CN101443792A - System and method for mapping electrophysiology information onto complex geometry - Google Patents

Abstract

The instant invention relates to an electrophysiology apparatus (8) and method used to measure electrical activity occurring in a portion of tissue of a patient (11) and to visualize the electrical activity and/or information related to the electrical activity. In particular, the instant invention relates to three-dimensional mapping of the electrical activity and/or the information related to the electrical activity.

Description

Be used for electrophysiology information is mapped to system and method on the complex geometric shapes

Cross-reference to related applications

[0001] the application requires the rights and interests of the U.S. Provisional Patent Application 60/800,848 (being called for short ' 848 applications) of submission on May 17 2006 applying date.The application also requires U. S. application 11/647,276 submission on Dec 29 2006 applying date, the at present unsettled rights and interests of (being called for short ' 276 applications).' 848 applications and ' 276 apply for that all the elements of the two all comprise in this application by reference, as setting forth fully at this.

[0002] all the elements of following common pending application all comprise in this application by reference, as setting forth fully at this: the U. S. application 11/227006 that on September 15th, 2005 submitted to; 10/819027 of submission on April 6th, 2004; Require to submit in 29 days Dec in 2006 of U.S. Provisional Application 60/800858 rights and interests submitted on May 17th, 2006 11/647275; And the 29 days Dec in 2006 that requires U.S. Provisional Application 60/851042 rights and interests submitted on October 12nd, 2,006 11/647298 (it is the part continuity of the U.S. Provisional Application 11/139908 submitted in 27 days Mays in 2005 of the rights and interests of the U.S. Provisional Application 60/575411 on May 28th, 2004 submitted to of requirement) of submitting to.

Background of invention

Technical field

[0003] the present invention relates to be used for measuring the electrical activity of the part that occurs in patient tissue and be used for visual this electrical activity and/or the electrophysiology equipment and the method for the information relevant with this electrical activity.More specifically, the present invention relates to the three-dimensional mapping of this electrical activity and/or the information relevant with this electrical activity.

Background technology

[0004] the present invention relates to produce the electrophysiology map of human dissection body, comprise for example electrophysiology map of human heart.

[0005] existing traditional modeling uses the three-dimensional model that produces heart such as the technology of CT scan, MRI, radar imagery, x-ray imaging and fluoroscopic image.Usually use dimensional Modeling Technology to handle this data.This imaging technique is useful in preparing patient treatment and/or operation usually, and before treatment and/or operation several hours and carried out this imaging process in some cases in several days usually.

[0006], use traditional system can produce electrophysiology map for the patient at this treatment and/or intra-operative.Electrophysiology map is particularly useful when combining with the diagnosis of the atrial fibrillation of patient's heart and treatment.But the measured point of electrophysiology data is seldom corresponding to the data point that is limited to the three-dimensional model of being prepared before the treatment.

[0007] therefore, need improve, making can be related with the 3 d surface model of patient's dissection with electrophysiology data.

Summary of the invention

[0008] the present invention by provide direct mapping electrophysiology measurement result to before the ability of the 3-D view that obtains enlarge the existing force of the electrophysiology mapped system of the heart.

The electrophysiology measurement result of being obtained when [0009] the invention provides combined treatment is utilized the ability of high resolution image data.Therefore, for improved treatment, the present invention allows the combination of different technologies.

[0010] by reading following description and claims and referring to accompanying drawing, aforementioned and others, feature, details, use and advantage of the present invention will be apparent.

[0011] embodiments of the invention provide a kind of method of electrophysiology information to the three-dimensional model that be used to shine upon, and comprise step: A) obtain the three-dimensional model to small part of heart, comprise the positional information of a plurality of location points of heart surface; B) obtain the electrophysiology map of the heart, comprise the positional information of a plurality of measurement points and the electrophysiology measurement result that realizes at each place of a plurality of measurement points; C) chosen position point and from the electrophysiology map of this heart, determine two immediate measurement points in a plurality of location points from three-dimensional model; D) limit be defined as and immediate these two measurement points of selected location point between Delaunay (De Luonei) edge; Each repeating step C for a plurality of location points in the three-dimensional model) and D), be used for limiting at least some a plurality of morals Lip river inward flange of a plurality of measurement points of the electrophysiology map that connects the heart; F) connect described moral Lip river inward flange and form a plurality of triangles; And G) from three-dimensional model identification a plurality of location points one of them, discern location point that its surrounded by edges discerns a plurality of leg-of-mutton one of them, and use the electrophysiology measurement result that records at each place of the vertex of a triangle of being discerned, distribute the electrophysiology level to the location point of being discerned based on method of interpolation.

[0012] described method also optional comprise dividing based on the relative amplitude of the electrophysiology level that is assigned to independent location point mix colours or each independent location points of a plurality of location points of gray scale in the three-dimensional model, and be assigned in the electrophysiology level under the situation of a plurality of location points, used the described color of a plurality of location points in the assigned three-dimensional model to present described three-dimensional model.

[0013] alternatively, the step of obtaining the electrophysiology map of the heart also is included in the part of heart and inserts electrode; This electrode is placed a plurality of measurement points along heart surface; Reception is along each positional information of a plurality of measurement points of heart surface; Be received in the electrophysiology measurement result at each place of a plurality of measurement points; And the measurement point separately of electrophysiology measurement result and measurement electrophysiology measurement result is associated.

[0014] alternatively, the step to the three-dimensional model of small part of obtaining heart also is included in the part of heart and inserts electrode; This electrode is placed a plurality of location points along heart surface; Reception is along each positional information of a plurality of location points of heart surface; And produce the three-dimensional model to small part of heart, this three-dimensional model comprises along the positional information of each of a plurality of location points of heart surface.

[0015] alternatively, the step to the three-dimensional model of small part of obtaining heart also is included in the part of heart and inserts electrode; This electrode is placed more than first location point along heart surface; Reception is along each positional information of more than first location point of heart surface; Produce the elementary 3 dimensional coil geometry to small part of heart, comprise along the positional information of each of more than first location point of heart surface; And handle this elementary 3 dimensional coil geometry comprises more than second location point with generation each the three-dimensional model of positional information, wherein said more than second (location points) comprise at least some location points from this more than first location point.

[0016] alternatively, handling this elementary 3 dimensional coil geometry can comprise with the step that produces three-dimensional model and handle this elementary 3 dimensional coil geometry has more than second location point with generation each the three-dimensional model of positional information, wherein said three-dimensional model has the resolution that is higher than elementary 3 dimensional coil geometry, makes more than second location point quantitatively more than more than first location point.The step of handling elementary 3 dimensional coil geometry can also comprise that utilizing smoothing algorithm to handle elementary 3 dimensional coil geometry has each the three-dimensional model of positional information that is used for more than second location point with generation.Can use the technology that comprises CT scan, MRI, radar imagery, x-ray imaging, fluoroscopic image, infrared imaging, ultrasonic imaging and its combination to produce this three-dimensional model.

[0017] alternatively, chosen position point and determine that from the electrophysiology map of the heart these two can also comprise chosen position point in a plurality of location points from three-dimensional model near the step of measurement point in a plurality of location points from described three-dimensional model, and use the Kirsanov-Hoppe geodesic algorithm to determine on distance two measurement points in the electrophysiology map with the immediate heart of selected location point.In addition, connecting moral Lip river inward flange becomes the measurement point that leg-of-mutton step can also comprise that use also is not connected to moral Lip river inward flange and produces additional triangle.

[0018] alternatively, chosen position point and the step of determining these two immediate measurement points from the electrophysiology map of the heart can comprise chosen position point in a plurality of location points from three-dimensional model in a plurality of location points from described three-dimensional model, and use Fast-Marching (advancing fast) geodesic algorithm to determine on distance two measurement points in the electrophysiology map with the immediate heart of selected location point.

[0019] according to another embodiment of the present invention, provide a kind of method of electrophysiology information to the three-dimensional model that be used to shine upon, may further comprise the steps: A) obtain the three-dimensional model to small part of heart, comprise the positional information of a plurality of location points on the heart surface; B) obtain the electrophysiology map of the heart, comprise the positional information of a plurality of measurement points and the electrophysiology measurement result that realizes at each place of a plurality of measurement points; C) chosen position point and from the electrophysiology map of this heart, determining and immediate two measurement points of selected location point in a plurality of location points from three-dimensional model; D) limit be defined as and immediate these two measurement points of selected location point between Delaunay (De Luonei) edge; E) for each the repeating step C in a plurality of location points in the three-dimensional model) and D), be used for limiting at least some a plurality of morals Lip river inward flange of a plurality of measurement points of the electrophysiology map that connects the heart; F) connect described moral Lip river inward flange formation triangle with generation trigonometric ratio model, and use any space in the new triangle filling trigonometric ratio model; G) identification is compared with the arbitrfary point on the inward flange of immediate moral Lip river and is approached this at least one location point of measurement point, and distribute the electrophysiology level at least one location point, the electrophysiology level of wherein being distributed is identical with the electrophysiology measurement result that records at measurement point; And H) uses the electrophysiology measurement result that records at each place of vertex of a triangle, distribute the electrophysiology level at least one location point that is positioned at triangle based on method of interpolation (for example center of gravity interpolation).

[0020] according to still another embodiment of the invention, a kind of system of electrophysiology information to the three-dimensional model that be used to shine upon is provided, comprise: the modeling processor, be used to produce the three-dimensional model to small part of heart, it comprises the positional information of a plurality of location points on the heart surface; The electrophysiology measuring equipment, be used to produce the electrophysiology map of the heart, comprise positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes at each place of a plurality of measurement points, the measurement point separately of described electrophysiology measurement result and measurement electrophysiology measurement result is associated; Moral Lip river inward flange is handled device, be used for handling the subclass of a plurality of location points of three-dimensional model, and for each processed location point, determine on the distance with the immediate electrophysiology map of processed location point at this heart in two measurement points, described processor limits a plurality of morals Lip river inward flange, and each moral Lip river inward flange comprises and is defined as right with each processed immediate measurement point of location point; The triangulation processor is used for a plurality of triangles based on the electrophysiology map of a plurality of morals Lip river inward flange qualification heart; With the projection processor, use and each relevant electrophysiology measurement result of vertex of a triangle, distribute the electrophysiology level to being arranged in a plurality of leg-of-mutton one of them at least one location point based on method of interpolation.

[0021] alternatively, described processor uses the electrophysiology measurement result of measuring at the end points place of moral Lip river inward flange, distributes the electrophysiology level at least one location point near threshold value that is positioned at moral Lip river inward flange based on bilinear interpolation.

[0022] alternatively, described processor also distributes the electrophysiology level at least one location point based on the electrophysiology measurement result that records near the measurement point in the threshold value, and the electrophysiology level of wherein being distributed is identical with electrophysiology level in measurement point.

[0023] according to another embodiment of the present invention, provide a kind of method of electrophysiology information to the three-dimensional model that be used to shine upon, may further comprise the steps: A) obtain the three-dimensional model to small part of heart, comprise the positional information of a plurality of location points on the heart surface; B) obtain the electrophysiology map of the heart, comprise that positional information that is used for a plurality of measurement points and the electrophysiology that realizes at each place of a plurality of measurement points measure; C) chosen position point and from the electrophysiology map of this heart, determine two immediate measurement points in a plurality of location points from three-dimensional model; D) limit be defined as and immediate these two measurement points of selected location point between the edge; E) for each the repeating step C of a plurality of location points in the three-dimensional model) and D), be used for limiting at least some a plurality of edges of a plurality of measurement points of the electrophysiology map that connects the heart; F) connect described edge to produce a plurality of polygons; And G) discern one of them of a plurality of location points from described three-dimensional model, the identification edge center on the location point discerned a plurality of polygonal one of them, and use the electrophysiology measurement result that records at each place on the polygonal summit of being discerned, distribute the electrophysiology level to the location point of being discerned based on method of interpolation.

[0024] according to still another embodiment of the invention, a kind of system of electrophysiology information to the three-dimensional model that be used to shine upon is provided, comprise: the surface modeling controller, be used to obtain the three-dimensional model to small part of heart, comprise the positional information of a plurality of location points on the heart surface; The electrophysiology measuring equipment, be used to produce the electrophysiology map of the heart, comprise that the measurement point separately of described electrophysiology measurement result and measurement electrophysiology measurement result is associated for the positional information of a plurality of measurement points and the electrophysiology measurement result that realizes at each place of a plurality of measurement points; Edge processor, be used for handling the subclass of a plurality of location points of three-dimensional model, and for each processed location point determine on the distance with the immediate electrophysiology map of processed location point at the described heart in two measurement points, described processor limits a plurality of edges, and each edge comprises and is defined as right with each processed immediate measurement point of location point; Geometry processor is used for a plurality of polygons based on the electrophysiology map of a plurality of edge limited hearts; With the mapping projector, use and each relevant electrophysiology measurement result on polygonal summit, based on method of interpolation distribution electrophysiology level to being arranged in a plurality of polygonal one of them at least one location point.

[0025] alternatively, described processor also uses the electrophysiology measurement result of measuring at the end points place at described edge to distribute the electrophysiology level at least one location point that is positioned near the edge based on bilinear interpolation.

[0026] alternatively, described geometry processor uses a plurality of triangles to limit the electrophysiology map of the described heart.The described mapping projector uses and each relevant electrophysiology measurement result of vertex of a triangle, based on method of interpolation distribution electrophysiology level to being arranged in leg-of-mutton one of them at least one location point.

[0027] according to still another embodiment of the invention, a kind of computerized method of electrophysiology information to the three-dimensional model that be used to shine upon is provided, may further comprise the steps: A) receive the three-dimensional model to small part of dissection, comprise the positional information of a plurality of location points on the dissection surface; B) receive the electrophysiology map that is used for dissection, comprise positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes at each place of a plurality of measurement points; C) for each the independent location point in a plurality of location points in the three-dimensional model, use a computer to determine with described independent location point immediate from this electrophysiology map two measurement points and limit the right edge that comprises determined measurement point subsequently; D) use a computer and connect the grid that described edge forms closed polygon; E) use a computer from being positioned at the lip-deep three-dimensional model recognizing site point of closed polygon that the edge centers on the location point of being discerned, wherein, the electrophysiology measurement result that described computing machine use centers on the polygonal summit of the location point of being discerned at the edge each place records distributes the electrophysiology level to the location point of being discerned based on method of interpolation; And F) output comprises the positional information that is used for a plurality of location points and is assigned to each the output file of electrophysiology level of a plurality of location points.

[0028] according to another embodiment of the present invention, be provided for shining upon the method for electrophysiology information to the three-dimensional model, may further comprise the steps: A) obtain the three-dimensional model to small part of heart, comprise the positional information of a plurality of location points on the heart surface; B) obtain the electrophysiology map of the heart, comprise positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes at each place of a plurality of measurement points; C) use triangulation to handle described three-dimensional model, thereby produce the three-dimensional model that comprises a plurality of leg-of-mutton segmentations, each of a plurality of measurement points is the summit in this triangle; And D) use three-dimensional model that extraction algorithm handles segmentation to comprise the three-dimensional model of more than second leg-of-mutton revision with generation, wherein each of a plurality of measurement points is a vertex of a triangle.

[0029] alternatively, described triangulation treatment step is programmed the triangular rim of being longer than predetermined distance threshold to forbid producing.

[0030] present embodiment can also comprise that the electrophysiology measurement result of using Kirsanov-Hoppe or Fast Marching geodesic algorithm projection measurement point is to the summit of the three-dimensional model of segmentation or the step at edge.

[0031] alternatively, present embodiment can also comprise the relative amplitude based on the electrophysiology level of distributing divide mix colours or gray scale to each summit of the three-dimensional model of revision, and use the described color on a plurality of summits in the three-dimensional model of assigned revision to present the step of the three-dimensional model of revision.

Description of drawings

[0032] Fig. 1 is the synoptic diagram that is used to carry out the system of the electrophysiological examination of the heart or ablation procedure, the position that wherein can determine and write down one or more electrode;

[0033] Fig. 2 the schematically illustrating of heart of electrophysiology duct inspection of serving as reasons with a plurality of remote electrodes;

[0034] the electrode position data point that writes down for use of Fig. 3 provides the synoptic diagram of illustrative methods on the surface of heart chamber;

[0035] Fig. 4 is used to show that cardiogram and relevant electrophysiology information describe for the signal of doctor's graphical user interface;

[0036] Fig. 5 is the enlarged drawing of the panel 66 described among Fig. 4;

[0037] Fig. 6 illustrates the view side by side of the time dependent EGM of collecting along the diverse location of the wall of heart;

[0038] Fig. 7 illustrates the view side by side of the time dependent EGM of collecting along the diverse location of the wall of heart;

[0039] Fig. 8 illustrates the comparing side by side of EGM of typical compact substance (compact) in time domain and the frequency field and fibrillar myocardial muscle tissue;

[0040] Fig. 9 A illustrates the time domain of EGM and comparing side by side of frequency-domain information;

[0041] Fig. 9 B illustrates the time domain of EGM and comparing side by side of frequency-domain information, with cross spider energy in a plurality of spectral bands is shown;

[0042] Figure 10 illustrates EGM and mapping time domain and/or the frequency field electrogram information method to the three-dimensional model of collecting;

[0043] Figure 11 illustrates the three-dimensional model of the part of heart, and the same color version (no Reference numeral) of Figure 11 is shown herein equally;

[0044] Figure 12 illustrates the electrophysiology data figure of the same section of heart shown in Figure 11, and the same color version (no Reference numeral) of Figure 12 is shown herein equally;

[0045] Figure 13 comprises the three-dimensional model of Figure 11, from the mid point that uses Figure 12 the to measure range line that draws, the same color version (no Reference numeral) of Figure 13 is shown equally herein on it;

[0046] Figure 14 illustrates the voltage pattern of the same section of heart shown in Figure 11, and wherein the electrophysiology data figure from Figure 12 has been projected onto on the three-dimensional model of Figure 11, and the same color version (no Reference numeral) of Figure 14 is shown herein equally.

Embodiment

[0047] the present invention improves system capability to produce the improved electrophysiology mapping of dissection.The invention is not restricted to produce the accurate model of heart, but for illustrative purposes, will be reference with the assessment of the tissue that is used for the heart and the navigation and the positioning system of treatment herein usually.Method described herein can be applied to the modeling of human dissection body other parts equally.For purpose of the present invention is described, below use description to produce the technology of electrophysiology map of the tissue of the heart.

[0048] there are a plurality of legacy systems that are used to produce the heart three-dimensional model, comprise the system of the technology of use such as CT scan, MRI, ultrasonic imaging, radar imagery, x-ray imaging and fluoroscopic image.The output of these data can be a plurality of x-y-z data coordinates, spherical coordinates and/or other form that is used to provide 3-D view.These imaging techniques are generally used in the diagnosis, and the treatment and/or the operation that are used to prepare the patient.Sometimes, before treatment and/or operation several hours and carry out imaging process some situation several days.

[0049] certain, three-dimensional model can use piecewise approximation, for example comprises the CT or the MRI scan image of segmentation.The subregion of the specification of a model 3-D view of segmentation is from bigger 3-D view digital separation, and for example, the image of atrium dextrum separates with the remainder of heart.Can also use other method and the technology of the three-dimensional model of the part that is used to produce the patient according to the present invention, for example comprise disclosed method and technology in the United States Patent (USP) 6728562 (' 562 patent), its all the elements comprise in this application by reference.

[0050] following other technology of other that the three-dimensional model that produces dissection further is discussed.

[0051] is used to produce the available techniques of electrophysiology map below in conjunction with Fig. 1 discussion, Fig. 1 illustrates the synoptic diagram of positioning system 8, this system 8 by the navigation heart conduit and measure electrical activity in the heart 10 occur in patient 11, and three-dimensional mapping electrical activity and/or information relevant with electrical activity or the sign electrical activity are carried out the electrophysiologic studies of the heart.System 8 can be used to use one or more electrode to help to produce anatomical model.System 8 can also be used to measure the electrophysiology data along a plurality of somes place of heart surface, and storage and the measured data that are associated in the positional information of each measurement point of measuring the electrophysiology data place.

[0052] in order to simplify, patient's 11 schematic representation are oval.Shown in three groups of surface electrodes (for example, plate electrode) be applied to patient 11 surface along X-axis, Y-axis and Z axle.X-axis surface electrode 12,14 is applied to the patient along first, (for example is applied to the skin under each arm of patient) on the side such as patient's chest area and can be called as a left side and right electrode.Y- axis electrode 18,19 such as femoribus internus and the neck area along the patient, and can be called as left leg and neck electrodes along substantially being applied to the patient perpendicular to second of X-axis.Z axial electrode 16,22 perpendicular to the 3rd application of X-axis and Y-axis, such as at breastbone and the spine of chest area along the patient, and can be called as chest and back electrode along substantially.Heart 10 these surface electrodes between.Additional surfaces reference electrode (for example, " sternite (belly patch) ") 21 is provided for the reference and/or the ground-electrode of system 8.Sternite electrode 21 substitutes for fixing intracardiac electrode 31.In addition, should be appreciated that patient 11 will have most or all of traditional cardiograms (ECG) system leads and put in place.Although do not illustrate among Fig. 1, this ECG information can be used for system 8.

[0053] in a preferred embodiment, location/mapped system is St.Jude Medical, AtrialFibrillation Division, the EnSite NavX of Inc ^TMNavigation and visualization system.But can use other positioning system in conjunction with the present invention, for example comprise Biosense Webster, navigational system in the CARTO navigation of Inc and positioning system and the Medtronic, the LOCALISA heart of Inc.Location and mapped system that following patent (it all comprises in the present invention by reference) is described can use together with the present invention: United States Patent (USP) 6990370,6978168,6947785,6939309,6728562,6640119,5983126 and 5697377.

[0054] the representative conduit 13 with at least one electrode 17 (for example remote electrode) also is shown among the figure.Shown in representative catheter electrode 17 run through instructions and be called " roving electrode (rovingelectrode) " or " potential electrode ".Usually will use on the conduit 13 or a plurality of these supravasal a plurality of electrodes.For example, in one embodiment, system 8 can comprise nearly 12 supravasal nearly 64 electrodes of arranging in patient's heart and/or the vascular system.Certainly, this embodiment only is used for example, and can use the electrode and the conduit of any amount within the scope of the invention.

[0055] optional fixed reference electrode 31 (for example investing the wall of heart 10) also is shown on second conduit 29.In order to calibrate, this electrode 31 can be static (for example invest or near the wall of heart) or arrange with fixed spatial relationship with roving electrode 17.Fixed reference electrode 31 can be used for replenishing or replacing of above-mentioned surface reference electrode 21.In a plurality of examples, the coronary sinus electrode in the heart 10 or other fixed electorde can be as the references of measuring voltage and displacement.

[0056] each surface electrode is coupled to multi-way switch 24 and selects electrode pair by the software that operates on the computing machine 20, and its this electrode that is coupled is to signal generator 25.For example, computing machine 20 can comprise traditional multi-purpose computer, special purpose computer, distributed computer or the computing machine of other type arbitrarily.Computing machine 20 can comprise one or more processor, such as single CPU (central processing unit) or a plurality of processing unit, is commonly referred to parallel processing environment.

[0057] common, produce three specified vertical electric fields by a series of being driven with the induced electricity dipole, be used for realizing the catheter navigation of biological conductor.Alternative, these perpendicualr fields can be decomposed and arbitrarily right surface electrode can be driven to dipole and be used to provide effective electrode triangulation.In addition, the dirigibility of this non-perpendicular method enhanced system.For the axle of any desired, by passing through of causing of one group of predetermined drive configuration (source-meeting point) electromotive force that intracardiac electrode 17 records by algebraic combination to produce and the same effective electromotive force of electromotive force that can obtain by simple driving uniform current along Z-axis.

[0058] therefore, can select any two conducts in the surface electrode 12,14,16,18,19,22 about dipole source electrode and the drain electrode of ground connection with reference to (for example sternite 21), unperturbed electrode measurement is about the voltage of ground connection reference simultaneously.Be arranged in potential electrode 17 in the heart 10 and be exposed in the field from current impulse, and measure with respect to ground (for example, sternite 21).In practice, the conduit in the heart can comprise a plurality of electrodes, and can measure the electromotive force of each electrode.As mentioned above, at least one electrode can be fixed on the inside surface of heart to form fixing reference electrode 31, and it is measured with respect to ground equally.May be used to determine the position of potential electrode 17 in the heart 10 or other electrode from each data set of surface electrode, internal electrode and dummy electrodes.

[0059] those of ordinary skills can recognize easily that potential electrode 17 also can be used to measure electrophysiology data, and system 8 (for example can be used to store the electrophysiology data that is associated with the positional information of the measurement point of measuring electrophysiology data, voltage is read, and comprises being not limited to the change in voltage in cycle in time).

[0060] for example, under the control of software, measure all original electrode voltage data and by computing machine 20 storages by A/D converter 26.Selected and remaining non-when being driven electrode and being used for measuring voltage when replacement group surface electrode, this electrode excitation process fast and occur in sequence.The set of this voltage measurements is called " electrode data set " herein.During each excitation each time to surface electrode, each individual voltage measurement result that softward interview is realized at each electrode.

[0061] original electrode data is used for determining such as the electrode of the heart inside of roving electrode 17 and is positioned at patient 11 heart and/or three dimensions (X, Y, Z) " basis " position in of other electrode of vascular system or any amount on every side.Fig. 2 illustrates the conduit 13 that extends into heart 10, and it can be traditional electrophysiology duct (being referred to as " EP conduit " sometimes).Among Fig. 2, conduit 13 extends into the left ventricle 50 of heart 10.Conduit 13 comprise above-mentioned with reference to Fig. 1 discussion remote electrode 17 and have supplemantary electrode 52,54 and 56.Because each of these electrodes is present in patient's (for example, being arranged in the left ventricle of heart), the assembling position data are used for each electrode simultaneously.In addition, when adjacent this surface arrangement of this electrode, although unnecessaryly directly be arranged on the heart surface, and when current source 25 " is closed " (promptly, when not having surface electrode when being energized), electrode 17,52,54 and 56 at least one can be used to measure heart 10 lip-deep electrical activities (for example voltage).

[0062] when surface electrode to applying electric field to heart the time, measure the data that are used for determining the position of electrode in the heart.(for example multiplexed) sampling is a plurality of (for example by simultaneously or in proper order, reach 62 electrodes that distribute in 12 conduits) and/or by the sampling patient (for example, heart chamber) one or more electrode that is moved in (for example, roving electrode 17) can be collected a plurality of electrode positions.In one embodiment, the position data that is used for single electrode is sampled simultaneously, and it allows the single stage of heartbeat or the data aggregation in period.In another embodiment, with one or more stage of heartbeat synchronously or need not to consider arbitrarily concrete stage of heartbeat, can the assembling position data.When collecting each phase data of heartbeat, will change in time corresponding to data along the position of the wall of heart.In a kind of variation, can be used for determining respectively the position of the wall of heart when the minimum and maximum volume corresponding to the data of outside or interior location.For example, by selecting outermost point, " shell " of the heart shape in the time of might producing the expression maximum volume.

[0063] electrode data also can be used to produce the raw position data that the breathing offset improves electrode position, and as describing in U.S. Patent Application Publication 2004/0254437, its full content comprises in this application by reference.Electrode data also can be used to compensate the variation of the impedance of patient body, and as description in the common unsettled U.S. Patent application of submitting on September 15th, 2,005 11/227580, its full content is also included among the application by reference.

[0064] in a word, system 8 at first selects one group of surface electrode and uses current impulse that it is driven subsequently.When sending current impulse, the electrical activity that at least one place of measurement and storage residual surface electrode and internal electrode records is such as voltage.Here, can carry out compensation as mentioned above such as the pseudomorphism of respiration and/or impedance variation.As mentioned above, collect the different location data points that is associated with a plurality of electrode positions (for example, intracardiac electrode position) by system 8.The every bit of concentrating has volume coordinate.In one embodiment, the nearly location data points of 64 electrodes is collected by system 8, and these electrodes can be simultaneously or closely close mutually being positioned at nearly on 12 conduits.But, the expression that can collect less or bigger data set and produce the heart of more uncomplicated and low resolution or complicated and high-resolution respectively.

[0065] for example identical or before process in, can produce patient's part from this location data points, for example, the three-dimensional model in the zone of patient's heart or the zone of peripheral vascular system, perhaps can use three-dimensional model, for example the CT of segmentation or MRI scan image in preceding generation.The model representation of segmentation from the subregion of bigger 3-D view digital separation 3-D view, for example, separates the image of atrium dextrum from the heart remainder.Exemplary segment applications comprise ANALYZE (Mayo, Minneapolis, MN), Verismo (St.Jude Medical, Inc., St.Paul, MN) and CardEP (General Electric Medical Systems, Milwaukee, WI).When the location data points of collecting by system 8 produces three-dimensional model, for example on by the scanning heart surface during the single process of one or more electrode, the outermost position point of data can be used for determining the shape corresponding to the body in patient's heart zone.

[0066], also can use other method and the technology of the three-dimensional model of the part that is used to produce the patient according to the present invention.For example, can use canonical algorithm to produce convex closure (convex hull) such as the Qhull algorithm.For example, the Qhull algorithm is at Barber, C.B., Dobkin, D.P., and Huhdanpaa, the ＂ The Quickhull algorithm for convex hulls of H.T., ＂ ACMTrans., on Mathematical Software, 22 (4): 469-483, describe among the Dec1996.It is also known and also go for realization of the present invention to be used for calculating other algorithm of convex closure shape.Sampled once more on uniform more grid subsequently and can be by interpolation to provide the level and smooth surface of appropriateness in this surface, described surface is stored as three-dimensional model to present to the doctor in identical process or process afterwards.Cai Yang surface can have bigger quantity data point usually once more.Can also use smoothing algorithm to handle this surface of sampling once more, it will be to more level and smooth outward appearance of geometric configuration.For example, this three-dimensional model provides the estimation border from the inside of the heart area of point set.

[0067] Fig. 3 illustrates to describe another illustrative methods that is used to produce corresponding to the shell of heart chamber shape.The position data of the location data points 40 of one or more electrode in the heart chamber is discerned in visit on a period of time.This position data can be represented as the some cloud in the heart chamber.Thereby location data points farthest 40 is corresponding to the inwall of the heart chamber of lax or diastole state (corresponding to maximum volume).By cooperate the array of " lattice " 44 around many group location data points 40, provide shell or surface from this position data.By the mean center point 42 in the cloud of determining location data points 40 and subsequently from this central point 42 border that extends radially outwardly, make up lattice 44.Lattice 44 extend to the location data points farthest in the section of being surrounded by lattice 44.Schematically show with two dimension although should be noted that Fig. 3, lattice 44 are said three-dimensional body.Therefore the longitudinal end surface 46 of lattice 44 is similar to the surface of heart chamber wall.Can use figure light and shade Processing Algorithm commonly used to come the surface of " smoothly " shell subsequently, thereby be created in the longitudinal end surface 46 of lattice 44.

[0068] in the U. S. application of submitting on Dec 29th, 2,006 11/647275 (it requires the rights and interests of the U.S. Provisional Application 60/800858 of submission on May 17th, 2006) another example that uses the some cloud to produce three-dimensional plot is described.Another technology of the three-dimensional plot that is used to produce tissue surface has been described in the U. S. application of submitting in the 29 days Dec in 2006 of the rights and interests of the U.S. Provisional Application 60/851042 that requires to submit on October 12nd, 2,006 11/647298 (it is the part continuity of the U. S. application 11/139908 submitted on May 27th, 2005 (it requires the rights and interests of the U.S. Provisional Application 60/575411 submitted on May 28th, 2004)).

[0069] can measure different electrophysiology data and the display 23 by system shown in Figure 18 offers the heart expert.Fig. 4 illustrates can be by the illustrative computer display of computing machine 20 demonstrations.For example, display 23 can be used for video data and give the user, is used for concrete application such as doctor and the configuration that presents certain options allow users custom-built system 8.Should be noted that, can easily revise the content on the display, and the concrete data that presented only are used for example and do not limit the present invention.Image panel 60 illustrates the three-dimensional model of heart chamber 62, discerns the zone that receives the depolarization waveform simultaneously, promptly arrives " time line " of this model with false color or grey scale mapping.In a kind of variation, this time line is mapped to corresponding to their three-dimensional coordinate (for example, X, Y, Z) from its EGM that obtains.Time line also illustrates as legend with bar 64, discerns and particular color that is mapped to three-dimensional model or the relevant information of gray scale.In this image, the position of a pair of supravasal a plurality of electrodes also is mapped to three-dimensional model.For example, other data that can be mapped to heart surface model comprise the amplitude of the voltage of surveying and the signal sequential relationship about heartbeat event.In addition, the peak-to-peak voltage that particular location records on the heart wall also can be mapped to show zone that reduces conductivity and the infarct area that can reflect heart.

[0070] for example, in variation shown in Figure 4, bar 64 is with the millisecond classification and each color or the gray scale that are mapped to three-dimensional model are shown are assigned to concrete time relationship.Color on three-dimensional model image 62 and the bar 64 or the relation between the gray scale also can be determined with reference to information shown in the panel 66 by the user.Fig. 5 illustrates the enlarged drawing of the panel of describing among Fig. 4 66.In this changed, panel 66 illustrated and is used to produce the isochronal timing information that is mapped on the three-dimensional model 62 shown in Figure 4.When usually, reference point is selected as " zero ".For example, among Fig. 5, the flex point 70 that appears at the voltage on the reference electrode is used as the isochronal basic timing point of generation.This voltage can obtain from virtual reference or physics reference (roving electrode 17 for example shown in Figure 1).In this changes, be marked with " REF " at Fig. 5 corresponding to the voltage trace of reference point." ROV " described and be marked with to the roving electrode signal in Fig. 5.The flex point 72 of voltage signal ROV is corresponding to roving electrode 31.Color guide bar 65 illustrates the distribution of color or gray tone, and it is respectively applied for visible timing relationship between the flex point 70 and 72 of reference and touring voltage signal REF and ROV.

[0071] amplitude corresponding to the voltage signal ROV of roving electrode 17 also is shown on the panel 66 of Fig. 5.The amplitude of variable signal ROV can be adjusted at two and be with between 74 and 76 in time, and it can be used for the choice criteria of the peak-to-peak voltage of signalization ROV.In specific implementation, the heart area with low peak-to-peak voltage is the result of blocking tissue, and peak-to-peak voltage is converted to gray scale, and perhaps the ability of false color allows the zone of identification infraction or atrophy.In addition, time dependent signal " V1 " also is illustrated and corresponding to surface reference electrode, such as traditional ECG surface electrode.For example, signal V1 can be directed to user (such as the doctor) the same incident of surveying on the patient surface.

[0072] with patient's heart in and/or can be mapped to this three-dimensional model around the movable relevant different time domain information of the EP of patient's heart.For example, the peak-to-peak voltage of the mistiming of the action potential that records at roving electrode and reference electrode place, action potential that the roving electrode place records and/or the peak negative voltage of the action potential that roving electrode records can be mapped to three-dimensional model.In one embodiment, can be collected and be mapped to three-dimensional model from the EP activity that reaches 62 roving electrodes.

[0073] (complex fractionated electrogram CFE) also can be mapped to three-dimensional model with frequency-domain information to multiple cracked electrograph.For example, CFE information can be used to discern and guide the ablation targets of atrial fibrillation.CFE information relates to irregular electric excitation (for example atrial fibrillation), wherein, EGM comprises at least two the discrete deviations and/or the disturbance of the baseline of EGM, and this EGM has the sustained deviation (for example greater than 10 second cycle) of the excitation complexity of prolongation.Having very fast and EGM continuous pump for example is consistent with the cardiac muscle with short refractory period and micro reentry.For example, Fig. 6 illustrates a series of EGMs.(Fig. 6 is relevant with following article: NADEMANEE, Koonlawee, M.D., FACC waits people's work., A new approach for catheter ablationof atrial fibrillation:Mapping of the electrophysiologic substrate, Journal of the American College of Cardiology, (2004) Vol.43, No.11,2044-53.).Preceding two EGM RAA-prox and RAA-dist comprise the typical electrograms from patient's atrium dextrum, such as respectively from near-end roving electrode in the patient atrium dextrum and far-end roving electrode.The 3rd EGM LA-roof comprises the CFE EGM, such as the top from the patient atrium sinistrum.In the 3rd EGM LA-roof, the Cycle Length of numeral shown in the EGM is shorter than the Cycle Length in the numeral shown in preceding two EGM RAA-prox and the RAA-dist basically.In another example shown in Fig. 7, the first EGM RA-Septum comprises the quick and continuous pump of being indicated by arrow than the second EGM RA.For example, this fast and continuous pump be consistent atrial fibrillation " nest (nest) " for example with cardiac muscular tissue with short refractory period and micro reentry.

[0074] from passing through can survey in the collected EP information (for example, EGM) of electrode the existence of CFE information, for example, by the deviation number in the segmentation of monitoring EGM; Calculate the averaging time between the deviation in the EGM segmentation; Variation in time in the Cycle Length of monitoring EGM between the deviation; And calculate slope, derivative and the amplitude of EGM.For example, discrete activation has the relevant peak-to-peak value that records on the cycle at special time.This peak-to-peak value can be used to quantize discrete activation.As shown in Figure 5, the moment of discrete activation can be marked on the EGM on the user display.The moment that EGM is cracked and/or other quantification can be used to determine the existence and/or the disappearance of CFE information.For example, the equispaced between the discrete activation in the predetermined period of time can be used as the index of the cracked degree that quantizes given EGM.In this example, if a discrete activation was only arranged in cycle preset time, can apportioning cost 1 to EGM, if preset time cycle memory more than a discrete activation, then distribute lower or high value.For example, another quantification can comprise the temporal variation between the discrete activation that quantizes EGM.These of time domain or other quantification can be relevant with the morphology of EGM, and again based on the foundation physiology in the zone that is carried out EGM sampling.

[0075] in diagnosis atrial fibrillation and guiding ablation catheter, by quantizing cracked can the identification in the EGM corresponding to the EGM that begins and keep the physiological mechanisms of atrial fibrillation.These quantize can be used to again discern the zone of eliminating atrial fibrillation and will be melted.Mid-diastolic potentials in the ischemic area of the chamber of the heart also can be discerned by the cracked of EGM that quantizes to collect in the heart area.Healthy tissue will be corresponding to there not being cracked EGM (that is, single discrete activation), and unhealthy tissue (for example, ischemic tissue) will be corresponding to cracked EGM (being the disturbance of a plurality of discrete activation and/or baseline).The moment of the CFE information in the EGM or other quantifications can be mapped in the above-mentioned three-dimensional model subsequently.

[0076] for from the replenishing and/or substituting of the time domain information of collected EP information analysis and mapping, frequency-domain information also can be mapped to three-dimensional model.For example, in one embodiment, Fast Fourier Transform (FFT) (FFT) or to change variable signal in time be that the additive method of frequency-domain information can be used to change collected signal to frequency field.Frequency field is described expression and is changed the energy of frequency component of electrogram signal or the spectrum of power in time.FFT and other transform methods are well known in the art and will describe in further detail herein.

[0077] Fig. 8 illustrates the compact substance cardiac muscle of wall and the comparing side by side of fiber cardiac muscle of common formation heart.Compact myocardial muscle tissue comprises that many groups closely connect cells, and this cell transmits electrical activity at the same rate and comes the conduct electricity activity by going up in any direction in even mode between the depolarizing phase of heart.But fibrillar myocardial muscle tissue generally includes loosely connected cell, such as the transition between nerve, vascular and the atrial tissue.Stretching by cell and/or degeneration cause the weak connection between these damaged tissues, also can form fibrillar myocardial muscle tissue.In A was capable, first was listed as even or consistent excitation of the compact myocardial muscle tissue between the wall depolarizing phase that heart is shown.But in secondary series, the irregular excitation of the fibrillar myocardial muscle tissue between depolarizing phase is shown, its medium wave by different strands fibrillar myocardial muscle tissue or propagate with different rates during the different piece of fibrillar myocardial muscle tissue, thereby cause nonsynchronous contraction in the different piece of cardiac muscle.

[0078] in B is capable, shows the compact myocardial muscle tissue during the depolarization phase of heartbeat and the time domain electrogram signal of fibrillar myocardial muscle tissue.As shown in Figure 8, the time domain electrogram signal generally includes two-phase or three-phase shape that is used for compact myocardial muscle tissue (shown in the row 1) and the more heterogeneous shape that is used for fibrillar myocardial muscle tissue (shown in the row 2).At last, go the frequency field of electrogram signal of the capable B that is used for compact myocardial muscle tissue and fibrillar myocardial muscle tissue shown in the C.Carry out FFT by the time cycle that changes EGM in time shown in the fibrillar myocardial muscle tissue of the compact myocardial muscle tissue of row B row 1 and row B row 2 is gone up, obtain frequency field.As shown in the capable C of Fig. 8, the frequency spectrum that is used for compact myocardial muscle tissue generally includes around the single peak value place of fundamental frequency by a relatively large margin, and because the dextroposition of the caused frequency of a plurality of harmonics frequency components, the frequency spectrum of fibrillar myocardial muscle tissue be usually included in its fundamental frequency place more by a small margin.

[0079] as shown in Figure 8, fibrillar myocardial muscle tissue can cause the irregular wavefront of electrical activity between the depolarizing phase of heart.The ratio of fibrillar myocardial muscle tissue and compact myocardial muscle tissue is big more, may have the tendency of atrial fibrillation more.In this zone, " atrial fibrillation nests " (or " AFIB nest ") but can be identified as the energy of atrial fibrillation.Therefore, by the frequency of utilization domain information, the doctor can further discern the possible problem points that causes atrial fibrillation.

[0080] can obtain the index of a plurality of numerals from the frequency spectrum of electrogram signal.Arbitrarily these indexs three-dimensional model that can be mapped to patient's heart is discerned corresponding to the position on the wall of the heart of concrete property to allow user such as the doctor then.In an exemplary variations of the present invention, can in the frequency spectrum that has obtained by FFT, discern the dominant frequency of electrogram signal.For example, as shown in Fig. 9 A, normally typical or compact myocardial muscle tissue can have single peak value in frequency spectrum, and fibrillar myocardial muscle tissue has the spectrum peak (spectral peaks) more than compact myocardial muscle tissue.Can determine the quantity of spectrum peak for a plurality of points around the wall of the heart on the aforesaid three-dimensional model.(Fig. 7-9A is relevant with following article: PACHON, Jose, C, Deng people's work., A new treatment foratrial fibrillation based on spectral analysis to guide the catheterRF-ablation, Europace, (2004) 6,590-601, The European Society ofCardiology.)

[0081] in of the present invention another changes, can be determined and can be mapped to the three-dimensional model of heart in the maximum peak amplitude at dominant frequency place by the frequency spectrum of electrogram signal.For example, in Fig. 9 A, can see that compact myocardial muscle tissue is higher in the maximum peak amplitude at dominant frequency place, be approximately 175dBmV, and fibrillar myocardial muscle tissue be lower in the maximum peak amplitude at dominant frequency place, is approximately 80dB mV.These values also can be mapped on the three-dimensional model of heart.

[0082] in another changes, the energy that can determine a band of frequency field and the ratio of second energy of being with of frequency field and this ratio is mapped to the three-dimensional model of heart.For example, Fig. 9 B illustrates the energy in the 60-240Hz passband and is lower than the ratio of the energy of 60Hz, and the ratio in the frequency spectrum of the EGM of fibrillar myocardial muscle tissue is greater than the ratio in the frequency spectrum of the EGM of compact myocardial muscle tissue.

[0083] though described the time domain of the three-dimensional plot that can be converted into patient's heart and the example of frequency-domain information herein, those of ordinary skill in the art can recognize that territory and frequency-domain information also can be determined and be mapped to three-dimensional model At All Other Times.For example, can determine following information and it is mapped to three-dimensional model from time domain or frequency field: low frequency of being paid close attention to or high frequency passband (for example, representing) with Hz; The frequency (for example, representing) that has ceiling capacity in the passband with Hz; A plurality of peak values in the passband (for example, counting); The energy of each peak value, power and/or area (for example, representing) with dB; The width (for example, representing) of each peak value in energy in each peak value in energy in each peak value and/or area and another passband and/or the ratio of area and the frequency spectrum with Hz.

[0084] Figure 10 illustrates and is used for determining from the information that changes EGM in time and being used to shine upon the example of this information to the method for three-dimensional model (for example, heart) in time domain and/or frequency field.In operation 100, a plurality of electrodes (for example contact or noncontact, single-stage or bipolar mapping electrode) are used to sample time dependent electrogram signal.For example, this electrogram signal can be sampled in a plurality of places along the wall and/or the peripheral vascular system of heart.

[0085] operating in 102 subsequently, on the time cycle of time dependent EGM, carrying out FFT to determine the frequency-domain information of EGM.In operation 104, can show the real-time demonstration of time domain and/or frequency-domain information.In operation 106, determine one or more parameter subsequently.Describe exemplary parameter above, and for example comprised the mistiming between roving electrode and the reference electrode; The peak-to-peak voltage of roving electrode; The peak negative voltage of roving electrode; CFE information; The dominant frequency of electrogram signal; The maximum peak amplitude at this dominant frequency place; The ratio of energy in energy and second band of frequency field in band of frequency field; Low frequency of being paid close attention to or high frequency passband; The frequency that has ceiling capacity in the passband; A plurality of peak values in the passband; The energy of each peak value, power and/or area; The energy of each peak value of the energy of each peak value and/or area and another passband and/or the ratio of area; Width with each peak value in the frequency spectrum.In operation 108, color, shade and/or gray scale are distributed to the value of the parameter that will be identified, and in operation 110, corresponding to by color, shade and/or the gray scale of the parameter of the EGM of electrode sample by continuously and real-time update to three-dimensional model (for example heart).

[0086] an interested concrete zone is the zone mapping that comprises the heart of autonomic nerve cell.Can shine upon ECG information and discern electric transmission focal by heart.The starting point of electric signal is generally automatic cells bundle or nerve center clump (ganglia plexi).Any ARR scope that causes for function fault in the automatic cells can strengthen result of treatment significantly and minimize the scope of treatment for the ability of this function fault finding.The concrete advantage of the EGM of this subdivision section of mapping is the ARR zone of its capable quick identification and location in frequency field.For example, be Fibrillated root if determine specific autonomic nerve bundle, the zone of aiming at the zone of this initial nervous system input rather than treating a plurality of fibr tissues roughly can reduce the quantity of the required damage of the described situation of treatment.

[0087] as mentioned above, need in the tissue of treatment in the location, electrophysiology data can be very useful.But to the three-dimensional model of heart, there is challenge for this electrophysiology data of mapping.Describe according to projection process of the present invention now.

[0088] as mentioned above, it surveys the electric excitation of heart or other EP signal on the heart surface to the electrode of at least one EP conduit in moving on the heart surface and moving.During measuring each time, together with the value of EP voltage or signal, the real time position of mark catheter electrode.Location point and measurement of correlation result are integrated into this and are called " EP data set ".Electrode position when these data are projected onto the EP data of the surface of three-dimensional model sampling corresponding to obtaining subsequently.Because this model is not to produce when the locating surface electrode is powered, projection process can be used to arrange the immediate heart surface that the information of electricity is represented to geometric configuration.In one exemplary embodiment, for example, according to the value of the single immediate position of EP data centralization, the lip-deep every bit of three-dimensional model is colored or imposes shades of gray.This new point is as " position " of the expression of the EP data in the image of presenting to the doctor.

[0089] in another embodiment, use new with improve technology-mapped EP data to three-dimensional model.Because measuring the point of these EP data may not be identical set with the physical location that is used to produce three-dimensional model, these EP data must be projected onto on the surface of three-dimensional model.In this preferred embodiment, these EP data are projected onto and are used on the three-dimensional model showing.This EP data value (crest voltage, actuation duration, maximum frequency or other value) also must be interpolated on the point of 3 dimensional coil geometry.In case these EP data are projected onto on the three-dimensional model, the EP data can be converted into color and be presented according to the computer graphics techniques of standard.Must determine three-dimensional model is associated with the method for EP data structure.For a plurality of surface interpolation problems, the good triangulation of expectation generation data point-be connected in the triangle of filling x-y plane (2 dimension).Use the level and smooth weighted mean of these leg-of-mutton three end points subsequently, can be similar to the data value of arbitrfary point planar.This interpolation based on triangulation is known as the center of gravity interpolation, but is appreciated that other known method that it can also use interpolation.In general two-dimensional space, can use the specific triangulation that is referred to as the De Luonei triangulation usually, and it knownly can provide optimal result.De Luonei triangulation and Voronoi figure are closely related, and wherein Voronoi figure is meant: around one group of zone of each data point, it is with respect to other is put more near that data point arbitrarily.More specifically, its Voronoi zone border on mutually each data point is connected by the edge in the De Luonei triangulation.But can believe and not exist known algorithm to be used for calculating at random and the De Luonei triangulation on the complex surface (such as three-dimensional model) in conjunction with heart of the present invention.The following calculating of the method for the preferred embodiment is to good being similar to of De Luonei triangulation.Each EP data point is projected onto its immediate point on the three-dimensional model, and the point that these throwed is searched determines Voronoi neighbours.In three-dimensional model, select the summit, and search approaches two EP data points on this summit in the three-dimensional model most in the EP data plot.Usually, the at first search EP data point adjacent with selected summit, and the common neighbours that search for neighbours subsequently is up to finding two immediate EP data points.Have high likelihood, these data points have the Voronoi zone that borders on mutually, thereby and these two points connect by moral Lip river inward flange.Repeat this process for each other summit in the three-dimensional model.Subsequently, organize moral Lip river inward flange thus and form a plurality of triangles, each edge should be two leg-of-mutton parts just in time as can be known.If having the circle of " hole "-four arbitrarily or more polygon edge, the triangulation that is produced do not comprise arbitrary triangle-then can fill these holes by the shortest new edge that recurrence increases by two data points of clamping ring.Be found to be moral Lip river inward flange although be close to all edges, because two are not found each moral Lip river inward flange near the data point algorithm, this is just necessary.Enter in this triangulation in case the EP data point has been collected, measured data can be interpolated on each summit of three-dimensional model.Most of summit is positioned at the leg-of-mutton inside of one of them De Luonei, and will use the EP data that record at each place of leg-of-mutton three data points to come interpolation.Some summits can with triangular rim enough near (for example, it is positioned at or approaches very much triangular rim), make that the value that will be assigned with will be from the measurement result separately of two end points by bilinear interpolation.Preferably, threshold value can be set and apply to be presented at that this summit must be how approaching with the edge before the bilinear interpolation.Data point can more be approached than any edge or triangle in several summits, in this case, the summit must be assigned with approaching data order the same the EP data.Preferably, threshold value can be set must be how approaching with measurement point with this summit before being presented at the value of distributing measurement point.In case the EP data value has been assigned to a plurality of points in the three-dimensional model, produce firm color diagram subsequently, and preferably, use level and smooth this color diagram of smoothing algorithm to present with the color that clinical rational is provided, wherein, the point in the three-dimensional model only obtains their color from the measurement result that adopts near measurement point.

[0090] in the context of Figure 11-14, the embodiment that describes will be discussed in leading portion.Figure 11 is the three-dimensional model of the part of heart, wherein uses triangulation to connect this location point 91.This surface can be on grid more uniformly sampling and can be provided rational smooth surface once more by further interpolation, it is stored as three-dimensional model and is used for being shown to the doctor during identical or afterwards program.Cai Yang surface has more substantial data point usually once more.Can also use smoothing algorithm to handle the surface of sampling once more, give the more level and smooth outward appearance of geometric configuration.For example, this three-dimensional model provides the estimation border of the inside of heart area from this group point.On the superimposed three-dimensional model in Figure 11 of mark 92 of the data measurement points of expression EP data centralization.As previously mentioned, the position that is used for the data measurement points (by mark 92 expression) of EP data set no longer is the same position with location point 91 usually.Therefore, mark 92 all is positioned at triangle sometimes, and is presented on the leg-of-mutton edge or near this edge at other times.

[0091] Figure 12 illustrates the EP data set that comprises a series of measurement points 93, and each measurement point has the correspondent voltage level.This voltage levvl is by mark 92 expressions, and the color that changes mark 92 is used to show this voltage levvl.

[0092] is appreciated that the EP data set described among Figure 12 is identical with global geometric shape among Figure 11, can observes the measurement point 93 of EP data set and not correspond to the location point 91 of three-dimensional model, though use the same area of same cardiac to produce.It lacks man-to-man position corresponding relation, and this produces the demand that the projection institute EP data of surveying arrive three-dimensional model.In order to help projection process, chosen position point 91 from a plurality of location points 91 of the three-dimensional model that comprises Figure 11.Next, compared in the position of at least one subclass of the position of selected location point 91 and a plurality of measurement point 93, be used for determining and selected location point 91 immediate two measurement points 93.This immediate measurement point is to being considered to form moral Lip river inward flange 94 (it draws with green line) on Figure 12, the very possible immediate measurement point of discerning 93 to being Voronoi neighbours.Can use the algorithm that is designed for estimated distance (comprising) of any amount to discern immediate measurement point such as Kirsanov-Hoppe or Fast Marching geodesic algorithm.Right identification can be repeated to discern additional moral Lip river inward flange to measurement point based on the degree of closeness with selected location point.In visiting, form a plurality of triangles probably for the right process of the immediate measurement point of each location point.If after this algorithm, still residue is not the location point of leg-of-mutton part, then form triangular relationship to other measurement point, give those measurement point optimal selections that to use shortest distance lines to connect (preferably producing the short triangular rim of length) by setting-out.

[0093] when selected location point 91 and its separately near between 93 pairs of the measurement points can use several different methods to follow the tracks of near relation the time, all figure illustrates this relation in Figure 12 and Figure 13.In Figure 12, the mid point 95 of most of moral Lip river inward flange has at least one and the common many lines (they illustrate with dark-coloured, red ink) that contact with mid point 95.These lines represent with three-dimensional model in being connected of a plurality of location points.Exist the line of particular location point to mean, determine that immediate measurement point is to for forming the right of the moral Lip river inward flange discerned for this particular location point.Same red line shown in Figure 12 and 13, but shown in Figure 12 have moral Lip river inward flange, and shown in Figure 13ly have a three-dimensional model.Figure 13 comprises the three-dimensional model of Figure 11, and range line adds and is used for discerning the selected location point of three-dimensional model and the relation between the moral Lip river inward flange of approaching selected location point thereon.When the measurement data of EP figure is projected onto on the location point of three-dimensional model, use these relations.Which moral Lip river inward flange these red lines only determine to use in triangulation; It is not used to indicate a plurality of location points from which moral Lip river inward flange interpolation three-dimensional model.

[0094] the following actual projected of describing the EP data value.With respect to the triangle that is used to modeling EP data set, each location point in the visit three-dimensional model.In theory, if when three-dimensional model is added on the trigonometric ratio model of EP data set, the relation between location point and the triangle just is easier to observe.Most of location point 91 will be positioned at one of them leg-of-mutton inside of the trigonometric ratio model of EP data set, and the EP data value that is assigned to this location point 91 can come interpolation based on the measured value use center of gravity method of interpolation of an Atria summit (measuring position 93).Center of gravity interpolation well known in the art and its are a kind of method for optimizing.But be appreciated that and also can use other known interpolation method.Some location points 91 can approach triangular rim (for example be positioned on the triangular rim or very approaching with it) very much, make the value of being distributed survey the EP data value by bilinear interpolation from respectively the controlling oneself of two end points at edge.Some location points 91 more approach measurement point than any edge or triangle, in this situation, location point 91 will be assigned with at the same EP data value of the measured value of immediate measurement point.In case the EP data value be assigned in the three-dimensional model a plurality of points (and preferably, all location points of three-dimensional model), then this three-dimensional model (the EP data value of the distribution corresponding with it) can be sent to coloring process, it can be based on painted this three-dimensional model of the EP data level of being distributed (for example, crest voltage, actuation duration, maximum frequency or other value).Figure 14 represents the output from this coloring process, and wherein color representation projects the different voltage levvls that distribute on the three-dimensional model of Figure 11 by the EP data plot with Figure 12.

[0095] in another embodiment, use to comprise the technology of segmenting this three-dimensional model, these EP data are mapped to this three-dimensional model.Particularly, use triangulation to segment this three-dimensional model by this way: to make all EP data points vertices be arranged in the three-dimensional model of segmentation.Can use the three-dimensional model after grid alligatoring (mesh-coarsening) or extraction algorithm (allow people to specify the output vertex collection, it will be designated as just in time is exactly the collection of EP data point) are handled segmentation subsequently.Extraction program can determine the correct connection of the point on the three-dimensional model subsequently.In this embodiment, preferably, use Kirsanov-Hoppe or Fast Marching geodesic algorithm, each summit of EP data is projected onto the edge of the three-dimensional model of immediate summit or segmentation.The output of extraction program can be sent to coloring process subsequently, and it can carry out painted to three-dimensional model based on the voltage levvl of three-dimensional model.Can recognize that also the moral Lip river inward flange of being longer than predetermined distance threshold will be under an embargo.

[0096] although abovely describe a plurality of embodiment of the present invention with singularity to a certain degree, the one of ordinary skilled in the art can not break away from the multiple change of making under the spirit or scope of the present invention situation these disclosed embodiments.For example, when above-mentioned instructions description was mapped to the data of three-dimensional model, data also can be mapped to figure arbitrarily, include but not limited to two dimension or three-dimensional, static state or time dependent image or model.The reference of all directivity (for example upper and lower, upwards, downward, left and right, left, to the right, top, the end, top, following, vertical, level, clockwise and counterclockwise) only be used for explanation to help reader understanding the present invention, rather than limit the invention, particularly for position of the present invention, orientation or use.Annexation was broadly understood with reference to (for example, adhere to, coupling, connection etc.), its can comprise element between connecting center section and element between relatively move.Therefore, annexation with reference to and unnecessary be meant that two elements directly link to each other and mutually between have fixed relationship.Be appreciated that above-mentioned instructions comprises or accompanying drawing shown in all the elements only be illustrative rather than definitive thereof.Do not breaking away under the mental condition of the present invention that limits by appended claims, can make change in details or the structure the present invention.

Claims (25)

1, a kind ofly be used to shine upon the method for electrophysiology information to the three-dimensional model, described method comprises:

A) obtain the three-dimensional model to small part of heart, comprise the positional information of a plurality of location points on the heart surface;

B) obtain the electrophysiology map of the heart, the electrophysiology map of the described heart comprises positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes in these a plurality of measurement point;

C) chosen position point and from the electrophysiology map of the described heart, determine two immediate measurement points in a plurality of location points of this from described three-dimensional model;

D) limit be confirmed as and immediate these two measurement points of selected location point between moral Lip river inward flange;

E) for each the repeating step C of these a plurality of location points in this three-dimensional model) and D), be used for limiting at least some a plurality of morals Lip river inward flange of these a plurality of measurement points of the electrophysiology map that connects the described heart;

F) connect described moral Lip river inward flange and form a plurality of triangles;

G) from described three-dimensional model identification these a plurality of location points one of them, discern this of location point that its surrounded by edges discerns a plurality of leg-of-mutton one of them, and use the electrophysiology measurement result that records at the vertex of a triangle place that is discerned, distribute the electrophysiology level to the location point of being discerned based on the center of gravity method of interpolation.

2, the process of claim 1 wherein that the electrophysiology level has been assigned to a plurality of location points, described method also comprises:

Based on the relative amplitude of the electrophysiology level that is assigned to independent location point, divide to mix colours or each independent location points of a plurality of location points of gray scale in this three-dimensional model; And

Use the described color of these a plurality of location points in assigned this three-dimensional model to present this three-dimensional model.

The process of claim 1 wherein that 3, the described step of obtaining the electrophysiology map of the heart comprises:

In the part of heart, insert electrode;

Described electrode is placed a plurality of measurement points along heart surface;

Reception is along each positional information of this a plurality of measurement points of heart surface;

Each place at these a plurality of measurement points receives the electrophysiology measurement result; And

The measurement point separately of this electrophysiology measurement result and this electrophysiology measurement result of measurement is associated.

The process of claim 1 wherein that 4, the described step to the three-dimensional model of small part of obtaining heart comprises:

In the part of heart, insert electrode;

Described electrode is placed a plurality of location points along heart surface;

Reception is along each positional information of this a plurality of location points of heart surface; And

Produce the three-dimensional model to small part of heart, comprise along the positional information of each of this a plurality of location points of heart surface.

The process of claim 1 wherein that 5, the described step to the three-dimensional model of small part of obtaining heart comprises:

In the part of heart, insert electrode;

Described electrode is placed more than first location point along heart surface;

Reception is along each positional information of this more than first location point of heart surface;

What produce heart should be to elementary 3 dimensional coil geometry of small part, comprises along the positional information of each of this more than first location point of heart surface; And

Handle described elementary 3 dimensional coil geometry comprises more than second location point with generation each the three-dimensional model of positional information, wherein said more than second comprise at least some location points from described more than first location point.

6, the method for claim 5, wherein, this elementary 3 dimensional coil geometry of described processing comprises with the step that produces three-dimensional model:

Handle this elementary 3 dimensional coil geometry and comprise each the three-dimensional model of positional information that is used for more than second location point with generation, wherein said three-dimensional model has the resolution that is higher than this elementary 3 dimensional coil geometry, makes this more than second location point quantitatively more than this more than first location point.

7, the method for claim 5, wherein, this elementary 3 dimensional coil geometry of described processing comprises with the step that produces three-dimensional model:

Utilize smoothing algorithm to handle this elementary 3 dimensional coil geometry and comprise each the three-dimensional model of positional information that is used for more than second location point with generation.

The process of claim 1 wherein that 8, the described step to the three-dimensional model of small part of obtaining heart comprises:

Obtain the three-dimensional model to small part of heart, described three-dimensional model comprises the positional information for a plurality of location points on the heart surface, wherein uses the technology that is selected from the group that comprises CT scan, MRI, radar imagery, x-ray imaging, fluoroscopic image, infrared imaging, ultrasonic imaging and its combination to produce this three-dimensional model.

9, the process of claim 1 wherein chosen position point and determine that from the electrophysiology map of the heart described two comprise near the step of measurement point in described these a plurality of location points from described three-dimensional model:

Chosen position point in a plurality of location points of from three-dimensional model this;

Use the kirsanov-Hoppe geodesic algorithm to determine on distance two measurement points in the electrophysiology map with the immediate heart of selected location point.

10, the method for claim 9, wherein, described connection moral Lip river inward flange becomes leg-of-mutton step and also comprises:

Use the measurement point that also is not connected to moral Lip river inward flange to produce additional triangle.

11, the process of claim 1 wherein chosen position point and determine that from the electrophysiology map of the heart step of described two immediate measurement points comprises in described these a plurality of location points from described three-dimensional model:

Chosen position point in a plurality of location points of from three-dimensional model this; And

Use the Fast-Marching geodesic algorithm to determine on distance two measurement points in the electrophysiology map with the immediate heart of selected location point.

12, a kind ofly be used to shine upon the method for electrophysiology information to the three-dimensional model, described method comprises:

A) obtain the three-dimensional model to small part of heart, described three-dimensional model comprises the positional information of a plurality of location points on the heart surface;

B) obtain the electrophysiology map of the heart, the electrophysiology map of the described heart comprises positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes in these a plurality of measurement point;

C) chosen position point and from the electrophysiology map of the described heart, determining and immediate two measurement points of selected location point in a plurality of location points of this from three-dimensional model;

D) limit be confirmed as and immediate described two measurement points of selected location point between moral Lip river inward flange;

E) for each the repeating step C of these a plurality of location points in a plurality of location points) and D), be used for limiting at least some a plurality of morals Lip river inward flange of these a plurality of measurement points of the electrophysiology map that connects the heart;

F) the described moral of connection Lip river inward flange becomes a plurality of triangles with generation trigonometric ratio model, and uses any space in the new triangle filling trigonometric ratio model;

G) be identified in immediate moral Lip river inward flange on arbitrfary point at least one location point of comparing and approaching measurement point, and distribute the electrophysiology level to this at least one location point, the electrophysiology level of wherein being distributed is identical with the electrophysiology measurement result that records at measurement point; With

H) use the electrophysiology measurement result that records at the vertex of a triangle place,, distribute the electrophysiology level at least one location point that is positioned at triangle based on method of interpolation.

13, a kind ofly be used to shine upon the system of electrophysiology information to the three-dimensional model, this system comprises:

The modeling processor is used to produce the three-dimensional model to small part of heart, and described three-dimensional model comprises the positional information of a plurality of location points on the heart surface;

The electrophysiology measuring equipment, be used to produce the electrophysiology map of the heart, the electrophysiology map of the described heart comprises positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes at each place of these a plurality of measurement points, and the measurement point separately of described electrophysiology measurement result and measurement electrophysiology measurement result is associated;

Moral Lip river inward flange is handled device, be used for handling the subclass of a plurality of location points of three-dimensional model, and be used for determining for each processed location point on distance with two measurement points of the immediate electrophysiology map at the described heart of processed location point, described processor limits a plurality of morals Lip river inward flange, and each moral Lip river inward flange comprises and is defined as right with each processed immediate measurement point of location point;

The triangulation processor is used for a plurality of triangles based on the electrophysiology map of this a plurality of morals Lip river inward flange qualification heart; With

The projection processor uses and each relevant electrophysiology measurement result of vertex of a triangle, distributes the electrophysiology level to being arranged in this a plurality of leg-of-mutton one of them at least one location points based on the center of gravity method of interpolation.

14, the system of claim 13, wherein, described processor also uses the electrophysiology measurement result of measuring at the end points place of moral Lip river inward flange, distributes the electrophysiology level at least one location point near threshold value that is positioned at moral Lip river inward flange based on bilinear interpolation.

15, the system of claim 13, wherein, described processor also uses the electrophysiology measurement result of measuring at the end points place of moral Lip river inward flange, distributes the electrophysiology level at least one location point near threshold value that is positioned at moral Lip river inward flange based on bilinear interpolation.

16, the system of claim 13, wherein, described processor also distributes the electrophysiology level at least one location point based on the electrophysiology measurement result that records near the measurement point in the threshold value, the electrophysiology level of wherein being distributed identical with in measurement point.

17, a kind ofly be used to shine upon the method for electrophysiology information to the three-dimensional model, this method comprises:

A) obtain the three-dimensional model to small part of heart, comprise the positional information of a plurality of location points on the heart surface;

B) obtain the electrophysiology map of the heart, comprise positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes at each place of a plurality of measurement points;

C) chosen position point and from the electrophysiology map of the described heart, determine two immediate measurement points in a plurality of location points of this from three-dimensional model;

D) limit be confirmed as and immediate these two measurement points of selected location point between the edge;

E) for each the repeating step C of these a plurality of location points in the three-dimensional model) and D), be used for limiting at least some a plurality of edges of a plurality of measurement points of the electrophysiology map that connects the heart;

F) connect described edge to produce a plurality of polygons;

G) discern one of them of this a plurality of location points from described three-dimensional model, the identification edge center on this of the location point discerned a plurality of polygonal one of them, and use the electrophysiology measurement result that records at each place on the polygonal summit of discern, based on method of interpolation, distribute the electrophysiology level to the location point of being discerned.

18, a kind ofly be used to shine upon the system of electrophysiology information to the three-dimensional model, this system comprises:

The surface modeling controller is used to obtain the three-dimensional model to small part of heart, comprises the positional information of a plurality of location points on the heart surface;

The electrophysiology measuring equipment, be used to produce the electrophysiology map of the heart, the electrophysiology map of the described heart comprises positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes at each place of a plurality of measurement points, and the measurement point separately of described electrophysiology measurement result and measurement electrophysiology measurement result is associated;

Edge processor, be used for handling the subclass of a plurality of location points of three-dimensional model, and be used for determining for each processed location point on distance with two measurement points of the immediate electrophysiology map at the described heart of processed location point, described processor limits a plurality of edges, and each described edge comprises and is defined as right with each processed immediate measurement point of location point;

Geometry processor is used for a plurality of polygons based on the electrophysiology map of a plurality of edge limited hearts; With

The mapping projector uses and each relevant electrophysiology measurement result on polygonal summit, and based on method of interpolation, distribution electrophysiology level is to being arranged in a plurality of polygonal one of them at least one location point.

19, the system of claim 18, wherein, described processor uses the electrophysiology measurement result of measuring at the end points place at described edge, distributes the electrophysiology level at least one location point that is positioned near the edge based on bilinear interpolation.

20, the system of claim 18, wherein, described geometry processor uses a plurality of triangles to limit the electrophysiology map of the described heart, and the wherein said mapping projector uses each the relevant electrophysiology measurement result with vertex of a triangle, based on method of interpolation, distribute the electrophysiology level to being arranged in leg-of-mutton one of them at least one location point.

21, a kind ofly be used to shine upon the computerized method of electrophysiology information to the three-dimensional model, this method comprises:

A) three-dimensional model to small part of reception dissection, described three-dimensional model comprises the positional information of a plurality of location points on the dissection surface;

B) receive the electrophysiology map that is used for dissection, described electrophysiology map comprises positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes in a plurality of measurement point;

C) for each the independent location point in a plurality of location points in the three-dimensional model, use a computer to determine with described independent location point immediate from described electrophysiology map two measurement points and limit the edge subsequently, described edge comprises the right of determined measurement point;

D) use a computer and connect described edge to form the grid of closed polygon;

E) use a computer from being positioned at the lip-deep three-dimensional model recognizing site point of closed polygon that the edge centers on the location point of being discerned, wherein, described computing machine uses the electrophysiology measurement result that records around the place, polygonal summit of location point at the edge, distributes the electrophysiology level to the location point of being discerned based on method of interpolation; With

F) output comprises the positional information that is used for a plurality of location points and is assigned to each the output file of electrophysiology level of a plurality of location points.

22, a kind ofly be used to shine upon the method for electrophysiology information to the three-dimensional model, this method comprises:

A) obtain the three-dimensional model to small part of heart, described three-dimensional model comprises the positional information of a plurality of location points on the heart surface;

B) obtain the electrophysiology map of the heart, comprise positional information that is used for a plurality of measurement points and the electrophysiology measurement result that realizes in a plurality of measurement point;

C) use triangulation to handle described three-dimensional model, thereby produce the three-dimensional model that comprises a plurality of leg-of-mutton segmentations, wherein, each of described a plurality of measurement points is the summit;

D) use three-dimensional model that extraction algorithm handles this segmentation to comprise the three-dimensional model of more than second leg-of-mutton revision with generation, wherein these a plurality of measurement points are vertex of a triangle.

23, the method for claim 22, wherein, described triangulation treatment step is programmed the triangular rim of being longer than predetermined distance threshold to forbid producing.

24, the method for claim 23 also comprises:

Use Kirsanov-Hoppe or Fast Marching geodesic algorithm, the electrophysiology measurement result of projection measurement point is on the summit or edge of the three-dimensional model of segmentation.

25, the method for claim 24 also comprises:

Based on the relative amplitude of the electrophysiology level of distributing divide mix colours or gray scale to each summit of the three-dimensional model of revision; And

Use the described color on a plurality of summits in the three-dimensional model of assigned described revision to present the three-dimensional model of revision.

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