Systems and processes for refining a registered map of a body cavity

• US 6,735,465 B2
• Filed: 10/24/2001
• Issued: 05/11/2004
• Est. Priority Date: 10/24/2001
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Panescu, Dorin
• Primary Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US10/145,125
• Publication Number:
  US 20030078509A1
• Time in Patent Office: 930 Days
• Field of Search: 607/122, 607/116, 607/119, 600/508, 600/509
• US Class Current: 600/509
• 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 2017/00053 Mapping
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• 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 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• 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 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• 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 5/063 using impedance measurements
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/6856 with a distal loop
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/4254 using sensors mounted on the probe

Abstract

A process of refining a map of a body cavity includes positioning a first probe and a second probe within the body cavity. Mapping elements on the first probe are used to gather local information from a plurality of locations along the body cavity. The absolute locations of the mapping elements are registered in a three-dimensional coordinate system, and are associated with the local information to generate the map. A mapping element on the second probe is then used to gather information local to a location between the plurality of locations along the body cavity. The absolute location of the mapping element is registered in the three-dimensional system and associated with the local information to refine the map.

Claims

1. A method of mapping a body cavity of a patient, comprising:

positioning a first probe carrying a plurality of mapping elements in the body cavity, wherein the plurality of mapping elements are located adjacent a plurality of locations along the body cavity;

positioning a second probe carrying a functional element in the body cavity;

determining an absolute position of the functional element within a three-dimensional coordinate system;

determining a proximity of the functional element to each of the plurality of mapping elements;

determining an absolute position within the coordinate system of each of the plurality of mapping elements based on the absolute position of the functional element and the proximity of the functional element to each of the plurality of mapping elements;

generating a map by detecting information local to the body cavity using the plurality of mapping elements and associating the local information to the absolute positions of the plurality of mapping elements;

locating the functional element adjacent a location on the body cavity between the plurality of locations, wherein the functional element comprises a mapping element;

determining an absolute position of the mapping element within the coordinate system; and

detecting information local to the body cavity using the mapping element and associating the local information to the absolute position of the mapping element to refine the map.

2. The method of claim 1, further comprising storing the refined map in memory.

3. The method of claim 2, further comprising:

retrieving the refined map from memory; and

displaying the refined map.

4. The method of claim 3, further comprising navigating a device in the coordinate system by reference to the displayed refined map.

5. The method of claim 4, wherein the device comprises the second probe.

6. The method of claim 4, wherein the device is a therapeutic device, and the local information comprises information indicating tissue targeted for therapy, the method further comprising treating the targeted tissue with the device.

7. The method of claim 6, wherein the therapeutic device comprises an ablation electrode, and the targeted tissue is ablated.

8. The method of claim 1, further comprising removing the first probe from the body cavity prior to locating the functional element adjacent the body cavity location.

9. The method of claim 1, further comprising maintaining the first probe within the body cavity while locating the functional element adjacent the body cavity location.

10. The method of claim 1, wherein the body cavity is a heart chamber.

11. A method of mapping a body cavity of a patient, comprising:

positioning a first probe carrying a plurality of mapping elements in the body cavity, wherein the plurality of mapping elements are located adjacent a plurality of locations along the body cavity;

positioning a second probe carrying a mapping element in the body cavity;

determining an absolute position within the coordinate system of each of the plurality of mapping elements;

generating a map by detecting information local to the body cavity using the plurality of mapping elements and associating the local information to the absolute positions of the plurality of mapping elements;

locating the mapping element adjacent a location on the body cavity between the plurality of locations;

determining an absolute position of the mapping element within the coordinate system; and

detecting information local to the body cavity using the mapping element and associating the local information to the absolute position of the mapping element to refine the map.

12. The method of claim 11, further comprising storing the refined map in memory.

13. The method of claim 12, further comprising:

retrieving the refined map from memory; and

displaying the refined map.

14. The method of claim 13, further comprising navigating a device in the coordinate system by reference to the displayed refined map.

15. The method of claim 14, wherein the device comprises the second probe.

16. The method of claim 14, wherein the device is a therapeutic device, and the local information comprises information indicating tissue targeted for therapy, the method further comprising treating the targeted tissue with the device.

17. The method of claim 16, wherein the therapeutic device comprises an ablation electrode, and the targeted tissue is ablated.

18. The method of claim 11, further comprising removing the first probe from the body cavity prior to locating the functional element adjacent the body cavity location.

19. The method of claim 11, further comprising maintaining the first probe within the body cavity while locating the functional element adjacent the body cavity location.

20. The method of claim 11, wherein the body cavity is a heart chamber.

21. A method of mapping a body cavity of a patient, comprising:

positioning a mapping probe within the body cavity;

generating a map of the body cavity with the mapping probe;

registering the map within a three-dimensional coordinate system;

positioning a roving probe in the body cavity; and

refining the map with the roving probe.

22. The method of claim 21, wherein the roving probe carries a mapping element, and the map is refined by:

locating the mapping element adjacent a location on the body cavity;

determining an absolute position of the mapping element within the coordinate system; and

detecting information local to the body cavity using the mapping element and associating the local information to the absolute position of the mapping element.

23. The method of claim 21, further comprising storing the refined map in memory.

24. The method of claim 23, further comprising:

retrieving the refined map from memory; and

displaying the refined map.

25. The method of claim 24, further comprising navigating a device in the coordinate system by reference to the displayed refined map.

26. The method of claim 25, wherein the device comprises the roving probe.

27. The method of claim 25, wherein the device is a therapeutic device and the refined map comprises information indicating tissue targeted for therapy, the method further comprising treating the targeted tissue with the device.

28. The method of claim 27, wherein the therapeutic device comprises an ablation electrode, and the targeted tissue is ablated.

29. The method of claim 21, further comprising removing the mapping probe from the body cavity prior to completion of map refinement.

30. The method of claim 21, further comprising maintaining the mapping probe within the body cavity until completion of the map refinement.

31. The method of claim 21, wherein the body cavity is a heart chamber.

32. A system for mapping a body cavity, comprising:

a first probe having a distal portion carrying a plurality of mapping elements and one or more location elements;

a second probe having a distal portion carrying a mapping element and a location element;

a mapping processing subsystem in communication with the plurality of mapping elements and the mapping element, and being configured for generating a map by detecting information local to the body cavity using the plurality of mapping elements and the mapping element;

a location determination subsystem in communication with the one or more location elements and the location element and being configured to determine absolute positions of the plurality of mapping elements and the mapping element in a three-dimensional coordinate system based on locations of the one or more location elements and the location element; and

a registration subsystem in communication with the mapping processing subsystem and the location determination subsystem, and being configured to associate the local information to the absolute positions of the plurality of mapping elements and the mapping element.

33. The system of claim 32, further comprising memory in communication with the registration subsystem for storing the refined map.

34. The system of claim 33, further comprising a display in communication with the registration subsystem for displaying the refined map.

35. The system of claim 34, further comprising a device carrying another location element, wherein the location determination subsystem is further in communication with another location element and being configured to determine an absolute position of the another location element.

36. The system of claim 35, wherein the device comprises the second probe.

37. The system of claim 35, wherein the device is a therapeutic device, and the local information comprises information indicating tissue targeted for therapy.

38. The system of claim 37, wherein the therapeutic device comprises an ablation electrode.

39. The system of claim 32, wherein the first probe comprises a 3-D catheter structure on which the plurality of mapping elements is carried.

40. The system of claim 39, wherein the 3-D catheter structure is 40 millimeters or less in size.