Systems and methods for guiding and locating functional elements on medical devices positioned in a body

• US 20030078494A1
• Filed: 10/24/2001
• Published: 04/24/2003
• Est. Priority Date: 10/24/2001
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Panescu, Dorin, Swanson, David K., Arnett, David W.
• Granted Patent: US 6,895,267 B2
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• 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 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• 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 5/063 using impedance measurements
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/6856 with a distal loop
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/4254 using sensors mounted on the probe
• CPC Class Codes: A61B 8/4472 Wireless probes

Abstract

A system for performing an invasive diagnostic or therapeutic medical procedure includes a first probe having a distal portion carrying a plurality of functional elements and a second probe having a distal portion carrying a functional element and a location sensor. The system includes a proximity processing subsystem in communication with the functional elements carried by each of the first and second probes and configured to determine a proximity of the functional element carried by the second probe relative to a first functional element carried by the first probe. The systems further includes a location processing subsystem configured to determine an absolute position and orientation of the location sensor carried by the second probe with respect to a three-dimensional reference coordinate system that can be internal or external to the three-dimensional space in which the first and second probes are positioned.

Claims

1. A system for performing a medical procedure, comprising:

a first probe having a distal portion carrying a first set of functional elements comprising a first functional element;

a second probe having a distal portion carrying a second set of functional elements comprising a second functional element;

a proximity determination subsystem in communication with the first and second sets of functional elements, and configured to determine a proximity of the first functional element relative to the second functional element; and

a location determination subsystem in communication with the second set of functional elements and configured to determine an absolute position of the second functional element in a three-dimensional coordinate system.

2. The system of claim 1, wherein the first set of functional elements comprises a plurality of functional elements, and the proximity determination subsystem is configured to determine a proximity of each of the plurality of functional elements relative to the second functional element.

3. The system of claim 1, wherein the second set of functional elements comprises only the second functional element, and both the proximity determination subsystem and location determination subsystem are in communication with the second functional element.

4. The system of claim 1, wherein the second functional element comprises a proximity element, the second set of functional elements further comprises a location element, the proximity determination subsystem is in communication with the first functional element and the proximity element and is configured to determine a proximity of the first functional element relative to the proximity element, the location determination subsystem is in communication with the location element and is configured to determine the absolute location of the location element.

5. The system of claim 1, wherein the distal portion of the second probe carries a third functional element that is offset from the second functional element a known distance, and ID the location determination subsystem is configured to determine an absolute location of the third functional element in the coordinate system based on the absolute location of the second functional element and the known offset distance between the second and third functional elements.

6. The system of claim 5, wherein the third functional element is an ablation electrode.

7. The system of claim 1, wherein the second functional element is an ablation electrode.

8. The system of claim 1, further comprising a location-proximity association subsystem configured to determine an absolute location of the first functional element in the coordinate system based on the absolute location of the second functional element and the proximity of the second functional element to the first functional element.

9. The system of claim 8, wherein the location-proximity association subsystem is configured to determine the absolute location of the first functional element when the second functional element is adjacent the first functional element.

10. The system of claim 1, wherein the first set of functional elements further comprises a plurality of remaining functional elements, and the system further comprises a location-proximity association subsystem configured to determine an absolute location of the plurality of remaining functional elements in the coordinate system based on the absolute location of the first functional element.

11. The system of claim 1, wherein the first set of functional elements further comprises a plurality of remaining functional elements, the distal portion of the second probe comprises a distal structure having a known geometry, and the system further comprises a location-proximity association subsystem configured to determine the absolute location of the plurality of remaining functional elements based on the absolute location of the first function element and the known geometry of the distal structure.

12. The system of claim 1, wherein the first set of functional elements further comprises a plurality of remaining functional elements, the distal portion of the second probe comprises a distal structure having a known geometry, the second set of functional elements comprises one or more location elements, the location determination subsystem is in communication with the one or more location elements and is configured to determine an absolute location of the one or more elements, and the system further comprises a location-proximity association subsystem configured to determine the absolute location of the plurality of remaining functional elements based on the absolute location of the first function element, the known geometry of the distal structure, and the absolute location of the one or more location elements.

13. The system of claim 1, wherein the first functional element is carried on a structure selected from the group consisting of a 3-D catheter structure, a loop structure, a helical structure, a multi-probe structure, and a single probe structure.

14. The system of claim 1, wherein the first and second probes each comprises a catheter.

15. The system of claim 1, wherein the first probe comprises a catheter selected from the group consisting of a basket catheter, a loop catheter, and a helical catheter.

16. The system of claim 1, wherein the first and second functional elements are selected from the group consisting of electrodes, ultrasound transducers, electromagnetic sensors, radio frequency transmitters, light diodes, electromagnetic resonant transducers, magnetic resonant transducers, electronic emitters, and infra- or near-infrared emitters.

17. The system of claim 1, wherein the first and second functional elements are selected from the group consisting of a wired functional element and a wireless functional element.

18. The system of claim 1, wherein the first set of functional elements comprises a plurality of mapping electrodes.

19. The system of claim 1, wherein the second functional element comprises a sensor.

20. The system of claim 1, wherein the coordinate system is based at least partially outside of a body in which the first and second probes are inserted.

21. The system of claim 1, wherein the coordinate system is based at least partially inside of a body in which the first and second probes are inserted.

22. The system of claim 1, wherein the proximity determination subsystem determines the proximity of the first functional element relative to the second functional element at least in part by a proximity detection technique selected from the group consisting of an ultrasound time delay technique, collision artifact detection technique, conduction delay sensing technique, iterative voltage analysis technique, and cardiac signal morphology analysis technique.

23. The system of claim 1, wherein the location determination subsystem determines the absolute position of the second functional element at least in part using an absolute position determination technique selected from the group consisting of a magnetic field measurement technique and ultrasound measurement technique.

24. The system of claim 1, wherein the second functional element is selected from the group consisting of a wired functional element and a wireless functional element.

25. The system of claim 1, further comprising a third probe having a distal portion carrying a third set of functional elements comprising a third functional element, wherein the proximity determination subsystem is in communication with the third set of functional elements, and is configured to determine a proximity of the third functional element relative to the second functional element.

26. A method of locating a probe in a body cavity, comprising:

positioning a first probe having a first functional element in the body cavity;

positioning a second probe carrying a second functional element in the body cavity;

determining an absolute position of the second functional element within a three-dimensional coordinate system; and

determining a proximity of the second functional element to the first functional element.

27. The method of claim 26, wherein the proximity of the second functional element relative to the first functional element is determined at least in part by using a proximity location technique selected from the group consisting of an ultrasound time delay technique, collision artifact detection technique, conduction delay sensing technique, iterative voltage analysis technique, and cardiac signal morphology analysis technique.

28. The method of claim 26, wherein the absolute position of the second functional element is determined at least in part by using an absolute position determination technique selected from the group consisting of a magnetic field measurement technique and ultrasound measurement technique.

29. The method of claim 26, wherein the second functional element is selected from the group consisting of a wired functional element and a wireless functional element.

30. The method of claim 26, wherein the body cavity is a heart chamber.

31. The method of claim 26, wherein the body cavity is a heart having a heart cycle, and wherein the determination steps are performed during a peak of a ventricular excitation phase of the heart cycle.

32. The method of claim 26, further comprising determining an absolute position within the coordinate system of the first functional element based on the absolute location of the second functional element and the proximity of the second functional element to the first functional element.

33. The method of claim 32, wherein the step of determining the absolute position of the first functional element comprises simultaneously locating the second functional element adjacent the first functional element and determining the absolute location of the second functional element.

34. The method of claim 32, further comprising storing in a memory the absolute positions of the first functional element.

35. The method of claim 34, further comprising:

retrieving the stored absolute positions from memory; and

displaying the retrieved absolute locations.

36. The method of claim 35, further comprising navigating a device in the coordinate system by reference to the retrieved absolute locations.

37. The method of claim 36, wherein the first probe is removed from the body cavity prior to navigating the device in the coordinate system by reference to the displayed map.

38. A method of locating a probe with a body cavity of a patient, comprising:

positioning a first probe carrying a plurality of functional elements in the body cavity;

positioning a second probe carrying a functional element in the body cavity;

determining an absolute position of the functional element within a three-dimensional coordinate system;

determining a proximity of the functional element to each of the plurality of functional elements; and

determining an absolute position within the coordinate system of each of the plurality of functional elements based on the absolute location of the functional element and the proximity of the functional element to each of the plurality of functional elements.

39. The method of claim 38, wherein the step of determining the absolute position of each of the plurality of functional elements comprises simultaneously locating the functional element adjacent each of the plurality of functional elements and determining the absolute position of the functional element.

40. The method of claim 38, wherein the step of determining the absolute position of each of the plurality of functional elements comprises simultaneously locating the functional element adjacent one of the plurality of functional elements, determining the absolute position of the functional element, and determining the absolute position of the plurality of functional elements based on the absolute position of the functional element.

41. The method of claim 38, further comprising storing in a memory the absolute position of each of the plurality of functional elements.

42. The method of claim 38, wherein the proximity of the functional element relative to each of the plurality of functional elements is determined at least in part by using a proximity location technique selected from the group consisting of an electrical field measurement technique, collision artifact detection technique, and cardiac signal morphology analysis technique.

43. The method of claim 38, wherein the absolute position of the functional element is determined at least in part by using an absolute position determination technique selected from the group consisting of an electrical field measurement technique, magnetic field measurement technique, and ultrasound measurement technique.

44. The method of claim 38, wherein the functional element is selected from the group consisting of a wired functional element and a wireless functional element.

45. The method of claim 38, wherein the body cavity is a heart chamber.

46. A method of locating a probe with a body cavity of a patient, comprising:

positioning a first probe carrying a plurality of functional elements in the body cavity;

positioning a second probe carrying a functional element in the body cavity;

determining an absolute position of the functional element within a three-dimensional coordinate system;

determining a proximity of the functional element to each of the plurality of functional elements; and

determining an absolute position within the coordinate system of each of the plurality of functional elements based on the absolute location of the functional element and the proximity of the functional element to each of the plurality of functional elements;

storing the absolute position of each of the plurality of functional elements in memory;

retrieving the stored absolute positions from the memory; and

displaying the retrieved absolute positions.

47. The method of claim 46, wherein the plurality of functional elements comprises a plurality of mapping elements for mapping a body cavity, the method further comprises generating a map by detecting information local to the body cavity using the plurality of mapping elements and associating the local information to the absolute positions of the plurality of mapping elements.

48. The method of claim 47, further comprising storing the map in memory.

49. The method of claim 48, further comprising:

retrieving the map from memory; and

displaying the map.

50. The method of claim 49, further comprising navigating a device in the coordinate system by reference to the displayed map.

51. The method of claim 50, wherein the first probe is removed from the body cavity prior to navigating the device in the coordinate system by reference to the displayed map.

52. The method of claim 50, wherein the device comprises the second probe.

53. The method of claim 50, wherein the device is a therapeutic device, and the local information comprises information indicating tissue targeted for therapy, the method further comprising treating the targeted tissue with the device.

54. The method of claim 53, wherein the therapeutic device comprises an ablation electrode, and the targeted tissue is ablated.

55. The method of claim 46, wherein the body cavity is a heart chamber.

56. A method of generating a composite map of tissue within a body region of a patient, comprising:

positioning a first probe carrying a plurality of mapping elements in a first location adjacent the tissue;

detecting information local to the first location using the plurality of mapping elements;

positioning a second probe carrying a functional element;

determining an absolute position of the functional element within a three-dimensional coordinate system;

determining a proximity of the functional element to each of the plurality of mapping elements while the first probe is positioned in the first location;

determining a first absolute position of each of the plurality of mapping elements within the coordinate system based on the absolute location of the functional element and the proximity of the functional element to each of the plurality of mapping elements;

generating first mapping information by associating the first local information to the first absolute positions of the plurality of mapping elements;

positioning the first probe in a second location adjacent the tissue;

detecting information local to the second location using the plurality of mapping elements;

determining a proximity of the functional element to each of the plurality of mapping elements while the first probe is positioned in the second location;

determining a second absolute position of each of the plurality of mapping elements within the coordinate system based on the absolute location of the functional element and the proximity of the functional element to each of the plurality of mapping elements;

generating second mapping information by associating the second local information to the second absolute positions of the plurality of mapping elements; and

combining the first and second mapping information into the composite map.

57. The method of claim 56, further comprising storing the composite map in memory.

58. The method of claim 57, further comprising:

retrieving the composite map from memory; and

displaying the composite map.

59. The method of claim 58, further comprising navigating a device in the coordinate system by reference to the displayed map.

60. The method of claim 59, wherein the first probe is removed from the body cavity prior to navigating the device in the coordinate system by reference to the displayed map.

61. The method of claim 56, wherein the body cavity is a heart chamber.

62. A method of navigating a probe in a body cavity of a patient, comprising:

positioning a mapping probe within the body cavity;

generating a map of the body cavity with the mapping probe;

registering the map in a three-dimensional coordinate system;

positioning a roving probe carrying a location element in the body cavity;

determining an absolute position of the location element within the coordinate system; and

navigating the roving probe within the body cavity by reference to the position of the location element within the coordinate system.

63. The method of claim 62, further comprising removing the mapping probe from the body cavity prior to completion of the roving probe navigation.

64. The method of claim 62, further comprising maintaining the mapping probe within the body cavity until completion of the roving probe navigation.