Automated mapping of anatomical features of heart chambers

• US 7,537,570 B2
• Filed: 09/11/2007
• Issued: 05/26/2009
• Est. Priority Date: 09/11/2006
• Status: Active Grant

• Current Assignee: Stereotaxis, Inc.
• Original Assignee: Stereotaxis, Inc.
• Inventors: Kastelein, Nathan
• Primary Examiner(s): Manuel; George
• Assistant Examiner(s): Flory; Christopher A
• Application Number:
  US11/853,507
• Publication Number:
  US 20080064969A1
• Time in Patent Office: 623 Days
• Field of Search: 600/508, 607/119, 607/122
• US Class Current: 600/508
• 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 5/062 using magnetic field

Abstract

A method is provided to facilitate the movement of a medical device for automated mapping of anatomical surfaces of a subject'"'"'s heart with a remote navigation. The method may include one or more distinct movements for moving a medical device for mapping a portion of an anatomical surface of a subject'"'"'s heart. Upon establishing contact of the tip of the medical device with a surface of the heart, one method provides for moving the medical device along the surface of the heart towards an anatomical feature until a loss of contact with the surface is sensed, and determining the point where the loss of contact occurred to identify at least one point along the anatomical feature. The process may be repeated to identify a multiplicity of points that serve to define the ridge on the interior heart surface. The ridge location in the anatomical map can be used as a reference or guide to facilitate the further mapping of physiological properties and to plan therapy delivery during the medical procedure.

Claims

1. A method for locating at least one point on an endocardial ridge of a subject'"'"'s heart with a medical device actuated by a remote navigation system, the method comprising:

advancing a medical device within a subject'"'"'s body near to a known anatomical feature of the heart with the remote navigation system;

establishing contact by the medical device with the surface of the heart;

moving the medical device along the surface of the heart towards the anatomical feature until a loss of contact with the surface is sensed;

detecting when a loss of contact with the heart surface has occurred; and

determining the point where the loss of contact occurred to identify at least one point along the known anatomical feature.

3. The method of claim 1 wherein the sensing of a loss of contact comprises detecting a change in orientation of the tip of the medical device that is more than a predetermined percentage from a previous tip orientation, measured relative to a reference orientation.

5. The method of claim 1 wherein the at least one identified point along a ridge of a subject'"'"'s heart is known with respect to an X-ray image of the subject'"'"'s heart, and the corresponding ridge on a pre-operative image of the subject'"'"'s heart is registered to the X-ray image using the at least one identified point along the ridge of the subject'"'"'s heart.

8. The method of claim 1, where the remote navigation system is a mechanically actuate navigation system.

9. The method of claim 1, wherein the steps are repeated to identify a multiplicity of points to define the location of the ridge along a subject'"'"'s heart.

2. A method for locating at least one point on an endocardial ridge of a subject'"'"'s head with a medical device actuated by a remote navigation system, the method comprising:

advancing a medical device within a subject'"'"'s body near to a known anatomical feature of the heart with the remote navigation system;

establishing contact by the medical device with the surface of the heart;

moving the medical device along the surface of the heart towards the anatomical feature until a loss of contact with the surface is sensed; and

determining the point where the loss of contact occurred to identify at least one point along the known anatomical feature, wherein the sensing of a loss of contact comprises detecting a change in tip orientation of more than a predetermined angle.

4. A method for locating at least one point on an endocardial ridge of a subject'"'"'s heart with a medical device actuated by a remote navigation system, the method comprising:

advancing a medical device within a subject'"'"'s body near to a known anatomical feature of the heart with the remote navigation system;

establishing contact by the medical device with the surface of the heart;

moving the medical device along the surface of the heart towards the anatomical feature until a loss of contact with the surface is sensed; and

determining the point where the loss of contact occurred to identify at least one point along the known anatomical feature, wherein the sensing of a loss of contact comprises identifying the existence of continuous contact by detecting an angular change in tip orientation of less than a predetermined amount, and determining when contact is no longer continuous.

6. A method for locating at least one point on an endocardial ridge of a subject'"'"'s heart with a medical device actuated by a remote navigation system, the method comprising:

advancing a medical device within a subject'"'"'s body near to a known anatomical feature of the heart with the remote navigation system;

establishing contact by the medical device with the surface of the heart;

moving the medical device along the surface of the heart towards the anatomical feature until a loss of contact with the surface is sensed; and

determining the point where the loss of contact occurred to identify at least one point along the known anatomical feature, where the sequence of steps is automatically executed by the remote navigation system.

7. A method for locating at least one point on an endocardial ridge of a subject'"'"'s heart with a medical device actuated by a remote navigation system, the method comprising:

advancing a medical device within a subject'"'"'s body near to a known anatomical feature of the heart with the remote navigation system;

establishing contact by the medical device with the surface of the heart;

moving the medical device along the surface of the heart towards the anatomical feature until a loss of contact with the surface is sensed; and

determining the point where the loss of contact occurred to identify at least one point along the known anatomical feature, where the remote navigation system is a magnetic navigation system.

10. A method for locating at least one point on a ridge of a subject'"'"'s heart for anatomical mapping with a device actuated by a magnetic navigation system, the method comprising:

advancing a medical device within a subject'"'"'s body to the point near the surface of the subject'"'"'s heart;

applying a magnetic field to at least one magnetically responsive element in the tip of the medical device to cause the tip to deflect towards an interior heart wall of a subject'"'"'s body and establish contact with an endocardial surface of the heart;

retracting the medical device while the tip is deflected against the surface of the heart; and

detecting a variable change indicative of a loss of contact between the tip and heart surface along the ridge, and determining the location of the tip at the point where a loss of contact occurred.

11. The method of claim 10 wherein detecting a variable change comprises detecting a change in tip orientation of more than a predetermined angle.

12. The method of claim 10 wherein detecting a variable change comprises continually measuring the orientation of the tip of the medical device and determining the occurrence of a change in orientation of the tip of the medical device from a previously measured orientation by more than a predetermined percentage, measured relative to a reference orientation.

13. The method of claim 10 wherein detecting a variable change comprises detecting a decrease in contact force to a value less than a predetermined threshold value.

14. The method of claim 10 wherein the at least one identified point along a ridge of a subject'"'"'s heart is known with respect to an X-ray image of the subject'"'"'s heart, and the corresponding ridge on a pre-operative image of the subject'"'"'s heart is registered to the X-ray image using the at least one identified point along the ridge of the subject'"'"'s heart.

15. The method of claim 10, where the sequence of steps is automatically executed by the magnetic navigation system.

16. The method of claim 10, wherein the steps are repeated to identify a multiplicity of points to define the location of the ridge along a subject'"'"'s heart.

17. A method for locating at least one point on a ridge of a subject'"'"'s heart utilizing a magnetic navigation system, the method comprising:

changing the direction of a magnetic field applied by the magnetic navigational system to cause a catheter tip to be deflected until the tip establishes contact with the surface of the heart at a given distance from the ridge of a subject'"'"'s heart;

identifying a direction of movement to provide a continuous line of contact along the heart tissue surface towards the ridge;

moving the catheter along the identified direction of movement towards the ridge until further movement is obstructed by the ridge;

retracting the catheter until a loss of tip contact with the tissue surface is sensed, and determining the location of the point at which the tip loses contact with the tissue surface.

18. The method of claim 17 wherein the sensing of a loss of contact comprises detecting a change in tip orientation of more than a predetermined angle.

19. The method of claim 17 wherein the sensing of a loss of contact comprises detecting a change in orientation of the tip of the medical device that is more than a predetermined percentage from a previous tip orientation, measured relative to a reference orientation.

20. The method of claim 17 wherein the sensing of a loss of contact comprises detecting a change in tip orientation of less than a predetermined angular amount.

21. The method of claim 17 wherein the sensing of a loss of contact comprises detecting a decrease in contact force to a value less than a predetermined minimum value.

22. The method of claim 17 wherein the at least one identified point along the ridge of a subject'"'"'s heart is known with respect to an X-ray image of the subject'"'"'s heart, and a corresponding ridge on a pre-operative image of the subject'"'"'s heart is registered to the X-ray image using the at least one identified point along the ridge of the subject'"'"'s heart.

23. The method of claim 17, wherein the steps are repeated to identify a multiplicity of points to define the location of the ridge along a subject'"'"'s head.

24. The method of claim 17, where the sequence of steps is automatically executed by the magnetic navigation system.