Determining a position of a member within a sheath

• US 20090264739A1
• Filed: 04/09/2009
• 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: Markowitz, H. Toby, Waldhauser, Steven L., Giese, Chad, Jannicke, Jeff
• Granted Patent: US 8,839,798 B2
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 2034/2046 Tracking techniques
• 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 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• 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 5/063 using impedance measurements
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: G06V 2201/03 Recognition of patterns in medical or anatomical images
• CPC Class Codes: G06V 2201/034 of medical instruments

Abstract

A system for determining a location of an instrument within an anatomy is provided. The system can include a first instrument, which can define at least one lumen. The system can further include a second instrument, which can be received through the at least one lumen. The system can include at least one electrode, which can be coupled to a distal end of the first instrument. The electrode can be responsive to electrical activity to generate at least one signal. The system can include a sensing unit, which can be in contact with the anatomy to sense electrical activity within the anatomy at a location near the instrument. The sensing unit can be in communication with the electrode to receive the signal. The system can further include a control module that can determine, based on the sensed electrical activity and the signal, the location of the first instrument.

Claims

1. A system for determining a location of an instrument within an anatomy comprising:

a first instrument navigable within the anatomy that defines at least one lumen, and includes a proximal end and a distal end;

a second instrument received through the at least one lumen and navigable within the anatomy relative to the first instrument;

at least one electrode coupled to the distal end of the first instrument, the at least one electrode responsive to electrical activity to generate at least one signal;

a sensing unit in contact with the anatomy to sense electrical activity within the anatomy at a location near the instrument, the sensing unit in communication with the at least one electrode to receive the at least one signal;

a control module that determines, based on the sensed electrical activity and the at least one signal, the location of the first instrument; and

wherein the at least one electrode is slittable so that the first instrument can be removed from about the second instrument.

2. The system of claim 1, further comprising:

a first drive patch in contact with the anatomy; and

a second drive patch in contact with the anatomy and spaced apart from the first drive patch, the first drive patch and the second drive patch positioned at or near the location.

3. The system of claim 2, further comprising:

a first reference patch in contact with the anatomy and spaced apart from the first drive patch and the second drive patch; and

a second reference patch in contact with the anatomy and spaced apart from the first drive patch, the second drive patch and the first reference patch, the first reference patch and the second reference patch positioned at or near the location.

4. The system of claim 3, wherein the sensing unit generates a voltage between the first drive patch and the second drive patch and the sensed electrical activity comprises voltages sensed between the first reference patch and the second reference patch.

5. The system of claim 4, wherein the at least one electrode of the first instrument is responsive to the voltages between the first drive patch, second drive patch, and the at least one signal from the at least one electrode comprises at least one voltage sensed by the at least one electrode.

6. The system of claim 5, wherein based on the sensed electrical activity between the first drive patch and the second drive patch and the at least one signal from the at least one electrode, the control module determines at least one impedance of the at least one electrode of the first instrument.

7. The system of claim 6, the control module determines a position of the second instrument relative to the anatomy based on the at least one impedance of the at least one electrode of the first instrument.

8. The system of claim 4, wherein the second instrument further comprises:

at least one second instrument electrode at a distal end, the at least one second instrument electrode responsive to the voltage to generate at least one second instrument signal that indicates at least one voltage sensed by the at least one second instrument electrode; and

wherein the sensing unit is in communication with the at least one second instrument electrode to receive the at least one second instrument electrode signal, and based on the sensed electrical activity and the at least one second instrument signal, the control module determines at least one impedance of the at least one second instrument electrode of the second instrument.

9. The system of claim 8, wherein the control module determines a position of the first instrument relative to the anatomy based on the at least one impedance of the at least one second instrument electrode of the second instrument.

10. The system of claim 9, wherein the control module determines a position of the first instrument relative to the second instrument.

11. The system of claim 10, further comprising a display that displays the position of the first instrument relative to the second instrument.

12. The system of claim 1, wherein the first instrument further comprises at least one pull wire, which is coupled near the distal end of the first instrument and extends to the proximal end of the instrument to enable deflection of the distal end of the first instrument by manipulating the at least one pull wire at the proximal end.

13. The system of claim 1, wherein the second instrument comprises a catheter, balloon catheter, mapping catheter, basket catheter, guide wire, arthroscopic system, cardiac lead, implant or combinations thereof.

14. A system for determining a location of an instrument within an anatomy comprising:

a first electrode patch in contact with the anatomy;

a second electrode patch in contact with the anatomy and spaced apart from the first electrode patch;

a first instrument navigable within the anatomy relative to the first electrode patch and the second electrode patch that defines at least one lumen, and includes a distal end;

a second instrument received through the at least one lumen and navigable within the anatomy relative to the first instrument, the first electrode patch and the second electrode patch;

at least one electrode coupled to the distal end of the first instrument, the at least one electrode responsive to electrical activity to generate at least one signal;

a sensing unit in communication with the first electrode patch and the second electrode patch to generate voltages between the first electrode patch and the second electrode patch, the sensing unit in communication with the at least one electrode of the first instrument to receive the at least one signal and to determine at least one impedance of the at least one electrode of the first instrument based on the at least one signal; and

a control module that determines, based on the at least one impedance of the at least one electrode of the first instrument, the location of the first instrument within the anatomy.

15. The system of claim 14, wherein the at least one electrode further comprises:

a metal portion that is in communication with the sensing unit; and

a conductive polymeric band coupled to the metal portion, the conductive polymeric band coupled about a circumference of the first instrument.

16. The system of claim 15, wherein the metal portion comprises a metal electrode that does not circumscribe the circumference of the first instrument.

17. The system of claim 15, wherein the metal portion comprises a band that circumscribes the circumference of the first instrument, the band able to be slit with a cutting member.

18. The system of claim 14, wherein the at least one electrode is able to be slit so that the first instrument can be removed without removing the second instrument.

19. The system of claim 16, wherein the metal electrode has a shape adapted to direct a cutting instrument, the shape selected from the group comprising a triangle, diamond, trapezoid, oval, circle, rectangle and a polygon.

20. The system of claim 17, wherein the metal band is positioned within the first instrument, the conductive polymeric band is formed about an exterior of the first instrument and the first instrument defines a bore, which receives a portion of the conductive polymeric band to enable electrical communication between the metal band and the conductive polymeric band.

21. The system of claim 20, wherein the metal band and conductive polymeric band are concentric about the first instrument.

22. A method for determining a location of an instrument within an anatomy comprising:

providing a first instrument that includes at least one lumen;

inserting a second instrument into the at least one lumen;

inserting the second instrument and at least a portion of the first instrument into the anatomy;

sensing electrical activity within the anatomy near the portion of the first instrument;

determining, based on the sensed electrical activity, the location of the first instrument; and

slitting the at least one electrode to remove the first instrument from the anatomy without removing the second instrument.

23. The method of claim 22, further comprising:

coupling a first drive patch to the anatomy;

coupling a second drive patch to the anatomy at a location spaced apart from the first drive patch; and

generating voltages in the first drive patch and the second drive patch.

24. The method of claim 23, wherein the first instrument includes at least one electrode and sensing the electrical activity further comprises:

sensing at least one voltage with the at least one electrode; and

determining, based on the at least one sensed voltage, an impedance of the at least one electrode of the first instrument.