Biosense Webster (israel) Ltd.

Biosense Webster, Inc.

Dror Berman

Assaf Pressman

Natan Sharon Katz

Benjamin Cohen

Lior Zar

Assaf Govari

Andres Claudio Altmann

Meir Bar-Tal

Avigdor Rosenberg

Eliahu Zino

Tal Haim Bar-on

Gil Zigelman

Oshrat Ben Zaken

Shaul Haim Raz

Tamir Demri

Ran Glazer

Tal Haim Bar-On

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

As part of a real-time three-dimensional (3D) cardiac imaging system and method, anatomical data of a cardiac structure may be acquired and a 3D model of the cardiac structure may be generated. Visual data relevant to a cardiac procedure may be generated, such as location and orientation of a catheter, tags, points, color-coded temperature information, and/or color-coded local activation times (LAT) for the cardiac structure. The visual data superimposed on the 3D model of the cardiac structure may be visually displayed on a visual display device. A glass state view may be generated by generating a modified set of the visual data that includes removing at least a portion of the visual data that obscures a view of an anatomical feature of interest and/or the catheter, and adding edge enhancement to the cardiac structure. The glass state view may be requested to be visually displayed on the visual display device.

System and method for glass state view in real-time three-dimensional (3D) cardiac imaging

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

Cardiac catheterization is carried out by inserting a multi-electrode probe into a heart of a living subject, preparing a current position map of the electrodes to define respective locations of the electrodes, and recording electrograms from the electrodes. Activation times are annotated at the respective locations by analysis of the electrograms and generating an activation map. A region of the activation map is selected and earliest ones of the activation times in the selected region identified. The earliest activation times are graphically indicated.

Automatic display of earliest LAT point

A coordinate system registration module, including radiopaque elements arranged in a fixed predetermined pattern and configured, in response to the radiopaque elements generating a fluoroscopic image, to define a position of the module in a fluoroscopic coordinate system of reference. The module further includes one or more connections configured to fixedly connect the module to a magnetic field transmission pad at a predetermined location and orientation with respect to the pad, so as to characterize the position of the registration module in a magnetic coordinate system of reference defined by the magnetic field transmission pad.

Integration between 3D maps and fluoroscopic images

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

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Haifa, Israel

Dror Berman