Determining a location of a member

• US 10,426,377 B2
• Filed: 11/09/2015
• Issued: 10/01/2019
• Est. Priority Date: 04/18/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Markowitz, H. Toby, Kryger, Michael
• Primary Examiner(s): Carey, Michael J
• Application Number:
  US14/936,050
• Publication Number:
  US 20160066814A1
• Time in Patent Office: 1,422 Days
• Field of Search: 600424, 600508
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/063 using impedance measurements
• CPC Class Codes: A61B 5/066 : Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/304 : Switching circuits
• CPC Class Codes: A61B 5/333 : Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/339 : Displays specially adapted therefor
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 8/06 : Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/4472 : Wireless probes

Abstract

An volume of a patient can be mapped with a system operable to identify a plurality of locations and save a plurality of locations of a mapping instrument. The mapping instrument can include one or more electrodes that can sense a voltage that can be correlated to a three dimensional location of the electrode at the time of the sensing or measurement. Therefore, a map of a volume can be determined based upon the sensing of the plurality of points without the use of other imaging devices. An implantable medical device can then be navigated relative to the mapping data.

Claims

1. A method to locate and determine a position of portions of an instrument in a volume, comprising:

providing an elongated and flexible member extending between a first end and a second terminal end with a first position element having a plurality of first position element portions positioned near the first end and between the first end and the second terminal end and a second position element positioned near the second terminal end;

positioning a set of axis generation electrodes on a surface of the volume;

injecting a current into the volume between the set of axis generation electrodes;

sensing with the first position element and the second position element an electrical property due to the injected current into the volume between the set of axis generation electrodes;

evaluating the sensed electrical property sensed with the first position element and the second position element;

determining a relative position of the first position element and the second position element based on the evaluation of the electrical property;

determining a non-linear geometry of the elongated and flexible member based on the determined relative position of the first position element having the plurality of first position element portions and the second position element; and

determining an amount of lead slack of the elongated and flexible member within the volume based on the determined non-linear geometry.

2. The method of claim 1, further comprising:

determining a relative location of each of the plurality of first position element portions;

wherein determining the non-linear geometry of the elongated and flexible member is based on the determined relative location of each of the plurality of first position element portions.

3. The method of claim 1, further comprising;

generating a map of an internal surface of the volume based on the determination a plurality of relative positions within the volume without an additional imaging modality; and

illustrating at least the determined non-linear geometry of the elongated and flexible member superimposed on the generated map on a display device.

4. The method of claim 1, wherein providing the elongated and flexible member extending between a first end and a second terminal end with a first position element positioned near the first end and a second position element positioned near the second end, includes:

fixing both the first position member and the second position member to an outer wall of the elongated and flexible member.

5. The method of claim 4, wherein the first position member is formed integrally with the outer wall of the elongated and flexible member.

6. The method of claim 1, wherein providing the elongated and flexible member extending between a first end and a second terminal end with a first position element positioned near the first end and a second position element positioned near the second end, includes:

providing an elongated flexible sleeve;

fixing the first position element and the second position element to the elongated flexible sleeve; and

positioning the elongated and flexible member through the elongated flexible sleeve.

7. The method of claim 1, further comprising:

implanting at least one of the first position element and the second position element into a wall of a heart of a patient; and

stimulating the heart of the patient with at least one of the first position element and the second position element.

8. The method of claim 1, wherein all of the plurality of first position element portions are removable from the flexible member.

9. A method to locate and determine a position of portions of an instrument in a volume, comprising:

providing an elongated and flexible member extending between a first end and a second terminal end with a plurality of first tracking devices positioned near the first end and between the first end and the second terminal end and a second tracking device positioned at the second terminal end;

sensing with the plurality of first tracking devices and the second tracking device electrical signals in the volume;

evaluating the sensed electrical signals sensed with the plurality of first tracking devices and the second tracking device;

determining a relative position of the plurality of first tracking devices and the second tracking device based on the evaluation of the electrical signals;

determining a non-linear geometry of the elongated and flexible member based on the determined relative position of the plurality of first tracking devices and the second tracking device; and

determining an amount of lead slack of the elongated and flexible member within the volume based on the determined non-linear geometry.

10. The method of claim 9, further comprising;

generating a map of an internal surface of the volume based on the determination a plurality of relative positions within the volume without an additional imaging modality; and

illustrating at least the determined non-linear geometry of the elongated and flexible member superimposed on the generated map on a display device.

11. The method of claim 9, wherein providing the elongated and flexible member extending between a first end and a second terminal end with the plurality of first tracking devices positioned near the first end and the second tracking device positioned at the second end, includes:

fixing the plurality of first tracking devices to an outer wall of the elongated and flexible member.

12. The method of claim 11, wherein the plurality of first tracking devices is formed integrally with the outer wall of the elongated and flexible member.

13. The method of claim 9, wherein providing the elongated and flexible member extending between the first end and the second terminal end includes:

providing an elongated flexible sleeve;

fixing the plurality of first tracking devices to the elongated flexible sleeve; and

positioning the elongated and flexible member through the elongated flexible sleeve.

14. The method of claim 13, further comprising:

implanting the second tracking device into a wall of a heart of a patient; and

stimulating the heart of the patient with the second tracking device.

15. The method of claim 9, further comprising:

positioning a set of axis generation electrodes on a surface of the volume; and

injecting a current into the volume between the set of axis generation electrodes to generate the electrical signals in the volume.

16. A system to locate and determine a position of portions of an instrument in a volume of a patient, comprising:

an elongated and flexible implantable lead extending between a first end and a second terminal end;

a first position element positioned near the first end of the implantable lead, wherein the first position element includes a plurality of first position element portions positioned along a length of the flexible implantable lead between the first end and the second terminal end;

a second position element positioned at the second terminal end of the implantable lead;

a set of axis generation electrodes configured to be positioned on a surface of the volume;

a driver to inject a current into the volume between the set of axis generation electrodes;

a processor operable to evaluate an electrical property sensed with the first position element and the second position element based at least on the injected current, wherein the processor is further operable to determine an amount of lead slack of the elongated and flexible implantable lead within the volume based on a determined non-linear geometry of the position of the elongated and flexible implantable lead; and

a display device operable to display the non-linear geometry of the elongated and flexible implantable lead.

17. The system of claim 16, further comprising:

a mapping instrument having a third position element;

a storage system operable to store a plurality of determined positions of the third position element;

the processor further operable to generate a map of the volume with the stored determined positions of the third position element; and

the display device further operable to display the map.

18. The system of claim 16, wherein the elongated and flexible implantable lead has an outer wall and both the first position member and the second position member are fixed to the outer wall.

19. The system of claim 16, further comprising:

an elongated flexible sleeve;

wherein the first position element is fixed to the elongated flexible sleeve;

wherein the elongated and flexible implantable lead is positioned through the elongated flexible sleeve.

20. The system of claim 16, wherein the second position element positioned at the second terminal end of the elongated and flexible implantable lead is operable to be implanted into a wall of a heart.