Method and apparatus for determining electrode/tissue contact

• US 5,836,990 A
• Filed: 09/19/1997
• Issued: 11/17/1998
• Est. Priority Date: 09/19/1997
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Li, Hong
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US08/934,286
• Time in Patent Office: 424 Days
• Field of Search: 607/28, 607/72, 600/372, 600/373, 600/374, 600/547
• US Class Current: 607/28
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• 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: A61N 1/056 Transvascular endocardial electrode systems

Abstract

Contact between an electrophysiology catheter electrode (6) and cardiac tissue covered by blood is sensed by applying a constant voltage or current square wave signal (23) to the electrode and then monitoring the voltage or impedance or current at the electrode before, during, and after the electrode contacts the tissue. The monitored pulse (22) includes an ohmic impedance portion (30) and combined ohmic and capacitive impedance portion (32). Successive monitored pulses can be measured in several ways to determine when tissue contact has occurred: the maximum magnitudes (36) of successive ohmic resistance portions; the initial slopes (38) for successive combined resistive portions; the amplitudes (40) of successive combined resistive portions at a preset time interval from the start of each pulse; and the average amplitudes (42) of successive combined impedance portions over a preset time period for each pulse. Upon contact, the magnitudes of each changes significantly, such as 40-50% in cardiac applications.

Claims

1. A method for determining electrode/tissue contact comprising the following steps:

choosing a constant current pulsed signal or a constant voltage pulsed signal, said chosen pulsed signal comprising a series of signal pulses;

applying said series of signal pulses to an electrode, each said signal pulse having a leading edge portion and a following portion;

placing the electrode into contact with a tissue site;

the placing step taking place with an ionic liquid covering the tissue site; and

determining when the electrode contacts the tissue by monitoring a chosen electrical characteristic at the electrode during a period of time before, during, and after the electrode contacts the tissue.

2. The method according to claim 1, wherein the signal choosing step is carried out by choosing a constant voltage pulsed signal as the pulsed signal.

3. The method according to claim 2 wherein the monitoring step is carried out by monitoring at least one of current or impedance as the chosen electrical characteristic.

4. The method according to claim 2 wherein the signal choosing step comprises the step of selecting the pulsed signal having the following characteristics:

a square wave of at least about 0.1V in amplitude and about 1 μ

sec to 2 msec in duration.

5. The method according to claim 4 wherein the signal choosing step is carried out so each said signal pulse is repeated at least 0.1 Hz.

6. The method according to claim 1, wherein the signal choosing step is carried out by selecting a constant current pulsed signal as the pulsed signal.

7. The method according to claim 6, wherein the monitoring step is carried out by monitoring at least one voltage or impedance as the chosen electrical characteristic.

8. The method according to claim 6 wherein the signal choosing step comprises the step of selecting the pulsed signal having the following characteristics:

a square wave of at least about 0.1 mA in amplitude and about 1 μ

sec to 2 msec in duration.

9. The method according to claim 8 wherein the signal choosing step is carried out so each said signal pulse is repeated at least 0.1 Hz.

10. The method according to claim 1 wherein the determining step comprises the steps of:

measuring the magnitude of an initial rise in impedance as the chosen electrical characteristic for successive ones of said pulsed signals; and

comparing said initial impedance rise magnitudes.

11. The method according to claim 1 wherein the determining step comprises the steps of:

measuring the magnitude of an initial change in the chosen electrical characteristic for successive ones of said pulsed signals; and

comparing said initial change magnitudes.

12. The method according to claim 11 wherein the monitoring step is carried out by monitoring current as the chosen electrical characteristic and the measuring step is carried out by measuring an initial fall in the measured current as the initial change in the chosen electrical characteristic.

13. The method according to claim 11 wherein the monitoring step is carried out by monitoring impedance as the chosen electrical characteristic and the measuring step is carried out by measuring an initial rise in the impedance.

14. The method according to claim 1 wherein the determining step comprises the step of:

separating said chosen electrical characteristic into an ohmic impedance portion, corresponding to said leading edge portion, and a combined ohmic and capacitive impedance portion, corresponding to the following portion.

15. The method according to claim 14 wherein the determining step further comprises the step of:

measuring the slope of a chosen electrical characteristic versus time plot for an initial part of the combined ohmic and capacitive impedance portion for successive ones of said pulsed signals.

16. The method according to claim 14 wherein the determining step further comprises the step of:

measuring the maximum magnitude of the electrical characteristic for the ohmic impedance portion for successive ones of said signal pulses.

17. The method according to claim 14 wherein the determining step further comprises the step of:

measuring the average magnitude of the electrical characteristic for the combined ohmic and capacitive impedance portion for successive ones of said signal pulses.

18. The method according to claim 14 wherein the determining step further comprises the step of:

measuring a chosen magnitude of the electrical characteristic for the combined ohmic and capacitive impedance portion for successive ones of said signal pulses, said chosen magnitude measured at a chosen time following said leading edge portion.

19. The method according to claim 1, wherein the placing step is carried out within the heart of a patient.

20. The method according to claim 1, wherein the monitoring step is carried out automatically.

21. A method for determining electrode/tissue contact comprising the following steps:

selecting a pulsed signal pattern having one of the following characteristics;

(a) a square wave constant current DC signal pulse at least about 0.1 mA in amplitude and about 1 μ

sec to 2 msec in duration, each said signal pulse having a leading edge portion and a following portion;

(b) a square wave constant voltage DC signal pulse at least about 0.1V in amplitude and about 1 μ

sec to 2 msec in duration, each said signal pulse having a leading edge portion and a following portion;

applying a series of the signal pulses to an electrode;

placing the electrode into contact with a tissue site;

the placing step taking place with an ionic liquid covering the tissue site;

monitoring a chosen electrical characteristic at the electrode during a period of time before, during, and after the electrode contacts the tissue;

separating said chosen electrical characteristic for successive ones of said signal pulses into an ohmic impedance portion, corresponding to said leading edge portion, and a combined ohmic and capacitive impedance portion, corresponding to the following portion;

determining when the electrode contacts the tissue by at least one of the following;

(a) measuring the maximum magnitude of the chosen electrical characteristic for the ohmic impedance portion for successive ones of said signal pulses and comparing said maximum magnitudes;

(b) measuring the slope of a chosen electrical characteristic versus time plot for an initial part of the combined ohmic and capacitive impedance portion for successive ones of said signal pulses;

(c) measuring the magnitude of the combined ohmic and capacitive impedance portion for successive ones said signal pulses at a preselected time from said leading edge portion; and

(d) measuring the average magnitude of the chosen electrical characteristic for a chosen portion of the combined ohmic and capacitive impedance portion for successive ones of the signal pulses; and

choosing at least one of voltage, impedance or current as said chosen electrical characteristic.

22. Apparatus for determining electrode/tissue contact comprising:

a signal generator capable of generating signal pulses at a generator output;

an electrode electrically connected to the generator output;

means for measuring a value for a chosen electrical characteristic corresponding to a series of said signal pulses at the electrode before, during, and after the electrode contacts an ionic fluid-covered tissue;

means for comparing the measured values corresponding to said series of signal pulses; and

means for providing an indication that said electrode has contacted the tissue based upon the compared measured values.

23. The apparatus according to claim 22 further comprising an electrophysiology catheter, the electrode being a part of the electrophysiology catheter.

24. The apparatus according to claim 22 wherein said signal generator is configured to create square wave, DC signal pulses.

25. The apparatus according to claim 22 wherein said signal generator is configured to create at least one of constant current and constant voltage signal pulses.

26. The apparatus according to claim 22 wherein said signal generator is configured to create a series of signal pulses each having the following characteristics:

constant current about 0.1 mA in amplitude for constant current signal pulses, constant voltage of at least about 0.1V in amplitude for constant voltage signal pulses; and

said signal pulses being about 1 μ

sec to 2 msec in duration.

27. The apparatus according to claim 22 wherein said signal generator is capable of generating said series of signal pulses at a rate of at least about 0.1 Hz.

28. The apparatus according to claim 22 wherein said indication providing step further comprises means for displaying the amplitude of said values.

29. Apparatus for determining electrode/tissue contact comprising:

a signal generator capable of generating a series of signal pulses at a generator output, each said signal pulse having a chosen one of the following characteristics;

constant current at least about 0.1 mA in amplitude and about 1 μ

sec to 2 msec in duration;

or

constant voltage of at least 0.1V in amplitude and about 1 μ

sec to 2 msec in duration;

said signal generator being capable of generating said series of signal pulses at least about 0.1 Hz;

an electrophysiology catheter comprising an electrode electrically connected to the generator output;

means for determining a value for at least a chosen one of voltage, impedance or current as a measured electrical characteristic between the tissue and the electrode before, during, and after the electrode contacts the tissue;

said measured electrical characteristic for each said signal pulse comprising an ohmic impedance portion and a combined ohmic and capacitive impedance portion;

means for comparing said determined values corresponding to said series of signal pulses before, during, and after the electrode contacts the tissue; and

means for providing an indication that said electrode has contacted the tissue based upon the determine values.