Design of Handle Set for Ablation Catheter with Indicators of Catheter and Tissue Parameters

• US 20080275465A1
• Filed: 12/06/2006
• Published: 11/06/2008
• Est. Priority Date: 12/06/2005
• 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: Paul, Saurav, Cao, Hong, Belhe, Kedar Ravindra, Thao, Chou, Hassett, James A.
• Granted Patent: US 8,728,077 B2
• Time in Patent Office: Days
• US Class Current: 606/129
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2018/00303 active, e.g. with a motor creating vibrations
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/0075 Phase
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00869 Phase
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• 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 5/053 Measuring electrical impedance or conductance of a portion of the body

Abstract

An electrode coupling output system provides indication to the physician, via electrode guidance instrumentation, concerning the electrical coupling of an electrode, such as an ablative or mapping electrode, with a patient. The output can be provided to the physician via an output device incorporated into the handle set of the electrode catheter. For example, a visual, audio or mechanical output can be provided via the handle set. Additionally or alternatively, the output can be provided to the physician via a navigation system. The indication may be provided by changing the color or other display characteristics of the electrode on the navigation system display or by way of providing a waveform indicating the electrode coupling. In this manner, electrode coupling information is provided to a physician in a manner that minimizes physician distraction.

Claims

1. A method for use in operating an electrode catheter, the method comprising the steps of

establishing an electrode coupling assessment system for evaluating an electrode coupling relationship, said assessment system being operative to distinguish between at least two different levels of electrode coupling between an electrode of said electrode catheter and a patient;

operating said electrode coupling assessment system in connection with a medical procedure to identify a level of electrode coupling; and

providing an output, via instrumentation used by a physician in guiding said electrode in relation to physiological structure of said patient, indicating said identified level of electrode coupling.

2. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative for distinguishing between multiple levels of electrode coupling, including at least one level corresponding to elevated coupling, wherein said elevated coupling indicates a potential for tissue penetration.

3. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative to distinguish between each of insufficient coupling for a procedure, sufficient coupling for said procedure and elevated coupling.

4. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative for distinguishing between said levels of electrode coupling based on an impedance-related value.

5. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative for distinguishing between said levels of electrode coupling based on a relationship between values related to resistance and reactance components of impedance.

6. The method as set forth in claim 1, wherein said step of operating comprises identifying said level of electrode coupling prior to operation of said electrode catheter to generate a desired effect.

7. The method as set forth in claim 1, wherein said step of operating comprises operating said electrode coupling assessment system during the course of a medical procedure involving said electrode catheter.

8. The method as set forth in claim 1, wherein said step of providing comprises conveying said output via a handle set of said electrode catheter.

9. The method as set forth in claim 8, wherein said output is provided by operating one of a visual, an audio or a mechanical output device.

10. An apparatus for use in operating an electrode catheter, the apparatus comprising

an input interface for receiving a signal indicative of a level of electrode coupling between an electrode of said electrode catheter and a patient;

a processor for processing said signal to determine said level of electrode coupling between said electrode of said electrode catheter and said patient; and

an output interface for generating an output signal for controlling instrumentation used by a physician in guiding said electrode in relation to tissue of said patient so as to indicate, via said guidance instrumentation, said determined level of electrode coupling.

11. The apparatus as set forth in claim 10, wherein said processor is operative for distinguishing between multiple levels of electrode coupling, including at least one level corresponding to elevated coupling.

12. The apparatus as set forth in claim 10, wherein said processor is operative to distinguish between each of insufficient coupling for a procedure, sufficient coupling for said procedure and elevated coupling.

13. The apparatus as set forth in claim 10, wherein said processor is operative for distinguishing between different levels of electrode coupling based on the relationship between values related to resistance and reactance components of impedance.

14. The apparatus as set forth in claim 10, wherein said output module is incorporated into a handle set of said electrode catheter.

15. The apparatus as set forth in claim 14, wherein said output module comprises one of a visual, an audio or a mechanical output device.

16. An electrode catheter system comprising

an electrode;

a catheter associated with said electrode;

guidance instrumentation for guiding said electrode relative to tissue of a patient, said guidance instrumentation including a navigation system for use in monitoring a position of said electrode and a manipulation system for use in controlling a position of said electrode; and

a processor for receiving signal information and determining a level of electrode coupling between said electrode and a patient, said processor further being operative to control said guidance instrumentation to provide an indication of said level of electrode coupling.

17. The electrode catheter system as set forth in claim 16, wherein said processor is operative for distinguishing between each of insufficient electrode coupling for a procedure, sufficient electrode coupling for said procedure and elevated coupling.

18. The electrode catheter system as set forth in claim 16, wherein said processor is operative for distinguishing between different levels of electrode coupling based on a relation between values related to resistance and reactance components of impedance.

19. The electrode catheter system as set forth in claim 16, wherein said guidance instrumentation includes a handle set of said electrode catheter, said handle set being operative to provide said indication of said level of electrode coupling.

20. An electrode catheter system comprising

a processor for monitoring a parameter of interest in relation to a medical procedure involving an electrode catheter and identifying a condition of interest based on said monitoring;

and

an electrode catheter handle set, operatively associated with said processor, for providing an output indicative of said condition of interest.

21. The electrode catheter system as set forth in claim 20, wherein said electrode catheter handle set includes one of a visual, an audio or a mechanical output device.

22. The electrode catheter system as set forth in claim 21, wherein the output device is operative to indicate the presence or absence of said condition of interest.

23. The electrode catheter system as set forth in claim 21, wherein said output device is operative to provide indication regarding a range of levels related to said condition of interest.