Biosense Webster (Israel) Ltd.

Biosense Webster, Inc.

Lior Botzer

Elad Nakar

Meir Bar-Tal

Eliyahu Ravuna

Eitan Peri

Noga Salomon

Jonathan Yarnitsky

Natan Sharon Katz

Aharon Turgeman

Gal Hayam

Shmuel Auerbach

Liron Shmuel Mizrahi

Shiran Eliyahu

Abraham Berger

Yoram Chmiel

Ana Kaufman

Daniel Osadchy

Assaf Cohen

Richard P M Houben

Ariel Garcia

Cesar Fuentes-Ortega

Debby Esther Highsmith

Amir Ben-Dor

Galia Givaty

Vladimir Rubinstein

Tal Haim Bar-on

Morris Ziv-Ari

Matityahu Amit

Stanislav Goldberg

Alaa Zoubi

Itai Doron

Refael Itah

Alon Baram

Sigal Altman

Roee Haimovich

Yariv Avraham Amos

Yoav Benaroya

Yaron Kadoshi

Jamie Lynn Malinaric

Guy Wekselman

Simon Rivron

Dor Zeev Keren Tal

Alaa Zoabi

Nuno Miguel Rocha Cortez-Diaz

Netta Dov

Dor Zeev Keren-Tal

Richard PM Houben

Tal Haim Bar-On

Erica Evelyenne Lovejoy

A method is described herein. The method is implemented by an optimization engine executed by a processor. The optimization engine receives data that includes performance metrics of mapping and ablation procedures. In turn, the optimization generates procedure expected outcomes for the mapping and ablation procedures based on the data and success predictions for a current ablation procedure utilizing the procedure expected outcomes. The optimization engine, also, outputs an ablation recommendation based on the success predictions.

Identification of ablation gaps

A method is provided. The method is implemented by a device orientation engine being executed by one or more processors. The method includes determining a movement between each electrode group of a catheter to provide movements and determining a total movement of electrodes of the catheter. The method also includes removing a standard component from the movements and the total movement and outputting a movement indication for the catheter based on the movements and the total movement with the standard component.

Signal analysis of movements of a reference electrode of a catheter in a coronary sinus vein

Systems and methods are disclosed for generating a pace-mapping prediction model. Techniques are provided that utilize a training dataset associated with biometrics of patients' hearts, including electrophysiological data associated with cardiac arrhythmia, pace-mapping datasets, and correlation data measuring the degree of correlation between the pace-mapping datasets and the electrophysiological data. Based on the training dataset, the pace-mapping prediction model is trained to predict a degree of correlation between a patient's electrophysiological data and a pace-mapping dataset. Based on the predicted degree of correlation, a cardiac location in the heart of a patient is predicted as the location for the next pace-mapping. Further systems and methods are disclosed for generating a pacing maneuver prediction model. The pacing maneuver prediction model is trained to predict interval measurement based on a pacing maneuver obtained during cardiac pace-mapping.

System and method to detect and identify cardiac pace-mapping sites and pacing maneuvers

A system and method for detecting a mapping annotation for an electrophysiological (EP) mapping system. The system includes a processor comprising a machine learning algorithm configured to receive a first heartbeat at an identified cardiac spatial location including a first set of attributes information corresponding to the first heartbeat; receive a second heartbeat at the identified cardiac spatial location including a second set of attributes information corresponding to the second heartbeat; compare the first set of attributes information with the second set of attributes information; and determine which of the first heartbeat and the second heartbeat has optimal characteristics based on the compared attribute information.

System and method to detect stable arrhythmia heartbeat and to calculate and detect cardiac mapping annotations

A method, including receiving a unipolar ECG signal from the location in the heart from a selected one electrode of a pair of electrodes, computing a local unipolar minimum derivative of the unipolar signal at a plurality of times of occurrences of the local unipolar minimum derivative, identifying candidate time of occurrences of the plurality of times of occurrences of the local unipolar minimum derivative as candidate annotations of the time of activation of the myocardium, extracting features for each of the candidate annotations, assigning a confidence level based on a feature value for each of the candidate annotations, eliminating candidate annotations that have a confidence level below a threshold and generating a local activation time map using the remaining candidate annotations.

Annotation of an electrocardiogramic wavefront

A system including a means for estimating the residual noise level in electrocardiogram (ECG) signals is disclosed. The disclosed system and methods may be used in an electrocardiograph devices. According to an exemplary embodiment of the present invention, a plurality of electrodes positioned in proximity to a cardiac structure may measure an electrical signal of the cardiac structure to produce the ECG signal. The system may segment the ECG signal into a plurality of segments. For each of the plurality of segments, the linear trend energy and/or direct current (DC) energy may be removed from the segment, and the estimated noise energy of the segment may be calculated. A subset of the plurality of segments with a minimum estimated noise energy may be selected. The residual noise energy of the ECG signal may be estimated by calculating an average of the estimated noise energy over the subset of segments.

Methods and systems for estimation of residual ECG noise level and adaptive noise threshold

A method is provided. The method includes pacing, by electrodes of a catheter, a heart tissue with pulses. The method includes observing, by the electrodes, a period of electrophysiological repolarization for the heart tissue. The period of electrophysiological repolarization is caused by the pacing. The method also includes measuring, by the electrodes, an electrical signal within the heart tissue after the period of electrophysiological repolarization.

Universal pacing of a catheter

A method, including receiving a bipolar signal from a pair of electrodes in proximity to a myocardium of a human subject, and receiving a unipolar signal from a selected one of the pair of electrodes. The method further includes delineating a window of interest (WOI) for the unipolar and bipolar signals, within the WOI computing local unipolar minimum derivatives of the unipolar signal, and times of occurrence of the local unipolar minimum derivatives, and within the WOI computing bipolar derivatives of the bipolar signal at the times of occurrence. The method also includes evaluating ratios of the bipolar derivatives to the local unipolar minimum derivatives, and when the ratios are greater than a preset threshold ratio value, assigning the times of occurrence as times of activation of the myocardium, counting a number of the times of activation; and classifying the unipolar signal according to the number.

Classifying ECG signals

A method, including ejecting irrigation fluid from a distal end of a probe so as to irrigate tissue, and receiving, over a period of time, initial signals indicative of respective temperatures of the distal end, from a temperature sensor in the distal end. The method also includes formulating from the initial signals a temperature range between upper and lower temperature thresholds and, when a further signal from the temperature sensor, received subsequent to the period of time, is indicative of a further temperature above the upper temperature threshold, raising an alarm that a bubble is present in the irrigation fluid.

Detection of bubbles in irrigation fluid

A method includes receiving a bipolar signal sensed by a pair of electrodes at a location in a heart of a patient. One or more electrocardiogram (ECG) signals are received, sensed by body-surface electrodes attached to the patient. Two or more successive QRS complexes are identified in the bipolar signal. One or more activations are detected in the bipolar signal, which occur within a window-of-interest that begins at least a given time with respect to the identified QRS complexes. The detected activations are checked whether they are late potentials, by verifying whether (i) the activations do not coincide with a predefined event observed in the ECG signals, and (ii) the activations are repeatable in the successive QRS complexes. In response to deciding that at least one of the detected activations is a late potential, the latest of the at least one of the late potentials is visualized to a user.

Annotation of late potentials comprising local abnormal ventricular activation (LAVA) signals

A method includes receiving a bipolar signal sensed by a pair of electrodes at a location in a heart of a patient. A unipolar signal is received, which is sensed by an electrode at the location in the heart. A derivative of the received bipolar signal is computed. A derivative of the received unipolar signal is computed. A ratio is evaluated, between the derivative of the bipolar signal and the derivative of the unipolar signal at local minima of the derivative of the unipolar signal. When the ratio is smaller than a preset threshold ratio value, an occurrence of ventricular activity is indicated.

Detection of ventricular activity using unipolar and bipolar signals

A method includes acquiring a bipolar signal from a first electrode and a second electrode contacting a first location and a second location, respectively, in a heart of a living subject. The method further includes acquiring a unipolar signal from the first electrode while in contact with the first location, and deriving from the bipolar signal and the unipolar signal a point in time at which the first location is generating the unipolar signal. The method also includes computing a metric for a conduction velocity of the unipolar signal at the first location based on a shape of the unipolar signal at the point in time.

Tissue conduction velocity

A method includes storing an anatomical map of at least a portion of a surface of a heart. Respective electrogram (EGM) signal amplitudes measured at respective positions on the surface of the heart are stored. Based on the on the EGM signal amplitudes, defined are: one or more first regions of the surface in which the EGM signal amplitudes are fractionated, and one or more second regions of the surface in which the EGM signal amplitudes are non-fractionated. A first surface representation is generated for the fractionated EGM signal amplitudes in the first regions. Propagation times are extracted from the non-fractionated EGM signal amplitudes in the second regions, and a second surface representation of the propagation times is derived. The first and second surface representations of the respective first and second regions of the surface are simultaneously presented, overlaid on the anatomical map.

Propagation map of a heart chamber with areas demonstrating fractionated electrograms

A probe having a temperature sensor on its distal portion is introduced into a fluid-filled body cavity of a subject, and an irrigating fluid passed through the probe. The temperature of the irrigating fluid exiting the probe differs from the temperature of the body cavity. Temperature readings of the irrigating fluid exiting the probe are recorded. A determination is made from the temperature readings that predetermined contact criteria between the probe and the interior wall of the body cavity are satisfied.

Catheter stability indication

A method, including receiving a bipolar ECG signal from a location in the heart from the pair of electrodes, receiving a unipolar ECG signal from the location in the heart from a selected one electrode of the pair of electrodes, computing a local unipolar minimum derivative of the unipolar signal at a plurality of times of occurrences of the local unipolar minimum derivative, computing a bipolar derivative of the bipolar signal, evaluating a ratio of the bipolar derivative to the local unipolar minimum derivative at the plurality of times of occurrences of the local unipolar minimum derivative, annotating each time of occurrence as a time of activation of the myocardium at the location in the heart when the ratio is greater than a preset threshold value, merging two annotations that arise from a single occurrence as a single annotation, evaluating features of the annotations and assigning a confidence level to each feature, eliminating annotations that have a confidence level below a threshold and generating a local activation time map using the remaining annotations.

Annotation of a wavefront with evaluation of the ratio of a bipolar derivative to a local unipolar minimum derivative

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Timrat, Israel

Lior Botzer