System and method for electrode localization using ultrasound
First Claim
1. A system for tracking the three-dimensional position of a medical device within a living body, comprising:
- a reference catheter having a plurality of ultrasound reference transducers mounted thereon, the reference catheter positionable within the living body;
an ultrasound target transducer mounted to a medical device which is to be tracked;
localization hardware electronically coupled to the ultrasound target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time, for determining a three-dimensional arrangement of the transducers, and for generating an image for display on the graphical display representing a three-dimensional position of at least a portion of the medical device.
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Accused Products
Abstract
The present invention is a device localization system that uses one or more ultrasound reference catheters to establish a fixed three-dimensional coordinate system within a patient'"'"'s heart using principles of triangulation. The coordinate system is represented graphically in three-dimensions on a video monitor and aids the clinician in guiding other medical devices, which are provided with ultrasound transducers, through the body to locations at which they are needed to perform clinical procedures. In one embodiment of a system according to the present invention, the system is used in the heart to help the physician guide mapping catheters for measuring electrical activity, and ablation catheters for ablating selected regions of cardiac tissue, to desired locations within the heart.
347 Citations
83 Claims
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1. A system for tracking the three-dimensional position of a medical device within a living body, comprising:
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a reference catheter having a plurality of ultrasound reference transducers mounted thereon, the reference catheter positionable within the living body;
an ultrasound target transducer mounted to a medical device which is to be tracked;
localization hardware electronically coupled to the ultrasound target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time, for determining a three-dimensional arrangement of the transducers, and for generating an image for display on the graphical display representing a three-dimensional position of at least a portion of the medical device. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A system for tracking the three-dimensional position of a medical device within a living body, comprising:
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a reference catheter having a plurality of ultrasound reference transducers mounted thereon, the reference catheter positionable within the living body;
an ultrasound target transducer mounted to a medical device which is to be tracked, the medical device having an electrode;
localization hardware electronically coupled to the ultrasound target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time, for establishing a coordinate system using the calculated distances, for determining a three-dimensional position of the target transducer relative to the coordinate system, for using the three-dimensional position of the target transducer to derive a three-dimensional position of the electrode relative to the coordinate system, and for generating an image for display on the graphical display representing a three-dimensional position of the electrode. - View Dependent Claims (15, 16, 17)
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18. A system for diagnosing and/or treating cardiac arrhythmias, the system comprising:
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a plurality of ultrasound reference transducers, the reference transducers mounted on at least one reference catheter positionable within a patient'"'"'s chest;
a mapping catheter having a mapping portion including at least one mapping electrode and at least one ultrasound target transducer adjacent to the mapping catheter;
localization hardware electronically coupled to the target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
electrophysiology hardware electronically coupled to the mapping electrode for receiving mapping signals corresponding to electrical activity measured by the mapping electrodes;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time;
for determining a three-dimensional arrangement of the transducers, for receiving mapping signals from the electrophysiology hardware, and for generating an image for display on the graphical display representing a three-dimensional position of at least a portion of the mapping catheter.- View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
an elongate shaft;
a plurality of arms extending from the shaft;
a plurality of the mapping electrodes carried on the arms; and
a plurality of ultrasound tracking transducers on the arms.
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26. The system of claim 18 wherein:
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the system further comprises an ablation catheter having an ablation section, an ablation electrode at the ablation section for forming lesions in the heart, and an ultrasound tracking transducer;
the localization hardware is electronically coupled to the ultrasound tracking transducer on the ablation catheter; and
the processor means is further for generating an image which represents the three-dimensional position of at least a portion of the ablation section of the ablation catheter.
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27. The system of claim 26 wherein the processor means is further for, with the ablation section at a target location at which a lesion has been formed, using the measured elapsed time for calculating the distances between the ultrasound tracking transducer on the ablation catheter and the other ultrasound transducers, for determining the three-dimensional location of the ablation section using the calculated distances, and for generating an image for selective display on the graphical display which represents the three-dimensional position of at least a portion of the lesion.
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28. The system of claim 18 wherein:
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the system further comprises a marking catheter having a distal tip and an ultrasound transducer;
the localization hardware is electronically coupled to the ultrasound transducer on the marking catheter;
the processor means is further for deriving the three-dimensional position of the distal tip from the three-dimensional position of the ultrasound transducer on the marking catheter.
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29. The system of claim 28 wherein the processor means is further for generating an image which includes the derived three-dimensional position of the distal tip.
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30. The system of claim 18 wherein the reference catheter comprises a single spline on which the ultrasound reference transducers are mounted.
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31. The method of claim 18, wherein the mapping and reference catheters are separate.
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32. An electrode localization and ablation system, comprising:
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a reference catheter having a plurality of ultrasound reference transducers mounted thereon, the reference catheter positionable within the living body;
an ablation catheter having an ablation section including at least one ablation electrode for forming lesions and at least one ultrasound target transducer;
localization hardware electronically coupled to the target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
a source of ablation energy electrically coupled to the ablation electrode to cause the ablation electrode to generate lesions within the living body;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time, for determining a three-dimensional arrangement of the transducers, and for generating an image for display on the graphical display representing a three-dimensional position of at least a portion of the ablation section. - View Dependent Claims (33, 34, 35)
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36. A method of tracking the position of a target catheter within a chamber of a living heart, comprising the steps of:
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positioning a reference catheter inside the body, near the heart, with the reference catheter having a plurality of ultrasound transducers mounted thereon;
positioning a target catheter within a chamber of the heart, the target catheter having at least one ultrasound transducer mounted thereon;
causing a plurality of the transducers to generate ultrasound signals, causing a plurality of the transducers to receive ultrasound signals, including causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and recording elapsed time between the generation of signals from each transmitting one of the transducers and the receipt of signals by receiving ones of the transducers;
determining a location of the target catheter with respect to the reference catheter based on the recorded times; and
displaying a location of at least a portion of the target catheter on a graphical display. - View Dependent Claims (37, 38, 39, 40, 41, 42)
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43. A method of tracking the position of a medical device within a living body, comprising the steps of:
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(a) providing a reference catheter having a plurality of ultrasound reference transducers, each reference transducer capable of transmitting and receiving ultrasound signals;
(b) providing a medical device, the medical device including an ultrasound target transducer;
(c) positioning the reference catheter and the medical device within the living body;
(d) causing a plurality of the transducers to transmit ultrasound signals for receipt by others of the transducers, including causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers;
(e) measuring elapsed time between transmission of each ultrasound signal emitted in step (d) and its receipt by each of the other transducers, and using the measured elapsed time to determine relative distances between the transducers;
(f) using distances determined in step (e), establishing a three-dimensional arrangement of the reference transducers to establish a coordinate system within the body, and determining a location of the medical device relative to the coordinate system; and
(g) displaying a three-dimensional position of at least a portion of the target transducer relative to the coordinate system on a graphical display. - View Dependent Claims (44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62)
(h) positioning the mapping electrode at a location within the living body;
(i) measuring electrical activity from the electrode; and
(j) deriving the three-dimensional position of the electrode from the three-dimensional position of the target transducer and graphically representing mapping signals corresponding to electrical activity measured by the electrode on the graphical display at the three dimensional position of the electrode.
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45. The method of claim 44 wherein the mapping catheter provided in step (b) includes multiple mapping electrodes and a plurality of target transducers, and wherein:
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step (h) includes simultaneously positioning a plurality of the mapping electrodes at a location;
step (i) includes measuring the electrical activity with the plurality of electrodes; and
step (j) includes deriving the three-dimensional positions of the electrodes using the three-dimensional positions of the target transducers and simultaneously displaying electrical activity measured by each of a plurality of the mapping electrodes on the graphical display at the three dimensional position of its corresponding electrode.
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46. The method of claim 45 wherein the mapping catheter provided in step (b) includes an elongate shaft, a plurality of arms extending from the shaft, a plurality of mapping electrodes on the arms, and a plurality of ultrasound transducers on the arms, and wherein the reference catheter provided in step (a) comprises the mapping catheter.
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47. The method of claim 44 wherein the mapping catheter provided in step (b) includes multiple mapping electrodes and a plurality of target transducers, and wherein:
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step (h) includes simultaneously positioning a plurality of the mapping electrodes at a location;
step (i) includes measuring the electrical activity with the plurality of electrodes; and
step (j) includes deriving the three-dimensional positions of the electrodes using the three-dimensional positions of the target transducers and graphically displaying parameters derived from the measured electrical activity on the graphical display at the three dimensional position of at least a portion of the electrodes.
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48. The method of claim 44, wherein the mapping and reference catheters are separate.
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49. The method of claim 43 wherein the medical device provided in step (b) is a mapping catheter having a mapping electrode, and wherein the method further comprises the steps of:
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(h) positioning the mapping electrode at a location within the living body;
(i) measuring electrical activity from the electrode; and
(j) deriving the three-dimensional position of the electrode from the three-dimensional position of the target transducer and graphically representing parameters derived from the measured electrical activity on the graphical display at the three dimensional position of the electrode.
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50. The method of claim 49 wherein:
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step (b) further provides a second medical device in the form of an ablation catheter having an ablation section including an ablation electrode and a target transducer, and wherein the method further includes;
(k) evaluating the display created at step (j) to identify a target location for ablation;
(l) moving the ablation catheter towards the target location in the body while tracking the location of the ablation catheter relative to the coordinate system;
(m) graphically representing the location of the ablation section on the graphical display;
(o) while observing the graphical display, repeating steps (l) and (m) until the graphical display shows the ablation section at the target location; and
(p) supplying ablation energy to the ablation electrode to induce ablation at the target location.
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51. The method of claim 49, wherein the mapping and reference catheters are separate.
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52. The method of claim 43 wherein the method is for tracking the position of a catheter within a patient'"'"'s heart, and wherein:
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step (a) provides a reference catheter having a distal tip;
step (c) includes positioning the reference catheter in the right ventricle of the patient'"'"'s heart with the distal tip at the right ventricular apex.
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53. The method of claim 52 wherein;
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step (a) provides a second reference catheter;
step (c) includes positioning the second reference catheter in the coronary sinus of the patient'"'"'s heart.
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54. The method of claim 43, wherein the method is for tracking the position of a catheter within a patient'"'"'s heart, wherein the patient'"'"'s heart has a cardiac cycle, and wherein the method further comprises the step of storing data representing the three-dimensional position of at least a portion of the catheter at a selected portion of the cardiac cycle.
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55. The method of claim 43 wherein the method is for tracking the position of a catheter within a patient'"'"'s heart, and wherein:
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step (a) provides a reference catheter;
step (c) includes positioning the reference catheter in the coronary sinus of the patient'"'"'s heart.
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56. The method of claim 43, further including the step of using the relative distances established in step (e), deriving the three-dimensional position and orientation of the reference catheter and displaying an image representing the three-dimensional position and orientation of at least a portion of the reference catheter on the graphical display.
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57. The method of claim 43, further including the step of repeating steps (d) through (g) while moving the medical device to a location within the living body.
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58. The method of claim 43 wherein step (e) includes using a triangulation algorithm to determine the location of the target transducer.
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59. The method of claim 43 wherein the medical device provided in step (b) is an ablation device having an ablation electrode, and wherein the method further comprises the steps of:
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(h) positioning the ablation electrode at a target location within the living body;
(i) delivering ablation energy to the electrode to induce ablation at the target location and to thereby form a lesion; and
(j) extrapolating the three-dimensional position of at least a portion of the lesion from the three-dimensional location of the target transducer established in step (f); and
(k) including the three-dimensional location of the lesion determined in step (j) on the graphical display.
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60. The method of claim 43 wherein the medical device is a marking catheter having a distal portion and wherein the ultrasound tracking transducer is located at the distal portion, and wherein:
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step (c) includes manipulating the marking catheter under fluoroscopic visualization to position the target transducer adjacent to a predetermined anatomical structure within the body; and
the method further includes the step of extrapolating the position of the anatomical structure from the three-dimensional position of the target transducer determined in step (f) and displaying the three-dimensional position of the anatomical structure on the graphical display.
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61. The method of claim 43 wherein the reference catheter comprises a single spline on which the ultrasound reference transducers are mounted.
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62. The method of claim 43, wherein the reference catheter is positioned within the coronary sinus of the heart.
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63. A system for tracking the three-dimensional position of a medical device within a living body, comprising:
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a plurality of reference catheters, each reference catheter having at least one ultrasound reference transducer mounted thereon and being positionable within the living body;
an ultrasound target transducer mounted to a medical device which is to be tracked;
localization hardware electronically coupled to the ultrasound target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time, for determining a three-dimensional arrangement of the transducers, and for generating an image for display on the graphical display representing a three-dimensional position of at least a portion of the medical device. - View Dependent Claims (64)
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65. A system for tracking the three-dimensional position of a medical device within a living body, comprising:
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a plurality of reference catheters, each having at least one ultrasound transducer mounted thereon, the reference catheters positionable within a living body;
an ultrasound target transducer mounted to a medical device which is to be tracked, the medical device having an electrode;
localization hardware electronically coupled to the ultrasound target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time, for establishing a coordinate system using the calculated distances, for determining a three-dimensional position of the target transducer relative to the coordinate system, for using the three-dimensional position of the target transducer to derive a three-dimensional position of the electrode relative to the coordinate system, and for generating an image for display on the graphical display representing a three-dimensional position of the electrode. - View Dependent Claims (66, 67)
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68. A system for diagnosing and/or treating cardiac arrhythmias, the system comprising:
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a plurality of reference catheters, each having at least one ultrasound reference transducer mounted thereon, the reference catheters positionable within a patient'"'"'s chest;
a mapping catheter having a mapping portion including at least one mapping electrode and at least one ultrasound target transducer adjacent to the mapping catheter;
localization hardware electronically coupled to the target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
electrophysiology hardware electronically coupled to the mapping electrode for receiving mapping signals corresponding to electrical activity measured by the mapping electrodes;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time, for determining a three-dimensional arrangement of the transducers, for receiving mapping signals from the electrophysiology hardware, and for generating an image for display on the graphical display representing a three-dimensional position of at least a portion of the mapping catheter. - View Dependent Claims (69, 70)
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71. An electrode localization and ablation system, comprising:
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a plurality of reference catheters, each having at least one ultrasound reference transducer mounted thereon, the reference catheters positionable within a living body;
an ablation catheter having an ablation section including at least one ablation electrode for forming lesions and at least one ultrasound target transducer;
localization hardware electronically coupled to the target and reference transducers for causing a plurality of the ultrasound transducers to transmit ultrasound signals, for causing a plurality of the ultrasound transducers to receive ultrasound signals including for causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and for measuring elapsed time between transmission of ultrasound signals by transmitting transducers and receipt of the signals by receiving transducers;
a source of ablation energy electrically coupled to the ablation electrode to cause the ablation electrode to generate lesions within the living body;
a graphical display; and
processor means electronically coupled to the localization hardware for calculating distances between the transducers using the measured elapsed time, for determining a three-dimensional arrangement of the transducers, and for generating an image for display on the graphical display representing a three-dimensional position of at least a portion of the ablation section. - View Dependent Claims (72, 73)
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74. A method of tracking the position of a target catheter within a chamber of a living heart, comprising the steps of:
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positioning a plurality of reference catheters inside the body, near the heart, with each reference catheter having at least one ultrasound mounted thereon;
positioning a target catheter within a chamber of the heart, the target catheter having at least one ultrasound transducer mounted thereon;
causing a plurality of the transducers to generate ultrasound signals, causing a plurality of the transducers to receive ultrasound signals, including causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers, and recording elapsed time between the generation of signals from each transmitting one of the transducers and the receipt of signals by receiving ones of the transducers;
determining a location of the target catheter with respect to the reference catheter based on the recorded times; and
displaying a location of at least a portion of the target catheter on a graphical display. - View Dependent Claims (75, 76, 77, 78)
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79. A method of tracking the position of a medical device within a living body, comprising the steps of:
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(a) providing a plurality of reference catheters, each reference catheter including at least one reference transducer capable of transmitting and receiving ultrasound signals;
(b) providing a medical device, the medical device including an ultrasound target transducer;
(c) positioning the reference catheter and the medical device within the living body;
(d) causing a plurality of the transducers to transmit ultrasound signals for receipt by others of the transducers, including causing ultrasound reference transducers to receive ultrasound signals emitted by other ultrasound reference transducers;
(e) measuring elapsed time between transmission of each ultrasound signal emitted in step (d) and its receipt by each of the other transducers, and using the measured elapsed time to determine relative distances between the transducers;
(f) using distances determined in step (e), establishing a three-dimensional arrangement of the reference transducers to establish a coordinate system within the body, and determining a location of the medical device relative to the coordinate system; and
(g) displaying a three-dimensional position of at least a portion of the target transducer relative to the coordinate system on a graphical display. - View Dependent Claims (80, 81, 82, 83)
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Specification