Method and apparatus for mapping a structure

• US 8,457,371 B2
• Filed: 05/08/2008
• Issued: 06/04/2013
• Est. Priority Date: 04/18/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc), Regents of The University of Minnesota (University of Minnesota)
• Original Assignee: Medtronic Incorporated (Medtronic Plc), Regents of The University of Minnesota (University of Minnesota)
• Inventors: Markowitz, H. Toby, Nowak, Karl Evan, Karamanoglu, Mustafa, Mehta, Pooja, Fleming, Ioana, Scanlon, David, Kryger, Michael, Campbell-Massa, Sean, Giese, Chad, Interrante, Victoria, Falkner, Phillip
• Primary Examiner(s): Hollington, Jermele M
• Application Number:
  US12/117,549
• Publication Number:
  US 20090262992A1
• Time in Patent Office: 1,853 Days
• Field of Search: None
• US Class Current: 382/128
• CPC Class Codes: A61B 2034/2046 Tracking techniques
• 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 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0536 Impedance imaging, e.g. by tomography
• 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 5/063 using impedance measurements
• CPC Class Codes: A61B 5/066 Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: G06V 2201/03 Recognition of patterns in medical or anatomical images
• CPC Class Codes: G06V 2201/034 of medical instruments

Abstract

An area of a patient can be mapped with a system operable to identify a plurality of locations and save a plurality of locations of a mapping instrument. The mapping instrument can include one or more electrodes that can sense a voltage that can be correlated to a three dimensional location of the electrode at the time of the sensing or measurement. Therefore, a map of an area or volume can be determined based upon the sensing of the plurality of points without the use of an imaging device. An implantable medical device can then be navigated relative to the mapping data.

Claims

1. A method of illustrating mapping data from a patient, comprising:

generating a variable parameter between a first drive patch and a second drive patch in contact with the patient;

sensing a first parameter at a first map position and a second parameter at a second map position in the patient;

acquiring map data points based upon the sensed parameters;

saving the acquired map points;

displaying on a display device the saved map points;

identifying an anatomical feature that is at least a location in the patient based at least in part on the saved map points; and

inputting an identification of the anatomical feature and displaying a representing the anatomical feature on the display device with the map points.

2. The method of claim 1, further comprising:

viewing the displayed map points by a user;

determining a landmark by the user based on viewing the displayed map points;

selecting from a menu a landmark identification;

inputting a position of the landmark relative to the displayed map points based upon the identified anatomical feature; and

wherein the anatomical feature is the landmark and the icon is displayed relative to a map displayed on the display device of the saved map points.

3. The method of claim 1, further comprising:

selecting a number of the saved map points;

determining a spatial relationship of the saved map points; and

displaying on the display device a representative icon of more than one of the saved map points.

4. The method of claim 3, further comprising:

executing instructions with a processor such that the display device displays a representative icon of saved map points where the representative icon does not overlap a second representative icon on the display device.

5. The method of claim 2, further comprising:

acquiring data related to the map point including at least one of measuring a pressure pulse at a map point, an electrogram at a map point, a pressure change between at least two map points, a determination of all possible locations of a subsequent map point based upon a previous map point;

or combinations thereof; and

determining a landmark based upon the acquired data for the map point.

6. The method of claim 5, wherein selecting a landmark identification includes selecting at least one of a valve, a heart chamber, a heart wall, an osteom or opening, or combinations thereof.

7. The method of claim 2, further comprising:

displaying a landmark icon representing the landmark at the inputted position of the landmark relative to the displayed map points; and

selecting the landmark icon from at least one of a point, a toroid, or combinations thereof.

8. The method of claim 2, further comprising:

displaying a text box on the display device identifying the landmark, wherein displaying the text box includes positioning the text box so as to minimally obstruct displayed map points on the display device; and

drawing a line between the text box and the landmark.

9. A method of illustrating mapping data from a patient, comprising:

generating a variable parameter between a first drive patch and a second drive patch in contact with a patient;

sensing a first parameter at a first map position and a second parameter at a second map position in the patient;

acquiring map data points based upon the sensed parameters;

saving the acquired map points;

displaying on a display device the saved map points; and

identifying an anatomical feature based at least in part on the saved map points;

viewing the displayed map points by a user;

selecting from a menu a landmark identification;

inputting a position of the landmark relative to the displayed map points based upon the identified anatomical feature;

displaying a toroid relative to the displayed map points at the inputted position of the landmark; and

determining an axis of the toroid based upon at least a map data point on either side of the toroid and defining an axis between the two saved map points.

10. The method of claim 9, further comprising:

selecting a plurality of saved map points on either side of the toroid and determining a best fit line between all of the saved map points to define the axis of the toroid.

11. A method of illustrating mapping data from a patient, comprising:

generating a variable parameter between a first drive patch and a second drive patch in contact with a patient;

sensing a first parameter at a first map position and a second parameter at a second map position in the patient;

acquiring map data points based upon the sensed parameters;

acquiring anatomical data associated with each map data point;

saving the acquired map points and the acquired anatomical data;

displaying on a display device the saved map points to represent at least a portion of the patient; and

identifying an anatomical feature of the patient that is at least one of a location or structure based at least on the saved map points and the saved anatomical data;

inputting a position of a landmark relative to the displayed map points based upon the identified anatomical feature; and

displaying a landmark icon representing a boundary of the landmark at the input position of the landmark and relative to the displayed map points on the display device.

12. The method of claim 11, further comprising:

selecting a number of the saved map points;

determining a spatial relationship of the saved map points;

displaying on the display device a representative icon of more than one of the saved map points; and

executing instructions with a processor such that the display device displays a representative icon of saved map points where the representative icon does not overlap a second representative icon on the display device.

13. The method of claim 11, further comprising:

viewing the displayed map points by a user;

wherein identifying the landmark includes selecting from a menu the landmark identification.

14. The method of claim 11, further comprising:

associating a time stamp with each acquired map point to associate an acquisition time of the acquired map point;

where an earlier time stamped map point includes a different display characteristic than a later time stamped map point.

15. The method of claim 11, wherein acquiring anatomical data further includes acquiring anatomical data related to the map point including at least one of measuring a pressure pulse at a map point, an electrogram at a map point, a pressure change between at least two map points, a determination of all possible locations of a subsequent map point based upon a previous map point, or combinations thereof.

16. The method of claim 15, further comprising:

viewing the displayed map points by a user;

selecting from a menu a landmark identification; and

wherein inputting the position of the landmark relative to the displayed map points is based upon an identified anatomical feature based on both the saved map points and the acquired anatomical data.

17. The method of claim 16, wherein selecting a landmark includes selecting at least one of a valve, a heart chamber, a heart wall, an osteom or opening, or combinations thereof.

18. The method of claim 17, further comprising:

displaying a text box on the display device identifying the landmark, wherein displaying the text box includes positioning the text box so as to minimally obstruct displayed map points on the display device; and

drawing a line between the text box and the landmark.

19. A method of illustrating mapping data from a patient, comprising:

generating a variable parameter between a first drive patch and a second drive patch in contact with a patient;

sensing a first parameter at a first map position and a second parameter at a second map position in the patient;

acquiring map data points based upon the sensed parameters;

acquiring anatomical data associated with each map data point;

saving the acquired map points and the acquired anatomical data;

displaying on a display device the saved map points; and

identifying an anatomical feature based at least in part on the saved map points and the saved anatomical data;

viewing the displayed map points by a user;

selecting from a menu a landmark identification;

inputting a position of the landmark relative to the displayed map points based upon the identified anatomical feature;

displaying a landmark icon representing the landmark at the inputted position of the landmark relative to the displayed map points;

wherein displaying the landmark icon includes displaying a toroid relative to the displayed map points at the inputted position of the landmark; and

determining an axis of the toroid based upon at least a map data point on either side of the toroid and defining an axis between the two saved map points.

20. The method of claim 19, further comprising:

selecting a plurality of saved map points on either side of the toroid and determining a best fit line between all of the saved map points to define the axis of the toroid.

21. The method of claim 19, further comprising:

determining a radius of the toroid for display on the display device based upon the saved map points in the toroid.

22. A method of illustrating mapping data from a patient, comprising:

generating a variable parameter between a first drive patch and a second drive patch in contact with a patient;

sensing a first parameter at a first map position and a second parameter at a second mapped position in the patient;

determining map data points based upon the sensed parameters;

sensing anatomical data associated with each map data point;

saving the acquired map points and the acquired anatomical data;

displaying on a display device the saved map points to represent at least a portion of the patient to identify a location of a structure of the patient, based at least in part on the saved map points and the saved anatomical data.

23. The method of claim 22, wherein sensing anatomical data further includes acquiring anatomical data related to the map point including at least one of measuring a pressure pulse at a map point, an electrogram at a map point, a pressure change between at least two map points, a determination of all possible locations of a subsequent map point based upon a previous map point, or combinations thereof.

24. The method of claim 22, further comprising:

rendering a surface based on the saved map data points,

wherein displaying on the display device the saved map points includes displaying the rendered surface of at least a portion of the patient and the identified anatomical feature is at least one of a location or structure of the patient displayed relative to the rendered surface.

25. The method of claim 22, further comprising:

displaying a boundary defining landmark icon representing a landmark at an inputted position of the identified location of the structure relative to the displayed map points.

26. The method of claim 25, further comprising:

displaying a text box on the display device identifying the landmark, wherein displaying the text box includes positioning the text box so as to minimally obstruct displayed map points on the display device; and

drawing a line between the text box and the landmark.

27. The method of claim 25, wherein displaying the boundary defining landmark icon relative to the displayed map points at the inputted position of the landmark includes displaying the boundary defining landmark icon around at least a portion of the rendered surface.

28. The method of claim 27, further comprising:

determining an axis through the boundary defining landmark icon; and

displaying an axis icon representing the determined axis.

29. The method of claim 28, further comprising:

forming the boundary of the landmark icon as a closed boundary.

30. A method of illustrating mapping data from a patient, comprising:

positioning a first drive patch and a second drive patch in contact with a patient to generate a voltage between the first drive patch and the second drive patch;

moving an instrument through an area of the patient between the first drive patch and the second drive patch to sense a first voltage at a first position and a second voltage at a second position in the patient, where a plurality of map points are acquired and saved based upon the sensed voltages;

viewing on a display device the saved plurality of map points; and

visually identifying an anatomical feature as at least a structure of the patient based at least on the displayed plurality of map points.

31. The method of claim 30, further comprising:

selecting from a menu a landmark identification; and

inputting a position of the identified structure relative to the displayed map points.

32. The method of claim 31, further comprising:

determining a landmark based upon an acquired anatomical data relating to each map point including at least one of measuring a pressure pulse at each map point, electrogram at each map point, a pressure change between at least two map points, a determination of all possible locations of a subsequent map point based upon a previous map point, or combinations thereof.

33. The method of claim 31, wherein the identified structure is at least one of a valve, a heart chamber, a heart wall, an osteom or opening, or combinations thereof.

34. The method of claim 33, further comprising:

selecting a landmark icon from at least one of a point, a toroid, or combinations thereof to display relative to the displayed plurality of map points to represent the identified structure.

35. The method of claim 33, wherein visually identifying the anatomical feature includes identifying a passage between a first portion and a second portion of the patient;

and

further includes selecting and displaying a landmark icon to illustrate the identified passage and a center through the passage.

36. A method of illustrating mapping data from a patient, comprising:

positioning a first drive patch and a second drive patch in contact with a patient to generate a voltage between the first drive patch and the second drive patch;

moving an instrument through an area of the patient between the first drive patch and the second drive patch to sense a first voltage at a first position and a second voltage at a second position in the patient, where map data points are acquired and saved based upon the sensed voltages;

viewing on a display device the saved map points;

visually identifying an anatomical feature based at least in part on the displayed map points;

selecting from a menu a landmark identification, wherein selecting a landmark includes selecting at least one of a valve, a heart chamber, a heart wall, an osteom or opening, or combinations thereof;

inputting a position of the landmark relative to the displayed map points based on the identified anatomical feature;

selecting a landmark icon from at least one of a point, a toroid, or combinations thereof to display the landmark icon representing the landmark at the inputted position of the landmark relative to the displayed map points; and

selecting a plurality of saved map points on either side of the toroid and determining a best fit line between all of the saved map points to define the axis of the toroid.