Determining a Location of a Member

• US 20090262982A1
• Filed: 04/14/2009
• Published: 10/22/2009
• Est. Priority Date: 04/18/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Receveur, Rogier, Markowitz, H. Toby, Falkner, Phillip, Warman, Eduardo N., Karamanoglu, Mustafa, Waldhauser, Steven L., Zhang, Shangqian Peter, Larik, Vincent, Michels, Koen, Giese, Chad, Eick, Olaf, Jannicke, Jeff, Scanlon, David A., Kryger, Michael, Campbell-Massa, Sean, Fleming, Ioana, Hefner, Don, Mehta, Pooja, Steeves, James
• Granted Patent: US 9,179,860 B2
• Time in Patent Office: Days
• US Class Current: 382/103
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• 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 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/063 using impedance measurements
• CPC Class Codes: A61B 5/066 : Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/304 : Switching circuits
• CPC Class Codes: A61B 5/333 : Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/339 : Displays specially adapted therefor
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 8/06 : Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/4472 : Wireless probes

Abstract

An volume of a patient can be mapped with a system operable to identify a plurality of locations and save a plurality of locations of a mapping instrument. The mapping instrument can include one or more electrodes that can sense a voltage that can be correlated to a three dimensional location of the electrode at the time of the sensing or measurement. Therefore, a map of a volume can be determined based upon the sensing of the plurality of points without the use of other imaging devices. An implantable medical device can then be navigated relative to the mapping data.

Claims

1. A system to locate and determine a position of portions of an instrument in a volume, comprising:

an elongated and flexible member extending between a first end and a second end;

a first position element positioned near the first end of the elongated and flexible member;

a second position element positioned near the second end of the elongated and flexible member;

a set of axis generation patches operable to be positioned on a surface of the volume;

a driver to inject a current into the volume between the set of axis generation patches;

a processor operable to evaluate an electrical property sensed with the first position element and the second position element;

wherein the elongated flexible member is operable to flex between the first position element and the second position element such that the first position element and the second position element are not aligned;

wherein the first position element and the second position element are operable to sense the electrical property within the volume due to the injected current into the volume between the set of axis generation patches.

2. The system of claim 1, further comprising:

a mapping instrument having a third position element;

a storage system operable to store a plurality of determined positions of the third position element;

the processor further operable to generate a map of the volume with the stored determined positions of the third position element;

a display device operable to display the map;

wherein a first icon representing the position of the first position element and a second icon representing a position of the second position element are operable to be superimposed on the map to illustrate a position of two portions of the elongated and flexible member within the volume.

3. The system of claim 1, wherein the elongated and flexible member has an outer wall and both the first position member and the second position member are fixed to the outer wall.

4. The system of claim 3, wherein the first position member is formed integrally with the outer wall.

5. The system of claim 1, further comprising:

an elongated flexible sleeve;

wherein the first position element and the second position element are fixed to the elongated flexible sleeve;

wherein the elongated and flexible member is positioned through the elongated flexible sleeve.

6. The system of claim 1, further comprising an additional plurality of position elements positioned along the length of the elongated and flexible member;

wherein the number of the additional plurality of position elements is operable to determine a resolution of a geometry of the elongated and flexible member.

7. The system of claim 1, wherein the elongated and flexible member is an implantable lead;

wherein at least one of the first position element and the second position element are positioned at a terminal distal end of the elongated and flexible member and operable to be implanted into a wall of a heart.

8. A system to locate and determine a position of portions of an instrument in a volume of a patient, comprising:

an elongated and flexible implantable lead extending between a first end and a second terminal distal end;

a first position element positioned near the first end of the implantable lead;

a second position element positioned at the second end of the implantable lead;

a set of axis generation patches operable to be positioned on a surface of the volume;

a driver to inject a current into the volume between the set of axis generation patches;

a mapping instrument having a third position element;

a storage system operable to store a plurality of determined positions of the third position element;

a processor operable to evaluate an electrical property sensed with the first position element, the second position element, and the third position element, wherein the processor is further operable to generate a map of the volume with the stored determined positions of at least the third position element; and

a display device operable to display the map;

wherein the implantable lead is operable to flex between the first position element and the second position element such that the first position element and the second position element are not aligned;

wherein the first position element and the second position element are operable to sense the electrical property within the volume due to the injected current into the volume between the set of axis generation patches;

wherein a first icon representing the position of the first position element and a second icon representing a position of the second position element are operable to be superimposed on the map to illustrate a position of two portions of the elongated and flexible member within the volume;

wherein at least the second position element is operable to be implanted into a wall of a heart of the patient.

9. The system of claim 8, wherein the first position member is formed integrally with an outer wall of the implantable lead.

10. The system of claim 8, further comprising:

an elongated flexible sleeve;

wherein the first position element includes a plurality of first position elements;

wherein all of the plurality of first position elements are fixed to the elongated flexible sleeve;

wherein the implantable lead is positioned through the elongated flexible sleeve and is operable to move and flex with the implantable lead.

11. The system of claim 8, wherein the first position element includes a plurality of first position elements positioned along the length of the implantable lead;

wherein the number of the plurality of first position elements is operable to determine a resolution of a geometry of the implantable lead.

12. The system of claim 11, wherein all of the plurality of first position elements are removable from the implantable lead.

13. The system of claim 11, wherein all of the plurality of first position elements are fixed to an exterior wall of the implantable lead.

14. A method to locate and determine a position of portions of an instrument in a volume, comprising:

providing an elongated and flexible member extending between a first end and a second end with a first position element positioned near the first end and a second position element positioned near the second end;

positioning a set of axis generation patches on a surface of the volume;

injecting a current into the volume between the set of axis generation patches;

sensing with the first position element and the second position element an electrical property due to the injected current into the volume between the set of axis generation patches;

evaluating the sensed electrical property sensed with the first position element and the second position element;

determining a relative position of the first position element and the second position element based on the evaluation of the electrical property;

determining a geometry of the elongated and flexible member based on the determined relative position of the first position element and the second position element.

15. The method of claim 14, further comprising:

providing an additional plurality of position elements along the length of the elongated and flexible member; and

resolving the geometry of the elongated and flexible member based on the number of the additional plurality of position elements.

16. The method of claim 14, further comprising;

generating a map of an internal surface of the volume based on the determination a plurality of relative positions within the volume without an additional imaging modality; and

illustrating at least one of the determined relative position of the first position element and the second position element and the determined geometry of the elongated and flexible member relative to the generated map.

17. The method of claim 14, wherein providing the elongated and flexible member extending between a first end and a second end with a first position element positioned near the first end and a second position element positioned near the second end, includes:

fixing both the first position member and the second position member to an outer wall of the elongated and flexible member.

18. The method of claim 17, wherein the first position member is formed integrally with the outer wall of the elongated and flexible member.

19. The method of claim 14, wherein providing the elongated and flexible member extending between a first end and a second end with a first position element positioned near the first end and a second position element positioned near the second end, includes:

providing an elongated flexible sleeve;

fixing the first position element and the second position element to the elongated flexible sleeve; and

positioning the elongated and flexible member through the elongated flexible sleeve.

20. The method of claim 14, further comprising:

implanting at least one of the first position element and the second position element into a wall of a heart of a patient; and

stimulating the heart of the patient with at least one of the first position element and the second position element.