DEVICE AND METHOD FOR THE GEOMETRIC DETERMINATION OF ELECTRICAL DIPOLE DENSITIES ON THE CARDIAC WALL

• US 20140121470A1
• Filed: 03/09/2012
• Published: 05/01/2014
• Est. Priority Date: 03/10/2011
• Status: Active Grant

• Current Assignee: Acutus Medical, Inc.
• Original Assignee: Acutus Medical, Inc.
• Inventors: Scharf, Christoph, Scharf, Gunter, Werneth, Randell L.
• Granted Patent: US 9,757,044 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• 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 2562/0204 Acoustic sensors
• CPC Class Codes: A61B 2562/0209 Special features of electrodes classified in A61B5/24, A61B5/25, A61B5/283, A61B5/291, A61B5/296, A61B5/053
• CPC Class Codes: A61B 2576/023 for the heart
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/367 Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart
• 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 8/445 Details of catheter construction
• CPC Class Codes: A61B 8/4483 characterised by features of the ultrasound transducer
• CPC Class Codes: A61B 8/5207 involving processing of raw data to produce diagnostic data, e.g. for generating an image reconstruction G06T11/00
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing

Abstract

Disclosed are devices (100), systems (500), and methods for determining the dipole densities on heart walls. In particular, a triangularization of the heart wall is performed in which the dipole density of each of multiple regions correlate to the potential measured at various located within the associated chamber of the heart. To create a database of dipole densities, mapping information recorded by multiple electrodes (316) located on one or more catheters (310) and anatomical information is used. In addition, skin electrodes may be implemented. Additionally, one or more ultrasound elements (340) are provided, such as on a clamp assembly or integral to a mapping electrode, to produce real time images of device components and surrounding structures.

Claims

1. A device for creating a database of dipole densities d(y) and distance measurements at the surface of one or more cardiac chambers of a patient, said device comprising:

multiple electrodes located on one or more catheters;

a transducer constructed and arranged to emit sound waves; and

a sensor constructed and arranged to receive reflections of the sound waves.

176. The device of claim 1, wherein the transducer comprises the sensor.

177. The device of claim 1, wherein the device is constructed and arranged to produce a real time image.

178. The device of claim 1, wherein the device is constructed and arranged to produce continuous images.

179. The device of claim 1, wherein the device is constructed and arranged to produce images of the patient'"'"'s tissue.

180. The device of claim 179, wherein the image comprises an image of the one or more cardiac chambers.

181. The device of claim 179, wherein the image comprises an image of at least one of the multiple electrodes.

182. The device of claim 1, wherein the device is constructed and arranged to provide motion information of the patient'"'"'s tissue.

183. The device of claim 1, wherein the device is constructed and arranged to provide thickness information of the patient'"'"'s tissue.

184. The device of claim 1, wherein the device is constructed and arranged to produce a distance measurement comprising the distance between at least one of the multiple electrodes and a wall of a cardiac chamber.

185. The device of claim 1, wherein the device is constructed and arranged to provide tissue diagnostic information by analyzing both tissue motion information and cell electrical signals.

186. The device of claim 185, wherein the device is constructed and arranged to provide the tissue diagnostic information during a cardiac ablation procedure.

187. The device of claim 1, wherein the device is constructed and arranged to provide the location of cardiac tissue with complex electrograms.

188. The device of claim 1, further comprising a delivery sheath.

189. The device of claim 1, wherein at least one of the sensor or the transducer comprises a single component.

190. The device of claim 1, wherein at least one of the sensor or the transducer comprises an array of components.

191. The device of claim 190, wherein the array comprises an array of ultrasound crystals.

192. The device of claim 1, wherein the device comprises a multiple arm assembly and wherein the at least one of the sensor or the transducer is mounted to the multiple arm assembly.

193. The device of claim 192, wherein a first electrode of the multiple electrodes is mounted to the multiple arm assembly.

194. The device of claim 1, wherein the transducer comprises an ultrasound transducer.

195. The device of claim 1, wherein the transducer produces signals with a frequency between 3 Mhz and 18 Mhz.

196. The device of claim 1, wherein the sensor comprises an ultrasound sensor.

197. The device of claim 1, wherein the sensor comprises multiple sensors.

198. The device of claim 1, further comprising:

a first receiver constructed and arranged to receive mapping information from the multiple electrodes, the mapping information received when the multiple electrodes are placed in the one or more cardiac chambers;

a dipole density module constructed and arranged to generate the three dimensional database of dipole densities d(y), wherein the dipole density module determines a dipole density for individual triangle shaped projections onto the cardiac chamber wall, where each triangle projection at a location y contributes {acute over (ω

)}(x,y) times the dipole density d(y) to a potential V(x) at a point x, wherein {acute over (ω

)}(x,y) is the solid angle for that triangle projection, and where;

a) x represents a series of locations within one or more cardiac chambers; and

b) V(x) is a measured potential at point x, said measured potential recorded by the multiple electrodes.

199. The device of claim 1, wherein the dipole density is determined for at least 1000 triangle shaped projections.

200. The device of claim 1, wherein the dipole density module determines a map of dipole densities d(y) at corresponding time intervals.

201. The device of claim 1, wherein the dipole density module generates a synthesis of maps that represents a cascade of activation sequences of each corresponding heart beat from a series of heart beats.

202. The device of claim 1, wherein the measured potentials V(x) are interpolated to increase the number of regions.

203. The device of claim 1, further comprising:

a third receiver configured to receive mapping information from one or more skin electrodes.

204. The device of claim 203, wherein the dipole density module uses said mapping

2-175. -175. (canceled)