Intra-cardiac tracking system

• US 8,463,368 B2
• Filed: 05/08/2012
• Issued: 06/11/2013
• Est. Priority Date: 04/02/2008
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Rhythmia Medical, Inc. (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Eldar, Rotem, Badics, Zsolt
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US13/466,511
• Publication Number:
  US 20120277567A1
• Time in Patent Office: 399 Days
• Field of Search: 600508-509, 600/424, 600/547, 606/34, 606/41
• US Class Current: 600/509
• 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 2018/00351 Heart
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2562/0214 Capacitive electrodes
• CPC Class Codes: A61B 2562/04 Arrangements of multiple sensors of the same type
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/063 using impedance measurements
• CPC Class Codes: A61B 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/068 using impedance sensors
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/308 for electrocardiography [ECG]
• CPC Class Codes: A61B 5/343 Potential distribution indication
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• 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

Abstract

In general, in one aspect, a method is disclosed for determining information about a position of an object. The method includes: (i) causing current to flow between each of three or more sets of current-injecting electrodes on a first catheter inserted into an organ in a patient'"'"'s body, the organ having a periphery (ii) in response to current flow caused by each set of current injecting electrodes, measuring an electrical signal at each of one or more measuring electrodes located on one or more additional catheters inserted into the organ in the patient'"'"'s body and (iii) determining the position of each of one or more of the measuring electrodes on the additional catheters relative to the first catheter based on the measured signals from the one or more measuring electrodes.

Claims

1. A method comprising:

causing, current to flow between each of three or more sets of current-injecting electrodes on a first catheter inserted into an organ in a patient'"'"'s body, the organ having a periphery;

in response to current flow caused by each set of current injecting electrodes, measuring an electrical signal at each of one or more measuring electrodes located on one or more additional catheters inserted into the organ in the patient'"'"'s body; and

determining a position of each of one or more of the measuring electrodes on the one or more additional catheters relative to the current-injecting electrodes on the first catheter based on the measured signals from the one or more measuring electrodes.

2. The method of claim 1, further comprising measuring electric signals at each of multiple measuring electrodes on the first catheter in response to current flow caused by each set of current injecting electrodes, and wherein the determination of the relative position between the first catheter and each of the one or more of the measuring electrodes on the one or more additional catheters is based on the measured signals for the measuring electrodes on the first catheter and the one or more additional catheters.

3. The method of claim 2, wherein the determination associates each measured signal with a homogeneous component that depends on the relative position of each signal measuring electrode with respect to each set of current injecting electrodes and an inhomogeneous component associated with the periphery of the organ, the inhomogeneous component being modeled as a variation in electric potential along a surface enclosing at least the first catheter that depends on the relative positions between the current injecting electrodes and the signal measuring electrodes.

4. The method of claim 3, wherein the homogeneous component further depends on an estimate for conductivity inside the organ.

5. The method of claim 2, wherein the determination accounts for a change in conductivity at the organ'"'"'s periphery.

6. The method of claim 2, wherein the organ comprises the patient'"'"'s heart and the determination accounts for a change in conductivity at the cardiac chamber periphery.

7. The method of claim 2, wherein the determination associates each measured signal with a homogeneous component and an inhomogeneous component associated with the organ'"'"'s periphery.

8. The method of claim 2, wherein the first catheter comprises more than 32 measuring electrodes.

9. The method of claim 2, wherein the determination is based on predetermined information about the relative positions of the electrodes on the first catheter.

10. The method of claim 2, wherein the determination comprises an optimization technique that minimizes collective differences between each of the measured signals and an estimate for each of the respective measured signals as a function of the relative position between each of the measuring electrodes on the first and the one or more additional catheters and the sets of current-injecting electrodes on the first catheter and the change in conductivity at the organ'"'"'s periphery.

11. The method of claim 2, wherein the determination comprises an optimization technique that minimizes collective differences between each of the measured signals and an estimate for each of the respective measured signals as a function of the relative position between each of the measuring electrodes on the first and the one or more additional catheters and the sets of current-injecting electrodes on the first catheter and the estimate for conductivity inside the organ.

12. The method of claim 2, wherein the determination comprises an optimization technique that minimizes collective differences between each of the measured signals and an estimate for each of the respective measured signals as a function of the relative position between each of the measuring electrodes on the first and the one or more additional catheters and the sets of current-injecting electrodes on the first catheter, the change in conductivity at the organ'"'"'s periphery and the estimate for conductivity inside the organ.

13. The method of claim 2, further comprising using the multiple signal measuring electrodes on the first catheter to measure cardiac signals.

14. The method of claim 1, further comprising securing at least three electrodes to be used for reference to fixed locations within the organ.

15. The method of claim 14, wherein the electrodes used for reference comprise measuring electrodes and the method further comprises determining the position of each of the electrodes used for reference relative to the first catheter.

16. The method of claim 14, wherein the at least three electrodes used for reference are on a single catheter.

17. The method of claim 16, further comprising using the determined position of each of the reference electrodes relative to the first catheter to determine a location of each of the one or more electrodes on the one of more additional catheters relative to the surface of the organ.

18. The method of claim 17, further comprising displaying the position of the one or more additional catheters relative to the surface of the organ.

19. The method of claim 16, further comprising using the determined position of each of the reference electrodes relative to the first catheter to determine a location of the first catheter relative to the surface of the organ.

20. The method of claim 19, further comprising displaying the position of the first catheter relative to the surface of the organ.

21. The method of claim 14, further comprising determining a position of each of the reference electrodes relative to the first catheter and determining a location of each of the one or more electrodes on the one or more additional catheters relative to the surface of the organ.

22. The method of claim 21, wherein determining a location of each of the one or more electrodes on the one or more additional catheters relative to the surface of the organ comprises correcting a location of the one or more additional catheters based on a movement of the organ.

23. The method of claim 22, wherein the movement of the organ comprises a translation of the organ.

24. The method of claim 22, wherein the movement of the organ comprises a rotation of the organ.

25. The method of claim 22, wherein the movement of the organ comprises a movement caused by respiration.

26. The method of claim 22, wherein the movement of the organ comprises a movement caused by movement of the patient.

27. The method of claim 21, wherein determining a location of each of the one or more electrodes on the second catheter relative to the surface of the organ comprises correcting a location of each of the one or more electrodes on the second catheter based on a movement of the first catheter.

28. The method of claim 14, further comprising using the reference electrodes to generate a fixed coordinate system relative to a surface of the organ.

29. The method of claim 14, further comprising determining the position of each of the one or more measuring electrodes on the second catheter relative to the surface of the organ.

30. The method of claim 14, further comprising determining the position of each of the one or more the measuring electrodes on the second catheter relative to the surface of the organ by solving an optimization problem that minimizes collective difference between a reference distribution of the reference electrodes based on the fixed locations and a determined position of each of the reference electrodes.

31. The method of claim 14, further comprising moving the first catheter within the organ relative to the reference electrodes.

32. The method of claim 31, further comprising tracking the position of the first catheter relative to the surface of the organ based on the measured signals on the first catheter and the fixed location of the reference electrodes.

33. The method of claim 1, further comprising using multiple signal measuring electrodes on the first catheter and the one or more electrodes on the one or more additional catheters to measure cardiac signals.

34. The method of claim 1, further comprising using the same one or more measuring electrodes on the one or more additional catheters to measure the electrical signals to determine the position of the one or more electrodes and to measure cardiac signals.

35. The method of claim 1, further comprising using one or more electrodes on the one or more additional catheters for delivering ablation energy for ablating tissue of the organ.

36. The method of claim 1, further comprising moving one or more of the additional catheters inside the organ and tracking the position of each of one or more measuring electrodes relative to the surface of the organ based on signals measured by the one or more measuring electrodes in response to current flow caused by each set of current injecting electrodes on the first catheter and the tracked position of the first catheter relative to the surface of the organ.

37. The method of claim 1, further comprising using a catheter to ablate selected regions of the organ based on the measured electrical activity and a tracked position of an electrode on the catheter used to ablate the selected regions.

38. The method of claim 37, further comprising moving a catheter comprising an ablation electrode inside the organ and tracking the position of the ablation electrode on that catheter relative to the surface of the organ based on signals measured by the ablation electrode in response to current flow caused by each set of current injecting electrodes on the first catheter.

39. The method of claim 38, further comprising using the ablation electrode on the catheter to ablate selected regions of a cardiac chamber.

40. The method of claim 1, wherein the one or more additional catheters comprises at least two additional catheters.

41. The method of claim 1, wherein measuring the electrical signal at each of the one or more measuring electrodes on the one or more additional catheters comprises simultaneously measuring the electrical signal at each the one or more measuring electrodes on the one or more additional catheters.

42. The method of claim 1, wherein three or more sets of current-injecting electrodes on a first catheter comprise three or more pairs of current-injecting electrodes configured to generate a dipole potential.

43. The method of claim 1, wherein three or more sets of current-injecting electrodes on a first catheter comprise three or more sets of current-injecting electrodes configured to generate a quadropole potential.

44. The method of claim 1, wherein the determination comprises an optimization technique that minimizes collective differences between each of the measured signals and an estimate for each of the respective measured signals as a function of the relative position between each of the one or more measuring electrodes on the one or more additional catheters and the sets of current-injecting electrodes on the first catheter.

45. The method of claim 1, wherein causing the current to flow between each of the three or more sets of current-injecting electrodes on the first catheter comprises modulating the current caused to flow between each of the three or more sets of current-injecting electrodes in frequency.

46. The method of claim 1, wherein determining the position of each of the one or more measuring electrodes on the one or more additional catheters relative to the first catheter based on the measured signals from the one or more electrodes comprises distinguishing the current from a particular one of the three or more sets of current-injecting electrodes from other electrical signals.

47. The method of claim 46, wherein the other electrical signals comprise currents from other ones of the three or more sets of current injecting electrodes.

48. The method of claim 46, wherein the other electrical signals comprise a cardiac signal.

49. The method of claim 1, wherein the current is caused to flow at a frequency outside the frequency range of the patient'"'"'s cardiac activity.

50. The method of claim 1, wherein determining the position of each of the one or more measuring electrodes on the second catheter relative to the first catheter based on the measured signals from the one or more electrodes comprises distinguishing cardiac signals from signals responsive to the injected current.

51. The method of claim 50, wherein distinguishing cardiac signals from signals responsive to the injected current comprises using a spread spectrum technique.

52. The method of claim 1, wherein the determination of the relative position between the first catheter and the one or more electrodes on the one or more additional catheters is repeated multiple times during the patient'"'"'s cardiac cycle.

53. The method of claim 1, wherein the first catheter comprises three or more pairs of current-injecting electrodes.

54. The method of claim 1, wherein three of the current injecting electrode sets define substantially orthogonal axes.

55. The method of claim 1, wherein causing current to flow between each of three or more sets of current injecting electrodes comprises sequentially causing current to flow between each of three or more sets of current injecting electrodes.

56. The method of claim 1, wherein causing current to flow between each of three or more sets of current injecting electrodes comprises concurrently causing current to flow between multiple sets of the three or more sets of current injecting electrodes, wherein the frequency of the current differs between the sets of current injecting electrodes.

57. The method of claim 1, wherein causing current to flow between each of three or more sets of current injecting electrodes comprises modulating each current with information for coding division of the currents from the three or more sets of current injecting electrodes.

58. The method of claim 1, wherein causing current to flow between each of three or more sets of current injecting electrodes comprises causing current to flow between each of three or more pairs of current injecting electrodes.

59. The method of claim 1, wherein the organ in the patient'"'"'s body comprises the patient'"'"'s heart.

60. The method of claim 1, further comprising using the determined position of each of the one or more electrodes on the one or more additional catheters to determine a position of the one or more additional catheters or portion of one or more of the catheters.

61. The method of claim 1, further comprising using the determined position of each of the one or more electrodes on the one or more additional catheters to determine a position of a portion of a catheter used for ablation.

62. The method of claim 1, further comprising displaying the position of the one or more additional catheters relative to a surface of the organ.

63. The method of claim 1, wherein the determination of the position of each of the one or more measuring electrodes on the one or more additional catheters relative to the first catheter accounts for a change in conductivity at the organ'"'"'s periphery.

64. The method of claim 1, wherein the organ comprises the patient'"'"'s heart and the determination accounts for a change in conductivity at a periphery of the cardiac chamber.

65. The method of claim 1, wherein the determination associates each measured signal with a homogeneous component and an inhomogeneous component associated with the organ'"'"'s periphery.

66. The method of claim 65, wherein the inhomogeneous component is modeled as a variation in electric potential along a surface enclosing the first and second catheters that depends on the relative positions between the current injecting electrodes and each of the one or more measuring electrodes.

67. The method of claim 66, wherein the inhomogeneous component further depends on a regularization parameter.

68. The method of claim 65, wherein the homogeneous component corresponds to a dipole potential in a medium with a homogeneous conductivity.

69. The method of claim 65, wherein the homogeneous component corresponds to a quadropole potential in a medium with a homogeneous conductivity.

70. The method of claim 65, wherein the homogeneous component depends on the relative position of each signal measuring electrode with respect to each set of current injecting electrodes.

71. The method of claim 65, wherein the homogeneous component further depends on an estimate for conductivity inside the organ.

72. The method of claim 71, wherein the determination comprises an optimization technique that minimizes collective differences between each of the measured signals and an estimate for each of the respective measured signals as a function of the relative position between the one or more measuring electrodes on the one or more additional catheters and the first catheter and the estimated conductivity.

73. A system comprising:

a first catheter configured for insertion into an organ in a patient'"'"'s body and comprising three or more sets of current injecting electrodes;

one or more additional catheters configured for insertion into the organ in the patient'"'"'s body and comprising one or more measuring electrodes;

an electronic control system coupled to the first catheter and the one or more additional catheters and configured to cause current to flow between each set of current-injecting electrodes and measure an electrical signal in response to the current flow caused by each set of current injecting electrodes at each of the measuring electrodes on the one or more additional catheters; and

a processing system coupled to the electronic system and configured to determine the position of the each of one or more of the one or more current measuring electrodes relative to the current-injection electrodes of the first catheter based on the measured signals from the one or more measuring electrodes.

74. A system comprising:

a processing system configured for use with;

a first catheter configured for insertion into an organ in a patient'"'"'s body and comprising three or more sets of current injecting electrodes;

one or more additional catheters configured for insertion into the organ in the patient'"'"'s body and comprising one or more measuring electrodes; and

an electronic control system coupled to the first catheter and the one or more additional catheters and configured to cause current to flow between each set of current-injecting electrodes and measure an electrical signal in response to the current flow caused by each set of current injecting electrodes at each of the measuring electrodes on the one or more additional catheters,

where in the processing system is configured to be coupled to the electronic system and configured to determine a position of the each of one or more of the one or more current measuring electrodes relative to the current-injecting electrodes on the first catheter based on the measured signals from the one or more measuring electrodes.

75. The system of claim 74 further comprising one or more of:

the first catheter;

the one or more additional catheters; and

the electronic control system.

76. A non-transitory computer program product residing on a computer readable medium, the computer program product comprising instructions for causing a computer to:

cause current to flow between each of three or more sets of current-injecting electrodes on a first catheter inserted into an organ in a patient'"'"'s body, the organ having a periphery;

in response to current flow caused by each set of current injecting electrodes, measure an electrical signal at each of one or more measuring electrodes located on one or more additional catheters inserted into the organ in the patient'"'"'s body; and

determine a position of each of one or more or the measuring electrodes on the additional catheters relative to the current-injecting electrodes on the first catheter based on the measured signals from the one or more measuring electrodes.

77. A non-transitory computer program product residing on a computer readable medium, the computer program product comprising instructions for causing a computer to:

cause current to flow between each set of at least three sets of current-injecting electrodes on a first catheter;

receive data relating to a measurement of an electrical signal measured in response to the current flow caused by each set of current injecting electrodes at each of the measuring electrodes on the one or more additional catheters, and

determine a position of the each of one or more of the one or more current measuring electrodes relative to the current-injecting electrodes on the first catheter based on the measured signals from the one or more measuring electrodes.