Biosense Webster (israel) Ltd.

Biosense Webster, Inc.

Assaf Pressman

Roy Urman

Shmuel Auerbach

Yaniv Ben Zriham

Meir Bar-Tal

Richard P M Houben

Shiran Eliyahu

Dror Berman

Daniel Osadchy

Eliahu Zino

Alaa Zoubi

Konstantin Feldman

Shmuel Cohen

Assaf Govari

Andres Claudio Altmann

Lior Zar

Avigdor Rosenberg

Oshrat Ben Zaken

Shaul Haim Raz

Richard P Houben

Noam Igra

Richard PM Houben

A tool positioning system for use in a medical procedure is provided which includes a medical tool configured to be navigated to a target tool location within a portion of an organ of a patient. The medical tool includes a sheath having a tube defined by a sheath wall, the sheath extending a length in a proximal-distal direction and an inflatable balloon coupled to the sheath and configured to move along the length of the sheath in the proximal-distal direction. When the inflatable balloon is inflated at a target balloon location along the length of the sheath, the inflated balloon is fixed at the target balloon location. The tool positioning system also includes memory configured to store location of the tool in a three dimensional (3D) space and at least one processor configured to generate mapping information for displaying locations of the tool in the 3D space.

Adjustable balloon fixation for a sheath

Described herein is a method and system for gap detection in ablation lines. Microelectrodes are implemented at a distal tip of a catheter to provide localized gap detection along an ablation line. A pacing protocol is used to sequence through each of the microelectrode pairs for a tissue location. If living tissue is present, the pacing signal travels through the living tissue to pulse the heart. An operator will see a capture signal and know that there is a gap in the ablation line. The ablation electrode is then used to ablate the tissue in the gap. Pacing and ablation are therefore performed at the same place without the need to switch between instruments and/or catheters. In an implementation, a force sensor can automate the pacing protocol by determining which microelectrode pair is contacting the tissue. Moreover, signaling between microelectrode pairs can determine contact between the catheter and the tissue.

Method and system for gap detection in ablation lines

Catheterization of the heart is carried out by inserting a probe having electrodes into a heart of a living subject, recording a bipolar electrogram and a unipolar electrogram from one of the electrodes at a location in the heart, and defining a window of interest wherein a rate of change in a potential of the bipolar electrogram exceeds a predetermined value. An annotation is established in the unipolar electrogram, wherein the annotation denotes a maximum rate of change in a potential of the unipolar electrogram within the window of interest. A quality value is assigned to the annotation, and a 3-dimensional map is generated of a portion of the heart that includes the annotation and the quality value thereof.

Double bipolar configuration for atrial fibrillation annotation

A method, including calculating locations of first sensors attached to a probe that has been inserted into a human patient, and calculating positions of second sensors attached to a sheath via which the probe is inserted. The method also includes calculating respective shapes of the probe and the sheath, to achieve a best fit to the calculated probe sensor locations and sheath sensor positions, while restricting the probe to pass through the sheath. The calculated respective shapes of the probe and the sheath are used to present an image of the sheath aligned with the probe.

Registering probe and sheath images on a display

A method, including recording parameters indicative of a quality of ablation performed at one or more sites in a region of a human heart, and receiving a set of electrophysiological signals indicative of a wave of electrical activation flowing through the region. The method further includes identifying locations within the region at which the wave is blocked from flowing and estimating confidence levels with respect to a blockage of the wave at the locations in response to the signals and the parameters. The method also includes displaying a map of the human heart including an indication of the confidence levels.

Wavefront analysis based on ablation parameters

Described embodiments include apparatus for use with a catheter. The apparatus includes a sheath configured for insertion into a body of a subject, and a sensor, coupled to the sheath, configured to detect an electric current passing through the catheter, when the catheter passes through the sheath and into the body of the subject. Other embodiments are also described.

Sensor for facilitating catheter visualization

Described embodiments include an apparatus that includes an electrical interface and a processor. The processor is configured to receive, via the electrical interface, a temperature sensed by a temperature sensor at a distal end of an intrabody probe, to estimate a temperature of tissue of a subject, based on the sensed temperature and a parameter of an ablating current driven, by an ablation electrode at the distal end of the intrabody probe, into the tissue, and to generate an output in response to the estimated temperature. Other embodiments are also described.

Estimating a temperature during ablation

Catheterization is carried out by inserting a sheath into a human patient and moving a catheter having an electrode through the sheath lumen. A variation between a first threshold value and a second threshold value in electrical current through the electrode is identified. Responsively to the variation, it is reported that a portion of the catheter has transitioned between an in-sheath condition and an out-of-sheath condition. The sheath is defined and identified by the historical data of the readings of the magnetic sensor during its movements.

Sheath visualization method by means of impedance localization and magnetic information

Apparatus, including a flexible insertion tube, having a distal segment that is configured to be inserted into a body organ. A plurality of elastic branches are connected to the distal segment of the insertion tube at different, respective locations and extend transversely away from the insertion tube at the respective locations. There are one or more respective electrodes disposed on each of the elastic branches and there are conductors traversing the elastic branches so as to couple the electrodes to the insertion tube.

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Pardes Hanna-Karkur, Israel

Assaf Pressman