Method and apparatus to correct for electric current leakage in conductance volumetry

• US 5,882,312 A
• Filed: 08/27/1997
• Issued: 03/16/1999
• Est. Priority Date: 09/17/1996
• Status: Expired due to Fees

• Current Assignee: Cleveland Clinic Foundation, Marquette Medical Systems, Inc.
• Original Assignee: Cleveland Clinic Foundation, Marquette Medical Systems, Inc.
• Inventors: Schluter, Paul, Gopakumaran, Balakrishnan, Petre, John H., Osborn, Peter K.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US08/920,605
• Time in Patent Office: 566 Days
• Field of Search: 607/24, 600/505, 600/507, 600/526, 600/547
• US Class Current: 600/526
• CPC Class Codes: A61B 2562/043 in a linear array
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• 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 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]

Abstract

A method of determining cardiac volume including the steps of positioning a catheter output including the steps of positioning a catheter in a blood-filled chamber of a patient'"'"'s heart. The catheter comprises an elongated body having a distal end, a proximal end and a plurality of spaced apart electrodes arrayed on the outer surface of the catheter. The electrodes are spaced apart a predetermined distance from each other to define a distal electrode, a proximal electrode and a plurality of pairs of adjacent electrodes between the distal and proximal electrodes to define volume segments within the chamber. The method includes the steps of providing a constant alternating current If1 at a first frequency f1 to the distal and proximal electrodes, measuring the potential between pairs of electrodes located between the distal and proximal electrodes while the distal and proximal electrodes are energized with the current If1, providing a constant alternating current If2 at a second frequency f2 to the distal and proximal electrodes, measuring the potential between pairs of electrodes located between the distal and proximal electrodes while the distal and proximal electrodes are energized with the current If2, determining the corrected volume of each volume segment corrected for current leakage from the measured voltages and the fractional change in tissue conductance due to changes in the frequency of the applied current.

Claims

1. A method of determining cardiac volume using a catheter adapted to be positioned in a blood filled chamber of a human heart, the catheter comprising an elongated body having a distal end and proximal end, a plurality of spaced electrodes arrayed on the outer surface of the catheter and being spaced apart a predetermined distance from each other to define a proximal electrode and a distal electrode and a plurality of electrodes disposed there between, pairs of adjacent electrodes between the distal and proximal electrodes defining volume segments within the chamber,

said method comprising the steps of positioning the catheter in a chamber of a human heart, providing a constant alternating electrical excitation Ef1 having a first frequency f1 to the distal and proximal electrodes,

measuring a first electrical parameter between pairs of adjacent electrodes located between the distal and proximal electrodes while the distal and proximal electrodes are energized with the constant alternating electrical excitation Ef1,

providing a constant amplitude alternating electrical excitation Ef2 at a second frequency f2 to the distal and proximal electrodes,

measuring a second electrical parameter between pairs of adjacent electrodes located between the distal and proximal electrodes while the distal and proximal electrodes are energized with the current If2,

determining the fractional change in tissue conductance due to changes in frequency from F1 to F2 of the applied electrical excitation Ef1 and Ef2, determining the leakage fraction of each segmental volume of the chamber,

determining separately the corrected volume of each volume segment corrected for leakage current from the measured electrical parameters and the fractional change in tissue conductance,

and determining the total volume from the total of the individual corrected volumes of each of the volume segments.

2. The method set forth in claim 1 wherein the alternating electrical excitations Ef1 and Ef2 are alternating voltages and the first and second electrical parameters are the current flowing between the pairs of adjacent electrodes.

3. The method set forth in claim 1 wherein the electrical excitations Ef1 and Ef2 are alternating currents and the first and second electrical parameters are the potential between pairs of adjacent electrodes.

4. The method set forth in claim 3 wherein the frequencies f1 and f2 are between 1-100 KHz.

5. The method set forth in claim 3 and including the step of determining the fractional change in total conductance due to the frequency change from F1 to F2 of the alternating currents from the difference between the total measured conductance at frequency F2 less the total measured conductance at frequency F1 divided by the total measured conductance at frequency f_i.

6. The method set forth in claim 3 and including the steps of determining the total tissue conductance path and measuring the total conductance, and determining the leakage segment LF_i of each segmental volume from the total tissue conductance path divided by the total measured conductance.

7. The method set forth in claim 1 wherein the fractional change in tissue conductance α

p due to the frequency change of the applied current is determined from the expression;

space="preserve" listing-type="equation">α

p= C.sub.tot (f2)-C.sub.tot (f1)!/C.sub.tot (f1)=α

C.sub.t /(C.sub.b +C.sub.t)

where

C_tot (f1)=total measured conductance at f1,

C_tot (f2)=total measured conductance at frequency f2,

α

=fractional change in tissue conductivity when frequency is changed from f₁.

p=C_t /(C_b +C_t)

C_tot (f1)=C_b +C_t C_tot (f2)=C_b +C_t +α

C_t

C_t =total tissue conductance path, and

C_b =total blood conductance path.

8. The method set forth in claim 1 wherein the leakage fraction of each segmental volume is determined by the expression:

space="preserve" listing-type="equation">L.sub.i =a.sub.i BLF+b.sub.i

where

LF_i =equals leakage fraction in segment `i`,

a_i and b_i are constant factors for segment `i`, and

BLF=C_t /C_tot,

where

C_tot =C_b +C_t,

C_t =the total tissue conductance path,

C_b =the total blood conductive path, and

C_tot =total measured conductance.

9. The method set forth in claim 1 wherein the corrected volume of each volume segment corrected for current leakage is determined by the expression:

space="preserve" listing-type="equation">LCVol.sub.i =Vol.sub.i (1-LF.sub.i)

where

LCVol_i =leakage corrected volume of segment `i`,

Vol_i =volume computed by equation Vol_i =ρ

L² /R_i

ρ

=blood resistivity,

L=electrode spacing,

R_i =segmental resistance.

10. The method set forth in claim 1 wherein the frequencies f1 and f2 are in the range of 1-100 KHz.

11. The method set forth in claim 10 wherein the change in the leakage fraction of each segmental volume due to frequency change of the applied current is determined from the expression:

space="preserve" listing-type="equation">∝

p= C.sub.tot (f2)-C.sub.tot (f1)!/C.sub.tot (f1)=α

C.sub.t /(C.sub.b +C.sub.t)

where

C_tot (f1)=total measured conductance at f1,

C_tot (f2)=total measured conductance at frequency f2,

p=C_t /(C_b +C_t)

α

=fractional change in tissue conductivity when frequency is changed from f_i to f₂.

C_tot (f1)=C_b +C_t C_tot (f2)=C_b +C_t +α

C_t

C_t =total tissue conductance path, and

C_b =total blood conductance path.

12. The method set forth in claim 1 wherein the leakage fraction of each segmental volume is determined by the expression:

space="preserve" listing-type="equation">LF.sub.i =α

.sub.i BLF+b.sub.i

where

LF_i =equals leakage fraction in segment `i`,

α

_i and b_i are constant factors for segment `i`, and

BLF=C_t /C_tot,

where

C_tot =C_b +C_t,

C_t =the total tissue conductance path,

C_b =the total blood conductive path, and

C_tot =total measured conductance.

13. The method set forth in claim 10 wherein the corrected volume of each volume segment corrected for current leakage is determined by the expression:

space="preserve" listing-type="equation">LCVol.sub.i =Vol.sub.i (1-LF.sub.i)

where

LCVol_i =leakage corrected volume of segment `i`,

Vol_i =volume computed by equation Vol_i =ρ

L² /R_i.

14. The method set forth in claim 13 wherein the leakage fraction LF_i is determined by the expression:

space="preserve" listing-type="equation">LF.sub.i =a.sub.i BLF+b.sub.i

where

LF_i =equals leakage fraction in segment `i`,

a_i and b_i are constant factors for segment `i`, and

BLF=C_t /C_tot,

where

C_tot =C_b +C_t,

C_t =the total tissue conductance path,

C_b =the total blood conductive path, and

C_tot =total measured conductance.

15. The method set forth in claim 13 wherein the corrected volume of each volume segment corrected for current leakage is determined by the expression:

space="preserve" listing-type="equation">LCVol.sub.i =Vol.sub.i (1-LF.sub.i)

where

LCVol_i =leakage corrected volume of segment `i`,

Vol_i =volume computed by equation Vol_i =ρ

L² /R_i.

16. Apparatus determining cardiac volume, said apparatus comprising

a catheter adapted to be positioned in a blood filled chamber of a human heart, the catheter comprising an elongated body having a distal end and proximal end,

a plurality of spaced electrodes arrayed on the outer surface of the catheter and being spaced apart a predetermined distance from each other to define a proximal electrode, a distal electrode and a plurality of electrodes disposed therebetween,

means for selectively providing constant alternating electrical excitation Ef1 having a first frequency f1 to the distal and proximal electrodes, and a constant alternating excitation Ef2 at a second frequency f2 to the distal and proximal electrodes,

means for measuring an electrical parameter between pairs of electrodes located between the distal and proximal electrodes while the distal and proximal electrodes are respectively energized with the electrical excitation Ef1 and Ef2,

and a processor programmed to determine the fractional change in tissue conductance due to changes in frequency of the applied electrical excitation and to determine the leakage fraction of each segmental volume of the chamber, and the corrected volume of each volume segment from the fractional change in tissue conductance, said processor being further programmed to determine the corrected volume of each volume segment corrected for leakage current from the measured parameters and the fractional change in tissue conductance.

17. The apparatus set forth in claim 16 wherein the means for providing a constant alternating electrical excitation comprises means for providing a constant alternating voltage and the means for measuring an electrical parameter is an ammeter.

18. The apparatus set forth in claim 16 wherein the means for providing a constant alternating electrical excitation is a constant alternating current source and the means for measuring an electrical parameter is a voltmeter.

19. The apparatus set forth in claim 18 wherein the constant current source is operative to provide currents at frequencies f1 and f2 in the range of 1-100 KHz.

20. The apparatus set forth in claim 18 wherein the means for determining the fractional change ∝

p in total measured conductance due to the frequency change of the applied current is programmed to make such determination from the expression;

space="preserve" listing-type="equation">α

p= C.sub.tot (f2)-C.sub.tot (f1)!/C.sub.tot (f1)=α

C.sub.t /(C.sub.b +C.sub.t)

where

C_tot (f1)=total measured conductance at f1,

C_tot (f2)=total measured conductance at frequency f2,

p=C_t /(C_b +C_t)

α

=fractional change in tissue conductivity when frequency is changed from f_i to f₂.

∂

=fractional change in tissue conductivity when frequency is changed from f1 to f2.

C_tot (f1)=C_b +C_t C_tot (f2)=C_b +C_t +α

C_t

C_t =total tissue conductance path, and

C_b =total blood conductance path.

21. The apparatus set forth in claim 20 wherein the means for determining the leakage fraction LF_i is programmed to make such determination from the expression:

space="preserve" listing-type="equation">LF.sub.i =a.sub.i BLF+b.sub.i

where

BLF_i =equals leakage fraction in segment `i`,

a_i and b_i are constant factors for segment `i`, and

BLF=C_t /C_tot,

where

C_tot =C_b +C_t,

C_t =the total tissue conductance path,

C_b =the total blood conductive path, and

C_tot =total measured conductance.

22. The apparatus set forth in claim 20 wherein the means for determining the corrected volume of each volume segment corrected for current leakage is programmed to make such determination from the expression:

space="preserve" listing-type="equation">LCVol.sub.i =Vol.sub.i (1-LF.sub.i)

where

LCVol_i =leakage corrected volume of segment `i`,

Vol_i =volume computed by equation Vol_i =ρ

L² /R_i.