System and method for detecting electrode-tissue contact

• US 6,569,160 B1
• Filed: 07/07/2000
• Issued: 05/27/2003
• Est. Priority Date: 07/07/2000
• Status: Expired due to Term

• Current Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Original Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Inventors: Goldin, Alexander, Levin, Michael, Matcovitch, Avraham
• Primary Examiner(s): Dvorak, Linda C. M.
• Assistant Examiner(s): Ruddy, David M.
• Application Number:
  US09/612,606
• Time in Patent Office: 1,054 Days
• Field of Search: 606/32, 606/39, 606/38, 606/41, 606/42, 606/49, 600/374, 600/375, 600/427, 600/378, 600/424, 607/119, 607/122, 607/101
• US Class Current: 606/41
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 18/1206 Generators 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 2017/003 Steerable
• CPC Class Codes: A61B 2018/00065 porous
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/0066 without feedback, i.e. open loop control
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/1253 monopolar
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/162 located on the probe body
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/3958 emitting a signal

Abstract

A system for detecting electrode-tissue contact comprises a catheter having a location sensor and a distal tip electrode. The catheter preferably further comprises a reference electrode that is preferably protected from making contact with tissue. The system further comprises a signal generator to transmit test signals to the distal tip and reference electrodes. Tissue contact is detected by comparing the signals across the tip electrode to a return electrode versus the signal across the reference electrode to a return electrode. Ablation energy may be delivered to the distal tip electrode if contact of the electrode with tissue is detected.

Claims

1. A system for detecting contact of an electrode with tissue, said system comprising:

a) a catheter comprising;

i) a body having a proximal end and a distal end, said distal end having a distal tip;

ii) a contact electrode adapted for contact with tissue, wherein said contact electrode is positioned at said catheter distal tip;

iii) a location sensor for determining a position of said distal end;

b) a reference electrode, wherein said reference electrode is positioned on said catheter;

c) a return electrode, said return electrode functioning as a sink for said test signals to said distal tip electrode and to said reference electrode; and

d) a contact detection circuit comprising;

i) a signal generator for sending test signals to said contact electrode and to said reference electrode; and

ii) a circuit to measure a differential electrical response to said test signals, said differential electrical response being indicative of contact of said contact electrode with tissue;

wherein said circuit to measure a differential electrical response to said test signals comprises;

(a) a first differential amplifier to measure a first electrical difference signal between said distal tip electrode and said return electrode; and

(b) a second differential amplifier to measure a second electrical difference signal between said reference electrode and said return electrode.

2. The system of claim 1 wherein said location sensor is an electromagnetic location sensor.

3. The system of claim 1 wherein said reference electrode is protected from making contact with tissue.

4. The system of claim 3 wherein said reference electrode is protected by a membrane covering said electrode, said membrane permitting contact of said reference electrode with blood but not permitting contact of said reference electrode with tissue.

5. The system of claim 3 wherein said reference electrode is recessed relative to said catheter body.

6. The system of claim 1 wherein said return electrode is adapted for positioning internal to the body.

7. The system of claim 6 wherein said return electrode is positioned on said catheter.

8. The system of claim 1 wherein said return electrode is adapted for contact skin external to the body.

9. The system of claim 1 wherein said return electrode is dedicated for measuring differential signals with said distal tip electrode and with said reference electrode.

10. The system of claim 1 wherein said return electrode is connected to isolated ground.

11. The system of claim 1 wherein said return electrode is connected to an electrocardiogram device isolated ground.

12. The system of claim 1 wherein said distal tip electrode and said reference electrode are supplied with a first constant current and second constant current, respectively, said first constant current being equal to said second constant current.

13. The system of claim 12 wherein said return electrode is driven with a third constant current, said third current being opposite in phase with said first constant current and said second constant current.

14. The system of claim 1 which further comprises a third differential amplifier to measure an electrical difference signal between said first differential signal and said second differential signal.

15. The system of claim 14 wherein said first differential amplifier measures a first voltage difference between said distal tip electrode and said return electrode, said second differential amplifier measures a second voltage difference between said reference electrode and said return electrode, and said third differential amplifier measures a voltage difference between said first voltage and said second voltage.

16. The system of claim 14 wherein said electrical difference signal measured by said third differential amplifier is rectified by a synchronous detector.

17. The system of claim 1 wherein said tip electrode and said reference electrode have a first area and a second area, respectively, and said first amplifier and said second amplifier have a first gain and a second gain, respectively, said first gain to said second gain being proportional to said first area to said second area.

18. The system of claim 1 wherein said location sensor is an electromagnetic location sensor.

19. The system of claim 1 wherein said circuit to measure a differential electrical response to said test signals comprises a bridge circuit, said bridge circuit comprising a first resistive element and a second resistive element, said resistive elements each having a first side and a second side, said first side of said first resistive element connected with said first side of said second resistive element, said second side of said first resistive element connected with said reference electrode, said second side of said second resistive element connected with said distal tip electrode, said bridge having a first input between said first resistive element and said second resistive element and a second input connected to said return electrode, and a first output between said first resistive element and said reference electrode and a second output between said second resistive element and said distal tip electrode.

20. The system of claim 19 wherein said first resistive element is a first resistor and said second resistive element is a second resistor.

21. The system of claim 20 wherein said first resistor has a first resistance and said second resistor has a second resistance, and wherein said tip electrode has a tip electrode area and said reference electrode has a reference electrode area, said first resistance to said second resistance being proportional to said tip electrode area to said reference electrode area.

22. The system of claim 19 wherein said first resistive element is a first high output impedance buffer and said second resistive element is a second high output impedance buffer.

23. The system of claim 22 wherein said first high output impedance buffer has a first output current, said second high output buffer has a second output current, and wherein said tip electrode has a tip electrode area and said reference electrode has a reference electrode area, said first output current to said second output current being proportional to said tip electrode area to said reference electrode area.

24. The system of claim 19 wherein said bridge outputs are connected to a differential amplifier, said differential amplifier measuring a bridge output voltage indicative of contact of said distal tip electrode with tissue.

25. The system of claim 24 wherein said differential amplifier has an output that is rectified by a synchronous detector.

26. The system of claim 19 wherein said location sensor is an electromagnetic location sensor.

27. The system of claim 1 wherein said circuit to measure a differential electrical response to said test signals comprises a first current sensor for measuring current to said reference electrode and a second current sensor for measuring current to said distal tip electrode.

28. The system of claim 27 wherein said current sensors are selected from current transformers and Hall effect sensors.

29. The system of claim 27 wherein said first current sensor has a first gain and said second current sensor has a second gain, said distal tip electrode has a tip electrode area and said reference electrode has a reference electrode area, said first gain to said second gain being proportional to said tip electrode area to said reference electrode area.

30. The system of claim 27 wherein said first current sensor and said second current sensor have outputs connected to a differential amplifier, said amplifier measuring a voltage indicative of contact of said distal tip electrode with tissue.

31. The system of claim 30 wherein said differential amplifier has an output rectified by a synchronous detector.

32. The system of claim 27 wherein said location sensor is an electromagnetic location sensor.

33. A method of detecting contact of an electrode with tissue, said method comprising the steps of:

a) providing a catheter comprising

i) a body having a proximal end and a distal end, said distal end having a distal tip;

ii) a contact electrode adapted for contact with tissue, wherein said contact electrode is positioned at said catheter distal tip;

iii) a location sensor for determining a position of said distal end;

b) providing a reference electrode, wherein said reference electrode is positioned on said catheter;

c) providing test signals to said contact electrode and to said reference electrode;

d) measuring a differential electrical response to said test signals, wherein said differential electrical response is indicative of contact of said contact electrode with tissue by;

i) measuring a first electrical difference signal between said distal tip electrode and a return electrode and a second electrical difference signal between said reference electrode and said return electrode; and

ii) comparing said first electrical difference signal with said second electrical difference signal to detect contact of said distal tip electrode with tissue.

34. The method of claim 33 wherein said location sensor is an electromagnetic location sensor.

35. The method of claim 33 wherein said reference electrode is protected from making contact with tissue.

36. The method of claim 35 wherein said reference electrode is protected by a membrane covering said electrode, said membrane permitting contact of said reference electrode with blood but not permitting contact of said reference electrode with tissue.

37. The method of claim 35 wherein said reference electrode is recessed relative to said catheter body.

38. The method of claim 33 wherein said test signals provided to said distal tip and reference electrodes are constant current signals.

39. The method of claim 33 wherein comparing said first electrical difference signal with said second electrical difference signal comprises feeding said first electrical difference signal and said second electrical difference signal to a differential amplifier to produce a third electrical difference signal indicative of contact of said distal tip electrode with tissue.

40. The method of claim 39 wherein said first and said second electrical difference signals are adjusted to provide a null difference signal from said differential amplifier when said distal tip electrode and said reference electrode are both in blood and neither electrode is in contact with tissue.

41. The method of claim 33 wherein said location sensor is an electromagnetic location sensor.

42. The method of claim 33 wherein measuring a differential electrical response to said test signals comprises:

a) providing a bridge circuit comprising a first resistive element and a second resistive element, said resistive elements each having a first side and a second side, said first side of said first resistive element connected with said first side of said second resistive-element, said second side of said first resistive element connected with said reference electrode, said second side of said second resistive element connected with said distal tip electrode, said bridge having a first input between said first resistive element and said second resistive element and a second resistive element and a second input connected to said return electrode, and a first output between said first resistive element and said reference electrode and a second output between said second resistive element and said distal tip electrode; and

b) measuring a signal across said bridge outputs to detect contact of said distal tip electrode with tissue.

43. The method of claim 42 wherein said first resistive element comprises a first resistor and said second resistive element comprises a second resistor.

44. The method of claim 42 wherein said first resistive element comprises a first high output impedance buffer and said second resistive element comprises a second high output impedance buffer.

45. The method of claim 42 wherein said signal across said bridge outputs is measured with a differential amplifier.

46. The method of claim 45 wherein said signal across said bridge outputs is adjusted to provide a null signal from said differential amplifier when said distal tip electrode and said reference electrode are both in blood and neither electrode is in contact with tissue.

47. The method of claim 42 wherein said location sensor is an electromagnetic sensor.

48. The method of claim 33 wherein measuring a differential electrical response to said test signals comprises measuring current to said reference electrode with a first current sensor and measuring current to said distal tip electrode with a second current sensor, said first current sensor and said second current sensor having outputs connected to a differential amplifier, said amplifier measuring a voltage indicative of contact of said distal tip electrode with tissue.

49. The method of claim 48 wherein said current sensors are selected from current transformers and Hall effect sensors.

50. The method of claim 48 wherein said current sensors have output signals, said signals being adjusted to provide a null signal from said differential amplifier when said distal tip electrode and said reference electrode are both in blood and neither electrode is in contact with tissue.

51. The method of claim 48 wherein said location sensor is an electromagnetic location sensor.

52. The method of claim 33 wherein measuring a differential electrical response to said test signals comprises:

a) measuring a first impedance between said distal tip electrode and a return electrode and a second impedance between said reference electrode and said return electrode; and

b) comparing said first and second impedances to detect contact of said catheter distal tip electrode with tissue.

53. The method of claim 52 wherein said location sensor is an electromagnetic location sensor.

54. The method of claim 53 which further comprises delivering ablation energy to said distal tip electrode in accordance with said distal tip electrode being in contact with tissue.

55. A method of detecting contact of an electrode with tissue, said method comprising the steps of:

a) providing a catheter comprising;

i) a body having a proximal end and a distal end, said distal end having a distal tip;

ii) a contact electrode adapted for contact with tissue, wherein said contact electrode is positioned at said catheter distal tip; and

iii) a location sensor for determining a position of said distal end;

b) providing a reference electrode, wherein said reference electrode is positioned on said catheter;

c) providing test signals to said contact electrode and to said reference electrode;

d) measuring a differential electrical response to said test signals, said differential electrical response being indicative of contact of said contact electrode with tissue;

e) collecting electrical information from said distal tip electrode and location information from said location sensor at a plurality of points on said tissue; and

f) generating an electrical map of said tissue from said electrical and location information, said electrical and location information at each of said points being weighted in said map in accordance with contact being detected between said distal tip electrode and said tissue at said points.

56. A method of detecting contact of an electrode with tissue, said method comprising the steps of:

a) providing a catheter comprising;

i) a body having a proximal end and a distal end, said distal end having a distal tip;

ii) a contact electrode adapted for contact with tissue, wherein said contact electrode is positioned at said catheter distal tip; and

iii) a location sensor for determining a position of said distal end;

b) providing a reference electrode, wherein said reference electrode is positioned on said catheter;

c) providing test signals to said contact electrode and to said reference electrode;

d) measuring a differential electrical response to said test signals, said differential electrical response being indicative of contact of said contact electrode with tissue;

e) collecting electrical information from said distal tip electrode and mechanical information from said location sensor at a plurality of points on said tissue; and

f) generating an electromechanical map of said tissue from said electrical and mechanical information, said electrical and mechanical information at each of said points being weighted in said map in accordance with contact being detected between said distal tip electrode and said tissue at said points.

57. The method of claim 56 which further comprises delivering ablation energy to said distal tip electrode in accordance with said distal tip electrode being in contact with tissue.