Patent Description:
In an electroanatomical mapping procedure, a catheter comprising one or more sensing electrodes is inserted into the heart of a patient, and the electrodes are used to acquire intracardiac electrogram signals. Based on the signals, an electroanatomical map of the heart is generated.

<CIT> describes cardiac electrograms recorded in a plurality of channels. Beats are classified automatically into respective classifications according to a resemblance of the morphologic characteristics of the beats to members of a set of templates. Respective electroanatomic maps of the heart are generated from the classified beats.

<CIT> describes a system for providing information about a patient's heart includes one or more electrodes that receive signals from electrical activity of the heart over one or more heart beat cycles. The system is characterized by an electronic processor coupled to the one or more electrodes to: receive the signals from the one or more electrodes; execute an automated set-up routine that processes the signals to automatically provide at least some set-up results for new mapping configurations; and/or process the signals with beat detection and beat acceptance criteria for new or existing mapping configurations to provide information about how well the signals match one or more of the new or existing mapping configurations.

In some applications, as described in <CIT>, multiple different electroanatomical maps of the heart are generated in parallel, i.e., are generated from a single session of electrogram-signal acquisition. The electroanatomical maps may correspond, for example, to different respective arrhythmic states exhibited by the patient during the session. Alternatively or additionally, the electroanatomical maps may show different types of information, or may be generated from different sets of electrogram signals.

In such applications, the maps are assigned respective sets of suitability criteria, and each acquired signal is used for a particular map only if the signal satisfies the suitability criteria for the map. The suitability criteria may include, for example, the criterion that a correlation score between the signal and a predefined signal template exceeds a predefined threshold. Alternatively or additionally, the suitability criteria may include criteria relating to the properties of the cardiac cycle over which the signal was acquired, or to the stability of the catheter while the signal was acquired.

A challenge, when performing parallel mapping as described above, is that it may be difficult for the physician to track the progression of the mapping procedure in real time, due to the multiplicity of the maps.

To address this challenge, embodiments of the present invention provide a graphical user interface (GUI) for parallel mapping. The GUI includes a plurality of widgets, such as buttons or tabs, which are typically arranged in a row or column. Each widget corresponds to a different respective one of the maps. Upon the physician selecting any one of the widgets, the GUI displays the status of the most-recently acquired electrogram signal with respect to the suitability criteria for the corresponding map. For example, the GUI may show the correlation score between the signal and the signal template, along with an indication as to whether the score exceeds the relevant threshold.

Advantageously, each widget may indicate whether the signal satisfies the suitability criteria, such that the physician may readily ascertain this information even without selecting the widget. Alternatively or additionally, the widget may include other high-level information, such as the aforementioned correlation score. Alternatively or additionally, the widget may include the name of the map and/or the name of the signal template used for the map.

Reference is initially made to <FIG>, which is a schematic illustration of a system <NUM> for real time tracking of a parallel electroanatomical mapping procedure, in accordance with some embodiments of the present invention.

<FIG> depicts a physician <NUM> performing a parallel electroanatomical mapping of a chamber of the heart <NUM> of a patient <NUM>. To perform the mapping, physician <NUM> inserts a catheter <NUM> into the chamber. Subsequently, the physician uses one or more electrodes disposed at the distal end of catheter <NUM> (which may be referred to as a "probe") to acquire electrogram signals from the chamber.

Typically, one electrogram signal is acquired during each cycle of heart <NUM>. In some cases, each acquired signal is a single-channel signal. For example, the signal may represent the voltage between a single electrode at the distal end of catheter <NUM> and an external electrode disposed on the patient's body. Alternatively, the signal may represent the voltage between a pair of electrodes at the distal end of the catheter. In other cases, each acquired signal is a multichannel signal. For example, the distal end of the catheter may comprise multiple pairs of electrodes, and each pair may acquire a respective channel of the signal.

System <NUM> comprises a processor <NUM>. As the electrogram signals are acquired, processor <NUM> receives the signals from catheter <NUM>. For example, the processor may be disposed within a console <NUM>, and the proximal end of the catheter may be connected to console <NUM> via an electrical interface <NUM> such as a port or socket, such that each acquired signal passes through the catheter and, via interface <NUM>, into the console. After passing through analog-to-digital conversion circuitry and any other relevant circuitry, each signal may be received by processor <NUM>.

Based on the received electrogram signals, the processor generates multiple electroanatomical maps. Each electroanatomical map is associated with a respective set of suitability criteria such that any particular electrogram signal is used to generate the map only if the signal satisfies the set of suitability criteria. For example, the electroanatomical maps may be associated with respective signal templates, in that the set of suitability criteria for each of the maps may include a criterion of matching the signal template. In other words, any particular electrogram signal may be used to generate the map only if the signal matches the signal template.

In some embodiments, the electroanatomical maps are generated in stages. For example, each electroanatomical map may be initialized, prior to the procedure, from a pre-acquired anatomical map of the chamber. Subsequently to the initialization of the map, the map may be continually updated as the electrogram signals are acquired. Alternatively, each map may be initialized during the procedure based on both electrical and anatomical information acquired during the procedure, and then continually updated as further electrogram signals are acquired. In other embodiments, the electroanatomical maps are generated in a single step, following the acquisition of all the electrogram signals.

System further comprises a display <NUM>, which may comprise, for example, a desktop or laptop computer monitor. Processor <NUM> may display one or more of the electroanatomical maps on display <NUM>, during and/or subsequently to the mapping procedure. Furthermore, as the signals are acquired, processor <NUM> displays a graphical user interface (GUI) <NUM> on display <NUM>. GUI <NUM> includes a plurality of widgets <NUM>, including one or more tabs and/or one or more buttons, corresponding to the electroanatomical maps. Typically, widgets <NUM> are arranged in a row or column.

System <NUM> further comprises one or more input devices, such as a keyboard or mouse. Alternatively or additionally, display <NUM> may function as an input device, in that the display may comprise a touch screen. Using any of these input devices, a user of the system, such as physician <NUM>, may select any one of widgets <NUM>. For example, the user may hover a mouse pointer over the widget and then click a mouse button, or, if the display comprises a touch screen, simply touch the screen at the location of the widget.

In some embodiments, the processor labels each widget with an identifier <NUM> of the electroanatomical map to which the widget corresponds. Alternatively or additionally, the processor may label each widget with an identifier <NUM> of the signal template with which the corresponding electroanatomical map is associated. Each of identifiers <NUM> and <NUM> may include any suitable sequence of letters, numbers, and/or other characters, which may be entered by the user (or by another user) at any time prior to the procedure, e.g., using a keyboard. For example, in <FIG>, the leftmost widget has two labels: "<NUM>-NSR," which indicates the first map by its number ("<NUM>") and name ("NSR"), and "NSR:<NUM>," which likewise indicates the template associated with the first map by its number ("<NUM>") and name ("NSR").

In response to the user selecting any one of widgets <NUM>, the processor displays, in the GUI, the status of the most recently acquired electrogram signal with respect to at least one criterion (e.g., each criterion) in the set of suitability criteria associated with the electroanatomical map to which the selected widget corresponds. Typically, the processor displays the status while continuing to display the widgets. For example, the widgets may be displayed in a first portion <NUM> of the GUI, while the status of the most recently acquired electrogram signal may be displayed in a second portion <NUM> of the GUI, which may be located, for example, beneath first portion <NUM>. In some embodiments, particularly if the widgets are not tabs, the processor modifies the appearance of the selected widget, e.g., by displaying a border <NUM> around the widget, to indicate that the widget was selected.

For example, <FIG> shows a scenario in which the user has selected the fourth, rightmost widget. Responsively to this selection, the processor displays the status of the most recently acquired electrogram signal with respect to the set of suitability criteria associated with the fourth map.

Typically, the processor displays the status of the most recently acquired electrogram signal by displaying a plurality of indicators, each indicator indicating whether the signal satisfies a different respective one of the criteria.

For example, the processor may display an indicator <NUM> indicating whether the signal matches the template (referred to as a "pattern" ("PTRN") in <FIG>) associated with the map. The signal may be deemed to match if, for example, a correlation score <NUM> between the signal and the template exceeds a predefined threshold. Correlation score <NUM> may also be displayed in second portion <NUM>, e.g., inside indicator <NUM>.

Alternatively or additionally to displaying indicator <NUM>, the processor may display, for each channel and for each channel-specific criterion, a channel-specific indicator <NUM> indicating whether the channel-specific criterion is satisfied by the channel. For example, in <FIG>, a channel-specific indicator <NUM> is displayed for each of the channels <NUM>-<NUM>, <NUM>-<NUM>,. , <NUM>-<NUM> and for each of the channel-specific criteria designated as "POS" and "DEN. " (Each pair of numbers in the list of channels refers to a different respective pair of electrodes.

In some embodiments, indicator <NUM> includes a portion (e.g., a rectangular or circular portion) of the GUI that is colored in a first color <NUM> (e.g., green) if the signal matches the template, and a second color <NUM> (e.g., red) if the signal does not match. Similarly, each channel-specific indicator <NUM> may include a portion (e.g., a rectangular or circular portion) of the GUI that is colored in first color <NUM> if the criterion is satisfied, and second color <NUM> otherwise. A third color <NUM> (e.g., gray) may be used to indicate the absence of a channel-specific criterion, and/or to indicate no acquisition over the channel.

Typically, widgets <NUM> include respective suitability indicators <NUM>. As the electrogram signals are acquired, the processor continually updates suitability indicator <NUM> for each of the widgets to indicate whether the most recently acquired electrogram signal satisfies the set of suitability criteria associated with the corresponding map. As described above, the signal is used to generate the map only if the signal satisfies the suitability criteria.

For example, suitability indicator <NUM> may include a portion of the widget whose color is continually changed by the processor. In other words, after each signal is acquired, the processor may set the color of the suitability indicator to a first color (e.g., green) if the signal satisfies the suitability criteria, and to a second color (e.g., red) otherwise. In some embodiments, as shown in <FIG>, suitability indicator <NUM> includes a relatively small portion of the widget, such as a horizontal strip along the bottom of the widget. In other embodiments, suitability indicator <NUM> includes most or all of the widget, as shown, for example, in <FIG> (described below).

In general, the set of suitability criteria may specify any minimum number of channels for which the channel-specific criteria must be satisfied. For example, the signal may be deemed to satisfy the set of suitability criteria if at least one channel satisfies each of the channel-specific criteria, provided that any non-channel-specific criteria are satisfied.

In some embodiments, the processor modifies suitability indicator <NUM> to indicate the number of channels satisfying each of the channel-specific criteria. For example, the processor may vary the shade of suitability indicator <NUM> in accordance with the number of channels, such that, for example, a lighter or darker shade of green indicates a greater number of channels. Alternatively or additionally, the processor may vary the size of suitability indicator <NUM> in accordance with the number of channels. For example, if the suitability indicator includes a horizontal strip as shown in <FIG>, the processor may vary the length of the horizontal strip. Alternatively or additionally, the suitability indicator may include an explicit indication of the number of channels, such that, for example, "<NUM>/<NUM>" indicates that three of ten channels satisfied each of the channel-specific criteria.

In some embodiments, the GUI may be displayed in either a fully-open mode or a partially-open mode. In the fully-open mode, both first portion <NUM> and second portion <NUM> of the GUI are displayed, as shown in <FIG>. In the partially-open mode, only the first portion, which includes widgets <NUM>, is displayed. Any suitable input from the user (received, for example, via a mouse or keyboard) may toggle between the two modes. Thus, for example, in response to receiving a mode-toggling input when the GUI is fully open, the processor may close second portion <NUM> such that only first portion <NUM> is displayed; conversely, when the GUI is only partially open, the processor may open second portion <NUM> in response to the mode-toggling input. (In some embodiments, when the GUI is initially displayed, the second portion of the GUI is closed. In other embodiments, the second portion of the GUI is initially open, and one of the widgets, such as the leftmost widget, is initially selected by default.

In general, processor <NUM> may be embodied as a single processor, or as a cooperatively networked or clustered set of processors. In some embodiments, the functionality of processor <NUM>, as described herein, is implemented solely in hardware, e.g., using one or more Application-Specific Integrated Circuits (ASICs) or Field-Programmable Gate Arrays (FPGAs). In other embodiments, the functionality of processor <NUM> is implemented at least partly in software. For example, in some embodiments, processor <NUM> is embodied as a programmed digital computing device comprising at least a central processing unit (CPU) and random access memory (RAM). Program code, including software programs, and/or data are loaded into the RAM for execution and processing by the CPU. The program code and/or data may be downloaded to the processor in electronic form, over a network, for example. Alternatively or additionally, the program code and/or data may be provided and/or stored on non-transitory tangible media, such as magnetic, optical, or electronic memory. Such program code and/or data, when provided to the processor, produce a machine or special-purpose computer, configured to perform the tasks described herein.

Reference is now made to <FIG>, which is a schematic illustration of a widget <NUM>, in accordance with some embodiments of the present invention.

In some embodiments, each widget includes a respective template-matching indicator <NUM>. As the electrogram signals are acquired, the processor continually modifies template-matching indicator <NUM> for each of the widgets to indicate whether the most recently acquired signal matches the template associated with the electroanatomical map to which the widget corresponds. For example, the template-matching indicator may include a portion (e.g., a rectangular or circular portion) of the widget colored by the processor in a first color (e.g., green) if the signal matches the template, and a second color (e.g., red) if the signal does not match the template. Optionally, the processor may further display identifier <NUM> and/or correlation score <NUM> inside the template-matching indicator. (In some such embodiments, indicator <NUM> may be omitted from second portion <NUM> of the GUI.

(It is noted that even if the signal matches the template, the signal may nonetheless not satisfy the set of suitability criteria. Hence, as shown in <FIG>, template-matching indicator <NUM> may be colored differently from suitability indicator <NUM>.

It is emphasized that, notwithstanding the particular examples shown in <FIG>, the scope of the present invention includes any suitable design for GUI <NUM> and widgets <NUM>.

Reference is now made to <FIG>, which is a flow diagram for a first GUI-display algorithm <NUM>, in accordance with some embodiments of the present invention.

In first GUI-display algorithm <NUM>, the processor continually checks, at a first checking step <NUM>, whether a new signal was received from the catheter. Upon ascertaining that a new signal was received, the processor processes the signal at a signalprocessing step <NUM>. For example, the processor may ascertain whether each channel of the signal satisfies the relevant channel-specific criteria, and/or compute the correlation score between the signal and a predefined signal template.

Subsequently to processing the signal, the processor, at a widget-updating step <NUM>, updates the widgets in the first portion of the GUI, based on the signal processing. For example, the processor may change the color of the suitability indicator of one or more of the widgets. (In the event that the widgets include only static information such as map names, or in the event that no updates to the widgets are required, widget-updating step <NUM> is not performed.

Following widget-updating step <NUM>, the processor checks, at a second checking step <NUM>, whether the second portion of the GUI is open. If yes, the processor, at a status-updating step <NUM>, updates the status of the signal with respect to the selected widget (i.e., with respect to the map to which the selected widget corresponds) in the second portion of the GUI, based on the signal processing. For example, the processor may change the color of one or more channel-specific indicators. (In the event that no updates to the status are required, status-updating step <NUM> is not performed. ) Following status-updating step <NUM>, or if the second portion of the GUI is closed, the processor returns to first checking step <NUM>.

Reference is now made to <FIG>, which is a flow diagram for a second GUI-display algorithm <NUM>, in accordance with some embodiments of the present invention. Typically, the processor executes second GUI-display algorithm <NUM> in parallel to first GUI-display algorithm <NUM>.

In second GUI-display algorithm <NUM>, the processor continually checks, at a third checking step <NUM>, whether another widget, which is different from the currently-selected widget, was selected by the user. If yes, the processor, at a status-displaying step <NUM>, displays the status of the most-recently received signal with respect to the selected widget in the second portion of the GUI. (If the second portion of the GUI was closed when the widget was selected, the processor may open the second portion of the GUI prior to performing status-displaying step <NUM>.

Subsequently to status-displaying step <NUM>, or if no other widget was selected, the processor checks, at a fourth checking step <NUM>, whether input for opening or closing the second portion of the GUI was received. If yes, the processor, at an opening- or-closing step <NUM>, opens or closes the second portion of the GUI, in accordance with the input. Subsequently, or if no input for opening or closing the second portion of the GUI was received, the processor returns to third checking step <NUM>.

Claim 1:
A system (<NUM>), comprising:
a display (<NUM>); and
a processor (<NUM>), configured:
to display on the display in a graphical user interface (GUI) (<NUM>), while a plurality of electrogram signals are acquired from a heart, a plurality of widgets (<NUM>) corresponding to different respective electroanatomical maps generated from the electrogram signals,
each of the electroanatomical maps being associated with a respective set of suitability criteria such that any one of the electrogram signals is used to generate the map only if the signal satisfies the set of suitability criteria, and
to display in the GUI, in response to a user selecting any one of the widgets, a status of a most recently acquired one of the electrogram signals with respect to at least one criterion in the set of suitability criteria associated with the electroanatomical map to which the selected widget corresponds, and
wherein the widgets include respective suitability indicators (<NUM>), and wherein the processor is further configured to, as the electrogram signals are acquired, continually update the suitability indicator for each of the widgets to indicate whether the most recently acquired one of the electrogram signals satisfies the set of suitability criteria associated with the electroanatomical map to which the widget corresponds.