Method and device for determining the position of a catheter inside the body of a patient

• US 5,899,860 A
• Filed: 08/28/1997
• Issued: 05/04/1999
• Est. Priority Date: 09/12/1996
• Status: Expired due to Term

• Current Assignee: Siemens Healthcare GMBH (Siemens AG)
• Original Assignee: Siemens-Elema AB (Siemens AG)
• Inventors: Slettenmark, Bruno, Pfeiffer, Georg
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US08/919,209
• Time in Patent Office: 614 Days
• Field of Search: 600/424, 600/300, 600/373, 600/374, 600/425, 600/427, 128/899, 607/122
• US Class Current: 600/424
• 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 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/0818 Redundant systems, e.g. using two independent measuring systems and comparing the signals
• CPC Class Codes: A61B 2562/043 in a linear array
• 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 5/062 using magnetic field
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence

Abstract

In a method and apparatus for determining the position of a catheter inside the body of a patient, position signals are transmitted between the catheter and a position location unit, located at a distance from the catheter, the position signals are transmitted during a calibration stage from known calibration positions inside the body, or position signals, transmitted by the position location unit, are received at the known calibration positions. A correction function is determined from the difference between the calibration positions derived from the received location signals and the known, true calibration positions, whereupon catheter positions, derived from received position signals, are corrected in subsequent measurement stages according to the correction function.

Claims

1. A method for detecting a position of a catheter when inside a body of a subject, comprising the steps of:

inserting a calibration catheter into a body cavity;

in a calibration phase, transmitting signals between a plurality of known calibration positions of said calibration catheter in said body cavity and a position locator, and obtaining, at said position locator, a plurality of apparent calibration positions respectively associated with said known positions but deviating therefrom due to passage of said signals through body tissue;

in said calibration phase, generating a correction function from the deviation of said apparent calibration positions from said known calibration positions; and

correcting, using said correction function, subsequent signals transmitted between a medical procedure catheter in said body cavity and said position locator to obtain an identification of an actual position of said medical procedure catheter in said body cavity.

2. A method as claimed in claim 1 comprising the step of using said calibration catheter as said medical procedure catheter.

3. A method as claimed in claim 1 wherein the step of transmitting signals comprises transmitting signals from said plurality of known calibration positions of said calibration catheter in said body cavity to said position locator.

4. A method as claimed in claim 3 wherein said calibration catheter has a tip, and wherein the step of transmitting signals comprises transmitting signals between a plurality of known calibration positions of said tip of said catheter in said body cavity and said position locator.

5. A method as claimed in claim 4 comprising the additional steps of:

deploying an expandable element at said tip of said calibration catheter, said expandable element carrying a plurality of communication elements which communicate with said position locator;

expanding said expandable element after inserting said calibration catheter into said body cavity for causing said plurality of communication elements to respectively assume said plurality of known calibration positions;

retracting said expandable element after said calibration phase; and

using said calibration catheter as said medical procedure catheter after said calibration phase.

6. A method as claimed in claim 1 wherein the step of transmitting signals comprises transmitting signals from said position locator to said calibration catheter at said plurality of known calibration positions in said body cavity.

7. A method as claimed in claim 1 comprising the step of physically moving said calibration catheter through a known movement in said body cavity for producing said plurality of known calibration positions.

8. A method as claimed in claim 7 wherein the step of physically moving said calibration catheter comprises physically moving said calibration catheter in said body cavity to describe a body of a known shape, and wherein the step of generating a correction function comprises deriving an apparent body shape from said apparent calibration positions and determining said correction function from a deviation of said apparent body shape from said known body shape.

9. A method as claimed in claim 8 comprising the additional step of identifying a reference position of said calibration catheter at a beginning of said physical movement using a biplane exposure obtained with a fluoroscope.

10. A method as claimed in claim 7 wherein the step of physically moving said calibration catheter comprises physically moving said calibration catheter in said body cavity to describe a surface of a known shape, and wherein the step of generating a correction function comprises deriving an apparent surface shape from said apparent calibration positions and determining said correction function from a deviation of said apparent surface shape from said known surface shape.

11. A method as claimed in claim 10 comprising the additional step of identifying a reference position of said calibration catheter at a beginning of said physical movement using a biplane exposure obtained with a fluoroscope.

12. An apparatus for detecting a position of a catheter when inside a body of a patient, comprising:

a calibration catheter adapted for insertion into a body cavity;

a position locator;

means for transmitting signals, in a calibration phase, between a plurality of known calibration positions of said calibration catheter in said body cavity and said position locator;

said position locator comprising means for obtaining a plurality of apparent calibration positions respectively associated with said known positions but deviating therefrom due to passage of said signals through body tissue;

means, in said calibration phase, for generating a correction function from the deviations of said apparent calibration positions from said known calibration positions;

a medical procedure catheter for conducting a medical procedure, subsequent to said calibration phase, in said body cavity, and means for transmitting signals between said medical procedure catheter and said position locator while said medical procedure catheter is in said body cavity, said position locator comprising means for identifying an apparent position of said medical procedure catheter in said body cavity from said signals transmitted between said medical procedure catheter and said position locator; and

means for correcting said apparent position of said medical procedure catheter, using said correction function, to identify an actual position of said medical procedure catheter in said body cavity.

13. An apparatus as claimed in claim 12 wherein said medical procedure catheter and said calibration catheter comprise a single catheter, and wherein said single catheter carries a transmitter arrangement operating in common as said means for transmitting signals between said medical procedure catheter and said position locator, and said means for transmitting signals between said plurality of known calibration positions and said position locator.

14. An apparatus as claimed in claim 12 wherein said means for transmitting signals comprises a transmitter disposed at said calibration catheter and a receiver disposed at said position locator.

15. An apparatus as claimed in claim 12 wherein said means for transmitting comprises a transmitter disposed at said position locator and a receiver disposed at said calibration catheter.

16. An apparatus as claimed in claim 12 wherein said means for transmitting signals includes a communication element carried by said calibration catheter for communicating via said signals with said position locator, and wherein said calibration catheter comprises a flexible, tubular outer sleeve and a mandrel slidably and rotatably disposed in said sleeve, said mandrel having a tip at which said communication element is disposed.

17. An apparatus as claimed in claim 16 wherein said mandrel has an end section, deployable beyond an end of said sleeve, said end section of said mandrel comprising resilient material and being pre-bent.

18. An apparatus as claimed in claim 16 wherein said mandrel has an end deployable beyond an end of said sleeve, and comprises a curved coil spring attached at said end of said mandrel and having an opposite end at which said communication element is disposed.

19. An apparatus as claimed in claim 16 wherein said mandrel has an end section deployable beyond an end of said sleeve, said end section comprising a memory alloy, and wherein said calibration catheter includes means for electrically heating said end section of said mandrel to cause said memory alloy to bend.

20. An apparatus as claimed in claim 16 wherein said mandrel has an end section deployable beyond an end of said sleeve, said end section of said mandrel comprising a mechanical joint permitting bending of said end section.

21. An apparatus as claimed in claim 16 wherein said mandrel is deployable beyond a first end of said sleeve, and wherein said sleeve has a second, opposite end at which means for manipulating said mandrel relative to said sleeve are disposed, said means for manipulating comprising means for at least of one sliding said mandrel and rotating said mandrel in said sleeve.

22. An apparatus as claimed in claim 21 wherein said means for manipulating comprise means for sliding said mandrel relative to said sleeve and wherein said means for manipulating include indicator means for displaying a magnitude of sliding of said mandrel relative to said sleeve.

23. An apparatus as claimed in claim 21 wherein said means for manipulating comprise means for rotating said mandrel relative to said sleeve and wherein said means for manipulating include indicator means for displaying a magnitude of rotating of said mandrel relative to said sleeve.

24. An apparatus as claimed in claim 21 wherein said means for manipulating comprise means for sliding and rotating said mandrel relative to said sleeve and wherein said means for manipulating include indicator means for displaying a magnitude of sliding and rotating of said mandrel relative to said sleeve.

25. An apparatus as claimed in claim 21 wherein said means for manipulating comprises means for motorized manipulating of said mandrel.

26. An apparatus as claimed in claim 25 wherein said means for motorized manipulating comprises a controllable drive motor and a transducer, connected to said controllable drive motor, for monitoring a degree of manipulation of said mandrel and for controlling said drive motor dependent on said degree of manipulation.

27. An apparatus as claimed in claim 16 further comprising an expandable element disposed at said tip of said mandrel, on which said communication element is disposed, said expandable element being deployable by said mandrel beyond an end of said sleeve.

28. An apparatus as claimed in claim 27 wherein said expandable element comprises a balloon, and wherein said calibration catheter includes means for inflating said balloon in said body cavity after said balloon is deployed beyond said end of said sleeve.

29. An apparatus as claimed in claim 27 wherein said expandable element comprises a basket which resiliently expands in said body cavity upon deployment beyond said end of said sleeve.

30. An apparatus as claimed in claim 27 wherein said expandable element is retractable, after said calibration phase, into said sleeve for allowing said end of said sleeve, after said calibration phase, to contact body tissue.

31. An apparatus as claimed in claim 12 wherein said means for transmitting signals includes a communication element carried by said calibration catheter which communicates via said signals with said position locator, and wherein said calibration catheter comprises an outer catheter sleeve having an end adapted for insertion in said body cavity, and an expandable element contained in said sleeve and deployable, in an expanded condition, beyond said end of said sleeve in said body cavity, said communication element being disposed on said expandable element.

32. An apparatus as claimed in claim 31 wherein said expandable element comprises a balloon, and wherein said calibration catheter includes means for expanding said balloon when said balloon is deployed beyond said end of said catheter in said body cavity.

33. An apparatus as claimed in claim 31 wherein said expandable element comprises a resilient basket which resiliently expands in said body cavity upon deployment beyond said end of said sleeve.

34. An apparatus as claimed in claim 12 wherein said medical procedure catheter comprises and said calibration catheter comprise a single catheter, and wherein said single catheter carries means for interacting with body tissue in said body cavity selected from the group consisting of stimulation electrodes, sensing electrodes, ablation equipment and pressure sensors.

35. An apparatus as claimed in claim 12 wherein each of said means for transmitting signals in said calibration phase and said means for transmitting signals between said medical procedure catheter and said position locator comprise means for ultrasonically transmitting signals.

36. An apparatus as claimed in claim 12 wherein each of said means for transmitting signals in said calibration phase and said means for transmitting signals between said medical procedure catheter and said position locator comprise means for electromagnetically transmitting signals.

37. An apparatus as claimed in claim 12 wherein each of said means for transmitting signals in said calibration phase and said means for transmitting signals between said medical procedure catheter and said position locator comprise means for magnetostatically transmitting signals.

38. An apparatus as claimed in claim 12 further comprising synchronization means for synchronizing said means for correcting for always identifying said actual position of said medical procedure catheter at a same phase of a heart cycle of said subject.

39. An apparatus as claimed in claim 12 further comprising a reference communication element, in communication with said position locator, for producing a reference signal identifying movement of said subject, and wherein said means for generating a correction function comprises means for generating a correction function dependent on said apparent calibration positions and said reference signal.