Impedance based anatomy generation

• US 8,103,338 B2
• Filed: 05/08/2009
• Issued: 01/24/2012
• Est. Priority Date: 05/08/2009
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Rhythmia Medical, Inc. (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Csendes, Alpar, Badics, Zsolt
• Primary Examiner(s): Hindenburg, Max
• Assistant Examiner(s): BECKER, CHARLES BARTON
• Application Number:
  US12/437,794
• Publication Number:
  US 20100286550A1
• Time in Patent Office: 991 Days
• Field of Search: 600/547, 702/150, 702/152
• US Class Current: 600/547
• CPC Class Codes: A61B 2562/04 Arrangements of multiple sensors of the same type
• CPC Class Codes: A61B 5/0044 for the heart
• CPC Class Codes: A61B 5/0536 Impedance imaging, e.g. by tomography
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/4869 Determining body composition
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart

Abstract

Methods and systems for the determination and representation of anatomical information are disclosed herein. In some examples, methods described herein can include determining a boundary of at least a portion of the heart based on measured electrical signals, determining an area of the boundary corresponding to an endocardial boundary, and displaying a portion of the boundary of the heart with the display including a visual indicia indicative of the determined area of the boundary.

Claims

1. A method comprising:

inserting a catheter into a heart, the catheter comprising three or more electrodes;

causing current to flow between at least some of the electrodes and in response to current flow, measuring an electrical signal at each of one or more of the electrodes;

for each of a plurality of catheter locations, determining a local surface of at least a portion of the heart based on the measured electrical signals and determining valid and invalid areas of the local surface, the valid areas corresponding to an endocardial boundary;

determining a representation of a chamber anatomy of at least a portion of the heart based on multiple ones of the valid areas of the local surfaces, the determined representation of a chamber anatomy of at least a portion of the heart representing an area larger than any one of the local surfaces; and

displaying at least a portion of the determined representation of the chamber anatomy of the at least a portion of the heart with a first visual indicia indicative of the determined valid area corresponding to the endocardial boundary.

2. The method of claim 1, further comprising:

measuring cardiac signals at the catheter electrodes in response to electrical activity in the heart; and

determining physiological information at multiple locations of the surface of the heart based the measured cardiac signals.

3. The method of claim 2, further comprising displaying the physiological information at multiple locations of the surface of the heart.

4. The method of claim 2, further comprising displaying the physiological information at multiple locations of the surface of the heart for only the determined valid areas corresponding to the endocardial boundary.

5. The method of claim 1, wherein displaying the surface representation of the chamber anatomy comprises displaying the surface for a portion of less than all of the heart.

6. The method of claim 1, wherein the determination of the local surfaces accounts for a change in conductivity at the cardiac chamber boundary.

7. The method of claim 6, wherein the determination accounts for a first conductivity inside the cardiac chamber boundary and, a second conductivity outside the cardiac chamber boundary.

8. The method of claim 1, wherein determining the local surfaces comprises determining anatomical information based at least in part on impedance information generated based on the measured signals.

9. The method of claim 8, wherein the impedance information is based on a conductivity contrast between blood and surrounding tissue.

10. The method of claim 8, wherein the impedance information is based on a permittivity contrast between blood and surrounding tissue.

11. The method of claim 8, wherein the impedance information comprises complex impedance information based on both a permittivity contrast and a conductivity contrast between blood and surrounding tissue.

12. The method of claim 1, wherein determining the local surfaces comprises, determining the local surface based on the measured signals, the local surface representing a surface at which the conductivity value changes.

13. The method of claim 12, wherein the local surfaces comprise closed and parameterized surfaces around at least a portion of the catheter.

14. The method of claim 12, wherein the local surfaces provide a boundary between a region represented by a first conductivity inside the surface and a region represented by a second conductivity outside the surface, the first conductivity being different from the second conductivity.

15. The method of claim 12, wherein determining the valid and invalid areas of the local surface further comprises, for each of the determined local surfaces selecting one or more regions of the surface corresponding to the expected boundary of the heart.

16. The method of claim 15, wherein selecting the one or more regions comprises selecting the one or more regions based at least in part on a distance between a portion of the surface and the catheter.

17. The method of claim 16, wherein selecting the one or more regions comprises selecting the one or more regions based at least in part on a magnitude of a distortion field, the distortion field being based at least in part on a difference between a field calculated based on the measurements and a field in a homogonous medium.

18. The method of claim 17, wherein selecting the one or more regions comprises selecting the one or more regions based at least in part on an error calculation in an optimization used to generate the surface.

19. The method of claim 17, wherein determining the representation of the chamber anatomy further comprises, joining the valid regions of the determined surfaces corresponding to an expected chamber boundary to generate the representation of the chamber anatomy.

36. The method of claim 1, wherein displaying the surface of at least a portion of the heart comprises displaying a portion of less than the entire surface of the heart.

37. The method of claim 1, wherein displaying the representation of the chamber anatomy comprises displaying a mesh having a plurality of faces and applying the first visual indicia to faces of the mesh for the determined area of the surface corresponding to the valid areas and applying a second visual indicia for other faces of the mesh.

38. The method of claim 1, wherein displaying the representation of the chamber anatomy comprises displaying a mesh having a plurality of faces with faces of the mesh being opaque for the determined area of the surface corresponding to the valid areas and transparent, gray, or semi-transparent for other areas of the surface.

39. The method of claim 1, wherein displaying surface of at least a portion of the heart comprises displaying portions of the surface of the heart not included in the determined valid area of the surface corresponding to the endocardial boundary.

40. The method of claim 1, wherein the first visual indicia differentiates the determined valid area of the surface corresponding to the endocardial boundary from other areas of the surface.

20. A system comprising:

a catheter comprising two or more electrodes configured to inject a current and to measure electrical signals in response to the injected current; and

a processing unit configured to;

for each of a plurality of catheter locations, determine a local surface of at least a portion of the heart based on measured electrical signals and determine valid and invalid areas of the local surface, the valid areas corresponding to an endocardial boundary;

determine a representation of a chamber anatomy of at least a portion of the heart based on multiple ones of the valid areas of the local surfaces, the determined representation of the chamber anatomy of at least a portion of the heart being larger than any one of the local surfaces; and

a display device configured to display at least a portion of the determined representation of the chamber anatomy of the at least a portion of the heart with a first visual indicia indicative of the determined valid areas corresponding to the endocardial boundary.

21. The system of claim 20, wherein:

the two or more electrodes are further configured to measure cardiac signals in response to electrical activity in the heart; and

the processing unit is further configured to determine physiological information at multiple locations of the surface of the heart based the measured cardiac signals.

22. The system of claim 21, wherein the display device is further configured to display the physiological information at multiple locations of the surface of the heart.

23. The system of claim 20, wherein the processing unit is configured to account for a change in conductivity at the cardiac chamber boundary in the determination of the local surfaces.

24. The system of claim 23, wherein the processing unit is configured to account for a first conductivity inside the cardiac chamber boundary and a second conductivity outside the cardiac chamber boundary.

25. The system of claim 20, wherein the processing unit is configured to determine the local surfaces based at least in part on impedance information generated based on the measured signals at the different catheter positions.

26. The system of claim 25, wherein the impedance information is based on a conductivity contrast between blood and surrounding tissue.

27. The system of claim 25, wherein the impedance information is based on a permittivity contrast between blood and surrounding tissue.

28. The system of claim 25, wherein the impedance information comprises complex impedance information based on both a permittivity contrast and a conductivity contrast between blood and surrounding tissue.

29. The system of claim 20, wherein the processing unit is configured to determine the local surfaces by determining a surface based on the measured signals, the surface representing a surface at which the conductivity changes.

30. The system of claim 29, wherein the processing unit is configured to determine the valid and invalid areas of the local surfaces based at least in part on a distance between a portion of the surface and the catheter.

31. The system of claim 30, wherein the processing unit is configured to determine the valid and invalid areas of the local surfaces based at least in part on a magnitude of a distortion field, the distortion field being based at least in part on a difference between a field calculated based on the measurements and a field in a homogonous medium.

32. The system of claim 31, wherein the processing unit is configured to determine the valid and invalid areas of the local surfaces based at least in part on an error calculation in an optimization used to generate the surface.

33. The system of claim 31, wherein the processing unit is configured to join the regions of the determined valid areas of the local surfaces corresponding to an expected chamber boundary to generate the representation of the chamber anatomy.

34. The system of claim 20, wherein the two or more electrodes are further configured to measure cardiac signals in response to electrical activity in the heart.

35. The system of claim 34, wherein the processing unit is configured to determine physiological information at multiple locations of the surface of the heart based on the determined positions of the catheter electrodes and the measured cardiac signals.