Method for displaying catheter electrode-tissue contact in electro-anatomic mapping and navigation system

• US 8,369,922 B2
• Filed: 12/06/2006
• Issued: 02/05/2013
• Est. Priority Date: 12/06/2005
• Status: Active Grant

• Current Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Original Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Inventors: Paul, Saurav, Cao, Hong
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US12/096,066
• Publication Number:
  US 20080288038A1
• Time in Patent Office: 2,253 Days
• Field of Search: 600/374, 600/424, 607/125
• US Class Current: 600/374
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2018/00303 active, e.g. with a motor creating vibrations
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/0075 Phase
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00869 Phase
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• 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 5/053 Measuring electrical impedance or conductance of a portion of the body

Abstract

An electrode coupling output system associated with an electrode catheter that provides indication to the physician via the navigation system, concerning the electrical coupling of an electrode, such as an ablative or mapping electrode, with a patient. The indication may be provided by changing the color or other display characteristics of the electrode on the navigation system display or by way of providing a waveform indicating the electrode coupling. In this manner, electrode coupling information is provided to a physician in a manner that minimizes physician distraction.

Claims

1. A method for use in operating an electrode catheter, the method comprising the steps of:

providing a navigation system for monitoring a position of a first electrode of said electrode catheter during a medical procedure;

establishing an electrode coupling assessment system for evaluating an electrode-to-patient coupling condition indicative of a level of electrical coupling between said first electrode of said electrode catheter and a tissue, said assessment system adapted to distinguish between multiple levels of said electrode coupling condition including at least levels of insufficient coupling for a procedure and sufficient coupling for said procedure;

operating said electrode coupling assessment system in connection with the medical procedure to compare an electrical signal measured between said first electrode and a second electrode to predetermined baseline ranges associated with said multiple levels of electrode coupling to identify said level of said coupling condition; and

providing an output via said navigation system indicating said identified level of said coupling condition.

2. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative for distinguishing between multiple levels of said coupling condition, including at least one level corresponding to elevated coupling, wherein said elevated coupling indicates a potential for tissue penetration.

3. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative to distinguish between multiple levels of said coupling condition including each of insufficient coupling for a procedure, sufficient coupling for said procedure and elevated coupling.

4. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative for distinguishing between said levels of said coupling condition based on an impedance-related value.

5. The as set forth in claim 1, wherein said electrode coupling assessment system is operative for distinguishing between said levels of coupling condition based on a relationship between values related to resistance and reactance components of impedance.

6. The method as set forth in claim 1, wherein said step of operating comprises identifying said level of said coupling condition prior to operation of said electrode catheter to generate a desired effect.

7. The method as set forth in claim 1, wherein said step of operating comprises operating said electrode coupling assessment system during the course of said medical procedure involving said electrode catheter.

8. The method as set forth in claim 1, wherein said step of providing comprises communicating said output via a display device of said navigation system.

9. The method as set forth in claim 8, wherein said step of providing comprises a graphical representation of said electrode on said display device of said navigation system.

10. The method as set forth in claim 8, wherein said step of providing comprises displaying a waveform showing values related to said coupling condition versus time on said display device of said navigation system.

11. The method as set forth in claim 9, wherein said step of providing further comprises:

providing a graphical representation of said position of said first electrode relative to tissue of said patient.

12. The method as set forth in claim 11, further comprising:

providing a graphical output indicating said identified level of said coupling condition on said graphical representation at said position of said first electrode relative to said tissue.

13. An apparatus for use in operating an electrode catheter, the apparatus comprising:

an input for receiving a signal indicative of a level of electrical coupling between an a first electrode of said electrode catheter and a tissue, wherein said signal is measured between said first electrode and a second electrode;

a processor for processing said signal to determine said level of electrical coupling between said first electrode of said electrode catheter and said tissue, wherein said processor is operative to compare said signal with multiple predetermined ranges associated with differing levels of electrical coupling between said first electrode and said tissue of said patient and wherein said ranges include at least insufficient coupling levels and sufficient coupling levels; and

an output interface for providing an output to a navigation system to indicate said determined level of electrical coupling, wherein said navigation system is adapted to monitor a position of said electrode catheter during a medical procedure.

14. The apparatus as set forth in claim 13, wherein said processor is operative for distinguishing between multiple levels of electrical coupling, including at least one level corresponding to elevated coupling, wherein said elevated coupling indicates a potential for tissue penetration.

15. The apparatus as set forth in claim 13, wherein said processor is operative to distinguish between each of insufficient coupling for a procedure, sufficient coupling for said procedure and elevated coupling.

16. The apparatus as set forth in claim 13, wherein said processor is operative for distinguishing between different levels of electrode coupling based on the relationship between values related to resistance and reactance components of impedance.

17. The apparatus as set forth in claim 13, wherein said output module is operative to provide information regarding said determined level of electrical coupling via a display device of said navigation system.

18. The apparatus as set forth in claim 17, wherein said output module is operative to alter a graphical representation of said electrode on said display device of said navigation system.

19. The apparatus as set forth in claim 17, wherein said output module is operative for displaying a waveform showing values related to electrical coupling versus time on said display device of said navigation system.

20. The apparatus as set forth in claim 18, wherein said output module is operative to alter said graphical representation of said first electrode on said display device of said navigation system to provide an indication of said determined level of electrical coupling on said graphical representation at said position of said first electrode.

21. An electrode catheter system comprising:

a first electrode;

a catheter associated with said first electrode;

a second electrode;

a navigation system for use in monitoring a position of said electrode during a medical procedure; and

a processor for receiving signal information measured between said first electrode and said second and determining a level of electrical coupling between said first electrode patient tissue, wherein said processor is operative to compare at least a portion of said signal information with predetermined value ranges associated with differing levels of electrical coupling between said first electrode and said patient tissue, said value ranges including at least insufficient coupling levels and sufficient coupling levels, said processor further adapted to transmit information to said navigation system such that said navigation system can provide an indication of said level of electrical coupling.

22. The electrode catheter system as set forth in claim 21, wherein said processor is operative for distinguishing between each of insufficient electrical coupling for a procedure, sufficient electrical coupling for said procedure, and elevated electrical coupling.

23. The electrode catheter system as set forth in claim 21, wherein said processor is operative for distinguishing between different levels of electrical coupling based on a relation between values related to resistance and reactance components of impedance.

24. The electrode catheter system as set forth in claim 21, wherein said navigation system comprises a display, wherein said display device of said navigation system is adapted to provide said indication of said level of electrical coupling.

25. The electrode catheter system of claim 24 wherein said display device provides a graphical display of said position of said first electrode relative to tissue of said patient.

26. The electrode catheter system of claim 25, wherein said display device provides said indication of said level of electrical coupling on said display at said position of said first electrode.