CN114869287A - 可视化导管电极的性能 - Google Patents

可视化导管电极的性能 Download PDF

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CN114869287A
CN114869287A CN202111575786.6A CN202111575786A CN114869287A CN 114869287 A CN114869287 A CN 114869287A CN 202111575786 A CN202111575786 A CN 202111575786A CN 114869287 A CN114869287 A CN 114869287A
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electrodes
tissue
contact
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distal end
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Y·帕尔蒂
V·格莱纳
A·戈瓦里
I·西伯曼
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Biosense Webster Israel Ltd
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Abstract

本申请涉及可视化导管电极的性能。一种用于电生理测量的系统包括探针，该探针具有被配置用于插入到活体受检者的体腔中并且包括电极的阵列的远侧端部，这些电极沿该远侧端部设置并且被配置成在该体腔内的多个位置处接触组织。处理器被配置成：在时间段内从该电极采集信号，在该时间段期间，探针在体腔内移动；响应于该信号来计算指示该时间段内的该电极中的每个电极与该组织之间的相应接触质量的量度；并且将该量度的指示输出给该系统的用户。

Description

可视化导管电极的性能
技术领域
本发明整体涉及用于感测和标测电生理(EP)信号的设备和方法，并且具体地涉及用于评估此类设备的操作的方法。
背景技术
在本领域已知的心脏电解剖标测系统中，操作员(通常为医师)将导管穿过患者的血管系统插入心脏的腔室中。该导管的远侧端部处的电极或电极组件接触腔室中的心肌组织并从该组织接收电信号，这些电信号通过导管传送到标测控制台。操作员操纵心脏内的导管，以便从心脏腔室内的许多点采集信号，从而使控制台能够构造示出该心脏腔室的壁的物理结构和这些壁上电活动分布的标测图。
由于操作员在心脏腔室中无法看到导管的远侧端部，因此已经开发了许多技术来帮助操作员可视化和理解EP信号采集的过程。例如，美国专利10,617,317描述了一种根据电极信号来突出显示电极图像的方法。患者的心脏的图形图像呈现在显示屏上，包括表示位于心脏内的导管和导管上的电极的图标，同时该电极与心脏中某个位置处的组织接触。该方法还包括使用电极从该位置处的该组织采集电信号，并且处理所采集的信号以便检测所采集的信号中预定义信号特征的发生。该方法还包括在检测到该预定义信号特征的发生时，修改显示屏上表示电极的图标和表示导管的图标中的至少一者的视觉特征。
作为另一个示例，美国专利10,582,872描述了一种用于可视化由导管上的电极感测到的电生理信息的方法和系统。该方法包括记录电极信号采集的时间、指定参考电极信号采集，相对于参考电极信号采集为每个记录的电极信号采集时间分配相对时间、用信号采集识别电极、将分配的相对时间与所识别电极相关以生成电极信号采集序列，以及生成电极信号采集序列的视觉表示、生成具有电极的图形图像的视觉表示，其中各个电极被视觉标记以表示电极信号采集序列。
发明内容
下文所述的本发明的实施方案提供了用于可视化EP信号采集的改进的方法和系统。
因此，根据本发明的实施方案，提供了一种用于电生理测量的系统，该系统包括探针，该探针具有被配置用于插入到活体受检者的体腔中并且包括电极的阵列的远侧端部，这些电极沿该远侧端部设置并且被配置成在该体腔内的多个位置处接触组织。处理器被配置成：在时间段内从该电极采集信号，在该时间段期间，探针在体腔内移动；响应于该信号来计算指示该时间段内的该电极中的每个电极与该组织之间的相应接触质量的量度；并且将该量度的指示输出给该系统的用户。
在所公开的实施方案中，该探针包括导管，并且该远侧端部被配置用于插入到该活体受检者的心脏的腔室中。
除此之外或另选地，该探针的该远侧端部包括柔性结构，在该柔性结构上排列该电极，并且该量度指示该柔性结构的不同部分与该组织之间的接触。在所公开的实施方案中，该结构包括多个柔性脊，该电极沿该多个柔性脊设置。
在一些实施方案中，该处理器被配置成将表示该远侧端部的图形图标渲染到显示器，并且将该远侧端部上的该电极的相应位置处的该量度的视觉指示结合到该图形图标中。在所公开的实施方案中，该量度由该图形图标上的该电极的该相应位置的颜色编码表示。
在一个实施方案中，该量度指示由该电极中的每个电极在该时间段内从该组织采集的有效信号的数量。通常，该处理器被配置成将一个或多个过滤标准应用于该信号，以便将从该电极中的每个电极采集的该信号的相应第一组分类为有效，同时将由该电极中的每个电极采集的该信号的相应第二组分类为无效。
在其他实施方案中，该量度指示该时间段内的相应持续时间，在该相应持续时间期间，该电极中的每个电极与该体腔中的该组织接触。在一个此类实施方案中，该信号指示该组织内的电生理活动，并且该处理器被配置成区分由与该组织接触的该电极采集的局部信号和由不与该组织接触的该电极采集的远场信号，并且响应于由该电极中的每个电极在该时间段内采集的该局部信号和该远场信号之间的关系来获取持续时间，在该持续时间期间，该电极中的每个电极与该组织接触。
根据本发明的实施方案，还提供了一种用于电生理测量的方法，该方法包括将探针插入到活体受检者的体腔中，该探针具有包括电极的阵列的远侧端部，这些电极沿该远侧端部设置并且被配置成在该体腔内的多个位置处接触组织。在时间段内从该体腔内的该电极采集信号，在该时间段期间，探针在体腔内移动。响应于该信号，计算量度，其中该量度指示该时间段内的该电极中的每个电极与该组织之间的相应接触质量。将该量度的指示输出给该系统的用户。
结合附图，通过以下对本发明的实施方案的详细描述，将更全面地理解本发明，其中：
附图说明
图1为根据本发明的实施方案的用于电解剖标测的系统的示意性图解；
图2为根据本发明的实施方案的示出用于采集EP信号的导管上的电极的性能的图形图标的示意图；并且
图3为示意性地示出根据本发明的实施方案的用于评估和可视化电极性能的方法的流程图。
具体实施方式
概述
为了产生心脏腔室的准确电解剖标测图，标测系统通常沿腔室的壁从数百或甚至数千个不同点采集电信号。为了减少采集此类大量数据所需的时间，标测系统通常使用在其远侧端部具有许多电极的导管，这些电极能够同时在心脏腔室内的不同相应位置处感测相应信号。电极通常沿导管诸如球囊或具有多个柔性脊的结构的远侧端部处的柔性结构诸如篮或多臂组件排列，这些电极沿该多个柔性脊设置。
在典型的操作中，并非所有电极都在任何给定时间与组织接触。由导管电极接收的不与心脏中的组织接触的信号通常由透射通过其中浸没电极的血池的远场信号决定。此远场分量具有有限的诊断价值。当导管电极与心脏组织接触时，信号的振幅主要源自局部组织电导率，而远场分布是次要的。
因此，为了有效、准确的EP测量和标测，通常期望尽可能多的电极在规程期间的所有时间与组织接触，并且接触具有良好的质量，使得信号适于结合在标测图中。同样地，当新导管处于开发中时，对于设计者而言重要的是理解电极中的每个电极在组织接触的一致性方面是否性能优异，以便优化导管的远侧结构和电极在该结构上的放置。尽管可以通过观察任何单个电极收集的信号来评估该电极的性能，但在任何给定时间由来自整个电极的阵列的信号提供的数据量对于操作员或设计者而言太大而不能透彻理解。因此，例如，对于设计者而言困难的是在导管移动通过心脏腔室时评估电极中的哪些电极与组织形成一致良好的接触并且哪些电极不与组织形成一致良好的接触，以便改进设计来实现更好、更一致的接触。需要自动化工具，该自动化工具可提供这种评估并且辅助导管的开发者和用户改进其设计和操作技术。
此处描述的本发明的实施方案通过提供用于电生理测量的系统中的探针诸如导管的远侧端部处的电极阵列中的电极中的每个电极的性能的视觉指示来解决这个问题。为了生成该指示，处理器在探针在体腔诸如心脏腔室内移动时从电极采集信号。基于所采集的信号，处理器连续地评估每个电极与腔壁中的组织之间的接触质量。出于此目的，例如，处理器可处理其从每个电极采集的信号，以便区分局部信号和远场信号或者测量通过电极的阻抗。
对于每个电极，处理器随后计算量度，该量度指示在探针在体腔内移动的时间段内电极与组织之间的接触质量。该量度可指示例如由该电极中的每个电极在该时间段内从该组织采集的有效信号的数量。出于此目的，例如，处理器可将过滤标准应用于信号，以便将满足标准的信号分类为有效信号，同时将不满足标准的信号分类为无效信号并且因此应丢弃。用于执行这种过滤的方法和标准描述于例如2020年8月17日提交的美国专利申请16/995,036中，该专利申请已转让给本专利申请的受让人并且以引用方式并入本文且副本附于附录。除此之外或另选地，该量度可指示该时间段内的持续时间，在该持续时间期间电极中的每个电极被发现与组织接触。
处理器将该量度的指示输出给系统的用户。在下文描述的实施方案中，指示采用表示探针的远侧端部的图形图标的形式，处理器将该图形图标渲染到显示器。图标包括例如通过在显示器上对电极位置进行颜色编码实现的探针的远侧端部上的电极的位置处的量度的视觉指示。此图标和/或其他输出使得操作员或设计者能够可视化电极中的每个电极接触组织的有效性并且因此能够改进探针设计或操作技术(视情况而定)，以便优化数据收集和标测的效率。例如，设计者可除去具有不良接触质量的电极并且/或者可将电极集中在具有良好接触质量的探针区域中，以便相对于可用区域和探针中的信号线的数量来最大化有效信号的收集。
为简洁和清晰起见，以举例的方式，附图所示和下文所述的实施方案涉及用于电解剖标测的特定类型的系统和可用于此类系统中的篮状导管。然而，本发明的原理不受这种特定种类的导管或系统的限制，并且可加以必要的变更来类似地应用于用于诊断和治疗应用的其他类型的心脏导管、以及用于其他体腔中的诊断测量和治疗的探针。所有这些另选的具体实施均被视为在本发明的范围内。
系统描述
图1为根据本发明的实施方案的用于标测患者28的心脏26中的EP参数的系统20的示意图。当前图和后续图所示的实施方案是指从心脏26的腔室采集EP信号的示例。在另选的实施方案中，EP参数值可使用其他种类的标测设备来采集，不仅从心脏内采集，还从其他器官和组织采集，这对于阅读本说明书之后的本领域的技术人员而言将是显而易见的。
操作员30通过使用导管22的近侧端部附近的操纵器32操纵导管的轴23，将该导管导航至患者28的心脏26中的目标位置。在图示示例中，导管22在其远侧端部处包括篮状组件40，如插图45所示。如插图25所示，操作员30操纵导管22以对心脏26的腔室执行电解剖标测。如下文所述，通过使篮状组件40上的电极48与心脏内的心肌组织接触来从该组织采集EP信号。
在图示示例中，出于位置跟踪的目的，篮状组件40将可见于插图45中的一对磁性传感器50A和50B结合在篮状组件40的近侧端部和远侧端部处。另选地，导管22可包括在这些位置或其他位置处的其他种类的磁性传感器。另选地或除此之外，导管可包括如本领域已知的其他类型的位置传感器，诸如基于阻抗的位置传感器或超声位置传感器。
篮状组件40包括机械柔性的多个可扩展脊55。多个电极48被固定到每个脊，总共有例如120个电极。电极48被配置为以感测EP信号(即，图示示例中的心内电描记图信号)的目的来接触心脏26内的组织。磁性传感器50A和50B以及电极48通过延伸穿过导管22的导线(未示出)连接到控制台24中的处理电路。
另选地，系统20可包括具有其他种类电极阵列的其他类型的导管，诸如在其外表面上具有电极48的可充胀球囊导管，或在其远侧端部处具有一个或多个柔性臂或具有弯曲“套索”的导管。
系统20包括控制台24中的位置跟踪子系统43，以用于找到篮状组件40的位置和取向，并且由此识别电极48的位置。将患者28放置在由包含磁场发生器线圈42的垫生成的磁场中，该磁场发生器线圈由位置跟踪子系统43驱动。由线圈42生成的磁场在传感器50A和传感器50B中引起指示传感器的位置和/或取向的电信号。来自传感器50A和传感器50B的信号被传输回位置跟踪子系统43，该位置跟踪子系统将这些信号转换为到处理器41的对应的数字输入。处理器41使用这些输入来计算篮状组件40的位置和取向，从而找到电极48中的每个电极的相应位置坐标。
另选地或除此之外，如上所述，系统20可使用其他位置感测方法来找到电极48的位置。例如，处理器41可通过测量电极48和体表电极49之间的阻抗来标测电极48的位置，该电极和体表电极被放置在患者28的胸部上并且由引线39连接到控制台24。
处理器41还经由前端电路44从篮状组件40上的电极48接收EP信号。这些电路在处理器的控制下将模拟和/或数字过滤器和放大器应用于信号。在典型的临床应用中，处理器41使用包含在这些EP信号中的信息以及由磁性传感器50A和50B提供的坐标来构造篮状组件40所在的心脏26的腔室的电解剖标测图，诸如示出EP信号的电压水平或局部激活时间(LAT)随沿腔室壁的位置的变化的标测图。然而，在本实施方案中，处理器41将表示篮状组件40的图形图标60渲染到显示器27。图标60结合了篮状组件上的电极的相应位置处的电极48的接触质量的视觉指示。下文描述了用于计算指示接触质量的量度并将其结合在图标60中的方法。
处理器41通常在软件中编程以执行本文所述的功能。该软件可通过网络以电子形式被下载到计算机，例如或者其可另选地或另外地设置和/或存储在非临时性有形介质(诸如磁存储器、光存储器或电子存储器)上。具体地，处理器41运行专用算法，该专用算法使处理器能够执行所公开的数据采集、接触质量计算和操作员指导步骤，如下所述。
如此前所述，图1所示的示例性例证完全是为了概念清晰而选择的。为简单和清晰起见，图1仅示出了与本发明所公开的技术有关的元件。系统20通常包括附加模块和元件，该附加模块和元件与本发明所公开的技术不直接相关，并且因此被有意地从图1和对应的描述中省略。
评估并显示接触质量
响应于由篮状组件40上的电极48提供的信号，处理器41评估电极中的每个电极与心脏26中的组织的相应接触质量。电极48中的任一个电极可在任何给定时间与心脏的组织完全或部分接触。另选地，电极中的任一个电极可与组织由流体(诸如心脏腔室中的血液)隔开，并且随后将仅通过流体从组织接收信号。可基于由导管提供的信号来评估导管电极中的任一个导管电极与组织的接触(完全或部分接触，或经由流体的接触)的质量。基于这些信号，处理器41测量在篮状组件40在心脏的腔室内移动的时间段内的接触质量。处理器将指示接触质量的用于每个电极的量度计算为例如电极在该时间段内与组织接触的持续时间的函数。在一些实施方案中，用于任何给定电极的量度对应于在所考虑的时间段期间由电极采集的有效信号的数量或在电极与组织之间存在良好接触质量的时间段的比率。
本说明书和权利要求书中所用的术语“接触质量”被定义为导管电极中的任一个导管电极与组织之间的稳定电接触程度的定量指标。“接触质量”可例如以测得的电阻抗直接地表示，或者例如以接触力或压力、或者基于由电极48采集的EP信号的振幅间接地表示。用于评估导管上的多个电极与心脏中的组织之间的接触质量的方法详细地描述于美国专利申请公布2020/0367829中，该专利申请公布已转让给本专利申请的受让人并且其公开内容以引用方式并入本文且副本附于附录中。
除此之外或另选地，接触质量可以通过电极的信号采集质量来表示，例如基于由每个电极48采集的被发现满足特定过滤标准(诸如描述于上文提及的美国专利申请16/995,036中的标准)的信号的数量。在一个实施方案中，使用这种质量量度，处理器41在每个心跳周期期间的特定感兴趣时间窗内从心脏腔室中的每个电极48采集信号。(心跳周期的开始时间(被称为“参考注释”)通常源自从体表电极49接收的ECG信号，并且窗是相对于该参考注释定义的。)如果采集期间的所采集信号和电极位置满足过滤标准，则处理器41将该信号计数为有效信号并且增加该电极的有效信号的数量的计数。否则，信号被认为是无效信号且被丢弃。用于每个电极的接触质量量度基于相应的计数。
以举例而非限制性的方式，用于对有效信号计数的过滤标准可包括以下：
·例如基于相对于已通过快速解剖标测(FAM)算法重建的壁的表面的由磁跟踪系统测量的电极位置坐标的电极与心脏腔室的壁的接近度。仅在位于壁的阈值距离内的位置处采集的信号被认为是有效信号。
·采集期间的导管稳定性。处理器41在EP信号的采集期间感测篮状组件40的运动的程度和速率。当篮状组件在EP样本或一组样本的采集期间移动超过某个最大距离时，处理器将信号拒绝为无效信号。
·电压太低。处理器41通过电压水平过滤EP信号，并且仅将电压高于某个最小值的信号计数为有效信号。
仅满足所有上述标准的信号被计数为有效信号。阈值(对于壁接近度、稳定性和电压等等)可为固定的，或者它们可由系统20的操作员设置。
在其他实施方案中，处理器41测量电极48与体表电极49之间的阻抗。阻抗的量值提供接触质量的指示。通常，电极中的一个电极与体表电极之间的较高阻抗值指示该导管电极与组织之间的较高接触质量，而低阻抗指示电极浸没在心脏内的血液中。处理器41可使用阻抗的值来计算指示导管电极中的每个导管电极与组织之间的接触质量的量度。
另选地或除此之外，篮40上的成对电极48之间的阻抗可用作接触质量的量度。可通过将一组电极之间的阻抗值与预先测量的阻抗值进行比较来评估组织接触，该预先测量的阻抗值包括针对已知与组织充分接触的电极测量的值和针对已知仅与血液接触的电极测量的值。
除此之外或另选地，可使用机器学习技术来评估电极48与心肌组织之间的接触质量，例如如美国专利9,168,004所述，该专利的公开内容以引用方式并入本文且副本附于附录中。
在一些实施方案中，正在评估的探针可包括力或压力传感器(图中未示出)。力或压力的量度提供接触质量的指示，使得较高的力或压力值指示相应电极与组织之间的较高接触质量，反之亦然。
在一些实施方案中，使用从电极48采集的EP信号来评估电极与组织之间的接触质量。处理器41区分在电极与组织接触时采集的局部信号和在电极不与组织接触时采集的远场信号，并且基于局部信号和远场信号之间的关系来获取接触质量。例如，与任何给定电极相关联的EP信号的最大振幅(电压)指示该电极与组织之间的接触质量，使得EP信号的最大振幅的较高值指示该导管电极与组织之间的较高接触质量。处理器41可使用EP信号的振幅来计算指示导管电极中的每个导管电极与组织之间的接触质量的量度。
另选地或除此之外，处理器41可应用其他方法来测量电极和组织48之间的接触质量，诸如在上述美国专利申请公布2020/0367829中进一步描述的方法或本领域已知的其他方法。
现在参考图2和图3，其示意性地示出了根据本发明的实施方案的用于评估和可视化电极性能的方法。图2为示出用于采集EP信号的导管上的电极的接触质量的图形图标60的示意图，而图3为示出用于计算和显示接触质量量度的方法的流程图。此方法在此专门参考如图1所示的导管22来描述；但其可加以必要的变更来适用于其他类型的导管。
处理器41通常将图标60渲染到显示器27，并且将标记62叠加在对应于脊55上的电极48的相应位置的图标60上。标记62被颜色编码以指示对应电极的相应接触质量量度，例如使用“热”标度(由图2中的不同影线样式表示)，其中蓝色指示最低接触并且红色指示最高接触。因此，在图示示例中，位置62B与心肌组织形成相对不良的接触，而另一位置62R形成良好接触。
标记62的颜色编码暗示地示出了脊中的哪些脊或脊的哪些部分与心肌组织形成频繁接触并且哪些没有形成频繁接触。导管22的设计者可随后改变脊的形状或其上的电极的分布，以便优化设计。当导管用于本领域的不同腔室时，接触量度可为不同的；并且设计者因此可开发不同的篮和电极布局以用于不同应用。同样地，系统20的操作员可使用图标60上的颜色编码来改进他或她的标测技术，以便更有效地采集EP数据。
作为创建和着色图标60中的第一步骤，在采集步骤70处，处理器41在篮40在解剖结构诸如心脏的腔室内移动时相对于电极48收集数据，如图3所示。在本示例中，所采集的数据包括由电极感测的EP信号，但另选地或除此之外可采集其他种类的数据，诸如阻抗或压力测量值。在质量评估步骤72处，处理器41测量由每个电极与组织形成的接触的质量并且计算对应的量度。
基于此评估，处理器在质量显示步骤74处输出用于每个电极的接触质量量度的指示。例如，图标60上的电极位置62可根据质量量度进行着色，如图2所示。另选地或除此之外，可使用其他种类的图形和/或数值输出，这对于阅读本说明书之后的本领域的技术人员而言将是显而易见的。
应当理解，上述实施方案以举例的方式被引用，并且本发明不限于上文具体显示和描述的内容。相反，本发明的范围包括上述各种特征的组合和子组合以及它们的变型和修改，本领域的技术人员在阅读上述说明时应当想到所述变型和修改，并且所述变型和修改并未在现有技术中公开。

Claims (20)

1.一种用于电生理测量的系统，包括：
探针，所述探针具有被配置用于插入到活体受检者的体腔中并且包括电极的阵列的远侧端部，所述电极沿所述远侧端部设置并且被配置成在所述体腔内的多个位置处接触组织；以及
处理器，所述处理器被配置成：在时间段内从所述电极采集信号，在所述时间段期间，所述探针在所述体腔内移动；响应于所述信号来计算指示所述时间段内的所述电极中的每个电极与所述组织之间的相应接触质量的量度；并且将所述量度的指示输出给所述系统的用户。
2.根据权利要求1所述的系统，其中，所述探针包括导管，并且所述远侧端部被配置用于插入到所述活体受检者的心脏的腔室中。
3.根据权利要求1所述的系统，其中，所述探针的所述远侧端部包括柔性结构，在所述柔性结构上排列所述电极，并且所述量度指示所述柔性结构的不同部分与所述组织之间的接触。
4.根据权利要求3所述的系统，其中，所述结构包括多个柔性脊，所述电极沿所述多个柔性脊设置。
5.根据权利要求1所述的系统，其中，所述处理器被配置成将表示所述远侧端部的图形图标渲染到显示器，并且将所述远侧端部上的所述电极的相应位置处的所述量度的视觉指示结合到所述图形图标中。
6.根据权利要求5所述的系统，其中，所述量度由所述图形图标上的所述电极的所述相应位置的颜色编码表示。
7.根据权利要求1所述的系统，其中，所述量度指示由所述电极中的每个电极在所述时间段内从所述组织采集的有效信号的数量。
8.根据权利要求7所述的系统，其中，所述处理器被配置成将一个或多个过滤标准应用于所述信号，以便将从所述电极中的每个电极采集的所述信号的相应第一组分类为有效，同时将由所述电极中的每个电极采集的所述信号的相应第二组分类为无效。
9.根据权利要求1所述的系统，其中，所述量度指示所述时间段内的相应持续时间，在所述相应持续时间期间，所述电极中的每个电极与所述体腔中的所述组织接触。
10.根据权利要求9所述的系统，其中，所述信号指示所述组织内的电生理活动，并且其中所述处理器被配置成区分由与所述组织接触的所述电极采集的局部信号和由不与所述组织接触的所述电极采集的远场信号，并且响应于由所述电极中的每个电极在所述时间段内采集的所述局部信号和所述远场信号之间的关系来获取所述持续时间，在所述持续时间期间，所述电极中的每个电极与所述组织接触。
11.一种用于电生理测量的方法，包括：
将探针插入到活体受检者的体腔中，所述探针具有包括电极的阵列的远侧端部，所述电极沿所述远侧端部设置并且被配置成在所述体腔内的多个位置处接触组织；
在时间段内从所述体腔内的所述电极采集信号，在所述时间段期间，所述探针在所述体腔内移动；
响应于所述信号来计算量度，所述量度指示所述时间段内的所述电极中的每个电极与所述组织之间的相应接触质量；以及
将所述量度的指示输出给所述系统的用户。
12.根据权利要求11所述的方法，其中，所述探针包括导管，并且其中采集所述信号包括在所述受检者的心脏的腔室内移动所述导管的所述远侧端部。
13.根据权利要求11所述的方法，其中，所述探针的所述远侧端部包括柔性结构，在所述柔性结构上排列所述电极，并且所述量度指示所述柔性结构的不同部分与所述组织之间的接触。
14.根据权利要求13所述的方法，其中，所述结构包括多个柔性脊，所述电极沿所述多个柔性脊设置。
15.根据权利要求11所述的方法，其中，输出所述指示包括将表示所述远侧端部的图形图标渲染到显示器，并且将所述远侧端部上的所述电极的相应位置处的所述量度的视觉指示结合到所述图形图标中。
16.根据权利要求15所述的方法，其中，所述量度由所述图形图标上的所述电极的所述相应位置的颜色编码表示。
17.根据权利要求11所述的方法，其中，所述量度指示由所述电极中的每个电极在所述时间段内从所述组织采集的有效信号的数量。
18.根据权利要求17所述的方法，其中，计算所述量度包括将一个或多个过滤标准应用于所述信号，以便将从所述电极中的每个电极采集的所述信号的相应第一组分类为有效，同时将由所述电极中的每个电极采集的所述信号的相应第二组分类为无效。
19.根据权利要求11所述的方法，其中，所述量度指示所述时间段内的相应持续时间，在所述相应持续时间期间，所述电极中的每个电极与所述体腔中的所述组织接触。
20.根据权利要求19所述的方法，其中，所述信号指示所述组织内的电生理活动，并且其中计算所述量度包括区分由与所述组织接触的所述电极采集的局部信号和由不与所述组织接触的所述电极采集的远场信号，并且响应于由所述电极中的每个电极在所述时间段内采集的所述局部信号和所述远场信号之间的关系来获取所述持续时间，在所述持续时间期间，所述电极中的每个电极与所述组织接触。
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Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20230157616A1 (en) * 2021-11-22 2023-05-25 Biosense Webster (Israel) Ltd. Transient Event Identification
US11931095B1 (en) * 2023-01-12 2024-03-19 St. Jude Medical, Cardiology Division, Inc. Method and system for determining baseline electrode impedance for tissue contact detection
US11950833B1 (en) 2023-01-12 2024-04-09 St. Jude Medical, Cardiology Division, Inc. Method and system for detecting contact status using electrode
US11969261B1 (en) 2023-01-12 2024-04-30 St. Jude Medical, Cardiology Division, Inc. Method and system for modifying contact status of an electrode
US20240335169A1 (en) * 2023-03-31 2024-10-10 Biosense Webster (Israel) Ltd. Methods and systems for displaying quality profiles points in an electro-anatomical map

Family Cites Families (280)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6014590A (en) 1974-03-04 2000-01-11 Ep Technologies, Inc. Systems and methods employing structures having asymmetric mechanical properties to support diagnostic or therapeutic elements in contact with tissue in interior body regions
US5904680A (en) 1992-09-25 1999-05-18 Ep Technologies, Inc. Multiple electrode support structures having optimal bio-mechanical characteristics
US4699147A (en) 1985-09-25 1987-10-13 Cordis Corporation Intraventricular multielectrode cardial mapping probe and method for using same
US5365926A (en) 1986-11-14 1994-11-22 Desai Jawahar M Catheter for mapping and ablation and method therefor
US5215103A (en) 1986-11-14 1993-06-01 Desai Jawahar M Catheter for mapping and ablation and method therefor
US4940064A (en) 1986-11-14 1990-07-10 Desai Jawahar M Catheter for mapping and ablation and method therefor
US5465717A (en) 1991-02-15 1995-11-14 Cardiac Pathways Corporation Apparatus and Method for ventricular mapping and ablation
US5456254A (en) 1991-02-15 1995-10-10 Cardiac Pathways Corp Flexible strip assembly having insulating layer with conductive pads exposed through insulating layer and device utilizing the same
US5345936A (en) 1991-02-15 1994-09-13 Cardiac Pathways Corporation Apparatus with basket assembly for endocardial mapping
US5415166A (en) 1991-02-15 1995-05-16 Cardiac Pathways Corporation Endocardial mapping apparatus and cylindrical semiconductor device mounting structure for use therewith and method
US5383917A (en) 1991-07-05 1995-01-24 Jawahar M. Desai Device and method for multi-phase radio-frequency ablation
US5255679A (en) 1992-06-02 1993-10-26 Cardiac Pathways Corporation Endocardial catheter for mapping and/or ablation with an expandable basket structure having means for providing selective reinforcement and pressure sensing mechanism for use therewith, and method
US5324284A (en) 1992-06-05 1994-06-28 Cardiac Pathways, Inc. Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method
US5411025A (en) 1992-06-30 1995-05-02 Cordis Webster, Inc. Cardiovascular catheter with laterally stable basket-shaped electrode array
US5772590A (en) 1992-06-30 1998-06-30 Cordis Webster, Inc. Cardiovascular catheter with laterally stable basket-shaped electrode array with puller wire
US7189208B1 (en) 1992-09-23 2007-03-13 Endocardial Solutions, Inc. Method for measuring heart electrophysiology
USRE41334E1 (en) 1992-09-23 2010-05-11 St. Jude Medical, Atrial Fibrillation Division, Inc. Endocardial mapping system
US5313943A (en) 1992-09-25 1994-05-24 Ep Technologies, Inc. Catheters and methods for performing cardiac diagnosis and treatment
US5293869A (en) 1992-09-25 1994-03-15 Ep Technologies, Inc. Cardiac probe with dynamic support for maintaining constant surface contact during heart systole and diastole
US5309910A (en) 1992-09-25 1994-05-10 Ep Technologies, Inc. Cardiac mapping and ablation systems
EP0668740A4 (en) 1992-09-25 1998-10-07 Ep Technologies STRIP-SHAPED CARRIER FOR ELECTRODES FOR DIAGNOSTICS AND THERAPY OF HEART COMBUSTS.
US5549108A (en) 1992-09-25 1996-08-27 Ep Technologies, Inc. Cardiac mapping and ablation systems
US5725525A (en) 1993-03-16 1998-03-10 Ep Technologies, Inc. Multiple electrode support structures with integral hub and spline elements
US5823189A (en) 1993-03-16 1998-10-20 Ep Technologies, Inc. Multiple electrode support structures with spline elements and over-molded hub
US5476495A (en) 1993-03-16 1995-12-19 Ep Technologies, Inc. Cardiac mapping and ablation systems
US5893847A (en) 1993-03-16 1999-04-13 Ep Technologies, Inc. Multiple electrode support structures with slotted hub and hoop spline elements
WO1994021170A1 (en) 1993-03-16 1994-09-29 Ep Technologies, Inc. Flexible circuit assemblies employing ribbon cable
WO1994021169A1 (en) 1993-03-16 1994-09-29 Ep Technologies, Inc. Flexible interlaced multiple electrode assemblies
DE69423285D1 (de) 1993-04-07 2000-04-13 Cardiac Pathways Corp Vorrichtung zur aufzeichnung der räumlichen verteilung und zur ablation
IL116699A (en) 1996-01-08 2001-09-13 Biosense Ltd Method of building a heart map
US5396887A (en) 1993-09-23 1995-03-14 Cardiac Pathways Corporation Apparatus and method for detecting contact pressure
US5526810A (en) 1993-10-07 1996-06-18 Wang; Dai-Yuen Intraventricular mapping catheter
US5400783A (en) 1993-10-12 1995-03-28 Cardiac Pathways Corporation Endocardial mapping apparatus with rotatable arm and method
US5881727A (en) 1993-10-14 1999-03-16 Ep Technologies, Inc. Integrated cardiac mapping and ablation probe
WO1995010320A1 (en) 1993-10-15 1995-04-20 Ep Technologies, Inc. Device for lengthening cardiac conduction pathways
US5577509A (en) 1994-01-28 1996-11-26 Ep Technologies, Inc. Systems and methods for examining the electrical characteristics and timing of electrical events in cardiac tissue
WO1995020348A1 (en) 1994-01-28 1995-08-03 Ep Technologies, Inc. Matching electrical characteristics and propagation velocities to locate ablation sites
US6216043B1 (en) 1994-03-04 2001-04-10 Ep Technologies, Inc. Asymmetric multiple electrode support structures
US5911739A (en) 1994-03-04 1999-06-15 Ep Technologies, Inc. Structures for supporting diagnostic or therapeutic elements in internal body regions
US5968040A (en) 1994-03-04 1999-10-19 Ep Technologies, Inc. Systems and methods using asymmetric multiple electrode arrays
US5598848A (en) 1994-03-31 1997-02-04 Ep Technologies, Inc. Systems and methods for positioning multiple electrode structures in electrical contact with the myocardium
US5876336A (en) 1994-10-11 1999-03-02 Ep Technologies, Inc. Systems and methods for guiding movable electrode elements within multiple-electrode structure
US5722401A (en) 1994-10-19 1998-03-03 Cardiac Pathways Corporation Endocardial mapping and/or ablation catheter probe
IT1278369B1 (it) 1995-02-14 1997-11-20 Sorin Biomedica Cardio Spa Catetere, particolarmente per il trattamento di aritmie cardiache.
IT1278372B1 (it) 1995-02-15 1997-11-20 Sorin Biomedica Cardio Spa Catetere, particolarmente per il trattamento di aritmie cardiache.
US5609157A (en) 1995-02-17 1997-03-11 Ep Technologies, Inc. Systems and methods for analyzing biopotential morphologies in body tissue using iterative techniques
US5595183A (en) 1995-02-17 1997-01-21 Ep Technologies, Inc. Systems and methods for examining heart tissue employing multiple electrode structures and roving electrodes
ES2179183T3 (es) 1995-02-17 2003-01-16 Boston Scient Ltd Sistemas y metodos para efectuar mediciones, secuenciales en el tiempo, de episodios biologicos.
US5681280A (en) 1995-05-02 1997-10-28 Heart Rhythm Technologies, Inc. Catheter control system
WO1996034560A1 (en) 1995-05-02 1996-11-07 Heart Rhythm Technologies, Inc. Catheter with expandable probe
US5722403A (en) 1996-10-28 1998-03-03 Ep Technologies, Inc. Systems and methods using a porous electrode for ablating and visualizing interior tissue regions
US6014579A (en) 1997-07-21 2000-01-11 Cardiac Pathways Corp. Endocardial mapping catheter with movable electrode
US6428537B1 (en) 1998-05-22 2002-08-06 Scimed Life Systems, Inc. Electrophysiological treatment methods and apparatus employing high voltage pulse to render tissue temporarily unresponsive
US6119030A (en) 1998-06-22 2000-09-12 Ep Technologies, Inc. Silicone tip for multiple electrode basket assemblies
DE60032751T2 (de) 1999-04-05 2007-11-08 The Regents Of The University Of California, Oakland Endomyokardiale einphasige aktionspotentiale zum frühnachweis der myokardium pathologie
US6892091B1 (en) 2000-02-18 2005-05-10 Biosense, Inc. Catheter, method and apparatus for generating an electrical map of a chamber of the heart
DE60138880D1 (de) 2000-05-03 2009-07-16 Bard Inc C R Vorrichtung zur mehrdimensionalen darstellung und ablation bei elektrophysiologischen prozeduren
US6584345B2 (en) 2001-03-13 2003-06-24 Biosense, Inc. Apparatus and method for measuring a plurality of electrical signals from the body of a patient
US7255695B2 (en) 2001-04-27 2007-08-14 C.R. Bard, Inc. Systems and methods for three-dimensional mapping of electrical activity
US6748255B2 (en) 2001-12-14 2004-06-08 Biosense Webster, Inc. Basket catheter with multiple location sensors
US6741878B2 (en) 2001-12-14 2004-05-25 Biosense Webster, Inc. Basket catheter with improved expansion mechanism
US6980858B2 (en) 2001-12-31 2005-12-27 Biosense Webster, Inc. Method and system for atrial defibrillation
DE60315427T2 (de) 2002-03-15 2008-04-30 C.R. Bard, Inc. Apparat zur steuerung von ablationsenergie und elektrogrammaufnahme mittels einer vielzahl gemeinsamer elektroden in einem elektrophysiologie-katheter
US6866662B2 (en) 2002-07-23 2005-03-15 Biosense Webster, Inc. Ablation catheter having stabilizing array
US6780183B2 (en) 2002-09-16 2004-08-24 Biosense Webster, Inc. Ablation catheter having shape-changing balloon
EP2213257B1 (en) 2003-03-28 2013-04-24 C. R. Bard, Inc. Braided Mesh Catheter
CN1822795A (zh) 2003-07-11 2006-08-23 史蒂文·A·丹尼尔 生物组织的热切除
US8007495B2 (en) 2004-03-31 2011-08-30 Biosense Webster, Inc. Catheter for circumferential ablation at or near a pulmonary vein
US8567265B2 (en) 2006-06-09 2013-10-29 Endosense, SA Triaxial fiber optic force sensing catheter
US8048063B2 (en) 2006-06-09 2011-11-01 Endosense Sa Catheter having tri-axial force sensor
US7729752B2 (en) 2006-06-13 2010-06-01 Rhythmia Medical, Inc. Non-contact cardiac mapping, including resolution map
US7515954B2 (en) 2006-06-13 2009-04-07 Rhythmia Medical, Inc. Non-contact cardiac mapping, including moving catheter and multi-beat integration
US8517999B2 (en) 2007-04-04 2013-08-27 St. Jude Medical, Atrial Fibrillation Division, Inc. Irrigated catheter with improved fluid flow
WO2008141150A2 (en) 2007-05-09 2008-11-20 Irvine Biomedical, Inc. Basket catheter having multiple electrodes
US8906011B2 (en) 2007-11-16 2014-12-09 Kardium Inc. Medical device for use in bodily lumens, for example an atrium
WO2009072035A1 (en) 2007-12-06 2009-06-11 Koninklijke Philips Electronics N.V. Apparatus, a method and a computer program for applying energy to an object
US8103327B2 (en) 2007-12-28 2012-01-24 Rhythmia Medical, Inc. Cardiac mapping catheter
WO2009094588A2 (en) 2008-01-24 2009-07-30 Coherex Medical, Inc. Systems and methods for reduction of atrial fibrillation
JP5646492B2 (ja) 2008-10-07 2014-12-24 エムシー１０ インコーポレイテッドＭｃ１０，Ｉｎｃ． 伸縮可能な集積回路およびセンサアレイを有する装置
US9339331B2 (en) 2008-12-29 2016-05-17 St. Jude Medical, Atrial Fibrillation Division, Inc. Non-contact electrode basket catheters with irrigation
US8712550B2 (en) 2008-12-30 2014-04-29 Biosense Webster, Inc. Catheter with multiple electrode assemblies for use at or near tubular regions of the heart
US8167845B2 (en) 2009-06-02 2012-05-01 St. Jude Medical, Atrial Fibrillation Division, Inc. Catheter having distal sealing member
WO2011060339A1 (en) 2009-11-13 2011-05-19 St. Jude Medical, Inc. Assembly of staggered ablation elements
US20110245756A1 (en) 2009-12-03 2011-10-06 Rishi Arora Devices for material delivery, electroporation, sonoporation, and/or monitoring electrophysiological activity
US8560086B2 (en) 2010-12-02 2013-10-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Catheter electrode assemblies and methods of construction therefor
CA2764494A1 (en) 2011-01-21 2012-07-21 Kardium Inc. Enhanced medical device for use in bodily cavities, for example an atrium
US9486273B2 (en) 2011-01-21 2016-11-08 Kardium Inc. High-density electrode-based medical device system
CA2833610C (en) 2011-04-22 2015-01-27 Topera, Inc. Basket style cardiac mapping catheter having a flexible electrode assembly for detection of cardiac rhythm disorders
US20130030430A1 (en) 2011-07-29 2013-01-31 Stewart Mark T Intracardiac tools and methods for delivery of electroporation therapies
US9277960B2 (en) 2011-09-08 2016-03-08 Kardium Inc. Intra-cardiac mapping and ablating
US8498686B2 (en) 2011-10-04 2013-07-30 Biosense Webster (Israel), Ltd. Mapping catheter with spiral electrode assembly
WO2013052852A1 (en) 2011-10-07 2013-04-11 Boston Scientific Scimed, Inc. Methods and systems for detection and thermal treatment of lower urinary tract conditions
US20140350553A1 (en) 2011-11-21 2014-11-27 Denerve Inc. Renal artery ablation catheter and system
US9131980B2 (en) 2011-12-19 2015-09-15 Medtronic Advanced Energy Llc Electrosurgical devices
CN104135958B (zh) 2011-12-28 2017-05-03 波士顿科学西美德公司 用有聚合物消融元件的新消融导管调变神经的装置和方法
US8825130B2 (en) 2011-12-30 2014-09-02 St. Jude Medical, Atrial Fibrillation Division, Inc. Electrode support structure assemblies
EP2840996B1 (en) 2012-04-26 2019-03-20 Medtronic Ablation Frontiers LLC System for detecting tissue contact during ablation
US9883908B2 (en) 2012-05-02 2018-02-06 The Charlotte-Mecklenburg Hospital Authority Devices, systems, and methods for treating cardiac arrhythmias
US9693832B2 (en) 2012-05-21 2017-07-04 Kardium Inc. Systems and methods for selecting, activating, or selecting and activating transducers
US20140025069A1 (en) 2012-07-17 2014-01-23 Boston Scientific Scimed, Inc. Renal nerve modulation catheter design
US10314649B2 (en) 2012-08-02 2019-06-11 Ethicon Endo-Surgery, Inc. Flexible expandable electrode and method of intraluminal delivery of pulsed power
US9801681B2 (en) 2012-08-17 2017-10-31 Medtronic Ablation Frontiers Llc Catheters and methods for intracardiac electrical mapping
US9168004B2 (en) 2012-08-20 2015-10-27 Biosense Webster (Israel) Ltd. Machine learning in determining catheter electrode contact
EP3868283A1 (en) 2012-08-31 2021-08-25 Acutus Medical Inc. Catheter system for the heart
US20140180147A1 (en) 2012-12-20 2014-06-26 Boston Scientific Scimed, Inc. Estimating interspline distances on mapping catheters
EP2934288A1 (en) 2012-12-20 2015-10-28 Boston Scientific Scimed, Inc. Real-time feedback for electrode contact during mapping
US9681817B2 (en) 2012-12-20 2017-06-20 Boston Scientific Scimed, Inc. Suppression of global activation signals during anatomical mapping
CA2899311C (en) 2013-02-08 2021-05-11 Acutus Medical, Inc. Expandable catheter assembly with flexible printed circuit board (pcb) electrical pathways
US9474486B2 (en) 2013-03-08 2016-10-25 St. Jude Medical, Atrial Fibrillation Division, Inc. Basket for a multi-electrode array catheter
WO2014165062A1 (en) 2013-03-13 2014-10-09 Kardium, Inc. Detecting improper energy transmission configuration in medical device system
US9345540B2 (en) 2013-03-15 2016-05-24 Medtronic Ablation Frontiers Llc Contact specific RF therapy balloon
US10602947B2 (en) 2013-04-11 2020-03-31 Biosense Webster (Israel), Ltd. High density electrode structure
US10575743B2 (en) 2013-04-11 2020-03-03 Biosense Webster (Israel) Ltd. High electrode density basket catheter
US10350002B2 (en) 2013-04-25 2019-07-16 St. Jude Medical, Cardiology Division, Inc. Electrode assembly for catheter system
US20160113709A1 (en) 2013-06-05 2016-04-28 Tel Hashomer Medical Research Infrastructure And Services Ltd Myocardial ablation by irreversible electroporation
US9814618B2 (en) 2013-06-06 2017-11-14 Boston Scientific Scimed, Inc. Devices for delivering energy and related methods of use
US20150011991A1 (en) 2013-07-03 2015-01-08 St. Jude Medical, Cardiology Division, Inc. Electrode Assembly For Catheter System
US20150045863A1 (en) 2013-08-07 2015-02-12 Boston Scientific Scimed, Inc. Expandable electrodes and methods for treating tissues
US9204929B2 (en) 2013-09-16 2015-12-08 Biosense Webster (Israel) Ltd. Basket catheter with deflectable spine
US10687889B2 (en) 2013-10-11 2020-06-23 Biosense Webster (Israel) Ltd. Patient-specific pre-shaped cardiac catheter
US20150119878A1 (en) 2013-10-24 2015-04-30 St. Jude Medical, Cardiology Division, Inc. Electrode assembly having asymmetric electrode placement
CN105682597B (zh) 2013-11-07 2018-06-12 圣犹达医疗用品心脏病学部门有限公司 具有接触力感测尖端的医疗装置
JP6625980B2 (ja) 2013-11-29 2019-12-25 キャスアールエックス リミテッドＣａｔｈｒｘ Ｌｔｄ バスケットカテーテルおよびその製造方法
US10314648B2 (en) 2013-12-13 2019-06-11 The Trustees of the Universoty of Pennsylvania Coaxial ablation probe and method and system for real-time monitoring of ablation therapy
US9993160B2 (en) 2014-01-07 2018-06-12 Kardium Inc. Medical device including manipulable portion with connected elongate members
US9554718B2 (en) 2014-01-29 2017-01-31 Biosense Webster (Israel) Ltd. Double bipolar configuration for atrial fibrillation annotation
US9907609B2 (en) 2014-02-04 2018-03-06 Boston Scientific Scimed, Inc. Alternative placement of thermal sensors on bipolar electrode
CN105960200B (zh) 2014-02-25 2019-08-30 圣犹达医疗用品心脏病学部门有限公司 用于使用电生理性质来对心律失常源进行分类的系统和方法
US9986949B2 (en) 2014-03-05 2018-06-05 Biosense Webster (Israel) Ltd. Multi-arm catheter with signal transmission over braid wires
WO2015134248A1 (en) 2014-03-06 2015-09-11 Boston Scientific Scimed, Inc. Medical devices for mapping cardiac tissue and methods for displaying mapping data
US20150270634A1 (en) 2014-03-21 2015-09-24 St. Jude Medical, Cardiology Division, Inc. Electrode assembly for catheter system including struts having a non-uniform thickness
JP6336620B2 (ja) 2014-05-06 2018-06-06 セント・ジュード・メディカル，カーディオロジー・ディヴィジョン，インコーポレイテッド 電極支持構造アセンブリ
US9585588B2 (en) 2014-06-03 2017-03-07 Boston Scientific Scimed, Inc. Electrode assembly having an atraumatic distal tip
CN104257427A (zh) 2014-08-05 2015-01-07 上海魅丽纬叶医疗科技有限公司 具有瓣状支架结构的射频消融导管及其设备
WO2016039824A1 (en) 2014-09-12 2016-03-17 X-Rhythm, Llc Multi-electrode mapping catheter
WO2016044687A1 (en) 2014-09-18 2016-03-24 University Of Utah Research Foundation Cardiac mapping catheter
US9314208B1 (en) 2014-10-28 2016-04-19 Biosense Webster (Israel) Ltd. Basket catheter with microelectrode array distal tip
WO2016065464A1 (en) 2014-10-30 2016-05-06 Kardium Inc. Catheter system
US9662033B2 (en) 2014-12-31 2017-05-30 Biosense Webster (Israel) Ltd. System and method for visualizing electrophysiology data
US9782099B2 (en) 2014-12-31 2017-10-10 Biosense Webster (Israel) Ltd. Basket catheter with improved spine flexibility
US9833161B2 (en) 2015-02-09 2017-12-05 Biosense Webster (Israel) Ltd. Basket catheter with far-field electrode
WO2016168778A1 (en) 2015-04-17 2016-10-20 Boston Scientific Scimed Inc. Tissue diagnosis and treatment using electrodes and mini-electrodes
US20160338770A1 (en) 2015-05-19 2016-11-24 Biosense Webster (Israel) Ltd. Woven foldable catheter
US9895073B2 (en) 2015-07-29 2018-02-20 Biosense Webster (Israel) Ltd. Dual basket catheter
EP3331467A4 (en) 2015-08-06 2019-01-23 Apama Medical, Inc. MULTI FUNCTION ELECTRODE
US10492857B2 (en) 2015-08-06 2019-12-03 Boston Scientific Scimed Inc Deployment control apparatus for a catheter with a deployable array
US10376170B2 (en) 2015-08-10 2019-08-13 Boston Scientific Scimed, Inc. Catheter with annular lumen to provide distal flushing
US20170071543A1 (en) 2015-09-14 2017-03-16 Biosense Webster (Israel) Ltd. Convertible basket catheter
US10987045B2 (en) 2015-09-14 2021-04-27 Biosense Webster (Israel) Ltd. Basket catheter with individual spine control
US10130420B2 (en) 2015-10-08 2018-11-20 Biosense Webster (Israel) Ltd. Catheter with membraned spines for pulmonary vein isolation
EP4230133A1 (en) 2015-10-21 2023-08-23 Autonomix Medical, Inc. Controlled and precise treatment of cardiac tissues
US10758304B2 (en) 2015-12-07 2020-09-01 Biosense Webster (Israel) Ltd. Basket catheter with an improved seal
US9894756B2 (en) 2015-12-08 2018-02-13 Kardium Inc. Circuits for flexible structures
US10078713B2 (en) 2015-12-24 2018-09-18 Biosense Webster (Israel) Ltd. Global mapping catheter contact optimization
US10172673B2 (en) 2016-01-05 2019-01-08 Farapulse, Inc. Systems devices, and methods for delivery of pulsed electric field ablative energy to endocardial tissue
US10130423B1 (en) 2017-07-06 2018-11-20 Farapulse, Inc. Systems, devices, and methods for focal ablation
US10660702B2 (en) 2016-01-05 2020-05-26 Farapulse, Inc. Systems, devices, and methods for focal ablation
WO2019143960A1 (en) 2018-01-18 2019-07-25 Farapulse, Inc. Systems, devices, and methods for focal ablation
WO2020206328A1 (en) 2019-04-04 2020-10-08 Farapulse, Inc. Systems, devices, and methods for focal ablation
US10582894B2 (en) 2016-01-14 2020-03-10 Biosense Webster (Israel) Ltd. Region of interest rotational activity pattern detection
US10314505B2 (en) 2016-03-15 2019-06-11 Biosense Webster (Israel) Ltd. Asymmetric basket catheter
US10136828B2 (en) 2016-03-31 2018-11-27 Biosense Webster (Israel) Ltd. Mapping of atrial fibrillation
US10362991B2 (en) 2016-04-04 2019-07-30 Biosense Webster (Israel) Ltd. Convertible basket catheter
US20170296251A1 (en) 2016-04-13 2017-10-19 Biosense Webster (Israel) Ltd. Basket catheter with prestrained framework
US20170296260A1 (en) 2016-04-15 2017-10-19 Cook Medical Technologies Llc Ablation medical device with basket
US10842558B2 (en) 2016-05-02 2020-11-24 Affera, Inc. Catheter sensing and irrigating
US9974460B2 (en) 2016-05-06 2018-05-22 Biosense Webster (Israel) Ltd. Basket-shaped catheter with improved distal hub
US10772566B2 (en) 2016-05-17 2020-09-15 Biosense Weber (Israel) Ltd. Multi-electrode catheter spine and method of making the same
US10898139B2 (en) 2016-06-03 2021-01-26 Biosense Webster (Israel) Ltd. Spine construction for basket catheter
US20170354338A1 (en) 2016-06-09 2017-12-14 Biosense Webster (Israel) Ltd. Dual-function sensors for a basket catheter
US10905329B2 (en) 2016-06-09 2021-02-02 Biosense Webster (Israel) Ltd. Multi-function conducting elements for a catheter
US10349855B2 (en) 2016-06-10 2019-07-16 Biosense Webster (Israel) Ltd. Identification and visualization of cardiac activation sequence in multi-channel recordings
US10376221B2 (en) 2016-07-06 2019-08-13 Biosense Webster (Israel) Ltd. Automatic creation of multiple electroanatomic maps
KR20190055059A (ko) 2016-07-11 2019-05-22 레트로배스큘러, 아이엔씨. 양극성 조직 절체 장치 및 이의 사용 방법
US20180085064A1 (en) 2016-09-29 2018-03-29 Biosense Webster (Israel) Ltd. Basket catheter conforming to organ using strain-relief elements
US10314507B2 (en) 2016-11-14 2019-06-11 Biosense Webster (Israel) Ltd. ASIC with switching noise reduction
US10403053B2 (en) 2016-11-15 2019-09-03 Biosense Webster (Israel) Ltd. Marking sparse areas on maps
US11129574B2 (en) 2016-12-12 2021-09-28 Biosense Webster (Israel) Ltd. Real time electroanatomical coloring of the heart
US10918306B2 (en) 2016-12-13 2021-02-16 Biosense Webster (Israel) Ltd. Catheter splines with embedded circuit elements
CN114052885A (zh) 2016-12-15 2022-02-18 圣犹达医疗用品心脏病学部门有限公司 肺静脉隔离球囊导管
US20180168511A1 (en) 2016-12-19 2018-06-21 Boston Scientific Scimed Inc. Distally-facing electrode array with longitudinally mounted splines
US20180184982A1 (en) 2017-01-05 2018-07-05 Biosense Webster (Israel) Ltd. Hybrid balloon basket catheter
US20180192958A1 (en) 2017-01-06 2018-07-12 Biosense Webster (Israel) Ltd. Multi-electrode assembly with controlled folding mechanism
EP3534816B1 (en) 2017-01-06 2021-12-08 St. Jude Medical, Cardiology Division, Inc. Pulmonary vein isolation balloon catheter
US11246534B2 (en) 2017-01-23 2022-02-15 Biosense Webster (Israel) Ltd. Basket catheter made from flexible circuit board with mechanical strengthening
US20180235692A1 (en) 2017-02-01 2018-08-23 The George Washington University High resolution multi-function and conformal electronics device for diagnosis and treatment of cardiac arrhythmias
US10617317B2 (en) * 2017-02-27 2020-04-14 Biosense Webster (Israel) Ltd. Highlighting an electrode image according to an electrode signal
DE102017001971A1 (de) 2017-03-01 2018-09-06 Peter Osypka Stiftung Stiftung des bürgerlichen Rechts Multi-Elektrodenanordnung
US11116450B2 (en) 2017-03-09 2021-09-14 Biosense Webster (Israel) Ltd. Electrode assembly having spines with controlled flexibility
US10014607B1 (en) 2017-03-13 2018-07-03 Bionsense Webster (Israel) Ltd. PCB sub-connectors
US10765371B2 (en) 2017-03-31 2020-09-08 Biosense Webster (Israel) Ltd. Method to project a two dimensional image/photo onto a 3D reconstruction, such as an epicardial view of heart
US11497550B2 (en) 2017-04-10 2022-11-15 St. Jude Medical, Cardiology Division, Inc. Electroporation system and method of energizing a catheter
WO2018187856A1 (en) 2017-04-12 2018-10-18 Kardium Inc. Medical device systems and methods including helically configured or twisted, non-helically configured elongate members
US20180310987A1 (en) 2017-04-27 2018-11-01 Biosense Webster (Israel) Ltd. Systems and processes for map-guided automatic cardiac ablation
US10617867B2 (en) 2017-04-28 2020-04-14 Farapulse, Inc. Systems, devices, and methods for delivery of pulsed electric field ablative energy to esophageal tissue
US12029545B2 (en) 2017-05-30 2024-07-09 Biosense Webster (Israel) Ltd. Catheter splines as location sensors
WO2018226761A1 (en) 2017-06-06 2018-12-13 Cardiac Pacemakers, Inc. Ablation delivery using a catheter having a semi-permeable inflatable balloon structure
US20180360534A1 (en) 2017-06-19 2018-12-20 St. Jude Medical, Cardiology Division, Inc. Apparatuses and methods for high-density sensing and ablation during a medical procedure
US10952795B2 (en) 2017-06-30 2021-03-23 Biosense Webster (Israel) Ltd. System and method for glass state view in real-time three-dimensional (3D) cardiac imaging
CN107329621B (zh) * 2017-07-04 2019-07-26 京东方科技集团股份有限公司 触控面板及其驱动方法和触控装置
US11666379B2 (en) 2017-07-06 2023-06-06 Biosense Webster (Israel) Ltd. Temperature controlled short duration ablation with multiple electrodes
US11109788B2 (en) 2017-07-17 2021-09-07 Biosense Webster (Israel) Ltd. Catheter with Fibonacci distributed electrodes
US11052246B2 (en) 2017-07-28 2021-07-06 Medtronic, Inc. Expandable elements for delivery of electric fields
US11304603B2 (en) 2017-08-21 2022-04-19 Biosense Webster (Israel) Ltd. Advanced current location (ACL) automatic map rotation to detect holes in current position map (CPM) mapping
US10682181B2 (en) 2017-09-06 2020-06-16 Biosense Webster (Israel) Ltd. Methods and systems for modeling and registration of 3-dimensional images of the heart
CN111065327B (zh) 2017-09-12 2023-01-06 波士顿科学医学有限公司 用于心室局灶性消融的系统、设备和方法
US10441188B2 (en) 2017-09-12 2019-10-15 Biosense Webster (Israel) Ltd. Automatic display of earliest LAT point
US11969197B2 (en) 2017-10-13 2024-04-30 Mayo Foundation For Medical Education And Research Methods and devices for electroporation for treatment of ventricular fibrillation
EP4360572A1 (en) 2017-10-13 2024-05-01 St. Jude Medical, Cardiology Division, Inc. Catheter with high-density mapping electrodes
US10398348B2 (en) 2017-10-19 2019-09-03 Biosense Webster (Israel) Ltd. Baseline impedance maps for tissue proximity indications
US10959784B2 (en) 2017-10-24 2021-03-30 Biosense Webster (Israel) Ltd. Determining balloon catheter contact with anatomy using ultrasound
EP4279004A3 (en) 2017-10-26 2024-01-03 Boston Scientific Scimed, Inc. Use of electromagnetic fields in ire device delivery and therapy monitoring
WO2019084442A1 (en) 2017-10-27 2019-05-02 St. Jude Medical, Cardiology Division, Inc. PULMONARY VEIN ISOLATION BALLOON CATHETER
US10881376B2 (en) 2017-11-08 2021-01-05 Biosense Webster (Israel) Ltd. System and method for providing auditory guidance in medical systems
US11295835B2 (en) 2017-11-27 2022-04-05 Biosense Webster (Israel) Ltd. System and method for interactive event timeline
US11612334B2 (en) 2017-12-19 2023-03-28 St. Jude Medical, Cardiology Division, Inc. Methods of assessing contact between an electrode and tissue using complex impedance measurements
US11164371B2 (en) 2017-12-20 2021-11-02 Biosense Webster (Israel) Ltd. Marking a computerized model of a cardiac surface
CN118383863A (zh) 2017-12-26 2024-07-26 盖能适治疗股份有限公司 用于各种应用的能量输送的优化
US11517715B2 (en) 2018-01-02 2022-12-06 Biosense Webster (Israel) Ltd. Deflectable medical probe
US10973461B2 (en) 2018-01-10 2021-04-13 Biosense Webster (Israel) Ltd. Mapping of intra-body cavity using a distributed ultrasound array on basket catheter
US11147496B2 (en) 2018-01-16 2021-10-19 Boston Scientific Scimed Inc. Systems and methods for mapping electrical activity in the heart
US20190216347A1 (en) 2018-01-16 2019-07-18 Boston Scientific Scimed Inc. Systems and methods for activation mapping of the heart without the use of a reference catheter
US20190314083A1 (en) 2018-04-11 2019-10-17 Biosense Webster (Israel) Ltd. Flexible Multi-Arm Catheter with Diametrically Opposed Sensing Electrodes
US11642165B2 (en) 2018-06-29 2023-05-09 Biosense Webster (Israel) Ltd. Catheter with mechanically expandable element having flex circuit
US10912484B2 (en) 2018-07-09 2021-02-09 Biosense Webster (Israel) Ltd. Multiplexing of high count electrode catheter(s)
US20200022653A1 (en) 2018-07-20 2020-01-23 Kardium Inc. Systems and methods for facilitating improved transducer-to-tissue contact
US11690551B2 (en) 2018-07-30 2023-07-04 Biosense Webster (Israel) Ltd. Left atrium shape reconstruction from sparse location measurements using neural networks
JP2020018606A (ja) 2018-08-01 2020-02-06 テルモ株式会社 医療デバイス
US11241281B2 (en) 2018-08-13 2022-02-08 Biosense Webster (Israel) Ltd. Estimation of electrode-tissue contact using oscillator at common ground of electrocardiogram (ECG) system
WO2020039392A2 (en) 2018-08-23 2020-02-27 St. Jude Medical, Cardiology Division, Inc. Curved high density electrode mapping catheter
WO2020061359A1 (en) 2018-09-20 2020-03-26 Farapulse, Inc. Systems, apparatuses, and methods for delivery of pulsed electric field ablative energy to endocardial tissue
US11596324B2 (en) 2018-10-25 2023-03-07 Biosense Webster (Israel) Ltd. Combined active current location (ACL) and tissue proximity indication (TPI) system
US11452484B2 (en) 2018-10-25 2022-09-27 Biosense Webster (Israel) Ltd. Electrodes on double-sided printed circuit board (PCB) to cancel far-held signal
US11660050B2 (en) 2018-10-25 2023-05-30 Biosense Webster (Israel) Ltd Balloon catheter with diagnostic electrodes, far field electrodes, and guidewire
US11045628B2 (en) 2018-12-11 2021-06-29 Biosense Webster (Israel) Ltd. Balloon catheter with high articulation
US11672952B2 (en) 2018-12-28 2023-06-13 Biosense Webster (Israel) Ltd. Finding elongation of expandable distal end of catheter
US20200205737A1 (en) 2018-12-28 2020-07-02 Biosense Webster (Israel) Ltd. Flexible Nested Sensing Electrodes
US11826088B2 (en) 2018-12-28 2023-11-28 Biosense Webster (Israel) Ltd. Adjusting phases of multiphase ablation generator to detect contact
US11207016B2 (en) 2018-12-28 2021-12-28 Biosense Webster (Israel) Ltd. Mapping ECG signals using a multipole electrode assembly
CN113853175A (zh) 2019-03-18 2021-12-28 伯恩森斯韦伯斯特(以色列)有限责任公司 用于心律失常诊断的电极构型
US11426126B2 (en) 2019-05-23 2022-08-30 Biosense Webster (Israel) Ltd. Indicating electrode contact
US20210015549A1 (en) 2019-05-29 2021-01-21 Sirona Medical Technologies, Inc. Ablation lesion quality
US11504042B2 (en) 2019-06-19 2022-11-22 Biosense Webster (Israel) Ltd. Extension of electrocardiography (ECG) acquisition capabilities of catheter-based cardiac system
US11712172B2 (en) 2019-07-18 2023-08-01 Biosense Webster (Israel) Ltd. Visual guidance for positioning a distal end of a medical probe
US11259751B2 (en) 2019-07-22 2022-03-01 Biosense Webster (Isreal) Ltd. Recording apparatus and method for noise reduction
US12114918B2 (en) 2019-08-15 2024-10-15 Biosense Webster (Israel) Ltd. Dynamic ablation and sensing according to contact of segmented electrodes
US20210059549A1 (en) 2019-08-26 2021-03-04 Biosense Webster (Israel) Ltd. Error estimation of local activation times (lat) measured by multiple electrode catheter
US11116435B2 (en) 2019-08-26 2021-09-14 Biosense Webster (Israel) Ltd. Automatic identification of a location of focal source in atrial fibrillation (AF)
US20210059743A1 (en) 2019-08-27 2021-03-04 Biosense Webster (Israel) Ltd. Estimation of Electrode-Tissue Contact Using Stem and Edge Electrodes
US11759150B2 (en) 2019-08-27 2023-09-19 Biosense Webster (Israel) Ltd. Accurate basket catheter tracking
CN114040722A (zh) 2019-08-29 2022-02-11 圣犹达医疗用品心脏病学部门有限公司 包括密封电极尖端组件的力传感导管及其组装方法
US20210082157A1 (en) 2019-09-12 2021-03-18 Biosense Webster (Israel) Ltd. Graphical user interface for an ablation system
US20210077184A1 (en) 2019-09-16 2021-03-18 Biosense Webster (Israel) Ltd. Catheter with thin-film electrodes on expandable membrane
US20210085215A1 (en) 2019-09-22 2021-03-25 Biosense Webster (Israel) Ltd. Ecg-based cardiac wall thickness estimation
US20210085387A1 (en) 2019-09-22 2021-03-25 Biosense Webster (Israel) Ltd. Guiding cardiac ablation using machine learning (ml)
US20210085204A1 (en) 2019-09-24 2021-03-25 Biosense Webster (Israel) Ltd. 3d intracardiac activity presentation
US11432754B2 (en) 2019-09-24 2022-09-06 Biosense Webster (Israel) Ltd. Intracardiac electrocardiogram presentation
US20210093374A1 (en) 2019-09-26 2021-04-01 Biosense Webster (Israel) Ltd. Wiring for Multi-Electrode Catheter
US11937975B2 (en) 2019-09-30 2024-03-26 Biosense Webster (Israel) Ltd. Multi-frequency mapping catheter and method of mapping
US11633229B2 (en) 2019-10-07 2023-04-25 Biosense Webster (Israel) Ltd. 3D electrical activity representation
US11541212B2 (en) 2019-10-18 2023-01-03 Biosense Wester (Israel) Ltd. Verifying proper withdrawal of catheter into sheath
US11366991B2 (en) 2019-11-05 2022-06-21 Biosense Webster (Israel) Ltd Optimizing mapping of ECG signals retrospectively by detecting inconsistency
US20210127999A1 (en) 2019-11-05 2021-05-06 Biosense Webster (Israel) Ltd. Using Statistical Characteristics of Multiple Grouped ECG Signals to Detect Inconsistent Signals
US11931182B2 (en) 2019-12-09 2024-03-19 Biosense Webster (Israel) Ltd. Catheter with plurality of sensing electrodes used as ablation electrode
US20210169568A1 (en) 2019-12-09 2021-06-10 Biosense Webster (Israel) Ltd. Oriented irreversible-electroporation (ire) pulses to compensate for cell size and orientation
US12042216B2 (en) 2019-12-09 2024-07-23 Biosense Webster (Israel) Ltd. Irreversible-electroporation (IRE) balloon catheter with membrane-insulated high-voltage balloon wires
US11950930B2 (en) 2019-12-12 2024-04-09 Biosense Webster (Israel) Ltd. Multi-dimensional acquisition of bipolar signals from a catheter
US11684302B2 (en) 2019-12-13 2023-06-27 Biosense Webster (Israel) Ltd. Automated graphical presentation of electrophysiological parameters
US11040208B1 (en) 2019-12-17 2021-06-22 Biosense Webster (Israel) Ltd. Distributed cardiac pacing system
US12029862B2 (en) 2019-12-20 2024-07-09 Biosense Webster (Israel) Ltd. Expandable assembly catheter
US11517218B2 (en) 2019-12-20 2022-12-06 Biosense Webster (Israel) Ltd. Selective graphical presentation of electrophysiological parameters
US11006902B1 (en) 2019-12-23 2021-05-18 Biosense Webster (Israel) Ltd. GUI for selective operation of multi-electrode catheters
US11484367B2 (en) 2019-12-27 2022-11-01 Biosense Webster (Israel) Ltd. Device and method of determining location of sheath using electromagnetic sensors on sheath
US20210196372A1 (en) 2019-12-31 2021-07-01 Biosense Webster (Israel) Ltd. Using irrigation on irreversible-electroporation (ire) electrodes to prevent arcing
US11730414B2 (en) 2020-01-21 2023-08-22 Biosense Webster (Israel) Ltd. Automatic pattern acquisition
US20210278936A1 (en) 2020-03-09 2021-09-09 Biosense Webster (Israel) Ltd. Electrophysiological user interface
US11497427B2 (en) 2020-03-12 2022-11-15 Biosense Webster (Israel) Ltd. Adjusting annotation points in real time
US20210307815A1 (en) 2020-04-07 2021-10-07 Biosense Webster (Israel) Ltd. Basket Catheter with Solid Conducting Spines as Electrodes for IRE
US11553961B2 (en) 2020-04-30 2023-01-17 Biosense Webster (Israel) Ltd. Catheter with stretchable irrigation tube
US20220047220A1 (en) 2020-08-17 2022-02-17 Biosense Webster (Israel) Ltd. Real-time assessment of rejection filters during cardiac mapping

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