Abstract: Catheterization of the heart is carried out by inserting a probe having electrodes into a heart of a living subject, recording a bipolar electrogram and a unipolar electrogram from one of the electrodes at a location in the heart, and defining a window of interest wherein a rate of change in a potential of the bipolar electrogram exceeds a predetermined value. An annotation is established in the unipolar electrogram, wherein the annotation denotes a maximum rate of change in a potential of the unipolar electrogram within the window of interest. A quality value is assigned to the annotation, and a 3-dimensional map is generated of a portion of the heart that includes the annotation and the quality value thereof.

Abstract: A method for treating a valve of a heart of a subject is provided. The method includes inserting a needle into the heart, and, using the needle, injecting a soft-tissue-filling material into an annulus of the valve. Other embodiments are also described.

Abstract: Catheterization of the heart is carried out by inserting a probe having electrodes into a heart of a living subject, recording a bipolar electrogram and a unipolar electrogram from one of the electrodes at a location in the heart, and defining a window of interest wherein a rate of change in a potential of the bipolar electrogram exceeds a predetermined value. An annotation is established in the unipolar electrogram, wherein the annotation denotes a maximum rate of change in a potential of the unipolar electrogram within the window of interest. A quality value is assigned to the annotation, and a 3-dimensional map is generated of a portion of the heart that includes the annotation and the quality value thereof.

Abstract: Electroanatomic mapping is carried out by inserting a multi-electrode probe into a heart of a living subject, recording electrograms from the electrodes concurrently at respective locations in the heart, delimiting respective activation time intervals in the electrograms, generating a map of electrical propagation waves from the activation time intervals, maximizing coherence of the waves by adjusting local activation times within the activation time intervals of the electrograms, and reporting the adjusted local activation times.

Abstract: A method for treating a valve of a heart of a subject is provided. The method includes inserting a needle into the heart, and, using the needle, injecting a soft-tissue-filling material into an annulus of the valve. Other embodiments are also described.

Abstract: Embodiments include methods, systems, and apparatuses for generating an enhanced electrocardiograph (ECG) that includes indicators of values of different types of supplemental information embedded into a trace of measured electrical potentials. More specifically, embodiments may include collecting first data samples of electrical potentials produced by a heart at a sequence of sampling times, and processing the data to calculate supplemental information over a number of sampling times. Based on the first data samples and the supplemental information, a trace of the electrical potentials collected at the sampling times is presented. The trace may have one or more embedded indicators of the supplemental information that vary responsively to the first data samples collected at each of the sampling times.

Abstract: Cardiac catheterization is carried out by constructing a left atrial model of a heart of a living subject, selecting a global catheter that is dimensioned to conform to the left atrial model, representing the catheter in the left atrial model; extending the length axis of the catheter in the left atrial model to form an intersection with the foramen ovale, and reporting the intersection as a recommended site of transseptal puncture for insertion of the catheter therethrough.

Abstract: Electroanatomic mapping is carried out by inserting a multi-electrode probe into a heart of a living subject, recording electrograms from the electrodes concurrently at respective locations in the heart, delimiting respective activation time intervals in the electrograms, generating a map of electrical propagation waves from the activation time intervals, maximizing coherence of the waves by adjusting local activation times within the activation time intervals of the electrograms, and reporting the adjusted local activation times.

Abstract: Cardiac catheterization is carried out by constructing a left atrial model of a heart of a living subject, selecting a global catheter that is dimensioned to conform to the left atrial model, representing the catheter in the left atrial model; extending the length axis of the catheter in the left atrial model to form an intersection with the foramen ovale, and reporting the intersection as a recommended site of transseptal puncture for insertion of the catheter therethrough.

Abstract: A catheter includes a shaft for insertion into an organ of a patient, an extendable distal-end assembly, and two or more strengthening elements. The extendable distal-end assembly is coupled to the shaft and includes multiple splines, at least one spline includes a flexible circuit board having one or more electrodes disposed thereon, the circuit board is configured, when the distal-end assembly is extended in the organ, to conform to a surface of the organ so as to make contact between the electrodes and the surface. The strengthening elements are distributed along the circuit board of the spline and are configured to mechanically strengthen the spline.

Abstract: A medical apparatus, used to acquire electrical activity of patient anatomy, is provided which includes an elongated body and a tip portion coupled to the elongated body. The tip portion includes one or more inflatable sections. Each inflatable section has a plurality of electrodes disposed on one of: (i) an outer surface of the one or more inflatable sections; and (ii) an inner surface and the outer surface of the one or more inflatable sections. The one or more inflatable sections, when inflated, cause a portion of the plurality of electrodes to contact a surface of an organ and provide a pathway for physiological fluid to flow through the tip portion. In one embodiment, the tip portion is a tulip balloon tip portion. In another embodiment, the tip portion is an inflatable tip portion having one or more concentrically wound inflatable sections.

Abstract: A catheter includes a shaft for insertion into an organ of a patient, and an extendable distal-end assembly. The distal-end assembly is coupled to the shaft and includes multiple splines. At least one spline includes one or more electrodes and at least one strain-relief element that is configured, when the distal-end assembly is extended in the organ, to allow the spline to conform to a surface of the organ so as to make contact between the electrodes and the surface.

Abstract: Described embodiments include an apparatus that includes an expandable structure, configured for insertion into a body of a subject, and a plurality of conducting elements coupled to the expandable structure. Each of the conducting elements comprises a respective coil and has an insulated portion that is electrically insulated from tissue of the subject, and an uninsulated portion configured to exchange signals with the tissue, while in contact with the tissue. Other embodiments are also described.

Abstract: Described embodiments include a catheter, which includes a plurality of splines at a distal end of the catheter, and a plurality of helical conducting elements disposed on the splines. Other embodiments are also described.

Abstract: A method includes inserting into a patient body a catheter, which includes an insertion tube and at least an expandable distal-end device coupled to a distal end of the insertion tube. The distal-end device is expanded in a blood vessel, thereby forming an annular guiding trench between the distal-end device and a circumference of the blood vessel, the annular trench shaped to receive and guide a distal tip of a medical instrument. The distal tip of the medical instrument is guided in the annular guiding trench formed by the expanded distal-end device of the catheter, so as to approach multiple points on the circumference of the blood vessel.

Abstract: Electroanatomic mapping is carried out by inserting a multi-electrode probe into a heart of a living subject, recording electrograms from the electrodes concurrently at respective locations in the heart, delimiting respective activation time intervals in the electrograms, generating a map of electrical propagation waves from the activation time intervals, maximizing coherence of the waves by adjusting local activation times within the activation time intervals of the electrograms, and reporting the adjusted local activation times.

Abstract: Apparatus, including a flexible insertion tube, having a distal segment that is configured to be inserted into a body organ. A plurality of elastic branches are connected to the distal segment of the insertion tube at different, respective locations and extend transversely away from the insertion tube at the respective locations. There are one or more respective electrodes disposed on each of the elastic branches and there are conductors traversing the elastic branches so as to couple the electrodes to the insertion tube.

Abstract: Cardiac catheterization is carried out by constructing a left atrial model of a heart of a living subject, selecting a global catheter that is dimensioned to conform to the left atrial model, representing the catheter in the left atrial model; extending the length axis of the catheter in the left atrial model to form an intersection with the foramen ovale, and reporting the intersection as a recommended site of transseptal puncture for insertion of the catheter therethrough.

Abstract: A method for treating a valve of a heart of a subject is provided. The method includes inserting a needle into the heart, and, using the needle, injecting a soft-tissue-filling material into an annulus of the valve. Other embodiments are also described.

Abstract: Cardiac catheterization is performed by recording electrograms from a multi-electrode probe at respective locations in the heart, determining slopes and annotations in the electrograms within time windows, establishing relationships among the slopes and annotations of the electrograms, and determining lines of conduction block in the heart from the relationships.