POST ABLATION VALIDATION VIA VISUAL SIGNAL

A system and method performed in association with medical equipment in a medical procedure are disclosed. The system and method include measuring at least one electrical signal in the medical procedure, rendering a depiction of the medical procedure on a display, representing the measured at least one electrical signal on the display in conjunction with the rendering of the medical procedure, recording the location of at least one piece of medical equipment during the medical procedure, processing the recorded location of at least one piece of medical equipment, depicting the value of signals measured via the at least one piece of medical equipment, and providing an output that correlates the processed recorded location of at least one piece of medical equipment with the depicted signals measured via the at least one piece of medical equipment at the processed recorded location by the at least one piece of medical equipment.

FIELD OF INVENTION

The present invention is related to ablations associated with cardiac arrythmias, and more particularly, to post ablation validation via visual signal.

BACKGROUND

An ablation catheter is often used to ablate heart tissue to prevent electric signals from crossing the ablated tissue. Such a procedure is often performed to prevent atrial fibrillation (AF) often caused by erroneous signals and/or signal sources.

After an ablation procedure has been completed, the effectiveness of the ablation is often verified during a validation period. During the validation period, electrodes of a catheter are placed over areas of ablation and/or areas around the ablation to confirm that electrical signals do not pass through the ablation region. A positive outcome corresponds to the catheter's electrodes reading a flat electrical signal.

During the validation period, a signal graph is provided and includes signals of all catheter's electrodes. When using multi electrode catheters, the signal graph shows the detected signal per electrode. After an effective ablation, the signals detected from the ablation region are supposed to be flat or to show low electrical activity. However, it is often difficult to determine which electrode on the catheter corresponds to the detected signal on the signal graph. For example, a first electrode on a catheter with 8 electrodes may detect a signal that is shown in the signal graph. However, a physician may not be able to easily identify what portion of the organ that signal corresponds to and whether that signal is from within an ablation region or outside the ablation region.

SUMMARY

A system and method for providing a visual representation to a user of a depiction of an organ involved in a medical procedure to show the location where an electrical signal is detected during an operative period, such as a post ablation validation period, for example, is provided.

The system and method performed in association with medical equipment in a medical procedure are disclosed. The system and method include measuring at least one electrical signal in the medical procedure, rendering a depiction of the medical procedure on a display, representing the measured at least one electrical signal on the display in conjunction with the rendering of the medical procedure, recording the location of at least one piece of medical equipment during the medical procedure, processing the recorded location of at least one piece of medical equipment, depicting the value of signals measured via the at least one piece of medical equipment, and providing an output that correlates the processed recorded location of at least one piece of medical equipment with the depicted signals measured via the at least one piece of medical equipment at the processed recorded location by the at least one piece of medical equipment.

DETAILED DESCRIPTION

Cardiac arrhythmias, and atrial fibrillation in particular, persist as common and dangerous medical ailments, especially in the aging population. In patients with normal sinus rhythm, the heart, which is comprised of atrial, ventricular, and excitatory conduction tissue, is electrically excited to beat in a synchronous, patterned fashion. In patients with cardiac arrythmias, abnormal regions of cardiac tissue do not follow the synchronous beating cycle associated with normally conductive tissue as in patients with normal sinus rhythm. Instead, the abnormal regions of cardiac tissue aberrantly conduct to adjacent tissue, thereby disrupting the cardiac cycle into an asynchronous cardiac rhythm. Such abnormal conduction has been previously known to occur at various regions of the heart, for example, in the region of the sino-atrial (SA) node, along the conduction pathways of the atrioventricular (AV) node and the Bundle of His, or in the cardiac muscle tissue forming the walls of the ventricular and atrial cardiac chambers.

Cardiac arrhythmias, including atrial arrhythmias, may be of a multiwavelet reentrant type, characterized by multiple asynchronous loops of electrical impulses that are scattered about the atrial chamber and are often self-propagating. Alternatively, or in addition to the multiwavelet reentrant type, cardiac arrhythmias may also have a focal origin, such as when an isolated region of tissue in an atrium fires autonomously in a rapid, repetitive fashion. Ventricular tachycardia (V-tach or VT) is a tachycardia, or fast heart rhythm that originates in one of the ventricles of the heart. This is a potentially life-threatening arrhythmia because it may lead to ventricular fibrillation and sudden death.

One type of arrhythmia, atrial fibrillation, occurs when the normal electrical impulses generated by the sinoatrial node are overwhelmed by disorganized electrical impulses that originate in the atria and pulmonary veins causing irregular impulses to be conducted to the ventricles. An irregular heartbeat results and may last from minutes to weeks, or even years. Atrial fibrillation (AF) is often a chronic condition that leads to a small increase in the risk of death often due to strokes. Risk increases with age. Approximately 8% of people over 80 having some amount of AF. Atrial fibrillation is often asymptomatic and is not in itself generally life-threatening, but it may result in palpitations, weakness, fainting, chest pain and congestive heart failure. Stroke risk increases during AF because blood may pool and form clots in the poorly contracting atria and the left atrial appendage. The first line of treatment for AF is medication that either slow the heart rate or revert the heart rhythm back to normal. Additionally, persons with AF are often given anticoagulants to protect them from the risk of stroke. The use of such anticoagulants comes with its own risk of internal bleeding. In some patients, medication is not sufficient and their AF is deemed to be drug-refractory, i.e., untreatable with standard pharmacological interventions. Synchronized electrical cardioversion may also be used to convert AF to a normal heart rhythm. Alternatively, AF patients are treated by catheter ablation.

A catheter ablation-based treatment may include mapping the electrical properties of heart tissue, especially the endocardium and the heart volume, and selectively ablating cardiac tissue by application of energy. Cardiac mapping, for example, creating a map of electrical potentials (a voltage map) of the wave propagation along the heart tissue or a map of arrival times (a local time activation (LAT) map) to various tissue located points, may be used for detecting local heart tissue dysfunction Ablations, such as those based on cardiac mapping, can cease or modify the propagation of unwanted electrical signals from one portion of the heart to another.

The ablation process damages the unwanted electrical pathways by formation of non-conducting lesions. Various energy delivery modalities have been disclosed for forming lesions, and include use of microwave, laser and more commonly, radiofrequency energies to create conduction blocks along the cardiac tissue wall. In a two-step procedure—mapping followed by ablation—electrical activity at points within the heart is typically sensed and measured by advancing a catheter containing one or more electrical sensors (or electrodes) into the heart, and acquiring data at a multiplicity of points. These data are then utilized to select the endocardial target areas at which ablation is to be performed.

Cardiac ablation and other cardiac electrophysiological procedures have become increasingly complex as clinicians treat challenging conditions such as atrial fibrillation and ventricular tachycardia. The treatment of complex arrhythmias can now rely on the use of three-dimensional (3D) mapping systems in order to reconstruct the anatomy of the heart chamber of interest.

For example, cardiologists rely upon software such as the Complex Fractionated Atrial Electrograms (CFAE) module of the CARTO®3 3D mapping system, produced by Biosense Webster, Inc. (Diamond Bar, Calif.), to analyze intracardiac EGM signals and determine the ablation points for treatment of a broad range of cardiac conditions, including atypical atrial flutter and ventricular tachycardia.

The 3D maps can provide multiple pieces of information regarding the electrophysiological properties of the tissue that represent the anatomical and functional substrate of these challenging arrhythmias.

Cardiomyopathies with different etiologies (ischemic, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular dysplasia (ARVD), left ventricular non-compaction (LVNC), etc.) have an identifiable substrate, featured by areas of unhealthy tissue surrounded by areas of normally functioning cardiomyocytes.

Electrode catheters have been in common use in medical practice for many years. They are used to stimulate and map electrical activity in the heart and to ablate sites of aberrant electrical activity. In use, the electrode catheter is inserted into a major vein or artery, e.g., femoral artery, and then guided into the chamber of the heart of concern. A typical ablation procedure involves the insertion of a catheter having at least one electrode at its distal end, into a heart chamber. A reference electrode is provided, generally taped to the skin of the patient or by means of a second catheter that is positioned in or near the heart. RF (radio frequency) current is applied to the tip electrode of the ablating catheter, and current flows through the media that surrounds it, i.e., blood and tissue, toward the reference electrode. The distribution of current depends on the amount of electrode surface in contact with the tissue as compared to blood, which has a higher conductivity than the tissue. Heating of the tissue occurs due to its electrical resistance. The tissue is heated sufficient to cause cellular destruction in the cardiac tissue resulting in formation of a lesion within the cardiac tissue which is electrically non-conductive. During this process, heating of the electrode also occurs as a result of conduction from the heated tissue to the electrode itself. If the electrode temperature becomes sufficiently high, possibly above 60 degrees C., a thin transparent coating of dehydrated blood protein can form on the surface of the electrode. If the temperature continues to rise, this dehydrated layer can become progressively thicker resulting in blood coagulation on the electrode surface. Because dehydrated biological material has a higher electrical resistance than endocardial tissue, impedance to the flow of electrical energy into the tissue also increases. If the impedance increases sufficiently, an impedance rise occurs and the catheter must be removed from the body and the tip electrode cleaned.

A system and method performed in association with medical equipment in a medical procedure are disclosed. The system and method include measuring at least one electrical signal in the medical procedure, rendering a depiction of the medical procedure on a display, representing the measured at least one electrical signal on the display in conjunction with the rendering of the medical procedure, recording the location of at least one piece of medical equipment during the medical procedure, processing the recorded location of at least one piece of medical equipment, depicting the value of signals measured via the at least one piece of medical equipment, and providing an output that correlates the processed recorded location of at least one piece of medical equipment with the depicted signals measured via the at least one piece of medical equipment at the processed recorded location by the at least one piece of medical equipment.

FIG. 1is a diagram of an exemplary system102in which one or more features of the disclosure subject matter can be implemented. All or parts of system102may be used to collect information for a training dataset and/or all or parts of system102may be used to implement a trained model. System102may include components, such as a catheter140, that are configured to damage tissue areas of an intra-body organ. The catheter140may also be further configured to obtain biometric data. Although catheter140is shown to be a point catheter, it will be understood that a catheter of any shape that includes one or more elements (e.g., electrodes) may be used to implement the embodiments disclosed herein. System102includes a probe121, having shafts that may be navigated by a physician130into a body part, such as heart126, of a patient128lying on a bed129. According to embodiments, multiple probes may be provided, however, for purposes of conciseness, a single probe121is described herein but it will be understood that probe121may represent multiple probes. As shown inFIG. 1, physician130may insert shaft122through a sheath123, while manipulating the distal end of the shafts122using a manipulator132near the proximal end of the catheter140and/or deflection from the sheath123. As shown in an inset125, catheter140may be fitted at the distal end of shafts122. Catheter140may be inserted through sheath123in a collapsed state and may be then expanded within heart126. Catheter140may include at least one ablation electrode147and a catheter needle148, as further disclosed herein.

According to exemplary embodiments, catheter140may be configured to ablate tissue areas of a cardiac chamber of heart126. Inset145shows catheter140in an enlarged view, inside a cardiac chamber of heart126. As shown, catheter140may include at least one ablation electrode147coupled onto the body of the catheter. According to other exemplary embodiments, multiple elements may be connected via splines that form the shape of the catheter140. One or more other elements (not shown) may be provided and may be any elements configured to ablate or to obtain biometric data and may be electrodes, transducers, or one or more other elements.

According to embodiments disclosed herein, the ablation electrodes, such as electrode147, may be configured to provide energy to tissue areas of an intra-body organ such as heart126. The energy may be thermal energy and may cause damage to the tissue area starting from the surface of the tissue area and extending into the thickness of the tissue area.

According to exemplary embodiments disclosed herein, biometric data may include one or more of LATs, electrical activity, topology, bipolar mapping, dominant frequency, impedance, or the like. The local activation time may be a point in time of a threshold activity corresponding to a local activation, calculated based on a normalized initial starting point. Electrical activity may be any applicable electrical signals that may be measured based on one or more thresholds and may be sensed and/or augmented based on signal to noise ratios and/or other filters. A topology may correspond to the physical structure of a body part or a portion of a body part and may correspond to changes in the physical structure relative to different parts of the body part or relative to different body parts. A dominant frequency may be a frequency or a range of frequency that is prevalent at a portion of a body part and may be different in different portions of the same body part. For example, the dominant frequency of a pulmonary vein of a heart may be different than the dominant frequency of the right atrium of the same heart. Impedance may be the resistance measurement at a given area of a body part.

As shown inFIG. 1, the probe121, and catheter140may be connected to a console124. Console124may include a processor141, such as a general-purpose computer, with suitable front end and interface circuits138for transmitting and receiving signals to and from catheter, as well as for controlling the other components of system102. In some embodiments, processor141may be further configured to receive biometric data, such as electrical activity, and determine if a given tissue area conducts electricity. According to an embodiment, the processor may be external to the console124and may be located, for example, in the catheter, in an external device, in a mobile device, in a cloud-based device, or may be a standalone processor.

As noted above, processor141may include a general-purpose computer, which may be programmed in software to carry out the functions described herein. The software may be downloaded to the general-purpose computer in electronic form, over a network, for example, or it may, alternatively or additionally, be provided and/or stored on non-transitory tangible media, such as magnetic, optical, or electronic memory. The example configuration shown inFIG. 1may be modified to implement the embodiments disclosed herein. The disclosed embodiments may similarly be applied using other system components and settings. Additionally, system102may include additional components, such as elements for sensing electrical activity, wired or wireless connectors, processing and display devices, or the like.

According to an embodiment, a display127connected to a processor (e.g., processor141) may be located at a remote location such as a separate hospital or in separate healthcare provider networks. Additionally, the system102may be part of a surgical system that is configured to obtain anatomical and electrical measurements of a patient's organ, such as a heart, and performing a cardiac ablation procedure. An example of such a surgical system is the Carto® system sold by Biosense Webster.

The system102may also, and optionally, obtain biometric data such as anatomical measurements of the patient's heart using ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) or other medical imaging techniques known in the art. The system102may obtain electrical measurements using catheters, electrocardiograms (EKGs) or other sensors that measure electrical properties of the heart. The biometric data including anatomical and electrical measurements may then be stored in a memory142of the mapping system102, as shown inFIG. 1. The biometric data may be transmitted to the processor141from the memory142. Alternatively, or in addition, the biometric data may be transmitted to a server160, which may be local or remote, using a network162.

In some instances, the server160may be implemented as a physical server. In other instances, server160may be implemented as a virtual server a public cloud computing provider (e.g., Amazon Web Services (AWS)0).

Control console124may be connected, by a cable139, to body surface electrodes143, which may include adhesive skin patches that are affixed to the patient128. The processor, in conjunction with a current tracking module, may determine position coordinates of the catheter140inside the body part (e.g., heart126) of a patient. The position coordinates may be based on impedances or electromagnetic fields measured between the body surface electrodes143and the electrode147or other electromagnetic components of the catheter140. Additionally, or alternatively, location pads may be located on the surface of bed129and may be separate from the bed129.

Processor141may include real-time noise reduction circuitry typically configured as a field programmable gate array (FPGA), followed by an analog-to-digital (A/D) ECG (electrocardiograph) or EMG (electromyogram) signal conversion integrated circuit. The processor141may pass the signal from an A/D ECG or EMG circuit to another processor and/or can be programmed to perform one or more functions disclosed herein.

Control console124may also include an input/output (I/O) communications interface that enables the control console to transfer signals from, and/or transfer signals to electrode147.

During a procedure, processor141may facilitate the presentation of a body part rendering135to physician130on a display127, and store data representing the body part rendering135in a memory142. Memory142may comprise any suitable volatile and/or non-volatile memory, such as random-access memory or a hard disk drive. In some embodiments, medical professional130may be able to manipulate a body part rendering135using one or more input devices such as a touch pad, a mouse, a keyboard, a gesture recognition apparatus, or the like. For example, an input device may be used to change the position of catheter140such that rendering135is updated. In alternative embodiments, display127may include a touchscreen that can be configured to accept inputs from medical professional130, in addition to presenting a body part rendering135.

Electrical activity at a point in the heart may be typically measured by advancing a catheter containing an electrical sensor at or near its distal tip to that point in the heart, contacting the tissue with the sensor and acquiring data at that point. One drawback with mapping a cardiac chamber using a catheter containing only a single, distal tip electrode is the long period of time required to accumulate data on a point-by-point basis over the requisite number of points required for a detailed map of the chamber as a whole. Accordingly, multiple-electrode catheters have been developed to simultaneously measure electrical activity at multiple points in the heart chamber.

Multiple-electrode catheters may be implemented using any applicable shape such as a linear catheter with multiple electrodes, a balloon catheter including electrodes dispersed on multiple spines that shape the balloon, a lasso or loop catheter with multiple electrodes, or any other applicable shape.FIG. 2Ashows an example of a linear catheter202including multiple electrodes204,205, and206that may be used to map a cardiac area. Linear catheter202may be fully or partially elastic such that it can twist, bend, and or otherwise change its shape based on received signal and/or based on application of an external force (e.g., cardiac tissue) on the linear catheter202.

FIG. 2Bshows an example balloon catheter212including multiple splines (e.g.,12splines in the specific example ofFIG. 2B) including splines214,216,217and multiple electrodes on each spline including electrodes221,222,223,224,225, and226as shown. The balloon catheter212may be designed such that when deployed into a patient's body, its electrodes may be held in intimate contact against an endocardial surface. As an example, a balloon catheter may be inserted into a lumen, such as a pulmonary vein (PV). The balloon catheter may be inserted into the PV in a deflated state such that the balloon catheter does not occupy its maximum volume while being inserted into the PV. The balloon catheter may expand while inside the PV such that electrodes on the balloon catheter are in contact with an entire circular section of the PV.

FIG. 3illustrates a display300designed to provide feedback during the validation period of the ablation. A rendering310of the organ that is ablated may be provided. Rendering310may be provided both during the ablation procedure and during the validation period. Rendering310may show an ablated area330such that a catheter320may be directed to the ablation area330during the validation period. The ablation area330may include one or more ablations340. As illustrated, the ablations340may include a vertical ablation and a horizontal ablation forming a plus sign. The catheter320may contact the ablation area330(and possibly ablations340) to collect any electrical signals that are present in the ablation area. A catheter depiction320may be provided in the rendering310of the organ.

FIG. 4Aillustrates a more detailed version of rendering310fromFIG. 3illustrating the display300with the heart chamber450and the four pulmonary veins4601,4602,4603,4604(collectively or generically referred to as pulmonary vein460), which may be isolated via a pulmonary isolation (PI). As described with respect toFIG. 3, there is a catheter320in an ablation area330having formed one or more ablations340. As described, the rendering310provides a visual indication to allow a physician an identification of the area of the organ where a signal is detected, during the validation period, to determine if additional ablation is necessary. In the organ, the catheter is visualized and over the catheter, the electrodes are visualized.

If a catheter detects a signal with a significant electrical activity (defined by the physician as a threshold), a visual representation such as a light, a marker, a flash, an emphasis, or the like may be visually shown on the electrode visualization of the catheter320in the display ofFIG. 3where the signal is detected. Based on the visual representation and the location of the signal, a determination may be made whether the detected signal is within an area330that should not have electrical activity or if it is outside such an area in an area, such as area4701and area4702, where good tissue existed and the ablation was not intended to affect the signals in such an area4701,4702. If the detected signal is within an area330that should not have electrical activity, then additional ablation may be performed.

By way of example, all the electrodes of catheter320detecting electrical activity may be presented “green,” while those measuring low electrical activity as compared to a threshold may be indicated as “red.” Alternatively, or additionally, the electrodes of catheter320detecting electrical activity may be presented “constant,” while those measuring zero electrical activity as compared to a threshold may be indicated as “blinking.”

FIG. 4Billustrates a signal graph400that may be provided in conjunction with rendering300. Signal graph400may illustrate a graph of electrical activity corresponding to all the electrodes of the catheter320. This may include any number of signals, such as 40 signals for example. The signal graph400ofFIG. 4Billustrates four such signals, in order to aid in understanding of the present invention. The four signals include signal1410, signal2420, signal3430and signal4440. Each of these signals1-4410-440corresponding to the signal being measured in an electrode of catheter320. As illustrated, signals1,2410,430include electrical activity, while signals3,4430,440include no electrical activity or low electrical activity. This may be determined from the signal graph400.

When the signal (signals3,4430,440) in display300is under a threshold, which can be defined by the user or by BWI, as a no active signal/flat line, this signal which is related to a specific electrode on the catheter320can have a visualized indication so the physician may be able to locate that area within rendering310and decide if the lack of signal is appropriate or not. When the signal (signals1,2410,420) in display300is above a threshold it may be indicated as an active signal exhibiting electrical activity, this signal which is related to a specific electrode on the catheter320can have a visualized indication on the electrode so the physician may be able to locate that area within rendering310and decide if having electrical activity is appropriate or not. The rendering310ofFIG. 4Aand signal graph400ofFIG. 4Bare synchronized allowing the location of the catheter electrode and signal visualization to be correlated. This correlation may be achieved by a visual representation, such as a light, a marker, a flash, an emphasis, or the like. That is, the signal graph of an electrode may flash, while the electrode in the rendering also flashes.

The correlation may provide detail when moving the catheter and when interacting with the display. In the situation where the catheter320is moving inside the chamber, when the catheter320moves, the electrodes within the rendering310are visualized as described. For example, where a signal is detected by the catheter320, the electrodes detecting such a signal may be marked in the rendering310with one of the methods specified. As the catheter moves to other places where a signal is detected by the catheter320, the electrodes detecting such a signal may further be marked in the rendering310with one of the methods specified. As the catheter320moves and is in a location where the electrodes detect the absence of a signal, the marking of electrodes may cease, or the electrode(s) without a signal may be marked in the rendering310distinctively from those electrode(s) marked as having a signal.

Specifically, as the cathode is positioned to measure the electrical signals using an electrode, the measured signal may be plotted. For example, an electrode positioned at location4101may provide the signal plot410, an electrode positioned at location4201may provide the signal plot420, an electrode positioned at location4301may provide the signal plot430, and an electrode positioned at location4401may provide the signal plot440.

As discussed above, when the electrode is at location4101with plot410, the electrode at the location4101and the plot410may be marked to provide a visual indication to the user that the plot410corresponds to the electrode4101. When the electrode is at location4201with plot420, the electrode at the location4201and the plot420may be marked to provide a visual indication to the user that the plot420corresponds to the electrode4201. When the electrode is at location4301with plot430, the electrode at the location4301and the plot430may be marked to provide a visual indication to the user that the plot430corresponds to the electrode4301. When the electrode is at location4401with plot440, the electrode at the location4401and the plot440may be marked to provide a visual indication to the user that the plot440corresponds to the electrode4401.

Alternatively, or additionally, the present system may operate in reverse from that described above, in that it may react to the user interacting with the display instead of the user interacting with the catheter. In such a configuration, the user may interact with the signal graph400via an input device to the display. For example, the graph of the signal in the signal graph400may be hovered over with the cursor and the corresponding electrode of the catheter may blink in the rendering310, or vice versa, such as by hovering over rendering310and the corresponding electrical signal blinking. While blinking is provided as one method of providing the user a visual indication, other techniques may additionally, or alternatively, be used. These other techniques may include using coloring, using hashing, flashing, pointers or other method of indicating or providing emphasis or highlight of a depiction in a display.

Alternatively, a single signal on signal graph400or electrode on catheter320may be selected by user input, for example. That is the depiction may highlight, or present for view, only a single electrode and its corresponding graphical depiction. The corresponding electrode on catheter320with signal on signal graph400may be presented. While the single signal on signal graph400or electrode on catheter320is selected, the other signals on signal graph400or electrode on catheter320may be hidden from view. Similarly, only the corresponding electrode on catheter320or signal on signal graph400is presented, while the other electrodes on catheter320or signals on signal graph400may be hidden from view.

By assessing whether the lack of signal, or electrical activity in various areas of rendering310by probing with the electrodes of the catheter320, the physician may determine if additional ablation is required. In essence, the physician may be able to determine if there is unwanted electrical activity within ablation area330, or if there is unwanted lack of electrical activity outside of ablation area330in areas4701,4702, for example. If unwanted electrical activity exists within ablation area330, additional ablation(s) may be performed to control the pathways of such electrical signals. If unwanted lack of electrical activity exists, such lack of electrical activity may indicate that a scar already exists in the chamber, for example. Such a scar may be from a previous procedure, or at least may not be from the present procedure. Such a scar may be a cause of another arrythmia and/or may be of no importance to the present procedure.

FIG. 5illustrates a method500of providing a rendering ofFIG. 3with correlated signals. Method500includes, at step510, measuring an electrical signal in a medical procedure. At step520, method500includes rendering the medical procedure on a display. At step530, method500includes representing the measured electrical signal on the display. At step540, method500includes recording medical equipment locations, such the catheter locations, for example. In addition, other data of the medical procedure may be recorded including ECG data, force data, and the like. At step550, method500may include processing, which includes analyzing, the data, such as catheter locations and associated electrical signals. This processing may include identifying annotations on the ECG data. As would be understood to those possessing an ordinary skill in the pertinent arts, reference annotation(s) may be included within the data while the procedure is occurring. The processing in step550may include detecting or determining the specific channel/s for these mapping annotations and mapping the annotations to the catheter channels. Visualizing or depicting, at step560, the value of the signals for each of the channels.

If no signal is measured on an electrode, the lack of signal information may be provided to the visualized depiction of that electrode and graph of that electrode's signal may be graphed as a flat line signal. As described above, the lack of signal or flat line may be presented in a number of ways. In short, the electrode and the graph of the signal for the electrode may be colored, or otherwise provided a visual indication allowing a user to notice the electrode, to indicate no signal exists. Visual indications include blinking, marking and the like.

If an ECG signal is measured on another electrode, the signal information, including amplitude, and other commonly understood ECG data, may be provided to the visualized depiction of that another electrode and a graph of that another electrode's signal. As described above, the signal for the electrode may be presented in a number of ways. In short, the electrode and the graph of the signal for the electrode may be colored green to indicate a signal exists.

At step570, method may include providing an output that correlates a given electrode and its position within the depicted medical procedure with the signal measured at that location by the electrode.

Method500may be performed in real-time. The data may be generated and renderer in real-time so when a flat line or signal on the signals is measured it may be simultaneously be depicted the signal/no signal visualization on the3dcatheter electrodes model.

In general, the system captures ongoing timeline data and correlates this timeline data with other sensed data. The sensed data may include data sensed by the system, such as ECG, location, and the like. The ECG data may be processed, and using thresholds this processing may identify one or more electrodes as “sensing no ECG data,” the identification of these one or more electrodes may then be combined with the location of the catheter at that time of no signal allowing the information to be displayed. A similar, approach may be utilized for the signals above a threshold detected based on catheter location.