Abstract: A system and method of identifying focal sources is presented. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals over time, each ECG signal detected via one of the sensors having a location in a heart and indicating electrical activity of the heart, each signal comprising at least an R wave and an S wave; creating an R-S map comprising an R-to-S ratio for each of the ECG signals, the R-to-S ratio comprising a ratio of absolute magnitude of the R wave to absolute magnitude of the S wave; identifying, for each of the ECG signals, local activation times (LATs); and correlating the R-to-S ratios for the ECG signals on the R-S map and the identified LATs and using the correlation to identify the focal sources.

Abstract: A system includes a memory and a processor. The memory is configured to store a definition of a cardiac pacing protocol. The processor is configured to (a) receive the stored definition of the cardiac pacing protocol, (b) in accordance with the pacing protocol, to automatically pace from an intracardiac location and to acquire respective sensed ECG signals, (c) based on one or more prespecified criteria for validity of the sensed ECG data, automatically accept or reject the sensed ECG signals, (d) based on one or more prespecified criteria for identification of an arrhythmia, identify the intracardiac location as an arrhythmogenic focus or pathway, (e) overlay the identified intracardiac location an electrophysiological (EP) map, and (f) subsequently identify or reject a new intracardiac location as an arrhythmogenic focus or pathway and overlay the new location on the EP map when pacing again from the new intracardiac location.

Abstract: A catheter has a mapping assembly having a plurality of splines mounted at its distal portion. The splines each have a proximal end disposed at the distal portion of the catheter body and a distal end and configured as a Fibonacci spiral arm that diverges outwardly from the proximal end. The splines have a support arm with shape memory, a non-conductive covering in surrounding relation to the support arm, at least one location sensor mounted at or near the distal end, a plurality of electrodes mounted in surrounding relation to the non-conductive covering, and a plurality of electrode lead wires extending within the non-conductive covering. Each electrode lead wire is attached to a corresponding one of the electrodes.

Abstract: A system and method of identifying focal sources is presented. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals over time, each ECG signal detected via one of the sensors having a location in a heart and indicating electrical activity of the heart, each signal comprising at least an R wave and an S wave; creating an R-S map comprising an R-to-S ratio for each of the ECG signals, the R-to-S ratio comprising a ratio of absolute magnitude of the R wave to absolute magnitude of the S wave; identifying, for each of the ECG signals, local activation times (LATs); and correlating the R-to-S ratios for the ECG signals on the R-S map and the identified LATs and using the correlation to identify the focal sources.

Abstract: A system and method of identifying focal sources is presented. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals over time, each ECG signal detected via one of the sensors having a location in a heart and indicating electrical activity of the heart, each signal comprising at least an R wave and an S wave; creating an R-S map comprising an R-to-S ratio for each of the ECG signals, the R-to-S ratio comprising a ratio of absolute magnitude of the R wave to absolute magnitude of the S wave; identifying, for each of the ECG signals, local activation times (LATs); and correlating the R-to-S ratios for the ECG signals on the R-S map and the identified LATs and using the correlation to identify the focal sources.

Abstract: A system includes a memory and a processor. The memory is configured to store a definition of a cardiac pacing protocol. The processor is configured to (a) receive the stored definition of the cardiac pacing protocol, (b) in accordance with the pacing protocol, to automatically pace from an intracardiac location and to acquire respective sensed ECG signals, (c) based on one or more prespecified criteria for validity of the sensed ECG data, automatically accept or reject the sensed ECG signals, (d) based on one or more prespecified criteria for identification of an arrhythmia, identify the intracardiac location as an arrhythmogenic focus or pathway, (e) overlay the identified intracardiac location an electrophysiological (EP) map, and (f) subsequently identify or reject a new intracardiac location as an arrhythmogenic focus or pathway and overlay the new location on the EP map when pacing again from the new intracardiac location.

Abstract: A method and system for automatic landmark registration and registration using trajectory information and shape sensing during an endoscopic procedure, such as bronchoscopy, are described herein. A segmentation centerline of airways of a lung may be generated based on a pre-operative computed tomography (CT) image of the lung. Landmarks may be automatically detected on the segmentation centerline corresponding to bifurcations in the airways of the lung. A location data point cloud of locations of a catheter through the airways of the lung during navigation may be generated. A bounding volume of the airways of the lung may be generated and a bounding volume centerline may be detected. Landmarks may be detected on the bounding volume centerline for the same bifurcations. Then, the two sets of landmarks may be mapped as part of registration. The trajectory information with shape sensing may be used to provide non-rigid or fine registration.

Abstract: A method of atrial rotational activity pattern (RAP) source detection is provided which includes detecting, via a plurality of sensors, electro-cardiogram (ECG) signals over time, each ECG signal detected via one of the plurality of sensors and indicating electrical activity of a heart. The method also includes determining, for each of the plurality of ECG signals, one or more local activation times (LATs) each indicating a time of activation of a corresponding ECG signal. The method further includes detecting whether one or more RAP source areas of activation in the heart is indicated based on the detected ECG signals and the one or more local LATs. Mapping information of the detected RAP source areas of activation in the heart is also generated for providing one or more maps.

Abstract: A method and system for automatic landmark registration and registration using trajectory information and shape sensing during an endoscopic procedure, such as bronchoscopy, are described herein. A segmentation centerline of airways of a lung may be generated based on a pre-operative computed tomography (CT) image of the lung. Landmarks may be automatically detected on the segmentation centerline corresponding to bifurcations in the airways of the lung. A location data point cloud of locations of a catheter through the airways of the lung during navigation may be generated. A bounding volume of the airways of the lung may be generated and a bounding volume centerline may be detected. Landmarks may be detected on the bounding volume centerline for the same bifurcations. Then, the two sets of landmarks may be mapped as part of registration. The trajectory information with shape sensing may be used to provide non-rigid or fine registration.

Abstract: A method of atrial focal source detection is provided which includes detecting, via sensors, electro-cardiogram (ECG) signals over time. Each ECG signal is detected via one of the sensors and indicates electrical activity of a heart. The method also includes determining, for each ECG signal, local activation times (LATs) each indicating a time of one of a plurality of atrial activations of a corresponding ECG signal and detecting whether one or more focal source areas of activation in the heart is indicated based on the detected ECG signals and the one or more local LATs. S-waves can be distinguished from non-S-waves by generating models for each atrial activation and classifying atrial activations. Maps can be generated by visually indicating, for each sensor, a level of incidence of the atrial activations occurring before atrial activations of neighboring sensors within a period of time.

Abstract: A system and method of determining regions of interest for heart ablation using fractionation. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals, each ECG signal detected via one of the sensors and indicating electrical activity of a heart, determining, for each of the ECG signals, activation times (LATs) each indicating a time of activation of a corresponding ECG signal, generating, based on the determined LATs of each of the ECG signals, one or more driver maps and one or more perpetuator maps, each representing the electrical activity of the heart, deriving parameters from the driver and perpetuator maps, using at least fractionation, processing and combining the derived parameters into driver evidence and perpetuator evidence, and determining the regions of interest for heart ablation in accordance with the fractionation used to derive the driver evidence and the perpetuator evidence.

Abstract: A conduit puncture alert method and apparatus are provided for a medical instrument having a flexible conduit through which a medical procedure is performed. In one embodiment, the flexible conduit is inserted into a subject. A highest degree of curvature of the conduit within the subject is sensed. A warning signal is then provided upon a condition that a curvature is sensed that exceeds a predetermined limit reflective of a maximum curvature permissible for a selected tool to be inserted through the conduit while avoiding puncturing of the conduit by the selected tool. For example, the method can be conducted with respect to a bronchoscope during a bronchoscopic procedure where a needle tool is to be used and the warning is given with respect to that tool when a conduit curvature is sensed that exceeds a predetermined limit determined with respect to the needle tool.

Abstract: Methods and apparatus for enhancing bronchial airways representations using vascular morphology. A representation of bronchial airways of a subject and a representation of a corresponding vascular network are obtained and may be stored in a memory. In the bronchial airways representation, termini of airways are identified where portions of the airways are not included in the representation though they are in fact continuous airways in the subject. In the vascular network representation, vessel portions corresponding to unrepresented airway portions between first and second identified airway termini are identified. An enhanced bronchial airways representation is produced that reflects an airway extending between the termini. The enhanced bronchial airways representation can be displayed on a monitor of a medical apparatus to facilitate a bronchoscopic procedure.

Abstract: A catheter has a mapping assembly having a plurality of splines mounted at its distal portion. The splines each have a proximal end disposed at the distal portion of the catheter body and a distal end and configured as a Fibonacci spiral arm that diverges outwardly from the proximal end. The splines have a support arm with shape memory, a non-conductive covering in surrounding relation to the support arm, at least one location sensor mounted at or near the distal end, a plurality of electrodes mounted in surrounding relation to the non-conductive covering, and a plurality of electrode lead wires extending within the non-conductive covering. Each electrode lead wire is attached to a corresponding one of the electrodes.

Abstract: A method and system for automatic landmark registration and registration using trajectory information and shape sensing during an endoscopic procedure, such as bronchoscopy, are described herein. A segmentation centerline of airways of a lung may be generated based on a pre-operative computed tomography (CT) image of the lung. Landmarks may be automatically detected on the segmentation centerline corresponding to bifurcations in the airways of the lung. A location data point cloud of locations of a catheter through the airways of the lung during navigation may be generated. A bounding volume of the airways of the lung may be generated and a bounding volume centerline may be detected. Landmarks may be detected on the bounding volume centerline for the same bifurcations. Then, the two sets of landmarks may be mapped as part of registration. The trajectory information with shape sensing may be used to provide non-rigid or fine registration.

Abstract: A conduit puncture alert method and apparatus are provided for a medical instrument having a flexible conduit through which a medical procedure is performed. In one embodiment, the flexible conduit is inserted into a subject. A highest degree of curvature of the conduit within the subject is sensed. A warning signal is then provided upon a condition that a curvature is sensed that exceeds a predetermined limit reflective of a maximum curvature permissible for a selected tool to be inserted through the conduit while avoiding puncturing of the conduit by the selected tool. For example, the method can be conducted with respect to a bronchoscope during a bronchoscopic procedure where a needle tool is to be used and the warning is given with respect to that tool when a conduit curvature is sensed that exceeds a predetermined limit determined with respect to the needle tool.

Abstract: A method of atrial rotational activity pattern (RAP) source detection is provided which includes detecting, via a plurality of sensors, electro-cardiogram (ECG) signals over time, each ECG signal detected via one of the plurality of sensors and indicating electrical activity of a heart. The method also includes determining, for each of the plurality of ECG signals, one or more local activation times (LATs) each indicating a time of activation of a corresponding ECG signal. The method further includes detecting whether one or more RAP source areas of activation in the heart is indicated based on the detected ECG signals and the one or more local LATs. Mapping information of the detected RAP source areas of activation in the heart is also generated for providing one or more maps.

Abstract: A method of atrial focal source detection is provided which includes detecting, via sensors, electro-cardiogram (ECG) signals over time. Each ECG signal is detected via one of the sensors and indicates electrical activity of a heart. The method also includes determining, for each ECG signal, local activation times (LATs) each indicating a time of one of a plurality of atrial activations of a corresponding ECG signal and detecting whether one or more focal source areas of activation in the heart is indicated based on the detected ECG signals and the one or more local LATs. S-waves can be distinguished from non-S-waves by generating models for each atrial activation and classifying atrial activations. Maps can be generated by visually indicating, for each sensor, a level of incidence of the atrial activations occurring before atrial activations of neighboring sensors within a period of time.

Abstract: A system and method of identifying focal sources is presented. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals over time, each ECG signal detected via one of the sensors having a location in a heart and indicating electrical activity of the heart, each signal comprising at least an R wave and an S wave; creating an R-S map comprising an R-to-S ratio for each of the ECG signals, the R-to-S ratio comprising a ratio of absolute magnitude of the R wave to absolute magnitude of the S wave; identifying, for each of the ECG signals, local activation times (LATs); and correlating the R-to-S ratios for the ECG signals on the R-S map and the identified LATs and using the correlation to identify the focal sources.

Abstract: A system and method of determining regions of interest for heart ablation using fractionation. The method can comprise detecting, via sensors, electro-cardiogram (ECG) signals, each ECG signal detected via one of the sensors and indicating electrical activity of a heart, determining, for each of the ECG signals, activation times (LATs) each indicating a time of activation of a corresponding ECG signal, generating, based on the determined LATs of each of the ECG signals, one or more driver maps and one or more perpetuator maps, each representing the electrical activity of the heart, deriving parameters from the driver and perpetuator maps, using at least fractionation, processing and combining the derived parameters into driver evidence and perpetuator evidence, and determining the regions of interest for heart ablation in accordance with the fractionation used to derive the driver evidence and the perpetuator evidence.