Abstract: Pulmonary vein isolation has become a first-line treatment for symptomatic drug refractory atrial fibrillation (AF). In the context of PVI procedures, linear ablation lesions are delivered in order to achieve PV isolation. Electrophysiological maps from data collected by high density (HD) grid catheters can be used to identify conduction gaps associated within circumferential pulmonary vein isolation lesions.

Abstract: Aspects of the present disclosure are directed to flexible high-density mapping catheters with a planar array of high-density mapping electrodes near a distal tip portion. These mapping catheters may be used to detect electrophysiological characteristics of tissue in contact with the electrodes, and may be used to diagnose cardiac conditions, such as cardiac arrhythmias for example.

Abstract: Conduction block across a lesion in tissue can be assessed by applying a pacing signal to tissue on one side of the lesion and sensing electrophysiological activity in the tissue on the opposite side of the lesion. A signal processor, such as may be incorporated into an electroanatomical mapping system, analyzes the sensed electrophysiological activity for a response evoked by the pacing signal and outputs an indicator of conduction block status. More particularly, when a preset number of consecutive pacing pulses do not yield an evoked response, an indicator of block can be output; conversely, when a preset number of consecutive pacing pulses do yield an evoked response, an indicator of no block can be output.

Abstract: Flexible high-density mapping catheter tips and flexible ablation catheter tips with onboard high-density mapping electrodes are disclosed. These tips can be used for diagnosing and treating cardiac arrhythmias. The flexible, distal tips are adapted to conform to tissue and comprise a plurality of microelectrodes mounted to permit relative movement among at least some of the microelectrodes. The flexible tip portions may comprise a flexible framework forming a flexible array of microelectrodes (for example, a planar or cylindrical array) adapted to conform to tissue and constructed at least in part from nonconductive material in some embodiments. The flexible array of microelectrodes may be formed from a plurality of rows of longitudinally-aligned microelectrodes. The flexible array may further comprise, for example, a plurality of electrode-carrying arms or electrode-carrier bands. Multiple flexible frameworks may be present on a single device.

Abstract: Aspects of the present disclosure are directed to flexible high-density mapping catheters with a planar array of high-density mapping electrodes near a distal tip portion. These mapping catheters may be used to detect electrophysiological characteristics of tissue in contact with the electrodes, and may be used to diagnose cardiac conditions, such as cardiac arrhythmias for example.

Abstract: Arrhythmic foci and other driver sites can be mapped using a multi-dimensional catheter. For instance, using a clique of three or more electrodes on the multi-dimensional catheter, an electroanatomical mapping system can identify a maximum bipolar voltage and an average unipolar voltage. The ratio of the average unipolar voltage to the maximum bipolar voltage can be interpreted as an indication of whether a cardiac location is an arrhythmic focus. Alternatively, an evaluation region can be defined about location in the patient's heart. The evaluation includes a plurality of rods, each associated with a respective E-field loop having a respective maximum and minimum amplitude bipole axes, with the rods being defined by the maximum amplitude bipole axes. For a sufficient number of rods within the evaluation region, a focus score for the evaluation region can be computed to reflect rod orientation consistency within the evaluation region.

Abstract: Electrical activation of tissue can be mapped from using electrophysiological data from a plurality of electrodes carried by a high density grid catheter. Each clique of three or more electrodes will define a pair of orthogonal bipoles as well as several unipoles. An electroanatomical mapping system can analyze the electrophysiological data such that, for each clique, an integral of an omnipolar electrogram the best morphologically matches a representative (e.g., average) unipolar electrogram for the clique is identified. The orientation of the best-fit omnipole is then defined as the activation direction for the clique. The conduction velocity magnitude can also be computed as a ratio of an amplitude of the unipolar electrogram for the clique to an amplitude of the integral of the omnipolar electrogram for the clique along the activation direction. The resulting activation map can also be output graphically.

Abstract: A method of mapping cardiac tissue repolarization with an electroanatomical mapping system includes receiving electrophysiological data from a plurality of electrodes on a multi-electrode catheter. The electrodes define a plurality of cliques. For each clique, the electroanatomical mapping system can compute a vectorcardiogram including a depolarization loop and a repolarization loop, identify a depolarization time on the depolarization loop, define a repolarization interval, after the depolarization time, and identify a repolarization time, within the repolarization interval, on the repolarization loop. Over a plurality of beats and at different locations within the heart, this process creates a cardiac tissue repolarization map, which can be output graphically in various forms, including isochronal maps of repolarization time and/or activation recovery interval, representations of activation distance margin, and animated representations of propagating depolarization and repolarization wavefronts.

Abstract: Arrhythmic foci and other driver sites can be mapped using a multi-dimensional catheter. For instance, using a clique of three or more electrodes on the multi-dimensional catheter, an electroanatomical mapping system can identify a maximum bipolar voltage and an average unipolar voltage. The ratio of the average unipolar voltage to the maximum bipolar voltage can be interpreted as an indication of whether a cardiac location is an arrhythmic focus. Alternatively, an evaluation region can be defined about location in the patient's heart. The evaluation includes a plurality of rods, each associated with a respective E-field loop having a respective maximum and minimum amplitude bipole axes, with the rods being defined by the maximum amplitude bipole axes. For a sufficient number of rods within the evaluation region, a focus score for the evaluation region can be computed to reflect rod orientation consistency within the evaluation region.

Abstract: Electrical activation of tissue can be mapped from using electrophysiological data from a plurality of electrodes carried by a high density grid catheter. Each clique of three or more electrodes will define a pair of orthogonal bipoles as well as several unipoles. An electroanatomical mapping system can analyze the electrophysiological data such that, for each clique, an integral of an omnipolar electrogram the best morphologically matches a representative (e.g., average) unipolar electrogram for the clique is identified. The orientation of the best-fit omnipole is then defined as the activation direction for the clique. The conduction velocity magnitude can also be computed as a ratio of an amplitude of the unipolar electrogram for the clique to an amplitude of the integral of the omnipolar electrogram for the clique along the activation direction. The resulting activation map can also be output graphically.

Abstract: Systems and methods for generating and displaying an electrophysiology (EP) map are provided. A system includes a device including at least one sensor configured to collect a set of location data points, and a computer-based model construction system coupled to the device and configured to generate a geometry surface model from the set of location data points, associate an EP parameter with each of a plurality of points on the geometry surface model to generate an EP map, calculate a confidence metric for the EP parameter associated with each point, and display the EP map based on the calculated confidence metrics.

Abstract: A method and system for assessing lesion formation in tissue is provided. The system includes an electronic control unit (ECU). The ECU is configured to acquire values for first and second components of a complex impedance between the electrode and the tissue, and to calculate an index responsive to the first and second values. The ECU is further configured to process the ECI to assess lesion formation in the tissue.

Abstract: The disclosure relates generally to applications of Orientation Independent Sensing (OIS) and Omnipolar mapping Technology (OT) to various system, device and method embodiments as recited herein. Similarly, systems and methods suitable for supporting OIS and OT systems and methods are disclosed. Further, OIS and OT implementations that provide end user interfaces, diagnostic indicia and visual displays generated, in part, based on measured data or derived from measured data are also disclosed. Embodiments also describe applying optimization techniques to determine the greatest voltage difference of a local electric field associated with an electrode-based diagnostic procedure and a vector representation thereof. Various graphic user interface related features are also described to facilitate orientation and electrode clique signal display.

Abstract: Flexible high-density mapping catheter tips and flexible ablation catheter tips with onboard high-density mapping electrodes are disclosed. These tips can be used for diagnosing and treating cardiac arrhythmias. The flexible, distal tips are adapted to conform to tissue and comprise a plurality of microelectrodes mounted to permit relative movement among at least some of the microelectrodes. The flexible tip portions may comprise a flexible framework forming a flexible array of microelectrodes (for example, a planar or cylindrical array) adapted to conform to tissue and constructed at least in part from nonconductive material in some embodiments. The flexible array of microelectrodes may be formed from a plurality of rows of longitudinally-aligned microelectrodes. The flexible array may further comprise, for example, a plurality of electrode-carrying arms or electrode-carrier bands. Multiple flexible frameworks may be present on a single device.

Abstract: The disclosure relates generally to applications of Orientation Independent Sensing (OIS) and Omnipolar mapping Technology (OT) to various system, device and method embodiments as recited herein. Similarly, systems and methods suitable for supporting OIS and OT systems and methods are disclosed. Further, OIS and OT implementations that provide end user interfaces, diagnostic indicia and visual displays generated, in part, based on measured data or derived from measured data are also disclosed. Embodiments also describe applying optimization techniques to determine the greatest voltage difference of a local electric field associated with an electrode-based diagnostic procedure and a vector representation thereof. Various graphic user interface related features are also described to facilitate orientation and electrode clique signal display.

Abstract: Flexible high-density mapping catheter tips and flexible ablation catheter tips with onboard high-density mapping electrodes are disclosed. These tips can be used for diagnosing and treating cardiac arrhythmias. The flexible, distal tips are adapted to conform to tissue and comprise a plurality of microelectrodes mounted to permit relative movement among at least some of the microelectrodes. The flexible tip portions may comprise a flexible framework forming a flexible array of microelectrodes (for example, a planar or cylindrical array) adapted to conform to tissue and constructed at least in part from nonconductive material in some embodiments. The flexible array of microelectrodes may be formed from a plurality of rows of longitudinally-aligned microelectrodes. The flexible array may further comprise, for example, a plurality of electrode-carrying arms or electrode-carrier bands. Multiple flexible frameworks may be present on a single device.

Abstract: An animated cardiac activation map can be created by simulating particle flow over a three-dimensional representation of a cardiac surface. In particular, an electroanatomical mapping system can simulate and display particle flow through a conduction velocity map for the cardiac surface, with the conduction velocity map defining a conduction velocity vector field over the cardiac surface. Particles may be spawned randomly and/or according to a local activation timing map for the cardiac surface. Likewise, particle simulation may be displayed for a preset time interval and/or for a time interval determined by the local activation timing map. Particle simulation may also end if a particle encounters a line of block. Regions of dispersion or breakout can also be identified using the conduction velocity vector field.

Abstract: A method of displaying a virtual electrogram for a virtual bipole includes receiving a plurality of electrophysiological signals from a respective plurality of electrodes carried by a multi-dimensional catheter; using the received electrophysiological signals to compute a plurality of virtual electrograms associated with a respective plurality of virtual bipoles, each having a corresponding virtual bipole orientation; selecting a virtual bipole orientation; and displaying the virtual electrogram associated with the virtual bipole having the selected virtual bipole orientation. Aspects of the disclosure can be executed through a graphical user interface of an electroanatomical mapping system that also incorporates a visualization processor.

Abstract: Electrophysiological signals from a graphical representation of an electrophysiology map including a plurality of electrophysiology data points can be sorted by receiving user inputs specifying a number of virtual electrodes for a virtual catheter and defining a pathway of the virtual catheter. A corresponding number of virtual electrodes can be defined on the pathway of the virtual catheter, and one or more electrophysiology data points relevant to electrical activity at the virtual electrodes can be identified, allowing output of a graphical representation of electrophysiological signals corresponding to the identified electrophysiology data points. Relevant electrophysiology data points can be identified by applying one or more relevance criterion, such as a distance criterion, a bipole orientation criterion, a time criterion, and/or a morphology criterion.