Method and device for transseptal facilitation based on injury patterns

• US 6,994,094 B2
• Filed: 04/29/2003
• Issued: 02/07/2006
• Est. Priority Date: 04/29/2003
• Status: Active Grant

• Current Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Original Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Inventors: Schwartz, Yitzhack
• Primary Examiner(s): Cohen, Lee S.
• Application Number:
  US10/425,165
• Publication Number:
  US 20040220462A1
• Time in Patent Office: 1,015 Days
• Field of Search: 600/374, 600/381, 128/898, 128/899
• US Class Current: 128/898
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• 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 5/06 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 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]

Abstract

A method for performing a procedure at the fossa ovalis in the septal wall of the heart includes the steps of providing a sheath having a body wherein the body has a lumen extending therethrough and an open end at the distal end of the body. The body also has at least one electrode and a position sensor at the distal end of the body. The position sensor generates signals indicative of the location of the distal end of the body. The sheath is navigated to the septal wall using the position sensor and the fossa ovalis in the septal wall is identified using the at least one electrode of the sheath.

Claims

1. A method for performing a procedure at a fossa ovalis in a septal wall of a heart, the method comprising the steps of:

providing a sheath comprising a body, the body having a lumen extending therethrough and an open end at a distal end of the body, the body also having at least one electrode and a position sensor at the distal end of the body, the position sensor generating signals indicative of a location of the distal end of the body;

navigating the sheath to the septal wall using the position sensor;

reconstructing an electroanatomical map using the at least one electrode and the position sensor of the sheath;

identifying the fossa ovalis in the septal wall using the at least one electrode and the position sensor of the sheath; and

displaying the fossa ovalis as a tagged point on the map.

2. The method according to claim 1, further comprising identifying the fossa ovalis based on injury patterns detected using the at least one electrode.

3. The method according to claim 2, further comprising identifying the fossa ovalis by determing an injury pattern for an area on the septal wall that exhibits less of an injury pattern than injury patterns exhibited by other areas on the septal wall.

4. The method according to claim 3, further comprising detecting injury patterns using injury curves.

5. The method according to claim 4, further comprising detecting injury patterns with an electrocardiogram.

6. The method according to claim 5, further comprising displaying the injury patterns in the form of PQRST waves.

7. The method according to claim 2, further comprising identifying the fossa ovalis by finding an area on the septal wall that does not exhibit an injury pattern.

8. The method according to claim 1, further comprising determining the location coordinates of the tagged point using the position sensor.

9. The method according to claim 8, further comprising determining the location coordinates of the tagged point by identifying position coordinates of the point.

10. The method according to claim 9, further comprising identifying orientation coordinates for the tagged point.

11. The method according to claim 1, further comprising tagging the point at the fossa ovalis with a physical tag.

12. The method according to claim 11, further comprising tagging the point at the fossa ovalis using an active tag.

13. The method according to claim 11, further comprising tagging the point at the fossa ovalis using a passive tag.

14. The method according to claim 1, further comprising perforating the fossa ovalis.

15. The method according to claim 14, further comprising perforating the fossa ovalis by extending a penetrating device through the lumen and the distal end of the sheath.

16. The method according to claim 15, further comprising withdrawing the penetrating device from the sheath.

17. The method according to claim 16, further comprising extending a secondary device through the sheath and the fossa ovalis and into the left atrium of the heart.

18. The method according to claim 17, further comprising performing a diagnostic procedure in the left atrium with the secondary device.

19. The method according to claim 17, further comprising performing a therapeutic procedure in the left atrium with the secondary device.