Method and system of treatment of heart failure using 4D imaging

• US 20050143777A1
• Filed: 12/17/2004
• Published: 06/30/2005
• Est. Priority Date: 12/19/2003
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sra, Jasbir S.
• Application Number:
  US11/016,231
• Publication Number:
  US 20050143777A1
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/543 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: G06T 17/00 Three dimensional [3D] modelling, e.g. data description of 3D objects
• CPC Class Codes: G06T 2207/10076 4D tomography; Time-sequential 3D tomography
• CPC Class Codes: G06T 2207/10121 Fluoroscopy
• CPC Class Codes: G06T 2207/30048 Heart; Cardiac
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G06T 7/38 Registration of image sequences
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method is provided for treatment of heart failure having the steps of obtaining cardiac digital data from a medical imaging system utilizing an ECG gated protocol; generating a series of 3D images of a cardiac chamber and its surrounding structures, preferably the left ventricle and coronary sinus, from this cardiac digital data at select ECG trigger points that correspond to different phases of the cardiac cycle; registering these 3D images with an interventional system; acquiring ECG signals from the patient in real-time; transmitting these ECG signals to the interventional system; synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image; visualizing this 4D image upon the interventional system in real-time; visualizing a pacing/defibrillation lead over the 4D image upon the interventional system; navigating the pacing/defibrillation lead utilizing the 4D image; and placing the pacing/defibrillation lead over the cardiac chamber at an appropriate site to treat the heart failure.

Claims

1. A method for treating heart failure in a patient using 4D imaging comprising:

obtaining cardiac digital data from a medical imaging system utilizing an electrocardiogram (ECG) gated protocol;

generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle;

registering the 3D images with an interventional system;

acquiring ECG signals from the patient in real-time;

transmitting the ECG signals to the interventional system;

synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image;

visualizing the 4D image upon the interventional system in real-time;

visualizing a pacing/defibrillation lead over the 4D image upon the interventional system;

navigating the pacing/defibrillation lead utilizing the 4D image; and

placing the pacing/defibrillation lead over the cardiac chamber at a select location.

2. The method of claim 1 wherein the medical imaging system is a computer tomography (CT) system.

3. The method of claim 1 further comprising the step of visualizing the 4D image over a computer workstation of the interventional system.

4. The method of claim 1 wherein the 3D images are of the left ventricle and coronary sinus.

5. The method of claim 4 wherein the select location is substantially devoid of coronary vessels, nerves and scar tissue such that the select location is considered appropriate for pacing and further comprising the step of utilizing the registered 3D images to identify the select location.

6. The method of claim 5 wherein generating 3D images from the cardiac digital data comprises using a protocol optimized for 3D imaging of the left ventricle and coronary sinus.

7. The method of claim 1 wherein the interventional system is a fluoroscopic system.

8. The method of claim 1 further comprising the step of continuously updating and adjusting the synchronization of the registered 3D images with the trigger points on the transmitted ECG signals during an interventional procedure.

9. A system for treating heart failure in a patient using 4D imaging comprising:

a medical imaging system for obtaining cardiac digital data utilizing an electrocardiogram (ECG) gated protocol;

an image generation system for generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle;

an ECG monitor for acquiring ECG signals from the patient in real-time and for transmitting the ECG signals to an interventional system;

a workstation for registering the 3D images with the interventional system and for synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image that is visualized upon the interventional system in real-time; and

a pacing/defibrillation lead for placement over the cardiac chamber at a select location, whereby the pacing/defibrillation lead is visualized over the 4D image upon the interventional system.

10. The system of claim 9 wherein the medical imaging system is a computer tomography (CT) system.

11. The system of claim 9 wherein the 3D images are of the left ventricle and coronary sinus.

12. The system of claim 11 wherein the select location is substantially devoid of coronary vessels, nerves and scar tissue such that the select location is considered appropriate for pacing and further comprising the step of utilizing the registered 3D images to identify the select location.

13. The system of claim 12 wherein the image generation system generates 3D images from the cardiac digital data utilizing a protocol optimized for 3D imaging of the left ventricle and coronary sinus.

14. The system of claim 9 wherein the interventional system is a fluoroscopic system.

15. The system of claim 9 wherein the workstation continuously updates and adjusts the synchronization of the registered 3D images with the trigger points on the transmitted ECG signals during an interventional procedure.

16. A method for planning treatment of heart failure in a patient using 4D imaging comprising:

obtaining cardiac digital data from a medical imaging system utilizing an electrocardiogram (ECG) gated protocol;

generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures having diminished cardiac function from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle;

registering the 3D images with an interventional system;

acquiring ECG signals from the patient in real-time;

transmitting the ECG signals to the interventional system;

synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image;

visualizing the 4D image upon the interventional system in real-time.

17. The method of claim 16 wherein the medical imaging system is a computer tomography (CT) system.

18. The method of claim 17 wherein generating 3D images from the cardiac digital data comprises using a protocol optimized for 3D imaging of the left ventricle and coronary sinus.

19. The method of claim 18 wherein the interventional system is a fluoroscopic system.

20. A system for planning treatment of heart failure in a patient using 4D imaging comprising:

a medical imaging system for obtaining cardiac digital data utilizing an electrocardiogram (ECG) gated protocol;

an image generation system for generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures having diminished cardiac function from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle;

an ECG monitor for acquiring ECG signals from the patient in real-time and for transmitting the ECG signals to an interventional system;

a workstation for registering the 3D images with the interventional system and for synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image that is visualized upon the interventional system in real-time.