Standardization of catheter-based treatment for atrial fibrillation

• US 20070032826A1
• Filed: 08/02/2005
• Published: 02/08/2007
• Est. Priority Date: 08/02/2005
• Status: Active Grant

• Current Assignee: Biosense Webster Incorporated (Johnson & Johnson)
• Original Assignee: Biosense Webster Incorporated (Johnson & Johnson)
• Inventors: Schwartz, Yitzhack
• Granted Patent: US 8,583,220 B2
• Time in Patent Office: Days
• US Class Current: 607/2
• 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 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 8/0891 for diagnosis of blood vessels
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method for treating atrial fibrillation in an atrium of a heart includes (a) acquiring an image or map of the atrium; (b) displaying the image or map of the atrium; (c) marking at least one feature on the image or map; (d) calculating dimensions of the at least one feature; (e) identifying one or more points on or within the atrium for treatment as part of a treatment plan; (f) determining paths to the one or more points on or within the atrium for treatment; (g) simulating insertion of a sheath into the atrium; (h) simulating insertion of a medical device through the sheath and into the atrium; (i) verifying that the one or more points on or within the atrium can be accessed for treatment; (j) computing an overall surface area of the atrium; (k) calculating an estimated area not treated in the atrium based on the treatment plan; (l) assessing whether macro-reentrant circuits can exist in the estimated area not treated in the atrium; (m) repeating steps (e)-(l) in the event step (l) indicates that macro-reentrant circuits can exist in the estimated area not treated in the atrium; and (n) implementing the treatment plan.

Claims

1. A method for preventing macro-reentrant circuits from occurring in a portion of a heart of a patient, comprising the steps of:

(a) acquiring an image or map of the portion of the heart;

(b) displaying the image or map of the portion of the heart;

(c) marking at least one feature on the image or map;

(d) calculating dimensions of the at least one feature;

(e) identifying one or more points on or within the heart for treatment as part of a treatment plan;

(f) determining paths to the one or more points on or within the heart for treatment;

(g) simulating insertion of a sheath into the heart;

(h) simulating insertion of a medical device through the sheath and within the heart;

(i) verifying that the one or more points on or within the heart can be accessed for treatment;

(j) computing an overall surface area of the portion of the heart;

(k) calculating an estimated area not treated in the portion of the heart based on the treatment plan;

(l) assessing whether macro-reentrant circuits can exist in the estimated area not treated in the portion of the heart;

(m) repeating steps (e)-(l) in the event step (l) indicates that macro-reentrant circuits can exist in the estimated area not treated in the portion of the heart; and

(n) implementing the treatment plan.

2. The method according to claim 1, further comprising measuring an actual area not treated in the portion of the heart after step (n).

3. The method according to claim 2, further comprising assessing whether macro-reentrant circuits can exist in the actual area not treated in the portion of the heart.

4. The method according to claim 3, further comprising repeating steps (e)-(l) in the event step (l) indicates that macro-reentrant circuits can exist in the actual area not treated in the portion of the heart.

5. The method according to claim 4, further comprising implementing a revised treatment plan in the event step (l) indicates that macro-reentrant circuits can exist in the actual area not treated in the portion of the heart.

6. The method according to claim 5, further comprising monitoring the treatment and robotically guiding the medical device according to the treatment plan.

7. The method according to claim 5, further comprising using ablation as the treatment.

8. The method according to claim 7, further comprising conducting step (l) for a range of refractory periods.

9. The method according to claim 8, further comprising treating atrial fibrillation in the portion of the heart.

10. A method for treating atrial fibrillation in an atrium of a heart of a patient, comprising the steps of:

(a) acquiring an image or map of the atrium;

(b) displaying the image or map of the atrium;

(c) marking at least one feature on the image or map;

(d) calculating dimensions of the at least one feature;

(e) identifying one or more points on or within the atrium for treatment as part of a treatment plan;

(f) determining paths to the one or more points on or within the atrium for treatment;

(g) simulating insertion of a sheath into the atrium;

(h) simulating insertion of a medical device through the sheath and into the atrium;

(i) verifying that the one or more points on or within the atrium can be accessed for treatment;

(j) computing an overall surface area of the atrium;

(k) calculating an estimated area not treated in the atrium based on the treatment plan;

(l) assessing whether macro-reentrant circuits can exist in the estimated area not treated in the atrium;

(m) repeating steps (e)-(l) in the event step (l) indicates that macro-reentrant circuits can exist in the estimated area not treated in the atrium; and

(n) implementing the treatment plan.

11. The method according to claim 10, further comprising measuring an actual area not treated in the atrium after step (n).

12. The method according to claim 11, further comprising assessing whether macro-reentrant circuits can exist in the actual area not treated in the atrium.

13. The method according to claim 12, further comprising repeating steps (e)-(l) in the event step (l) indicates that macro-reentrant circuits can exist in the actual area not treated in the atrium.

14. The method according to claim 13, further comprising implementing a revised treatment plan in the event step (l) indicates that macro-reentrant circuits can exist in the actual area not treated in the atrium.

15. The method according to claim 14, further comprising monitoring the treatment and robotically guiding the medical device according to the treatment plan.

16. The method according to claim 14, further comprising using ablation as the treatment.

17. The method according to claim 16, further comprising conducting step (l) for a range of refractory periods.