex Fractionated Atrial Electrograms (CFAE) module of the CARTO® 3 3D mapping system manufactured by Biosense Webster, Inc. (Diamond Bar, Calif.) to generate and analyze ECG data. The mapping engine 101 of system 100 enhances this software to generate and analyze improved biometric data, thereby further providing multiple pieces of information regarding the electrophysiological properties of the heart 120 (including scar tissue) that represent the cardiac matrix (anatomical and functional) of aFib.

[0045] Therefore, system 100 can implement a 3D mapping system, such as the CARTO® 3 3D mapping system, to identify the location of potential arrhythmogenic substrates in cardiomyopathy from the perspective of detecting abnormal ECGs. These substrates associated with cardiac disease are linked to the presence of segmentation and delayed ECGs in the endocardial and / or epicardial layers of the ventricular chambers (right and left). Generally, abnormal tissue is characterized by low-voltage ECGs. However, early clinical experience in endocardial-epidermal mapping has shown that low-voltage regions are not always present as the sole arrhythmic mechanism in such patients. In fact, low-voltage or medium-voltage regions may show segmentation and delayed activity of the ECG during sinus rhythm, which corresponds to the critical isthmus identified in persistent, cohesive ventricular arrhythmias (e.g., only in unacceptable ventricular tachycardia). Furthermore, in many cases, segmentation and delayed activity of the ECG are observed in regions showing normal or near-normal voltage amplitudes (>1-1.5mV). The latter region can be evaluated according to voltage amplitude, but is not considered normal according to intracardiac signals and therefore represents a true arrhythmogenic substrate. 3D mapping can identify the location of arrhythmogenic substrates on the endocardial and / or epicardial layers of the right / left ventricle, whose distribution may vary depending on the progression of the major disease.

[0046] As another exemplary operation, cardiac mapping may also be performed by system 100 using one or more multi-electrode catheters (e.g., catheter 110). The multi-electrode catheter is used to stimulate and map electrical activity within the heart 120 and to ablate areas where abnormal electrical activity is observed. When used, the multi-electrode catheter is inserted into a major vein or artery, such as the femoral vein, and then guided into the cardiac chambers of the target heart 120. A typical ablation procedure involves inserting catheter 110, which has at least one electrode 111 at its distal end, into the cardiac chambers. A reference electrode is provided by being taped to the patient's skin, by a second catheter positioned in or near the heart, or by selecting one or other electrodes 111 of catheter 110. A radiofrequency (RF) current is applied to the tip electrode 111 of the ablation catheter 110, causing the current to flow through the surrounding medium (i.e., blood and tissue) toward the reference electrode. The distribution of the current depends on the amount of electrode surface in contact with tissue, compared to blood, which has higher conductivity than tissue. Tissue heating occurs due to the electrical resistance of the tissue. When the tissue is sufficiently heated, cell destruction occurs in the cardiac tissue, resulting in the formation of damaged areas within the non-conductive cardiac tissue. In this process, heating of the tip electrode 111 also occurs due to conduction from the heated tissue to the electrode itself. When the electrode temperature becomes sufficiently high, and may exceed 60°C, a thin, transparent film of dehydrated blood proteins may form on the surface of the electrode 111. As the temperature continues to rise, this dehydrated layer may gradually thicken, and blood coagulation occurs on the electrode surface. Since dehydrated biological material has a higher electrical resistance than endocardial tissue, the impedance to the flow of electrical energy into the tissue also increases. When the impedance becomes sufficiently high, an impedance surge occurs, and the catheter 110 must be withdrawn from the body and the tip electrode 111 must be cleaned.

[0047] Referring now to Figure 2, a schematic diagram of a system 200 in which one or more features of the subject matter of this disclosure may be implemented in one or more embodiments. The system 200 includes, for a patient 202 (for example, an example of patient 125 in Figure 1), an apparatus 204, a local computing device 206, a remote computing system 208, a first network 210, and a second network 211. Furthermore, the apparatus 204 may include a biometric sensor 221 (for example, an example of catheter 110 in Figure 1), a processor 222, a user input (UI) sensor 223, a memory 224, and a transceiver 225. Note that for ease of explanation and brevity, the mapping engine 101 in Figure 1 is reused in Figure 2.

[0048] According to one embodiment, the device 204 may be an example of the system 100 in Figure 1, and the device 204 may include both internal and external components of the patient. According to one embodiment, the device 204 may be an external device of the patient 202, including an attachable patch (e.g., attached to the patient's skin). According to another embodiment, the device 204 may be internal to the patient 202's body (e.g., subcutaneously implantable), and the device 204 may be inserted into the patient 202's body by any applicable method, including oral infusion, surgical insertion via vein or artery, endoscopic surgery, or laparoscopic surgery. According to one embodiment, a single device 204 is shown in Figure 2, but the exemplary system may include multiple devices.

[0049] Therefore, the device 204, the local computing device 206, and / or the remote computing system 208 can be programmed to execute computer instructions relating to the mapping engine 101. As an example, memory 223 stores these instructions for execution by processor 222 so that the device 204 can receive and process biometric data via biometric sensor 201. Thus, processor 22 and memory 223 represent the processor and memory of local computing device 206 and / or remote computing system 208.

[0050] The apparatus 204, the local computing device 206, and / or the remote computing system 208 can be any combination of software and / or hardware that individually or collectively store, execute, and implement the mapping engine 101 and its functions. Furthermore, the apparatus 204, the local computing device 206, and / or the remote computing system 208 can be an electronic computer framework that includes and / or uses any number and combination of computing devices and networks utilizing various communication technologies, as described herein. The apparatus 204, the local computing device 206, and / or the remote computing system 208 can be easily scalable, expandable, and modular, allowing for modification to suit different services or the reconfiguration of some functions independently of others.

[0051] Networks 210 and 211 may be wired networks, wireless networks, or may include one or more wired and wireless networks. According to one embodiment, network 210 is an example of a short-range network (e.g., a local area network (LAN) or a personal area network (PAN)). Information can be transmitted between device 204 and local computing device 206 via the short-range network 210 using one of various short-range wireless communication protocols such as Bluetooth, Wi-Fi, Zigbee, Z-Wave, near-field communication (NFC), Ultraband, Zigbee, or infrared (IR). Furthermore, network 211 is an example of one or more of the following: an intranet, a local area network (LAN), a wide area network (WAN), a metropolitan area network (MAN), a direct connection or a series of connections, a cellular telephone network, or any other network or medium that can facilitate communication between local computing device 206 and remote computing system 208. Information can be transmitted over network 211 using any one of the various long-range wireless communication protocols (e.g., TCP / IP, HTTP, 3G, 4G / LTE, or 5G / New Radio). Note that the wired connection between networks 210 and 211 can be implemented using Ethernet, Universal Serial Bus (USB), RJ-11, or any other wired connection, and the wireless connection can be implemented using Wi-Fi, WiMAX, Bluetooth, infrared, cellular networks, satellite communications, or any other wireless connection method.

[0052] During operation, the device 204 can continuously or periodically acquire, monitor, store, process, and communicate biometric data related to the patient 202 via the network 210. Furthermore, the device 204, the local computing device 206, and / or the remote computing system 208 communicate via the networks 210 and 211 (for example, the local computing device 206 can be configured as a gateway between the device 204 and the remote computing system 208). For example, the device 204 may be an example of system 100 in Figure 1, configured to communicate with the local computing device 206 via the network 210. The local computing device 206 can be, for example, a stationary / standalone device, a base station, a desktop / laptop computer, a smartphone, a smartwatch, a tablet, or another device configured to communicate with other devices via the networks 211 and 210. A remote computing system 208, implemented as a physical server on or connected to network 211, or as a virtual server within a public cloud computing provider for network 211 (e.g., Amazon Web Services (AWS)), can be configured to communicate with a local computing device 206 via network 211. This allows biometric data related to patient 202 to be communicated throughout the entire system 200.

[0053] The elements of the device 224 are described below. The biometric sensor 221 may include, for example, one or more transducers configured to convert one or more environmental conditions into electrical signals so that different types of biometric data are observed / acquired / obtained. For example, the biometric sensor 221 may include one or more of the following: electrodes (e.g., electrode 111 in Figure 1), temperature sensors (e.g., thermocouples), blood pressure sensors, blood glucose sensors, blood oxygen sensors, pH sensors, accelerometers, and microphones.

[0054] When executing the mapping engine 101, the processor 222 can be configured to receive, process, and manage biometric data acquired by the biometric sensor 221, and to communicate the biometric data to the memory 224 for storage and / or to the entire network 210 via the transceiver 225. Biometric data from one or more other devices 204 may also be received by the processor 222 via the transceiver 225. Furthermore, as will be described in more detail below, the processor 222 can be configured to selectively respond to different tapping patterns (e.g., single tap or double tap) received from the UI sensor 223 so that different tasks on a patch (e.g., data acquisition, storage, or transmission) are triggered based on the detected pattern. In some embodiments, the processor 222 can generate audible feedback with respect to gesture detection.

[0055] The UI sensor 223 includes, for example, a piezoelectric or capacitive sensor configured to receive user input such as a tap or touch. For example, the UI sensor 223 may be controlled to perform capacitive coupling in response to a patient 202 tapping or touching the surface of the device 204. Gesture recognition can be implemented via any one of various capacitive types, such as resistive capacitive, surface capacitive, projected capacitive, surface ultrasonic, piezoelectric, and infrared touch. The capacitive sensor may be positioned over a small area or length of the surface so that a tap or touch on the surface activates the monitoring device.

[0056] Memory 224 is any non-temporary tangible medium such as magnetic, optical, or electronic memory (e.g., any suitable volatile and / or non-volatile memory such as random access memory or a hard disk drive). Memory 224 stores computer instructions executed by processor 222.

[0057] The transceiver 225 may include a separate transmitter and a separate receiver. Alternatively, the transceiver 225 may include a transmitter and receiver integrated into a single device.

[0058] During operation, the device 204 utilizing the mapping engine 101 observes / acquires biometric data of the patient 202 via the biometric sensor 221, stores the biometric data in memory, and shares this biometric data throughout the system 200 via the transceiver 225. The mapping engine 101 can then measure and track the flow and progression of signals around the heart using any coherent mapping algorithm or combination thereof, such as fuzzy logic, models, neural networks, machine learning, and / or artificial intelligence, to provide improved visualization. For example, the mapping engine 101 simplifies the cardiac chambers into a triangular mesh, performs interpolation by calculating the individual velocity vectors of electrical waves on the triangular mesh, and uses the entire map to visualize the flow of electrical signals across the cardiac chambers (e.g., providing improved visualization).

[0059] The mapping operation of the mapping engine 101 will now be explained with reference to Figures 3 to 6.

[0060] With respect to Figure 3, an exemplary method 300 (performed, for example, by the mapping engine 101 in Figures 1 and / or 2) is shown in one or more exemplary embodiments. The exemplary method 300 addresses the need to understand the flow of arrhythmias, assuming that the mesh morphology of current medical mapping systems uses a mesh-based approximation to anatomical morphology when presenting any map, e.g., LAT or voltage. The mesh may be detailed or coarse, or have any combination of resolutions.

[0061] According to one or more embodiments, a secondary mesh can be used by the mapping engine 101 in addition to the original anatomical mesh. The mapping engine 101 approximates the original anatomical mesh using the secondary mesh. For example, the secondary mesh is designed to have triangles of uniform size (e.g., 3 mm in length) and can be used as the basis for a coherent mapping algorithm to calculate LAT and conduction velocity vectors, where the conduction velocity vectors are assigned to the center of each triangle (of the secondary mesh). Conventionally, when simple interpolation of these vectors is performed and they are projected onto the original anatomical mesh, the resulting image often appears discontinuous, and the correspondence between the time integrals along these vectors does not correspond to the LAT difference along the trace. The mapping engine 101 overcomes this problem, as shown by at least exemplary method 300.

[0062] An exemplary method 300 begins in block 320, where the mapping engine 101 subdivides a triangular mesh of uniform edges (e.g., an anatomical mesh or a first mesh) into one or more finer meshes (e.g., one or more other meshes or a second mesh) of the cardiac chambers (e.g., at least a portion of the anatomical structure). For example, Figure 4 shows a geometrical figure 400 according to one or more embodiments, where the mapping engine 101 subdivides each existing / original triangle 410 into 16 sub-triangles 420. Each triangle 410 (e.g., including a single sub-triangle 420) constitutes a single plane. By subdividing the triangles 410, the mapping engine 101 subdivides the anatomical mesh (e.g., the current mesh or a simplified mesh) into one or more other meshes (e.g., a finer-grained mesh or a very fine mesh).

[0063] Furthermore, the mapping engine 101 uses the central values ​​to calculate the LAT values ​​at the vertices (e.g., boundary vertex 430 and interior vertex 440) and calculates the velocity (e.g., from the coherent solution) for projecting onto the vertices with respect to Equation 1.

[0064]

number

[0065] It should be noted that in some mathematical cases, the mapping engine 101 may have easier computational work with slowness instead of velocity. Slowness is defined as a vector whose direction is identical to that of the velocity vector and whose magnitude is the reciprocal of the magnitude of the velocity vector, and where v is velocity, we define s for slowness as shown in Equation 2.

[0066]

number

[0067] In one or more embodiments, if the slowness is greater than 10, which indicates a very low conduction velocity, the mapping engine 101 uses a vector having a magnitude of 10. Note that if a vertex belongs to two or more existing / original triangles 410 (i.e., boundary vertices 430), the average value is taken. Also, the LAT value at the vertex is used to calculate the velocity of each sub-triangle 420, and the average of the LAT values ​​at the internal vertices 440 is the LAT value at the center of each sub-triangle 420. The central sub-triangle 450 of the 16 sub-triangles 420 stores the original LAT and velocity vectors.

[0068] For example, Figure 5 shows a geometrical figure 500 according to one or more embodiments. Geometrical figure 500 shows that the triangle of the throne vector can be calculated. For example, the coordinate transformation is performed so that the three vertices of the triangle lie in the xy-plane of the new system. The vertices and the throne vector can be expressed as two-component vectors, as shown in Figure 5 and Equations 3 and 4.

[0069]

number

[0070] Furthermore, with respect to velocity, the solutions to equations 4 and 5 yield an explicit equation 5, which can be transformed back to the original three-dimensional coordinate system.

[0071]

number

[0072] In block 340, the mapping engine 101 interpolates the LAT and velocity values ​​of a very fine mesh. In block 360, the mapping engine 101 follows the path of the velocity vector according to the interpolation. For example, Figure 6 shows geometrical figures 600 and 650 according to one or more embodiments, where the mapping algorithm (e.g., the coherent mapping algorithm of the mapping engine 101) performs interpolation of LAT and velocity values ​​to follow the path 610 (e.g., the internal path) of the velocity vector. Furthermore, the mapping engine 101 receives an anatomical mesh (e.g., geometrical figure 650 drawn by a physician 115, etc.) and follows the catheter 110 along the inner surface to create a triangular mesh that approximates the anatomical structure. Note that in geometrical figure 650, mesh 652 is an example of a CARTO anatomical mesh, and the triangles within it are not as equilateral as those in mesh 654. Mesh 654 is a "coarse" mesh used in the coherent mapping algorithm, where each triangle is divided by 16. Note that Mesh 654 is a simple type of thinning of the original CARO anatomical mesh so that the projection behaves very well. Filled points 660 are a uniform process in the time trace on Mesh 654 (e.g., 0.1 milliseconds). Unfilled points 670 are projections onto the CARTO mesh (e.g., the display is a connection of green points).

[0073] It should be noted that, according to one or more embodiments, the coarse mesh is the mesh from which the coherent mapping algorithm supplies LAT values ​​and velocity vectors, and is not visible to the user (e.g., physician 115). Rather, the user sees the LAT values ​​and velocity vectors projected onto a finer or coarser CARTO anatomical mesh, as applicable. In one example, the internal "coarse" mesh of the coherent mapping algorithm is designed to have an average face length of 3.5 mm. The working mesh for the interpolation scheme can then have an average face length of 3.5 / 4 (approximately 0.9) mm. If the original velocity vectors from the coherent mapping algorithm are presented only as projections onto the anatomical structures at the locations where they are calculated, the view appears sparse or disjointed. Thus, conventionally, a simple interpolation of the vectors was observed (e.g., within a field, the resulting velocity vector stream looked incorrect / suspicious, and the vectors did not look as expected from the time gradient). The mapping engine 101 solves this problem by interpolating the velocity vectors inside and between coherent triangles in a mathematically correct manner, so that the flow appears continuous and the integral over the velocity path matches the time difference (e.g., LAT) from the start to the end of the path. When these points are projected onto the anatomical mesh, the vectors look good and are mathematically correct.

[0074] In block 380, the mapping engine 101 projects the path onto a simplified mesh to provide improved visualization of the heart. In one or more exemplary embodiments, the mapping engine 101 projects each point in a stream orthogonal to the mesh. In particular, as shown in Figure 7, exemplary interfaces 700 and 750 represent protrusions of points in a stream orthogonal to the CARTO mesh, where interface 700 is a simplified mesh and interface 750 is a very fine mesh. Note that if two triangles are at points on edges with different normal vectors, the mapping system 101 uses the average direction of the two different normal vectors. Interfaces 700 and 750 tend to overlap well, except near openings where interface 750 has lower coverage.

[0075] The advantages, technical effects, and benefits of Method 300 include, at a minimum, providing cardiologists and healthcare professionals with a visualization of signal flow to verify the global correlation between velocity vector solutions and LAT value solutions. Thus, the mapping engine 101 utilizes and transforms medical devices and equipment that enable / implement improved visualizations that are otherwise not currently available or performed by cardiologists and healthcare professionals.

[0076] Referring here to Figure 8, an exemplary method 800 is shown in one or more embodiments. An exemplary method 800 is shown in one or more exemplary embodiments (for example, performed by the mapping engine 101 in Figures 1 and / or 2). The exemplary method 800 addresses the need to understand the flow of arrhythmias, given the coarse mesh morphology of current medical mapping systems, by providing a multi-step operation of electrical signals that enables a more accurate and improved understanding of electrophysiology. That is, generally, the mapping engine 101 by implementing the exemplary method 800 takes a given signal origin and then calculates the next sub-triangle to which the signal moves. Since each sub-triangle of the mesh corresponds to a specific time and velocity, the mapping engine 101 interpolates the LAT and velocity values ​​of each sub-triangle to which the signal moves. The mapping engine 101 projects from one sub-triangle to the next in short time units to trace the complete progress and entire path of the signal.

[0077] More specifically, the exemplary method begins in block 810, where the mapping engine 101 positions the initial signal orientation within the intermediate portion of the sub-triangle. In block 820, a uniform time interval dt (e.g., 0.1 milliseconds) is selected for the process. For example, it can be understood that the particles flow with the starting point at the center of the first triangle (e.g., the sub-triangle).

[0078] In block 830, the position of the particle is determined. For example, the position of the particle after the first step, determined according to equation 6.

[0079]

number

[0080] In the determination block 840, the position is repeatedly checked to see if the boundaries of the first triangle (e.g., seams) intersect (e.g., using Plucker coordinates). Note that at the boundaries, the path continues for the remainder of the time process using the velocity of the adjacent triangles.

[0081] According to one or more embodiments, with respect to the edges of sub-triangles, the mapping engine 101 addresses the point where the initial seam intersects with the later seam. That is, when the initial boundary intersects with the later boundary, the change in LAT (e.g., ΔLAT) is very large and the velocity is physically low. Next, the mapping engine calculates the cyclically shifted LAT by performing subdivision and vertex LAT calculations using the shifted LAT values ​​and calculating the velocity of each small triangle. Note that the velocity may be the same except where the initial seam / boundary intersects with the later seam / boundary. Furthermore, the mapping engine 101 repeats the face subdivision and velocity calculations using the shifted LAT. With respect to the velocity vector in the stream calculation, the mapping engine 101 selects the larger of the two velocities. Near where the initial intersects with the later, the small vertex LATs may differ widely. For small faces with vertices having a larger LAT difference (e.g., LAT difference > 10), the mapping engine 101 replaces the LAT values ​​with cyclically shifted interpolated LAT cyclically shifted back.

[0082] The mapping engine 101 can change the plane of the signal path as it moves from one sub-triangle to another around the heart by arranging interconnected sub-triangles in three-dimensional space. Note that the interpolation process maintains each velocity within its own plane.

[0083] The mapping engine 101 provides a velocity stream on the subdivided mesh. In this regard, the mapping engine 101 starts at the center of a triangle and traces the velocity vector toward the edge of the triangle. Note that within a small triangle, the velocity can be constant. Next, the mapping engine 101 provides LAT at the edge as an interpolated value for two vertices. The mapping engine 101 can further loop by determining which triangle is next, tracing the velocity vector toward the edge of the triangle, and tracking the sum according to equation 7.

[0084]

number

[0085] The loop can be stopped when the mapping engine 101 hits a scar and / or when a desired elapsed time (e.g., 5 milliseconds or an interval of other value) is reached.

[0086] The mapping engine 101 can test for intersections by using coordinates (for example, Plucker coordinates can be used by the mapping engine 101 to assign six uniform coordinates to each line in projection space). For example, equation 8 can be applied to two points (x1, y1, z1) and (x2, y2, z2) on a line (e.g., L), and the lateral operator can be used on lines a and b according to equation 9.

[0087]

number

[0088] Furthermore, the mapping engine 101 considers any point P that is not in the plane formed by line segments S and L. If S1 and S2 have different signs (for example, one is <0 and the other is >0), line L does not intersect line segment S. If S1 and S2 have the same sign (>0 or <0), line L passes through line segment S, and if S1=S2=0, line L contains line segment S. Note that if one of s1 or s2 is zero, line L passes through the endpoint of line segment S.

[0089] In block 860, method 800 is continued until the total time reaches a predetermined limit (e.g., 10 milliseconds) or until the test particles reach a mesh boundary triangle or a triangle determined to be nonconductive. The total time is calculated by summing each segment according to equation 10.

[0090]

number

[0091] In many cases, LAT values ​​can be circular. In these cases, the LAT values ​​correspond to the phases of the cardiac cycle, with the earliest and latest times being essentially the same, and the signal flowing smoothly across the boundary where the early and late phases intersect.

[0092] In block 870, the mapping engine 101 projects the calculated paths on the fine mesh onto the system anatomical mesh to provide an improved visualization of the heart. In one or more exemplary embodiments, the mapping engine 101 projects each point in a stream orthogonal to the mesh.

[0093] The flowcharts and block diagrams in the figures illustrate the structure, functionality, and operation of possible implementations of systems, methods, and computer program products according to various embodiments of the present invention. In this regard, each block in a flowchart or block diagram may represent a module, segment, or portion of an instruction containing one or more executable instructions for performing the indicated logical function. In some alternative implementations, the functions shown in a block may be performed in an order other than that shown in the figure. For example, two consecutively shown blocks may actually be executed substantially simultaneously, or they may sometimes be executed in reverse order depending on the relevant functionality. It should also be noted that each block in a block diagram and / or flowchart, and combinations of blocks in a block diagram and / or flowchart, may be performed by a dedicated hardware-based system that performs a specific function or operation, or they may operate or execute a combination of dedicated hardware and computer instructions.

[0094] While features and elements are described above in specific combinations, those skilled in the art will understand that each feature or element can be used individually or in combination with other features and elements. In addition, the methods described herein may be implemented in computer programs, software, or firmware incorporated into a computer-readable medium for execution on a computer or processor. The computer-readable medium as used herein should not be interpreted as being a transient signal in itself, such as radio waves or other freely propagating electromagnetic waves, electromagnetic waves propagating through waveguides or other transmission media (e.g., optical pulses passing through fiber optic cables), or electrical signals transmitted through moving wires.

[0095] Examples of computer-readable media include electrical signals (transmitted via wired or wireless connections) and computer-readable storage media. Examples of computer-readable storage media, though not limited to these, include registers, cache memory, semiconductor memory devices, magnetic media such as internal hard disks and removable disks, magneto-optical media, optical media such as compact disks (CDs) and digital versatile disks (DVDs), random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), static random access memory (SRAM), and memory sticks. A processor can be used with software to implement a radio frequency transceiver for use in terminals, base stations, or any host computer.

[0096] The terms used herein are intended solely to describe specific embodiments and are not intended to be limiting. Where used herein, unless otherwise specified in the context, the singular forms "a," "an," and "the" also include the plural forms. The terms "comprise" and / or "comprising," as used herein, indicate the presence of a described feature, integer, process, operation, element, and / or component, but do not exclude the presence or addition of one or more other features, integers, processes, operations, elements, components, and / or groups thereof.

[0097] The descriptions of different embodiments in this specification are for illustrative purposes only and are not intended to be exhaustive or limitful to the embodiments disclosed. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the embodiments described. The terms used herein have been selected to best describe the principles, practical applications, or technical improvements of the embodiments compared to the art available on the market, or to enable those skilled in the art to understand the embodiments disclosed herein.

[0098] [Implementation Method] (1) A method, A mapping engine, run by one or more processors, subdivides an anatomical mesh of at least a portion of an anatomical structure into one or more other meshes of the anatomical structure, wherein the subdivision is such that the one or more other meshes have a finer grain size than the anatomical mesh. The mapping engine interpolates the local activation time values ​​and velocity values ​​of one or more other meshes. The mapping engine traces the path of the velocity vector on one or more other meshes according to the interpolation of the local activation time value and the velocity value. A method comprising projecting the pathways onto the anatomical mesh using the mapping engine to provide an improved visualization of the anatomical structure. (2) The method according to Embodiment 1, wherein the anatomical mesh includes at least one triangle, and the one or more other meshes include a plurality of sub-triangles within the at least one triangle. (3) The method according to embodiment 2, wherein each of the at least one triangles constitutes a single plane of the anatomical mesh. (4) The method according to Embodiment 2, wherein the mapping engine uses the center value to determine the local activation time value at the vertices of the plurality of sub-triangles. (5) The method according to Embodiment 4, wherein the mapping engine determines the speed for projection onto the vertices.

[0099] (6) The method according to Embodiment 4, wherein the vertex belongs to two or more of the at least one triangle, and the average value of the local activation time is taken. (7) The method according to Embodiment 4, wherein the local activation time value at the vertex is used by the mapping engine to calculate the velocity value for each of the plurality of sub-triangles. (8) The method according to Embodiment 1, wherein the mapping engine subdivides each of the at least one triangle into 16 sub-triangles. (9) The method according to Embodiment 1, wherein the central subtriangle of the plurality of subtriangles preserves the original local activation time and velocity vector. (10) The method according to Embodiment 1, wherein the anatomical structure includes a heart, and at least a portion of the anatomical structure includes cardiac chambers.

[0100] (11) A system, Memory for storing program code for the mapping engine, The system includes at least one processor that executes the program code, and the program code is transmitted to the system The mapping engine subdivides at least a portion of the anatomical mesh into one or more other meshes of the anatomical structure, wherein the subdivision is such that the one or more other meshes have a finer grain size than the anatomical mesh. The mapping engine interpolates the local activation time values ​​and velocity values ​​of one or more other meshes. The mapping engine traces the path of the velocity vector on one or more other meshes according to the interpolation of the local activation time value and the velocity value. A system that causes the mapping engine to project the pathways onto the anatomical mesh to provide an improved visualization of the anatomical structure. (12) The system according to Embodiment 11, wherein the anatomical mesh includes at least one triangle, and the one or more other meshes include a plurality of sub-triangles within the at least one triangle. (13) The system according to embodiment 12, wherein each of the at least one triangles constitutes a single plane of the anatomical mesh. (14) The system according to embodiment 12, wherein the mapping engine uses the center value to determine the local activation time value at the vertices of the plurality of sub-triangles. (15) The system according to embodiment 14, wherein the mapping engine determines the velocity for projection onto the vertices.

[0101] (16) The system according to embodiment 14, wherein the vertex belongs to two or more of the at least one triangle, and the average value of the local activation time is taken. (17) The system according to embodiment 14, wherein the local activation time value at the vertex is used by the mapping engine to calculate the velocity value for each of the plurality of sub-triangles. (18) The system according to embodiment 11, wherein the mapping engine subdivides each of the at least one triangle into 16 sub-triangles. (19) The system according to embodiment 11, wherein the central subtriangle of the plurality of subtriangles preserves the original local activation time and velocity vector. (20) The system according to embodiment 11, wherein the anatomical structure includes a heart, and at least a portion of the anatomical structure includes cardiac chambers.

Claims

1. It is a system, Memory for storing program code for the mapping engine, The system includes at least one processor that executes the program code, and the program code is transmitted to the system. The mapping engine obtains an anatomical mesh of at least a portion of the anatomical structure, which includes multiple spatial map elements. The mapping engine subdivides each spatial map element into multiple sub-spatial map elements with a finer granularity than the spatial map element, The mapping engine assigns the arrival time value of the local activation of each spatial map element as the arrival time of the local activation of the central sub-spatial map element among the corresponding sub-spatial map elements. The mapping engine interpolates the arrival time values ​​of boundary vertices of sub-spatial map elements that lie on the boundary of adjacent spatial map elements by calculating the average of the arrival time values ​​of the adjacent spatial map elements. The mapping engine interpolates the arrival time values ​​of each internal vertex based at least on (i) the interpolated arrival time values ​​of the boundary vertices and (ii) the arrival time values ​​assigned to each central subspatial map element, The mapping engine calculates the paths of local activations on the plurality of subspatial map elements based on the arrival time values ​​of each boundary vertex and each internal vertex of each interpolated subspatial map element, A system that causes the mapping engine to project the pathways onto the anatomical mesh.

2. The system according to claim 1, wherein the plurality of spatial map elements are a plurality of triangles, and the plurality of sub-spatial map elements are a plurality of sub-triangles with a finer granularity than the plurality of triangles.

3. The system according to claim 2, wherein each of the plurality of sub-triangles constitutes a single plane of the anatomical mesh.

4. The system according to claim 2, wherein the mapping engine subdivides each of the plurality of triangles into 16 sub-triangles.

5. The system according to claim 4, wherein interpolating the arrival time values ​​of each vertex of each subspatial map element includes interpolating such that the average value of the arrival time values ​​at the three vertices of the central subtriangle of the plurality of subtriangles matches the arrival time value associated with the corresponding pre-subdivision triangle.

6. The system according to claim 1, wherein the anatomical structure includes a heart, and at least a portion of the anatomical structure includes cardiac chambers.

7. It is a method, A mapping engine, run by one or more processors, obtains an anatomical mesh of at least a portion of an anatomical structure, which includes multiple spatial map elements. The mapping engine subdivides each spatial map element into multiple sub-spatial map elements with a finer granularity than the spatial map element, The mapping engine assigns the arrival time value of the local activation of each spatial map element as the arrival time of the local activation of the central sub-spatial map element among the corresponding sub-spatial map elements. The mapping engine interpolates the arrival time values ​​of boundary vertices of sub-spatial map elements that lie on the boundary of adjacent spatial map elements by calculating the average of the arrival time values ​​of the adjacent spatial map elements. The mapping engine interpolates the arrival time values ​​of each internal vertex based at least on (i) the interpolated arrival time values ​​of the boundary vertices and (ii) the arrival time values ​​assigned to each central subspatial map element, The mapping engine calculates the paths of local activations on the plurality of subspatial map elements based on the arrival time values ​​of each boundary vertex and each internal vertex of each interpolated subspatial map element, A method comprising projecting the pathway onto the anatomical mesh using the mapping engine.

8. The method according to claim 7, wherein the plurality of spatial map elements are a plurality of triangles, and the plurality of sub-spatial map elements are a plurality of sub-triangles with a finer granularity than the plurality of triangles.

9. The method according to claim 8, wherein each of the plurality of sub-triangles constitutes a single plane of the anatomical mesh.

10. The method according to claim 8, wherein the mapping engine subdivides each of the plurality of triangles into 16 sub-triangles.

11. The method of claim 10, wherein interpolating the arrival time values ​​of each vertex of each subspatial map element is performed such that the average value of the arrival time values ​​at the three vertices of the central subtriangle of the plurality of subtriangles matches the arrival time value associated with the corresponding pre-subdivision triangle.

12. The method according to claim 7, wherein the anatomical structure includes a heart, and at least a portion of the anatomical structure includes cardiac chambers.

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