Device for mapping electrical activity in the heart

• US 6,052,618 A
• Filed: 07/02/1998
• Issued: 04/18/2000
• Est. Priority Date: 07/11/1997
• Status: Expired due to Term

• Current Assignee: Siemens AG
• Original Assignee: Siemens-Elema AB (Siemens AG)
• Inventors: Hjarne, Elisabeth, Darpo, Borje, Rasmundson, Kjell, Lindkvist, Leif, Dahlke, Mikael
• Primary Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US09/109,390
• Time in Patent Office: 656 Days
• Field of Search: 600/509, 600/523, 600/513, 600/515, 600/407, 600/424, 600/436, 600/437, 600/525, 600/439, 600/463
• US Class Current: 600/523
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal

Abstract

A device for mapping electrical activity in a patient'"'"'s heart, has an imaging unit, such as a fluoroscopic imaging unit, for generating a physical in vivo image of a patient'"'"'s heart as an anatomical reference image, an electrode catheter, with at least one electrode for sensing intracardiac electrical activity, for insertion into a patient'"'"'s heart, and signal processing equipment for determining activation times, from sensed electrical activity, in relation to a reference time for electrical activity at different points in the heart, and for generating a graphic image showing the activation times at different points in the heart and superimposing this graphic image onto the anatomical image. An arrangement is further provided for inserting at least one reference point into the anatomical image, and a setting unit moves the graphic image in relation to the reference image with the aid of the reference point.

Claims

1. A device for mapping in vivo electrical activity of a heart, comprising:

an imaging unit which generates an anatomical reference image comprising an in vivo physical image of a heart disposed in a patient;

a catheter carrying at least one electrode for sensing intracardiac electrical activity, said catheter being adapted for insertion into a heart;

signal processing means for determining activation times, from electrical activity sensed by said at least one electrode, in relation to a reference time for electrical activity at different points in a heart;

means for generating a graphic image showing said activation times at said different points in the heart and for superimposing said graphic image onto said anatomical reference image;

reference means for inserting at least one reference point into said anatomical reference image; and

setting means for aligning said graphic image with said anatomical reference image dependent on said reference point.

2. A device as claimed in claim 1 wherein said reference means comprises means for inserting a graphic image reference point into said graphic image corresponding to said reference point in said anatomical reference image.

3. A device as claimed in claim 2 comprising an electronic memory connected to said setting means for storing said anatomical reference image and said graphic image and said measured electrical activity, and wherein said setting means comprises means for arranging said graphic image in said memory so that said reference point in said anatomical reference image and said graphic image reference point are aligned.

4. A device as claimed in claim 1 wherein said reference means comprises means for inserting first and second reference points in said anatomical reference image and for inserting first and second graphic image reference points into said graphic image, and wherein said setting means comprises means for aligning said first reference point in said anatomical reference image with said first graphic image reference point and for aligning said second reference point in said anatomical reference image with said second graphic image reference point to align said graphic image with said reference image.

5. A device as claimed in claim 1 wherein said imaging unit and said signal processing means comprise means for generating superimposed images in more than one projection.

6. A device as claimed in claim 1 wherein said imaging unit comprises a radiation source and a radiation detector for detecting radiation from said radiation source attenuated by a heart, means for moving said radiation source and said detector relative to each other and relative to a patient, a patient table adapted to receive a patient thereon, and memory means for storing information during generation of said anatomical reference image regarding angular positions of said radiation source and said detector relative to said patient table 3, and information identifying a distance between said radiation source and said patient table.

7. A device as claimed in claim 1 wherein said intracardiac electrical activity comprises an IEGM identifying a succession of heart cycle phases, and wherein said signal processing means comprises means for identifying said activation times in a same phase of each heart cycle.

8. A device as claimed in claim 1 further comprising a respiration sensor which produces electrical signals representative of a respiration cycle of a patient, said electrical signals being supplied to said signal processing means, and wherein said signal processing means comprises means for identifying said activation times in a same phase of each respiration cycle.

9. A device as claimed in claim 1 wherein said activation times have numerical values associated therewith, and said device further comprising color generator means for translating said numerical values into a color-coded image for superimposition on said anatomical reference image as said graphic image.

10. A device as claimed in claim 1 further comprising ablation equipment, connected to said electrode catheter, for performing ablation dependent on said anatomical reference image and said graphic image.

11. A device as claimed in claim 10 wherein said signal processing means comprises means for displaying ablation information in said graphic image.

12. A device as claimed in claim 11 wherein said signal processing means comprises means for displaying ablation information selected from the group consisting of a position of said catheter in a heart, a time ablation was performed, and an effect of the ablation.

13. A device as claimed in claim 1 wherein said imaging unit comprises means for generating a fluoroscopic image as said anatomical image.