System for non-invasive heart treatment

• US 20050161051A1
• Filed: 03/14/2005
• Published: 07/28/2005
• Est. Priority Date: 01/08/2003
• Status: Active Grant

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Cyberheart, Inc. (Siemens AG)
• Inventors: Benetti, Federico, Pankratov, Michail, Vivian, Judie
• Granted Patent: US 7,645,276 B2
• Time in Patent Office: Days
• US Class Current: 128/898
• CPC Class Codes: A61N 5/10 X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 5/1039 using functional images, e.g. PET or MRI
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1064 for adjusting radiation treatment in response to monitoring
• CPC Class Codes: A61N 5/1084 for delivering multiple intersecting beams at the same time, e.g. gamma knives

Abstract

The invention provides a non-invasive method for treatment of arrhythmia. In a first aspect, a method for treatment of atrial fibrillation in a heart of a patient comprises directing radiation from outside the patient toward one or more target treatment regions of the heart so as to inhibit the atrial fibrillation. The radiation may induce isolation of a pulmonary vein.

Claims

1. A system for treatment of atrial fibrillation in a heart of a patient, the system comprising:

a source of particle beam radiation or x-ray radiation; and

a robotic system configured for directing the particle beam radiation or x-ray radiation from outside the patient toward one or more target treatment regions in the heart so as to inhibit the atrial fibrillation, the robotic system coupled to the source.

2. The system of claim 1, wherein the robotic system comprises an imaging system for imaging a first pulmonary vein and a processor configured for targeting the radiation from outside the patient so as to induce isolation of the first pulmonary vein.

3. The system of claim 2, wherein the processor is configured to target the radiation so that it effects bilateral pulmonary vein isolation.

4. The system of claim 2, wherein the processor is configured to target at least one ectopic focus of the heart for treatment with the radiation.

5. The system of claim 2, wherein the processor is configured to target the radiation so that the radiation ablates linear lesions within the heart to inhibit an ectopic electrical pathway, the lesions corresponding to a Maze lesion pattern.

6. The system of claim 2, wherein the processor is configured so that a first portion of the radiation is directed to the patient in a first treatment, and a second portion of the radiation is directed to the patient in a second treatment so that the atrial fibrillation is inhibited in a fractionated radiation procedure allowing assessing of the patient between the first treatment and the second treatment.

7. The system of claim 2, wherein the processor is configured to direct the radiation so as to avoid exceeding a tolerance of tissues adjacent the one or more target regions.

8. The system of claim 1, wherein the robotic system comprises a robotic arm movably supporting the source and a processor coupled to the robotic arm, the processor configured to effect delivery of the radiation as a series of radiation beams extending toward the heart and movement of the robotic arm between beams so that the beams are directed toward the heart from different angles.

9. The system of claim 8, further comprising an imaging system coupled to the processor, wherein the processor is configured to dynamically register the radiation beams with the one or more regions of the heart using the imaging system.

10. The system of claim 9, wherein the processor is configured to dynamically register so as to compensate for pumping of the heart, movement of the patient, or breathing of the patient.

11. The system of claim 9, wherein the processor is configured to acquire a plurality of target adjustment images from the imaging system during a radiation treatment procedure, and to determine a position of the one or more regions relative to a reference frame of the robot arm from the target adjustment images.

12. The system of claim 11, further comprising radiopaque fiducial markers suitable for insertion into the patient around the one or more regions, wherein the imaging system comprises first and second fluoroscopic systems.

13. The system of claim 12, wherein the target adjustment images are acquired between delivery of successive radiation beams.

14. The system of claim 8, wherein the robot arm moves the source with six degrees of freedom.

15. The system of claim 8, wherein the processor is configured to plan the series of radiation beams, and wherein the imaging system comprises a CT scanner or an MRI scanner.

16. The system of claim 15, wherein processor generates a plan for the series of radiation beams, the plan comprising a number of the radiation beams, intensities of the radiation beams, and directions of the radiation beams.

17. The system of claim 15, wherein the target region comprises a non isocentric treatment.

18. The system of claim 1, wherein the source comprises a portable linear accelerator, the radiation comprising x-ray radiation.

19. The system of claim 1, wherein the radiation comprises gamma radiation.

20. A system for treatment of atrial fibrillation in a heart of a patient, the system comprising:

an imaging system for imaging the heart;

a radiation source for generating a sequential series of radiation beams from outside the patient;

a robotic arm supporting the radiation source;

a processor coupled to the robotic arm and the source, the processor configured to target one or more regions of the heart with the radiation so as to inhibit the atrial fibrillation by registering the source outside the patient with the one or more regions, and transmit a radiation beam toward the registered one or more region; and

wherein the processor is also configured to repeatedly reposition the robotic arm so as to orient another radiation beam toward the one or more regions from another angle, dynamically register the source with the one or more regions in response to the imaging system, and transmit the other radiation beam toward the dynamically registered one or more region.