Robotic surgical system and method for diagnostic data mapping

• US 20070185404A1
• Filed: 12/29/2006
• Published: 08/09/2007
• Est. Priority Date: 05/28/2004
• Status: Active Grant

• Current Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Original Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Inventors: Hauck, John, Belhe, Kedar, Schweitzer, Jeffrey
• Granted Patent: US 8,755,864 B2
• Time in Patent Office: Days
• US Class Current: 600/509
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2053 Tracking an applied voltage gradient
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/301 for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2034/303 specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter
• 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 34/30 Surgical robots
• CPC Class Codes: A61B 34/71 Manipulators operated by drive cable mechanisms
• 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 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/6885 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/7425 Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B

Abstract

A method of generating a diagnosis map of at least a portion of the heart includes inserting an electrode within the portion of a heart, robotically moving the electrode therein, measuring electrophysiology information at a point on the surface of the heart, associating the measured electrophysiology information with position information for the point on the surface of the heart, repeating the measuring and associating steps for a plurality of points on the surface of the heart, thereby generating a plurality of surface diagnostic data points, and generating the diagnosis map therefrom. The electrode may be moved within the heart randomly, pseudo-randomly, or according to one or more predetermined patterns. A three-dimensional model of the portion of the heart may be provided and presented as a graphical representation, either with or without information indicative of the measured electrophysiology information superimposed thereon.

Claims

1. A system for generating a diagnosis map of at least a portion of a heart, the system comprising:

a catheter for insertion into an interior region of the heart;

a controller for moving the catheter within the heart;

a position detector to detect position information of the catheter and to generate position information for a point on a surface of the heart that is in meaningful proximity to the catheter;

an instrument to measure electrophysiology information at the point on the surface of the heart; and

a processor to cause the controller to move the catheter into meaningful proximity with a plurality of points on the surface of the heart, to detect position information for each of the plurality of points on the surface of the heart, to associate the electrophysiology information with one of the plurality of points on the surface of the heart at which the electrophysiology information was measured, and to generate the diagnosis map of the portion of the heart.

2. The system of claim 1, further comprising a storage medium for storing the diagnosis map.

3. The system of claim 1, further comprising a three-dimensional surface model of the portion of the heart.

4. The system of claim 3, further comprising:

a display device for presenting a graphical representation of the three-dimensional surface model of the portion of the heart;

an electrophysiology processor for processing the measured electrophysiology information to identify one or more points on the surface of the heart that are potential treatment sites, said processor being coupled to the display device so that the one or more identified potential treatment sites may be superimposed on the graphical representation of the three-dimensional model and displayed on the display device; and

an interface to permit a user to select one or more of the identified potential treatment sites, said interface being coupled to the controller and to the catheter such that the controller may cause the catheter to be relocated to the one or more selected treatment sites.

5. A method of generating a diagnosis map of at least a portion of a heart, comprising the steps of:

inserting an electrode within a portion of a heart;

robotically moving the electrode within the portion of the heart;

measuring electrophysiology information at a point on the surface of the heart in meaningful proximity to the electrode;

associating the measured electrophysiology information with position information for the point on the surface of the heart;

repeating the measuring and associating steps for a plurality of points on the surface of the heart, thereby generating a plurality of surface diagnostic data points; and

generating the diagnosis map from the plurality of surface diagnostic data points.

6. The method of claim 5, wherein robotically moving the electrode within the portion of the heart comprises robotically moving the electrode randomly within the portion of the heart.

7. The method of claim 5, further comprising storing the plurality of surface diagnostic data points.

8. The method of claim 5, further comprising providing a three-dimensional model of the portion of the heart.

9. The method according to claim 8, further comprising presenting the three-dimensional model of the portion of the heart as a graphical representation with information indicative of the measured electrophysiology information superimposed thereon.

10. A method of generating a diagnosis map of at least a portion of a heart, comprising the steps of:

inserting an electrode within a portion of a heart;

robotically moving the electrode within the portion of the heart;

detecting position information of the electrode, thereby generating a plurality of location points that define a space occupied by the portion of the heart;

measuring electrophysiology information at a plurality of surface points where the electrode is in meaningful proximity to a surface of the heart;

associating the measured electrophysiology information with the surface point at which the measurement was made;

storing the measured electrophysiology information and location information for the contact point at which the measurement was made; and

generating a three-dimensional model of the portion of the heart comprising location information and associated electrophysiology information for at least some of the plurality of surface points.

11. The method of claim 10, further comprising:

presenting a graphical representation of the three-dimensional model of the portion of the heart;

receiving input that identifies one or more target locations on the graphical representation of the three-dimensional model of the portion of the heart; and

robotically moving the electrode to each of the identified target locations.

12. The method of claim 11, further comprising presenting the graphical representation of the three-dimensional model of the portion of the heart with information indicative of the measured electrophysiology information superimposed thereon.

13. The method of claim 11, further comprising treating tissue at each of the identified target locations.

14. The method of claim 13, wherein treating tissue at each of the identified target locations comprises ablating tissue at each of the identified target locations.

15. The method of claim 10, further comprising:

presenting a graphical representation of the three-dimensional model of the portion of the heart;

processing the measured electrophysiology information to identify one or more contact points that are potential treatment sites; and

flagging the one or more identified potential treatment sites on the graphical representation of the three-dimensional model of the portion of the heart.

16. The method of claim 15, further comprising:

receiving input that selects one or more of the identified potential treatment sites on the graphical representation of the three-dimensional model of the portion of the heart; and

robotically moving the electrode to at least one selected treatment site.

17. The method according to claim 16, further comprising treating tissue at the at least one selected treatment site.

18. The method according to claim 17, wherein treating tissue at the at least one selected treatment site comprises ablating tissue at the at least one selected treatment site.

19. A method of generating a diagnosis map of at least a portion of a heart, comprising the steps of:

inserting an electrode within a portion of a heart;

using a robotic controller to move the electrode within the portion of the heart;

detecting position information of the electrode, thereby generating a plurality of location points that define a space occupied by the portion of the heart;

processing the plurality of location points to distinguish those location points that are interior to a surface of the portion of the heart;

generating a plurality of surface points defining a three-dimensional surface model of the portion of the heart;

measuring electrophysiology information of at least some of the plurality of surface points;

associating measured electrophysiology information with the surface point at which the measurement was made; and

storing the plurality of surface points defining the three-dimensional surface model of the portion of the heart with the associated measured electrophysiology information.

20. The method of claim 19, further comprising:

presenting a graphical representation of the three-dimensional surface model of the portion of the heart;

receiving input that identifies one or more target locations on the graphical representation of the three-dimensional surface model of the portion of the heart; and

robotically moving the electrode to each of the identified target locations.

21. The method of claim 19, further comprising:

presenting a graphical representation of the three-dimensional surface model of the portion of the heart;

processing the measured electrophysiology information to identify one or more contact points that are potential treatment sites; and

flagging the one or more identified potential treatment sites on the graphical representation of the three-dimensional model of the portion of the heart.

22. The method of claim 21, further comprising:

receiving input that selects one or more of the identified potential treatment sites on the graphical representation of the three-dimensional model of the portion of the heart; and

robotically moving the electrode to at least one selected treatment site.

23. A method of generating a diagnosis map of at least a portion of a heart, comprising the steps of:

a) inserting a catheter within a heart;

b) using a robotic controller to move the catheter within the heart;

c) detecting position information of the catheter and generating position information for a surface point on the surface of the heart;

d) measuring electrophysiology information at the surface point and associating the measured electrophysiology information with the position information for the surface point at which the electrophysiology information was measured;

e) repeating steps c) and d) for each of a plurality of surface points; and

f) generating a three-dimensional surface model of the portion of the heart, the model comprising position information for the plurality of surface points and the associated measured electrophysiology information.

24. The method of claim 23, further comprising storing the three-dimensional surface model on a storage medium.

25. The method of claim 23, further comprising presenting the three-dimensional surface model as a graphical representation having information indicative of the measured electrophysiology information superimposed thereon.

26. The method of claim 23, further comprising:

presenting a graphical representation of the three-dimensional surface model of the portion of the heart;

processing the measured electrophysiology information to identify one or more surface points that are potential treatment sites;

presenting the one or more identified potential treatment sites on the graphical representation of the three-dimensional model of the heart;

receiving input that identifies one or more target locations on the graphical representation of the three-dimensional surface model of the heart; and

robotically moving the electrode to each of the identified target locations.