Navix International Limited

Spectrum Dynamics LLC

Biosensors International Group, Ltd.

Spectrum Dynamics Medical Limited

International Business Machines Corporation

Eli Dichterman

Shlomo Ben-Haim

Yitzhack Schwartz

Benny Rousso

Ran Ravhon

Omer Ziv

Michael Nagler

Yizhaq Shmayahu

Yoel Zilberstein

Nathaniel Roth

Zalman Ibragimov

Simona Ben-Haim

Leonid Gluhovsky

Haim Zvi Melman

Dalia Dickman

Zohar Bronshtine

Shankar Vallabhajosula

Yehonatan Ben David

Daniel Berman

Ziv Popper

Nir Weissberg

Yaara Yarden

Yoel Zilberstien

Haim Rodriguez

Adi Rabinovich

Ilan Beer

Yaron Wolfsthal

Shoham Ben-David

Yossi Malka

Anna Gringauze

Shlomo Ben-haim

In some embodiments, a body cavity shape of a subject is reconstructed based on intrabody measurements of voltages by an intrabody probe (for example, a catheter probe) moving within a plurality of differently-oriented electromagnetic fields crossing the body cavity. In some embodiments, the method uses distances between electrodes as a spatially calibrated ruler. Positions of measurements made with the intrabody probe in different positions are optionally related by using spatial coherence of the measured electromagnetic fields as a constraint. Optionally, reconstruction is performed without using a detailed reference (image or simulation) describing the body cavity shape. Optionally, reconstruction uses further information to refine and/or constrain the reconstruction; for example: images, simulations, additional electromagnetic fields, and/or measurements characteristic of body cavity landmarks. Optionally, reconstruction accounts for time-dependent cavity shape changes, for example, phasic changes (e.g., heartbeat and/or respiration), and/or changes in states such as subject hydration, edema, and/or heart rate.

Systems and methods for reconstruction of intra-body electrical readings to anatomical structure

Devices and methods for assessing tissue contact based on dielectric properties and/or impedance sensing are disclosed. In some embodiments, one or more probing frequencies are delivered via electrodes including an electrode in proximity to a tissue (for example, myocardial tissue). In some embodiments, dielectric parameter values, optionally together with other known and/or estimated tissue characteristics, are measured to determine a contact quality with the tissue. In some embodiments, dielectric contact quality is used, for example, in guiding the formation of a lesion (for example, RF ablation of heart tissue to alter electrical transmission characteristics).

Contact quality assessment by dielectric property analysis

Devices and methods for tissue lesion assessment and/or creation based on dielectric properties are disclosed. In some embodiments, one or more probing frequencies are delivered via electrodes including an electrode in proximity to a tissue (for example, myocardial tissue). Measured dielectric properties (such as impedance properties), optionally together with other known and/or estimated tissue characteristics, are used to determine the lesion state of the tissue. In some embodiments, a developing lesion state is monitored during treatment formation of a lesion (for example, ablation of heart tissue to alter electrical transmission characteristics).

Lesion assessment by dielectric property analysis

Methods for creation and use (e.g., for navigation) of displays of flattened (e.g., curvature-straightened) 3-D reconstructions of tissue surfaces, optionally including reconstructions of the interior surfaces of hollow organs. In some embodiments, data comprising a 3-D representation of a tissue surface (for example an interior heart chamber surface) are subject to a geometrical transformation allowing the tissue surface to be presented substantially within a single view of a flattened reconstruction. In some embodiments, a catheter probe in use near the tissue surface is shown in positions that correspond to positions in 3-D space sufficiently to permit navigation; e.g., the probe is shown in flattened reconstruction views nearby view regions corresponding to regions it actually approaches. In some embodiments, automatic and/or easily triggered manual view switching between flattened reconstruction and source reconstruction views is implemented.

Flattened view for intra-lumenal navigation

There is provided a method of displaying a pre-acquired three dimensional (3D) image of at least a portion of an organ of a patient, the method comprising: receiving a plurality of electrical readings, each from a different electrode mounted on a catheter inside the portion of the organ of the patient, wherein the electrodes are mounted on the catheter at known distances from each other, transforming the plurality of electrical readings to a corresponding plurality of image points using a mapping transformation that transforms each electrical reading of the catheter from inside the portion of the organ of the patient to an anatomically corresponding image point in the 3D image based on the known distances, and displaying the 3D image with a marking of at least one of the plurality of image points.

Systems and methods for registration of intra-body electrical readings with a pre-acquired three dimensional image

Systems and methods are described for planning of catheter ablation procedures, and in particular for planning of the placement of lesions and/or parameters used in ablation. In some embodiments, planning is based on thermal and/or dielectric simulation of lesions, individualized to the anatomy of the particular patient. Optionally, a plan comprises planning of a path along which an ablation lesion is to be formed, the ablation lesion optionally comprising one or more sub-lesions. The plan is optionally optimized for one or more criteria including, for example: minimization of path length, minimization of sub-lesion number, simplification of catheter maneuvering, avoidance of collateral damage to non-target tissue, access to the target dependent on anatomy shape and/or catheter mechanics, and/or features of the target anatomy such as tissue wall thickness and/or fiber direction.

Calculation of an ablation plan

Methods for estimating of the effectiveness of catheter ablation procedures to form lesions, and particular lesions which together form an ablation segment of an ablation line. Lesion effectiveness parameters are received, and effectiveness, optionally the joint effectiveness, of corresponding ablations (optionally planned, current, and/or already performed) is estimated. In some embodiments, estimating is based on use by computer circuitry of an estimator constructed based on observed associations between previously analyzed lesion effectiveness parameters, and observed lesion effectiveness. Additionally or alternatively, estimators may be constructed based on analytic functions. The estimator is used by application to the received lesion effectiveness parameters.

Estimation of effectiveness of ablation adjacency

A method of reconstructing a shape of a volume of a part of a subject based on intrabody measurements of a plurality of crossing electromagnetic fields established within the volume, the method including:

Reconstruction of an anatomical structure from intrabody measurements

Methods for estimating of the effectiveness of catheter ablation procedures to form lesions. Lesion effectiveness parameters are received, and effectiveness of a corresponding ablation (optionally planned, current, and/or already performed) is estimated. The estimating is based on use by computer circuitry of an estimator constructed based on observed associations between previously analyzed lesion effectiveness parameters, and observed lesion effectiveness. The estimator is used by application to the received lesion effectiveness parameters.

Estimators for ablation effectiveness

There is provided a computerized method of tracking a position of an intra-body catheter, comprising: physically tracking coordinates of the position of a distal portion of a physical catheter within the physical body portion of the patient according to physically applied plurality of electrical fields within the body portion and measurements of the plurality of electrical fields performed by a plurality of physical electrodes at a distal portion of the physical catheter; registering the physically tracked coordinates with simulated coordinates generated according to a simulation of a simulated catheter within a simulation of the body of the patient, to identify differences between physically tracked location coordinates and the simulation coordinates; correcting the physically tracked location coordinates according to the registered simulation coordinates; and providing the corrected physically tracked location coordinates for presentation.

Systems and methods for tracking an intrabody catheter

In some embodiments, a body cavity shape of a subject is reconstructed based on intrabody measurements of at least one property of an electromagnetic field by an intrabody probe (for example, a catheter probe) moving within a plurality of electrical fields intersecting the body cavity. In some embodiments, the electrical fields are generated at least in part from electrodes positioned in close proximity, for example, within 1 cm, of the body cavity. In some embodiments, the body cavity is a chamber of a heart (for example, a left atrium or left ventricle), and the electrodes used to generate the electrical field are positioned in the coronary sinus, a large vein occupying the groove between the left atrium and left ventricle. In some embodiments, known distances between measuring electrodes are used in guiding reconstruction, potentially overcoming difficulties of reconstruction from measurements of non-linear electrical fields.

Coronary sinus-based electromagnetic mapping

Registration of catheter-sensed intrabody voltage field measurements obtained along one or more tracks of catheter advance of withdrawal is made, in some embodiments, to reference voltage field measurements lying along predetermined tracks. Tracks optionally comprise the course of a blood vessel such as the superior or inferior vena cava, a path defined and/or limited by encounters with a wall of a heart chamber and/or apertures thereof, and/or another track of catheter motion. In some embodiments, transform parameters are propagated to regions away from the track, potentially allowing more rapid acquisition of targets.

Characteristic track catheter navigation

A method of estimating a spatial relationship between at least a part of a patient esophagus and a heart chamber, including: measuring at least one electric parameter at one or more positions within the heart chamber to obtain measured values; and estimating the spatial relationship based on the measured values.

Esophagus position detection by electrical mapping

A method of generating a combined image of a body part from a sequence of partially overlapping source images of the body part, each of the partially overlapping source images showing the body part at one of a plurality of different times, the source images being ordered in the sequence according to the different times, the method including defining a temporally coherent sequence of transformations, for registering the partially overlapping source images in the sequence with each other, registering the source images to each other using the defined temporally coherent sequence of transformations, to obtain co-registered images, and combining at least some of the co-registered images into a combined image. Related apparatus and methods are also described.

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Haifa, Israel

Eli Dichterman