Systems and methods for positioning multiple electrode structures in electrical contact with the myocardium

• US 5,598,848 A
• Filed: 03/31/1994
• Issued: 02/04/1997
• Est. Priority Date: 03/31/1994
• Status: Expired due to Term

• Current Assignee: EP Technology (Boston Scientific Corporation)
• Original Assignee: EP Technology (Boston Scientific Corporation)
• Inventors: Panescu, Dorin, Swanson, David K.
• Primary Examiner(s): Cohen, Lee S.
• Application Number:
  US08/221,347
• Time in Patent Office: 1,041 Days
• Field of Search: 128/642, 128/696, 128/639, 128/734, 607/119, 607/122, 607/123, 607/124, 607/125, 607/126, 607/113, 607/116
• US Class Current: 600/508
• 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 2018/1465 Deformable electrodes
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2562/043 in a linear array
• CPC Class Codes: A61B 5/276 Protection against electrode failure
• 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 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/6885 Monitoring or controlling sensor contact pressure

Abstract

Systems and methods evaluate electrical contact between the myocardium and one or more electrodes inside the heart. The systems and methods electrically sense electrical contact between the myocardium and electrodes and generate unitary contact-indicating outputs indicating the presence or absence of electrical contact between the myocardium and each particular electrode. The systems and methods also correlate the electrode-specific unitary outputs to generate a compound contact-indicating output. The compound output represents the aggregate of the electrical contact between the myocardium and multiple electrodes on a multiple electrode array.

Claims

1. A system for evaluating electrical contact between the myocardium and a multiple electrode array inside the heart, the multiple electrode array comprising first and second circumferentially spaced splines for contacting circumferentially spaced endocardial regions, each spline supporting at least one electrode, the system comprising

first means for electrically sensing electrical contact between at least one electrode on the first spline and the myocardium and for generating a first unitary contact-indicating output indicating the presence or absence of the electrical contact, and

second means, operable independently of the first means, for electrically sensing electrical contact between at least one electrode on the second spline and the myocardium and for generating a second unitary contact-indicating output indicating the presence or absence of the electrical contact,

at least one of the first and second means being operable to sense electrical contact by emitting from the respective electrode an electrical signal that activates the myocardium.

2. A system according to claim 1

and further including third means for correlating the first and second unitary contact-indicating outputs to generate a compound contact-indicating output indicating the aggregate electrical contact between the myocardium and the multiple electrode array.

3. A system according to claim 1

wherein the one first or second means emits a pacing signal from the respective electrode and senses electrical contact by sensing electrograms.

4. A system according to claim 1

and further including means for conditioning at least one electrode on the first and second splines to emit a therapeutic signal into the myocardium.

5. A system according to claim 1

and further including means for conditioning at least one electrode on the first and second splines to obtain a diagnostic signal from the myocardium.

6. A system for evaluating electrical contact between the myocardium and a multiple electrode array within the heart, the multiple electrode array comprising first and second circumferentially spaced splines for contacting circumferentially spaced endocardial regions, each spline supporting at least one electrode, the system comprising

an energy generating element for electrical connection to at least one electrode on each support spline to emit electrical energy into the myocardium through the electrodes, and

a signal acquisition element adapted to be electrically coupled to the emitting electrodes for detecting, independently for each emitting electrode, at least one acquired signal resulting from the emission of electrical energy by the respective electrode, the acquired signal varying with electrical contact between the respective emitting electrode and the myocardium to differentiate between the presence of the electrical contact and the absence of the electrical contact.

7. A system according to claim 6

and further including means for comparing the acquired signal for each emitting electrode with an expected signal to determine the presence or absence of the electrical contact.

8. A system according to claim 6

and further including a processing element electrically coupled to the signal acquisition element that, independently for each emitting electrode, compares the acquired signal for each emitting electrode with an expected signal.

9. A system according to claim 8

and further including an output element for generating, independently for each emitting electrode, a unitary contact-indicating output for the respective emitting electrode based upon the comparison, the unitary contact-indicating output indicating the presence or absence of the electrical contact.

10. A system according to claim 9

wherein the output element generates, independently for each emitting electrode, a unitary contact-confirm output for the respective electrode if the acquired signal for the respective electrode compares with the expected signal and a unitary contact-contrary output for the respective electrode if the acquired signal does not compare with the expected signal.

11. A system according to claim 9

wherein the processing element correlates the independent unitary contact-indicating output for each emitting electrode to derive a compound contact-indicating output indicating the aggregate of the electrical contact for the multiple electrode array.

12. A system according to claim 6

wherein the energy generating element generates electrical energy that does not activate the myocardium.

13. A system according to claim 12

wherein the generated electrical energy is an electric current, and

wherein the signal acquisition element detects tissue impedance.

14. A system according to claim 6

wherein the energy generating element generates electrical energy that activates the myocardium.

15. A system according to claim 14

wherein the generated electrical energy is a pacing signal, and

wherein the signal acquisition element detects electrograms.

16. A system according to claim 6

and further including means for conditioning at least one electrode on the first and second support splines to emit a therapeutic signal into the myocardium.

17. A system according to claim 6

and further including means for conditioning at least one electrode on the first and second support splines to obtain a diagnostic signal from the myocardium.

18. A system for evaluating electrical contact between the myocardium and an electrode inside the heart comprising

an energy generating element for electrical connection to the electrode to emit electrical energy into the myocardium through the electrode that activates the myocardium,

a signal acquisition element adapted to be electrically coupled to the electrode for detecting at least one acquired signal resulting from the emission of electrical energy by the electrode, the acquired signal varying with electrical contact between the electrode and the myocardium to differentiate between electrical contact and the absence of electrical contact,

a processing element electrically coupled to the signal acquisition element to compare the acquired signal for the electrode with an expected signal, and

an output element for generating a contact-indicating output for the electrode based upon the comparison, the contact-indicating output indicating the presence or absence of electrical contact between the electrode and the myocardium.

19. A system according to claim 18

wherein the acquired signal is an electrogram.

20. A system for evaluating electrical contact between the myocardium and multiple electrodes inside the heart comprising

an energy generating element for electrical connection to the electrodes to emit electrical energy into the myocardium in a predetermined sequence through at least two electrodes,

a signal acquisition element adapted to be electrically coupled to the electrodes for detecting, independently for each emitting electrode, at least one acquired signal resulting from the emission of electrical energy by the respective electrode, the acquired signal varying with electrical contact between the respective electrode and the myocardium to differentiate between the presence of the electrical contact and the absence of the electrical contact,

a processing element electrically coupled to the signal acquisition element that compares, independently for each emitting electrode, the acquired signals for the respective electrode with an expected signal, and

an output element for generating, independently for each emitting electrode, a contact-indicating output for the respective electrode based upon the comparison.

21. A system according to claim 20

wherein the energy generating element generates electrical energy that activates the myocardium.

22. A system according to claim 21

wherein the acquired signal is an electrogram.

23. A system according to claim 20

wherein the energy generating element generates electrical energy that does not activate the myocardium.

24. A system according to claim 23

wherein the acquired signal is a tissue impedance measurement.

25. A method for evaluating electrical contact between the myocardium and a multiple electrode array inside the heart comprising the steps of

deploying a multiple electrode array into a chamber of the heart, the array comprising first and second circumferentially spaced splines for contacting circumferentially spaced endocardial regions, each spline supporting at least one electrode,

electrically sensing electrical contact between at least one electrode on the first spline and the myocardium in a first endocardial region to generate a first unitary contact-indicating output indicating the presence or absence of the electrical contact in the first region, and

electrically sensing electrical contact between at least one electrode on the second spline and the myocardium in a second endocardial region circumferentially spaced from the first region to generate a second unitary contact-indicating output indicating the presence or absence of the electrical contact in the second region,

wherein, in electrically sensing electrical contact, the respective electrode is caused to emit an electrical signal that activates the myocardium.

26. A method according to claim 25

and further including the step of correlating the first and second unitary contact-indicating outputs to generate a compound contact-indicating output indicating the aggregate of the electrical contact between the myocardium and the multiple electrode array.

27. A method according to claim 25

wherein, in electrically sensing electrical contact, electrograms are sensed.

28. A method according to claim 25

wherein the steps of electrically sensing electrical contact comprises the steps of

emitting electrical energy into the myocardium independently through the electrodes, and

detecting, independently for each emitting electrode, at least one acquired signal resulting from the emission of electrical energy by the respective electrode, the acquired signal varying with electrical contact between the respective emitting electrode and the myocardium to differentiate between the presence of the electrical contact and the absence of the electrical contact.

29. A method according to claim 28

wherein the steps of generating the first and second unitary contact-indicating outputs include comparing the acquired signal for each emitting electrode with an expected signal to determine the presence or absence of the electrical contact.

30. A method according to claim 29

wherein the steps of generating the first and second unitary contact-indicating outputs include generating, independently for each emitting electrode, a unitary contact-confirm output for the respective electrode if the acquired signal for the respective electrode compares with the expected signal and a unitary contact-contrary output for the respective electrode if the acquired signal does not compare with the expected signal.

31. A method according to claim 25

and further including the step of conditioning at least one electrode on the first and second support splines to emit a therapeutic signal into the myocardium.

32. A method according to claim 25

and further including the step of conditioning at least one electrode on the first and second support splines to obtain a diagnostic signal from the myocardium.