Simulation of invasive procedures

• US 7,877,128 B2
• Filed: 08/02/2005
• Issued: 01/25/2011
• Est. Priority Date: 08/02/2005
• Status: Active Grant

• Current Assignee: Biosense Webster Incorporated (Johnson & Johnson)
• Original Assignee: Biosense Webster Incorporated (Johnson & Johnson)
• Inventors: Schwartz, Yitzhack
• Primary Examiner(s): Casler; Brian
• Assistant Examiner(s): Roy; Baisakhi
• Application Number:
  US11/195,050
• Publication Number:
  US 20070043285A1
• Time in Patent Office: 2,002 Days
• Field of Search: 600/437, 600/407, 600/409, 600/424, 600/427, 600/443, 600/463, 600/467
• US Class Current: 600/407
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method for pre-planning and performing a cardiac procedure on a heart includes acquiring an image or map of the heart; displaying the image or map of the heart; marking at least one feature on the image or map; calculating dimensions of the at least one feature; identifying one or more points on or within the heart for treatment; determining paths to the one or more points on or within the heart for treatment; simulating insertion of a sheath into the heart; simulating insertion of a medical device through the sheath and within the heart; verifying that the one or more points on or within the heart can be accessed for treatment; and performing a medical procedure on or within the heart.

Claims

1. A method for pre-planning a cardiac procedure on a heart comprising the steps of:

acquiring an image or map of the heart;

displaying the image or map of the heart;

marking at least one feature on the image or map;

calculating dimensions of the at least one feature;

identifying one or more points on or within the heart for treatment;

determining paths based on the at least one marked feature and the dimensions of the at least one marked feature to the one or more points on or within the heart for treatment;

simulating insertion of a sheath into the heart through one of the paths;

simulating insertion of a medical device through the sheath and within the heart;

verifying that the one or more points on or within the heart can be accessed by the medical device for treatment;

measuring a penetration depth of the sheath in the heart using the step of simulating insertion of the sheath;

verifying that the penetration depth does not exceed a specified measurement;

confirming that the insertion of the sheath avoids injury to the heart at the penetration depth of the sheath using the step of simulating insertion of the sheath; and

simulating insertion of selected ablation catheters through the sheath.

2. The method of claim 1, further comprising:

selecting ablation catheters having different radii of curvature for the step of simulating insertion of the selected ablation catheters through the sheath; and

determining the paths to the heart of the ablation catheters in relation to the penetration depth of the sheath.

3. A method for developing a plan for a cardiac procedure comprising the steps of

acquiring an image or map of the heart;

displaying the image or map of the heart;

marking at least one feature on the image or map;

calculating dimensions of the at least one feature;

identifying one or more points on or within the heart for treatment;

determining paths based on the at least one marked feature and the dimensions of the at least one marked feature to the one or more points on or within the heart for treatment;

simulating insertion of a sheath into the heart through one of the paths;

simulating insertion of a medical device through the sheath and within the heart; and

verifying that the one or more points on or within the heart can be accessed by the medical device for treatment;

measuring a penetration depth of the sheath in the heart using the step of simulating insertion of the sheath;

verifying that the penetration depth does not exceed a specified measurement;

confirming that the insertion of the sheath avoids injury to the heart at the penetration depth of the sheath using the step of simulating insertion of the sheath; and

simulating insertion of selected ablation catheters through the sheath.

4. A method for pre-planning and performing a cardiac procedure on a heart comprising the steps of:

acquiring an image or map of the heart;

displaying the image or map of the heart;

marking at least one feature on the image or map;

calculating dimensions of the at least one feature;

identifying one or more points on or within the heart for treatment;

determining paths based on the at least one marked feature and the dimensions of the at least one marked feature to the one or more points on or within the heart for treatment;

simulating insertion of a sheath into the heart through one of the paths;

simulating insertion of a medical device through the sheath and within the heart;

verifying that the one or more points on or within the heart can be accessed by the medical device for treatment;

performing a medical procedure on or within the heart;

measuring a penetration depth of the sheath in the heart using the step of simulating insertion of the sheath;

verifying that the penetration depth does not exceed a specified measurement;

confirming that the insertion of the sheath avoids injury to the heart at the penetration depth of the sheath using the step of simulating insertion of the sheath; and

simulating insertion of selected ablation catheters through the sheath.

5. The method according to claim 4, wherein the medical procedure is monitored and guided according to the plan.

6. The method according to claim 5, wherein the medical procedure is monitored and robotically guided according to the plan.

7. A method for developing a plan and performing a cardiac procedure on a heart comprising the steps of:

acquiring an image or map of the heart;

displaying the image or map of the heart;

marking at least one feature on the image or map;

calculating dimensions of the at least one feature;

identifying one or more points on or within the heart for treatment;

determining paths based on the at least one marked feature and the dimensions of the at least one marked feature to the one or more points on or within the heart for treatment;

simulating insertion of a sheath into the heart through one of the paths;

simulating insertion of a medical device through the sheath and within the heart;

verifying that the one or more points on or within the heart can be accessed by the medical device for treatment;

performing a medical procedure on or within the heart;

measuring a penetration depth of the sheath in the heart using the step of simulating insertion of the sheath;

verifying that the penetration depth does not exceed a specified measurement;

confirming that the insertion of the sheath avoids injury to the heart at the penetration depth of the sheath using the step of simulating insertion of the sheath; and

simulating insertion of selected ablation catheters through the sheath.

8. The method according to claim 7, wherein the medical procedure is monitored and guided according to the plan.

9. The method according to claim 8, wherein the medical procedure is monitored and robotically guided according to the plan.

10. A method for simulating a cardiac procedure on a heart comprising the steps of:

acquiring an image or map of the heart;

displaying the image or map of the heart;

marking at least one feature on the image or map;

calculating dimensions of the at least one feature;

identifying one or more points on or within the heart for treatment;

determining paths based on the at least one marked feature and the dimensions of the at least one marked feature to the one or more points on or within the heart for treatment;

simulating insertion of a sheath into the heart through one of the paths;

simulating insertion of a medical device through the sheath and within the heart;

verifying that the one or more points on or within the heart can be accessed by the medical device for treatment;

measuring a penetration depth of the sheath in the heart using the step of simulating insertion of the sheath;

verifying that the penetration depth does not exceed a specified measurement;

confirming that the insertion of the sheath avoids injury to the heart at the penetration depth of the sheath using the step of simulating insertion of the sheath; and

simulating insertion of selected ablation catheters through the sheath.

11. A method for simulating and developing a plan for a cardiac procedure comprising the steps of:

acquiring an image or map of the heart;

displaying the image or map of the heart;

marking at least one feature on the image or map;

calculating dimensions of the at least one feature;

identifying one or more points on or within the heart for treatment;

determining paths based on the at least one marked feature and the dimensions of the at least one marked feature to the one or more points on or within the heart for treatment;

simulating insertion of a sheath into the heart through one of the paths;

simulating insertion of a medical device through the sheath and within the heart;

verifying that the one or more points on or within the heart can be accessed by the medical device for treatment;

measuring a penetration depth of the sheath in the heart using the step of simulating insertion of the sheath;

verifying that the penetration depth does not exceed a specified measurement;

confirming that the insertion of the sheath avoids injury to the heart at the penetration depth of the sheath using the step of simulating insertion of the sheath; and

simulating insertion of selected ablation catheters through the sheath.

12. A method for simulating and performing a cardiac procedure on a heart comprising the steps of:

acquiring an image or map of the heart;

displaying the image or map of the heart;

marking at least one feature on the image or map;

calculating dimensions of the at least one feature;

identifying one or more points on or within the heart for treatment;

determining paths based on the at least one marked feature and the dimensions of the at least one marked feature to the one or more points on or within the heart for treatment;

simulating insertion of a sheath into the heart through one of the paths;

simulating insertion of a medical device through the sheath and within the heart;

verifying that the one or more points on or within the heart can be accessed by the medical device for treatment;

performing a medical procedure on or within the heart;

measuring a penetration depth of the sheath in the heart using the step of simulating insertion of the sheath;

verifying that the penetration depth does not exceed a specified measurement;

confirming that the insertion of the sheath avoids injury to the heart at the penetration depth of the sheath using the step of simulating insertion of the sheath; and

simulating insertion of selected ablation catheters through the sheath.

13. The method according to claim 12, wherein the medical procedure is monitored and guided according to the plan.

14. The method according to claim 13, wherein the medical procedure is monitored and robotically guided according to the plan.

15. A method for simulating a cardiac procedure, developing a plan and performing a cardiac procedure on a heart comprising the steps of:

acquiring an image or map of the heart;

displaying the image or map of the heart;

marking at least one feature on the image or map;

calculating dimensions of the at least one feature;

identifying one or more points on or within the heart for treatment;

determining paths based on the at least one marked feature and the dimensions of the at least one marked feature to the one or more points on or within the heart for treatment;

simulating insertion of a sheath into the heart through one of the paths;

simulating insertion of a medical device through the sheath and within the heart;

verifying that the one or more points on or within the heart can be accessed by the medical device for treatment;

performing a medical procedure on or within the heart;

measuring a penetration depth of the sheath in the heart using the step of simulating insertion of the sheath;

verifying that the penetration depth does not exceed a specified measurement;

confirming that the insertion of the sheath avoids injury to the heart at the penetration depth of the sheath using the step of simulating insertion of the sheath; and

simulating insertion of selected ablation catheters through the sheath.

16. The method according to claim 15, wherein the medical procedure is monitored and guided according to the plan.

17. The method according to claim 16, wherein the medical procedure is monitored and robotically guided according to the plan.