Cardiac electromechanics

• US 6,285,898 B1
• Filed: 07/07/1998
• Issued: 09/04/2001
• Est. Priority Date: 07/20/1993
• Status: Expired due to Term

• Current Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Original Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Inventors: Ben-Haim, Shlomo
• Primary Examiner(s): Dvorak, Linda C. M.
• Assistant Examiner(s): Ruddy, David M.
• Application Number:
  US09/111,317
• Time in Patent Office: 1,155 Days
• Field of Search: 600/374, 600/378, 600/508, 600/509, 600/513, 600/523, 600/527, 600/407, 600/416, 600/421, 600/424, 600/425, 128/916, 128/922, 607/122
• US Class Current: 600/374
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00869 Phase
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/3958 emitting a signal
• 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 5/0215 by means inserted into the body catheters A61M25/00
• 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 5/06 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 5/066 Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/068 using impedance sensors
• CPC Class Codes: A61B 5/145 : Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/352 : Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/6843 : Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/6852 : Catheters
• CPC Class Codes: A61B 5/6859 : with multiple distal splines
• CPC Class Codes: A61B 5/6885 : Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 8/0833 : involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61M 2025/0166 : Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61M 25/0133 : Tip steering devices
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/32 : alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/3621 : for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3627 : for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36564 : controlled by blood pressure
• CPC Class Codes: A61N 1/368 : comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: Y10S 128/922 : including image analysis

Abstract

A method of constructing a cardiac map of a heart having a heart cycle including; bringing an invasive probe into contact with a location on a wall of the heart; determining, at at least two different phases of the heart cycle, a position of the invasive probe; and determining a local non-electrical physiological value at the location. The method is repeated for a plurality of locations in the heart The positions are combined to form a time-dependent map of at least a portion of the heart and local relationships between changes in positions of the invasive probe and determined local non-electrical physiological values are determined. Preferably, local electrical activity at the plurality of locations is also acquired.

Claims

1. A method of constructing a cardiac map of a heart having a heart cycle comprising:

(a) bringing an invasive probe into contact with a location on a wall of the heart;

(b) determining, at at least two different phases of the heart cycle, a position of the invasive probe;

(c) determining a local non-electrical physiological value at the location;

(d) repeating (a)-(c) for a plurality of locations of the heart; and

(e) combining the positions to form a time-dependent map of at least a portion of the heart.

2. A method according to claim 1, comprising:

(f) determining at least one local relationship between changes in positions of the invasive probe and a determined local non-electrical physiological value.

3. A method according to claim 1, comprising determining a trajectory of the probe as a function of the cardiac cycle.

4. A method according to claim 3, comprising analyzing the trajectory.

5. A method according to claim 1, wherein the map comprises a plurality of maps, each of which correspondes to a different phase of the cycle of the heart.

6. A method according to claim 1, including:

constructing a first map of a heart prior to a treatment;

constructing a second map of the heart, after the treatment; and

comparing the first and second maps to diagnose the effect of the treatment.

7. A method according to claim 1 comprising:

analyzing the map to assess the viabilty of portions of the heart.

8. A method of constructing a cardiac map of a heart having a heart cycle comprising:

(a) bringing an invasive probe into contact with a location on a wall of the heart;

(b) determining a position of the invasive probe;

(c) determining a local non-electrical physiological value at the location at a plurality of different phases of the heart cycle;

(d) repeating (a)-(c) for a plurality of locations of the heart; and

(e) combining the positions to form a map of at least a portion of the heart.

9. A method according to claim 8, comprising determining at least a second position of the invasive probe at a phase at which the local non-electrical value is found, which position is different from the position determined in (b).

10. A method according to claim 9, comprising determining at least one local relationship between changes in positions of the invasive probe and determined local non-electrical physiological values.

11. A method to claim 8, comprising determining a movement of the location on the heart wall relative to the movement of neighboring locations.

12. A method according to claim 11, including determining a relative motion profile of the location on the heart wall relative to neighboring locations.

13. A method according to claim 12, including detecting differences changes in the motion profile for different heart cycles.

14. A method according to claim 13, including detecting differences in positions of the probe at the same phase for different heart cycles.

15. A method according to claim 8, comprising, determining a local change in the geometry of the heart.

16. A method according to claim 15, wherein the local change comprises a change in a size of an area surrounding the location.

17. A method according to claim 15, wherein the local change comprises a change in a local radius of the heart at the location.

18. A method according to claim 8, comprising, determining an intra-cardiac pressure of the heart.

19. A method of analysis, comprising:

bringing a probe into contact with a location on a wall of a heart;

determining a position of the probe at the location;

generating a map of electrical activation of the heart with the probe at the location;

generating a map of mechanical activation of the heart with the probe at the location; and

determining local relationships between the local electrical activation and mechanical activation.

20. A method according to claim 19, wherein the mechanical activation comprises a profile of movement.

21. A method according to claim 20, wherein

the electrical activation comprises an activation time.