Catheter tracking and endocardium representation generation

• US 8,615,287 B2
• Filed: 08/30/2010
• Issued: 12/24/2013
• Est. Priority Date: 02/08/2007
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Rhythmia Medical, Inc. (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Pidlisecky, Adam
• Primary Examiner(s): Jung, Unsu
• Assistant Examiner(s): Santos Rodriguez, Joseph M
• Application Number:
  US12/871,336
• Publication Number:
  US 20100324414A1
• Time in Patent Office: 1,212 Days
• Field of Search: 600/424, 600/425, 600/431, 600/433, 600/506, 600/509, 600/547
• US Class Current: 600/424
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• 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 5/0044 for the heart
• CPC Class Codes: A61B 5/0536 Impedance imaging, e.g. by tomography
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/068 using impedance sensors
• CPC Class Codes: A61B 5/6859 with multiple distal splines
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

Methods and systems are disclosed for determining information about a position of an object within a distribution of materials having different complex conductivities. The method includes: (i) causing current to flow in the distribution; (ii) measuring an electrical signal at each of multiple locations in the distribution of materials in response to the current flow; (iii) providing spatial information about the distribution of materials with respect to a first reference frame, the spatial information indicative of regions of different complex conductivity in the distribution of materials; and (iv) determining the position of the object with respect to the spatial information about the distribution of materials based on measured electrical signals and the spatial information. In certain embodiments, the object is a catheter inserted into a patients heart cavity for cardiac mapping.

Claims

1. A method for determining information about a location and orientation of a catheter in a patient'"'"'s heart, the method comprising:

determining electrical signals as a function of relative position based on spatial information indicative of regions of different complex conductivity in the patient'"'"'s heart cavity and conductivity values;

causing current to flow between each of three or more sets of current-injecting electrode source/sink pairs on a catheter inserted into the patient'"'"'s heart;

measuring by multiple measuring electrodes located on the catheter, electrical signals in response to the current flow caused by each set of current injecting electrode source/sink pairs on the catheter;

determining the location and orientation of the catheter in the patient'"'"'s heart based on the electrical signals measured by the multiple measuring electrodes located on the catheter in response to the current flow caused by the current injecting electrode source/sink pairs on the catheter and the

determined electrical signals based on the spatial information;

measuring, by at least some of the multiple measuring electrodes on the catheter, electrical signals indicative of cardiac electrical activity; and

determining information about electrical activity of the heart based on the measured electrical signals indicative of cardiac electrical activity and the determined location and orientation of the catheter in the patient'"'"'s heart;

wherein causing the current to flow comprises injecting the current at frequencies spaced from those corresponding to the cardiac electrical activity and the determining the location and orientation of the catheter comprises frequency processing the measured electrical signal responsive to the injected current to distinguish electrical signals responsive to the injected current from those corresponding to the cardiac electrical activity.

2. The method of claim 1, further comprising:

displaying the information about the electrical activity of the heart on a representation of the patient'"'"'s heart.

3. The method of claim 1, wherein determining the location and orientation of the catheter further comprises using an optimization algorithm that determines a conductivity value for each of one or more of the materials in the distribution of materials;

determines electrical signals based on the determined conductivity values and the spatial information about the distribution of materials as a function of the relative position; and

minimizes differences between the measured electrical signals responsive to the injected current and the determined electrical signals.

4. The method of claim 1, wherein the spatial information about the distribution of materials is determined based on one or more of:

a computed tomography (CT) image;

a magnetic resonance imaging (MRI) image;

a fluoroscopic rotational angiography image; and

an ultrasound image.

5. The method of claim 1, wherein determining the location and orientation of the catheter comprises frequency processing of the measured electrical signal responsive to the injected current to distinguish electrical signals responsive to the injected current from those corresponding to cardiac electrical activity.

6. The method of claim 1, further comprising:

receiving a signal indicative of the mechanical contraction of a patient'"'"'s heart, the signal comprising an ECG signal; and

synchronizing the current to flow and the measuring with respect to a cardiac cycle by synchronizing the current to flow based on an R wave detected from the ECG signal.

7. A system for determining information about a location and orientation of a catheter in a patient'"'"'s heart, the system comprising:

a catheter configured to be inserted into the patient'"'"'s heart, the catheter including three or more sets of current-injecting electrodes and multiple measuring electrodes;

electronics coupled to the three or more sets of current-injecting electrodes for causing current to flow by injecting current in the patient'"'"'s heart;

electronics coupled to the measuring electrodes for measuring an electrical signal in response to the current flow and for measuring electrical signals indicative of cardiac electrical activity; and

an electronic processor coupled to current causing and signal measuring electronics, wherein the electronic processor is configured to determine electrical signals as a function of relative position based on spatial information indicative of regions of different complex conductivity in the patient'"'"'s heart cavity and conductivity values;

determine the location and orientation of the catheter in the patient'"'"'s heart based on the electrical signals measured by the multiple spatially distributed measuring electrodes located on the catheter in response to the current flow by injecting currents at frequencies spaced from those corresponding to the cardiac electrical activity caused by the current injecting electrode source/sink pairs on the catheter; and

use electrical signals indicative of cardiac electrical activity measured by the electrodes on the catheter to determine information about electrical activity of the heart based on the measured electrical signals indicative of cardiac electrical activity and the determined location and orientation of the catheter in the patient'"'"'s heart;

wherein the determining the location and orientation of the catheter comprises frequency processing the measured electrical signal responsive to the injected current to distinguish electrical signals responsive to the injected current from those corresponding to the cardiac electrical activity.

8. The system of claim 7, further comprising:

a display device configured to display the information about the electrical activity of the heart on a representation of the patient'"'"'s heart.

9. The system of claim 7, wherein the determination of the location and orientation of the catheter by the electronic processor comprises determining the location and orientation of the catheter based on spatial information indicative of regions of different complex conductivity in the patient'"'"'s heart cavity.

10. The system of claim 9, wherein the determination of the location and orientation of the catheter by the electronic processor comprises using an optimization algorithm that minimizes differences between the measured electrical signals responsive to the injected current and electrical signals determined from the spatial information about the distribution of materials as a function of the relative position.

11. The system of claim 9, wherein the electronic processor is further configured to determine the spatial information about the distribution of materials based on one or more of:

a computed tomography (CT) image;

a magnetic resonance imaging (MRI) image;

a fluoroscopic rotational angiography image; and

an ultrasound image.

12. The system of claim 7, wherein the surface of one or more of the current injecting electrodes has a coating to reduce its electrical impedance with respect to blood in the heart cavity.

13. The system of claim 7, wherein the current injection electrodes are positioned at opposite ends of a deployed configuration for the catheter with respect to each of multiple axes.