Navigation system for cardiac therapies

• US 8,046,052 B2
• Filed: 03/24/2010
• Issued: 10/25/2011
• Est. Priority Date: 11/19/2002
• Status: Expired due to Term

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Bzostek, Andrew, Verard, Laurent, Hunter, Mark W.
• Primary Examiner(s): Rozanski; Michael T
• Application Number:
  US12/730,714
• Publication Number:
  US 20100210938A1
• Time in Patent Office: 580 Days
• Field of Search: 600/407, 600/424, 600/428, 600/433, 600/437
• US Class Current: 600/424
• CPC Class Codes: A61B 1/00071 Insertion part of the endoscope body A61B1/0055 takes precedence
• CPC Class Codes: A61B 1/0058 using shape-memory elements
• CPC Class Codes: A61B 1/012 characterised by internal passages or accessories therefor
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• 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 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• 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 34/25 : User interfaces for surgical systems
• CPC Class Codes: A61B 5/0215 : by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/062 : using magnetic field
• CPC Class Codes: A61B 5/068 : using impedance sensors
• CPC Class Codes: A61B 5/413 : Monitoring transplanted tissue or organ, e.g. for possible rejection reactions after a transplant
• CPC Class Codes: A61B 5/7285 : for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 5/743 : Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 6/12 : Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/463 : characterised by displaying multiple images or images and diagnostic data on one display
• CPC Class Codes: A61B 6/507 : for determination of haemodynamic parameters, e.g. perfusion CT
• CPC Class Codes: A61B 6/541 : involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/4254 : using sensors mounted on the probe

Abstract

An image guided navigation system for navigating a region of a patient includes an imaging device, a tracking device, a controller, and a display. The imaging device generates images of the region of a patient. The tracking device tracks the location of the instrument in a region of the patient. The controller superimposes an icon representative of the instrument onto the images generated from the imaging device based upon the location of the instrument. The display displays the image with the superimposed instrument. The images and a registration process may be synchronized to a physiological event. The controller may also provide and automatically identify an optimized site to navigate the instrument to.

Claims

1. An image guided navigation system for guiding an instrument through a region of a patient, said image guided navigation system comprising:

a tracking device operable to track the position of the instrument in the region of the patient;

a controller operable to receive anatomical gating information regarding a physiological event and receive captured image data of the region of the patient in response to said physiological event, and in communication with said tracking device and operable to automatically register said image data with the region of the patient at least with said physiological event by,

collecting a position of the instrument as the instrument moves through at least a portion of the region of the patient synchronized with said physiological event,

building a virtual three-dimensional (3D) curve of at least the portion of the region of the patient, and

comparing the built virtual 3D curve with a shape of an anatomical curve in the captured image data; and

a display operable to display the captured image data of the region of the patient with a superimposed icon representing the instrument, wherein said controller is further operable to superimpose the icon representing the instrument onto the image data of the region of the patient based upon the position tracked by said tracking device;

wherein comparing the built virtual 3D curve with the shape of the anatomical curve in the captured image data includes executing instructions with the controller including at least one of pattern recognition algorithms or distance map algorithms to locate and find the specific shape of the built virtual 3D curve with an identified shape of the anatomical curve in the captured image data.

2. The system of claim 1, wherein at least the portion of the region of the patient is a vessel in a vasculature of the patient.

3. The system of claim 2, wherein the instrument is operable to pass through the vasculature of the patient to a heart of that patient.

4. An image guided navigation system for guiding an instrument through a region of a patient, said image guided navigation system comprising:

a tracking device operable to track the position of the instrument in the region of the patient;

a controller operable to receive anatomical gating information regarding a physiological event and receive captured image data of the region of the patient in response to said physiological event, and in communication with said tracking device and operable to automatically register said image data with the region of the patient at least with said physiological event by,

collecting a position of the instrument as the instrument moves through at least a portion of the region of the patient synchronized with said physiological event,

building a virtual three-dimensional (3D) curve of at least the portion of the region of the patient, and

comparing the built virtual 3D curve with a shape of an anatomical curve in the captured image data; and

a display operable to display the captured image data of the region of the patient with a superimposed icon representing the instrument, wherein said controller is further operable to superimpose the icon representing the instrument onto the image data of the region of the patient based upon the position tracked by said tracking device;

wherein the tracking device includes a plurality of tracking devices;

wherein the instrument includes a spiral catheter including the plurality of the tracking sensors positioned apart along a length of the spiral catheter, wherein the spiral catheter is operable to be positioned spirally within the inner surface of the at least a portion of the region of the patient, wherein a position of each of the plurality of tracking devices is operable to be determined by the controller to build the virtual 3D curve.

5. The system of claim 4, further comprising:

a dynamic reference frame operable to be connected to the region of the patient, wherein the dynamic reference frame includes a frame tracking device and is operable to be tracked to maintain registration;

wherein a right side of the heart and a left side of the heart are tracked simultaneously to assist in optimizing lead placement.

6. An image guided navigation system for guiding an instrument through a region of a patient, said image guided navigation system comprising:

a tracking device operable to track the position of the instrument in the region of the patient;

a controller operable to receive anatomical gating information regarding a physiological event and receive captured image data of the region of the patient in response to said physiological event, and in communication with said tracking device and operable to automatically register said image data with the region of the patient at least with said physiological event by,

collecting a position of the instrument as the instrument moves through at least a portion of the region of the patient synchronized with said physiological event,

building a virtual three-dimensional (3D) curve of at least the portion of the region of the patient, and

comparing the built virtual 3D curve with a shape of an anatomical curve in the captured image data; and

a display operable to display the captured image data of the region of the patient with a superimposed icon representing the instrument, wherein said controller is further operable to superimpose the icon representing the instrument onto the image data of the region of the patient based upon the position tracked by said tracking device;

wherein the tracking device includes a plurality of tracking devices;

wherein the instrument includes a balloon catheter that includes a plurality of balloons spaced apart along a length of the catheter with each of the plurality of balloons having at least one of the plurality of tracking devices, wherein the plurality of balloons are configured to fit in the at least the portion of the region of the patient, wherein a position of each of the plurality of tracking devices is operable to be determined by the controller to build the virtual 3D curve.

7. The system of claim 6, wherein each of the tracking devices are substantially in a center of each of the respective balloons.

8. The system of claim 7, wherein the controller is further operable to segment the captured image data to identify the shape of the anatomical curve in the captured image data prior to the comparing the built virtual 3D curve with a shape of a curve in the captured image data.

9. The system of claim 8, further comprising:

a dynamic reference frame operable to be connected to the region of the patient, wherein the dynamic reference frame includes a frame tracking device operable to be tracked to maintain registration;

wherein a right side of the heart and a left side of the heart are tracked simultaneously to assist in optimizing lead placement.

10. An image guided navigation system for guiding an instrument through a region of a patient, said image guided navigation system comprising:

an instrument operable to be positioned within the region of the patient;

a sensor connected to the instrument and operable to be positioned with the instrument within the region of the patient and generate a signal based on a sensed feature in the region of the patient;

a tracking device operable to track a position of the instrument in the region of the patient;

a controller operable to receive anatomical gating information regarding a physiological event and receive captured image data of the region of the patient in response to said physiological event, and in communication with said tracking device and operable to automatically register said image data with the region of the patient at least with said physiological event; and

a display operable to display the image data of the region of the patient with a superimposed icon representing the instrument, wherein said controller is further operable to superimpose the icon representing the instrument onto the image data of the region of the patient based upon the position tracked by said tracking device;

wherein the controller is operable to;

receive the signal from the sensor to find an optimized lead placement site within the region of the patient,

generate multiple color coded maps based on the signal the sensor communicates to the controller, and

execute instructions to automatically register said image data with the region of the patient at least with said physiological event, including;

collecting the position of the instrument as the instrument moves through at least a portion the region of the patient synchronized with said physiological event;

building a virtual three-dimensional (3D) curve of at least the portion of the region of the patient; and

comparing the built virtual 3D curve with a shape of an anatomical curve in the captured image data;

wherein the display is operable to overlay the color maps on the captured image data.

11. The system of claim 10, wherein the sensor includes at least one of a pressure sensor, a temperature sensor, an accelerometer, a Doppler transducer, a tissue sensor, and a spectroscopy sensor.

12. The system of claim 11, wherein the sensor can include a plurality of sensors and further include an electrophysiological (EP) sensor;

wherein each of the plurality of sensors can generate the signal to be received by the controller.

13. The system of claim 11, wherein the signal is operable to be real time with the tracked position of the instrument using the tracking device.

14. The system of claim 11, wherein the color coded maps can include at least one of a temperature map overlaid in real-time on the captured image data based on the signal from the temperature sensor or the signal from an EP sensor can be assigned to a collection of points overlaid on the captured image data.

15. The system of claim 10, further comprising:

an anatomical gating device operable to sense said physiological event; and

an imaging device operable to capture said image data of the region of the patient in response to said physiological event.

16. A method for guiding an instrument through a region of a patient with an image guided navigation system comprising:

receiving information regarding a physiological event with an anatomical gating device;

receiving captured image data of the region of the patient with an imaging device;

tracking a position of an instrument with a tracking device, wherein the instrument and the tracking device are operable to be positioned within the region of the patient;

automatically registering, by executing instructions with a controller, the received captured image data of the region of the patient at least with said information regarding said physiological event, said received captured image data, and said tracked position of said tracking device;

displaying the image data of the region of the patient;

superimposing an icon representing the instrument on the displayed image data;

automatically determining a lead placement site for placement of a lead relative to a heart;

segmenting the captured image data to identify a shape of an anatomical curve in the captured image data; and

comparing a built virtual three-dimensional (3D) curve with the identified shape of the anatomical curve in the captured image data, wherein the built virtual 3D curve is compared to the segmented captured image data;

wherein said superimposed icon represents a position of the instrument relative to the region of the patient based on the registered image data and the position of the instrument tracked by said tracking device.

17. The method of claim 16, wherein capturing the image data is in response to said physiological event sensed with the anatomical gating device;

wherein the automatically registering the image data to the region of the patient is at least with said sensed physiological event.

18. The method of claim 17, wherein automatically registering the captured image data with the region of the patient further includes:

collecting a position of the instrument as the instrument is moved synchronized with said physiological event, and

building the virtual three-dimensional (3D) curve of at least the portion of the region of the patient.

19. The method of claim 18, further comprising:

sensing a feature in the region of the patient; and

generating a signal based on the sensed feature in the region of the patient.

20. The method of claim 19, further comprising:

receiving the generated signal with the controller; and

wherein automatically determining a lead placement site for placement of a lead relative to a heart includes executing instructions with the controller to find an optimized lead placement site within the region of the patient.

21. The method of claim 19, further comprising:

positioning a first tracking device in a left portion of the region of the patient;

positioning a second tracking device in a right portion of the region of the patient; and

tracking both the first tracking device and the second tracking device to automatically determine the lead placement site for placement of the lead relative to the heart.

22. The method of claim 19, further comprising:

receiving the generated signal with the controller;

moving the instrument to a coronary sinus;

administering a contrast agent through the instrument;

collecting additional image data of the coronary sinus after administering the contrast agent;

generating a road map for lead placement based on the collected additional image data;

registering the road map to the region of the patient; and

displaying an estimated target site icon superimposed on the registered road map;

wherein the displayed estimated icon is based on the automatically determining a lead placement site for placement of a lead relative to a heart that is based on the generated road map.