Determining a size of a representation of a tracked member

• US 8,660,640 B2
• Filed: 04/14/2009
• Issued: 02/25/2014
• Est. Priority Date: 04/18/2008
• Status: Expired due to Fees

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Markowitz, H. Toby, Karamanoglu, Mustafa, Mehta, Pooja, Fleming, Ioana, Scanlon, David A., Kryger, Michael, Campbell-Massa, Sean, Giese, Chad, Waldhauser, Steven L., Zhang, Shangqian Peter, Jannicke, Jeff, Falkner, Phillip, Hefner, Don, Warman, Eduardo N., Steeves, James, Receveur, Rogier, Michels, Koen, Eick, Olaf, Larik, Vincent
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): KIMBALL, JEREMIAH T
• Application Number:
  US12/423,454
• Publication Number:
  US 20090264741A1
• Time in Patent Office: 1,778 Days
• Field of Search: 600/523
• US Class Current: 600/523
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• 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 5/06 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 5/061 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 5/062 using magnetic field
• 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 5/304 : Switching circuits
• CPC Class Codes: A61B 5/333 : Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/339 : Displays specially adapted therefor
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 8/06 : Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/4472 : Wireless probes

Abstract

An volume 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 a volume can be determined based upon the sensing of the plurality of points without the use of other imaging devices. An implantable medical device can then be navigated relative to the mapping data.

Claims

1. A method of determining a position of an instrument in a patient, comprising:

moving at least a first position element and a second position element with the instrument into a volume of the patient;

determining a position of the instrument with only a position sensing system, including;

providing a set of axis generation electrodes on an exterior surface of the volume establishing an axis and a conductive path therebetween; and

injecting a current into the volume between the set of electrodes and generating a voltage gradient between the set of electrodes;

evaluating an electrical property with the first and second position elements mounted on the instrument;

determining a position of the first and second position elements within the volume based on the evaluated electrical property;

determining a scalar distance between the first position element and the second position element on the instrument;

evaluating the determined position of the first and second position elements based on the scalar distance to correct for a distortion of the injected current between the set of axis generation electrodes in the patient to determine a corrected position determination; and

displaying a graphical representation of the corrected determined position of the first and second position elements.

2. The method of claim 1, further comprising:

collecting a plurality of determined positions of the first and second position elements; and

illustrating the collected plurality of determined positions as map data of an interior of the volume.

3. The method of claim 2, further comprising:

evaluating each of the collected plurality of the determined positions to generate a plurality of corrected determined positions;

illustrating only the plurality of corrected determined positions as map data of an interior of the volume.

4. The method of claim 1, wherein providing a set of axis generation electrodes includes providing at least three sets of axis generation electrodes injecting a separate axis current into the volume between each of the at least three set of axis generation electrodes;

applying the scalar distance to a position of the first electrode relative to the second electrode in each of the three axes.

5. The method of claim 1, wherein determining the scalar distance between the first position element and the second position element on the instrument includes:

determining an initial position of the first position element;

determining an initial position of the second position element; and

determining a distance between the first position element and the second position element based on the determined initial position of the first position element and the determined initial position of the second position element.

6. The method of claim 1, wherein determining the scalar distance between the first position element and the second position element on the instrument includes inputting a known distance between the first position element and the second position element on the instrument into a memory system and recalling the input distance with the position sensing system from the memory system.

7. The method of claim 1, further comprising:

selecting a location for implanting a lead of an implantable medical device;

wherein moving at least a first position element and a second position element with the instrument into a volume of the patient includes moving the instrument into a heart of the patient;

wherein displaying a graphical representation includes displaying a graphical representation of an interior wall of the heart.

10. The method of claim 1, further comprising:

measuring a motion of a fluid within the volume because the fluid acts on the instrument;

measuring a rhythmic feature of a volume;

wherein determining the position of the first and second position elements includes tracking the first and second position elements, includes at least one of;

selecting between a uni-polar and bi-polar collection of positions;

determining whether an interfering frequency is present during or prior to collecting the positions;

inflating a portion of the instrument;

fixing a location of the first position element relative to the second position element;

moving a flexible member with the first position element relative to the second position element at a fixed position and measuring the position of the first member position element relative to the second position element;

measuring a temperature within the volume at at least one of the position element, the first position element, and the second position element; and

displaying on a display device at least one of;

a corrected map data generated by reducing distortion of a measured position of the instrument by determining a scaling factor between the first and second position elements of the instrument;

a pseudo location of an axis electrode relative to the corrected map;

a location of a reference electrode relative to the corrected map;

a location of a feature determined by generating a filled volume and determining curvilinear portions to be displayed relative to the filled volume with the instrument;

a map point determined by generating a virtual point based on a known position of a physical portion of the instrument relative to a position element of the instrument;

the map based on locations categorized relative to the measured rhythmic feature;

a virtual map data point determined based on a geometry of the instrument relative to the position element; and

a location of an introducer through which the instrument or the procedure instrument is passed.

8. A method of determining a position of an instrument in a patient, comprising:

determining a position of an instrument having at least a first position element and a second position element with only a position sensing system within the patient, including;

providing a set of axis generation electrodes on an exterior surface of the volume establishing an axis and a conductive path therebetween, wherein providing the set of axis generation electrodes includes providing at least three sets of axis generation electrodes injecting a separate axis current into the volume between each of the at least three set of axis generation electrodes; and

injecting a current into the volume between the set of electrodes and generating a voltage gradient between the set of electrodes;

evaluating an electrical property with the first and second position elements mounted on the instrument;

determining a position of the first and second position elements within the patient based on the evaluated electrical property;

determining a scalar distance between the first position element and the second position element on the instrument;

applying the scalar distance to a position of the first electrode relative to the second electrode in each of the three axes, wherein applying the scalar distance to a position of the first electrode relative to the second electrode in each of the three axes, includes;

determining a correction vector in three dimensions between the first position element and the second position element;

determining a scaling factor r_nx along the x-axis based on the correction vector and the scalar distance;

determining a scaling factor r_ny along the y-axis based on the correction vector and the scalar distance; and

determining a scaling factor r_nz, along the z-axis based on the correction vector and the scalar distance;

evaluating the determined position of the first and second position elements based on the scalar distance to correct for a distortion of the injected current between the set of axis generation electrodes in the patient to determine a corrected position determination, wherein evaluating the determined position includes calculating a position of the first position element relative to the second position element based on the determined scaling factors r_nx, r_ny, and r_nz; and

displaying a graphical representation of the corrected determined position of the first and second position elements.

9. A method of determining a position of an instrument in a patient, comprising:

moving at least a first position element and a second position element with the instrument into a volume of the patient;

determining a position of the instrument with only a position sensing system, including;

providing a set of axis generation electrodes on an exterior surface of the volume establishing an axis and a conductive path therebetween; and

injecting a current into the volume between the set of electrodes and generating a voltage gradient between the set of electrodes;

evaluating an electrical property with the first and second position elements mounted on the instrument;

determining a position of the first and second position elements within the volume based on the evaluated electrical property;

determining a scalar distance between the first position element and the second position element on the instrument, including;

determining an initial position of the first position element;

determining an initial position of the second position element; and

determining a distance between the first position element and the second position element based on the determined initial position of the first position element and the determined initial position of the second position element;

evaluating the determined position of the first and second position elements based on the scalar distance to correct for a distortion of the injected current between the set of axis generation electrodes in the patient to determine a corrected position determination;

determining a three dimensional position of the first position element relative to the second position element;

determining a correction vector based on the determined scalar distance and the determined three dimensional position of the first position element relative to the second position element, wherein the corrected position of first position element and the second position element includes correcting the determined position of the first position element relative to the second position element based on the correction vector;

displaying a graphical representation of the corrected determined position of the first and second position elements.

11. A method of determining a position of an instrument in a patient, comprising:

moving at least a first position element and a second position element with the instrument into a heart of the patient;

determining a scalar distance between the first position element and the second position element on the instrument;

determining a position of the instrument with only a position sensing system, including;

providing a three sets of axis generation electrodes on an exterior surface of the volume establishing three axes and a three conductive paths therebetween; and

injecting a current into the volume between each of the three sets of electrodes and generating a voltage gradient between each of the three sets of electrodes;

evaluating an electrical property with the first and second position elements mounted on the instrument to determine an initial position of both the first position element and the second position element;

determining a corrected position of the second position element relative to the first position element, including;

determining a correction vector direction between the first position element and the second position element in each of the three axes;

determining three scaling factors, one scaling factor for each of the three axes based on the determined scalar dimension and the determined correction vector

calculating the position of the second position element based on the scaling factors relative to the determined position of the first position element to correct for a distortion of the injected current between the three sets of axis generation electrodes in the patient; and

displaying a graphical representation of the determined corrected position of the first and second position elements.

12. The method of claim 11, wherein displaying a graphical representation includes displaying a map representing an internal wall of the heart.

13. The method of claim 12, wherein the graphical representation is displayed without image data other than that generated by the position sensing system.

14. The method of claim 13, further comprising:

providing a processor to execute instructions to at least one of determining a position of the instrument, evaluating an electrical property, determining a corrected position of the second position element, and calculating the position of the second position element.

15. The method of claim 14, further comprising:

storing a plurality of the determined positions;

wherein displaying a map includes displaying at least a sub-plurality of the stored plurality of determined positions.

16. The method of claim 11, wherein determining a scalar distance between the first position element and the second position element on the instrument includes physically measuring a distance between the first position element and the second position element fixed to the instrument.

17. The method of claim 11, wherein determining a scalar distance between the first position element and the second position element on the instrument includes:

positioning the instrument in the patient prior to moving the instrument to the heart of the patient;

determining an initial position of the first position element;

determining an initial position of the second position element; and

determining a distance between the first position element and the second position element based on the determined initial position of the first position element and the determined initial position of the second position element.

18. A system to determine a position of an instrument in a patient, comprising:

an instrument operable to be positioned into a volume of the patient having at least a first position element and a second position element;

a position sensing system, including;

a set of axis generation electrodes on an exterior surface of the volume establishing an axis and a conductive path therebetween; and

a driver operable to inject a current into the volume between the set of axis generation electrodes and generating a voltage gradient between the set of axis generation electrodes;

a processor operable to execute instructions to evaluate an electrical property measured with the first and second position elements mounted on the instrument to determine a sensed position of the first and second position elements within the volume based on the evaluated electrical property;

the processor further operable to execute instructions to evaluate the sensed position of the first and second position elements based on a scalar distance between the first position element and the second position element to correct for a distortion of the injected current axis in the patient to determine a corrected position determination; and

a display device to display a graphical representation of the corrected determined position of the first and second position elements.

19. The system of claim 18, wherein the set of axis generation electrodes includes at least three sets of axis generation electrodes operable to inject a separate axis current into the volume between each of the at least three sets of axis generation electrodes along three substantially orthogonal axes;

wherein the processor is operable to execute instructions to apply the scalar distance to a position of the first electrode relative to the second electrode in each of the three axes.

20. The system of claim 19, wherein the first position element and the second position element are fixed relative to one another on the instrument.

21. The system of claim 20, wherein the processor is operable to define a scaling factor in each of the three axes based on the scalar distance and a correction vector defined as a determined orientation between the first position element and the second position element when a position of both the first position element and the second position element is determined.

22. The system of claim 21, wherein the determined correction vector is in three dimensions between the first position element and the second position element.

23. The system of claim 21, wherein the processor operable to define the scaling factor in each of the three axes based on the scalar distance includes:

determining a scaling factor r_nx along a x-axis based on the correction vector and the scalar distance;

determining a scaling factor r_ny along a y-axis based on the correction vector and the scalar distance; and

determining a scaling factor r_nz, along a z-axis based on the correction vector and the scalar distance.

24. The system of claim 18, further comprising:

a catheter including an opening in a sidewall of the catheter operable to allow a fluid into an interior of the catheter and a catheter cover operable to selectively cover the opening in the sidewall of the catheter, wherein the catheter includes a third position element;

a physiological measuring device;

an introducer operable to be located with the processor; and

a reference electrode at a fixed position on a surface of the volume and a location of the reference electrode is operable to be determined with the processor;

wherein the instrument includes at least one of;

an inflatable portion;

at least a first electrode as the first position element and a second electrode as the second position element;

a guidewire operable to be positioned through a cannula;

a plurality of the first or second position elements along a length of the instrument; and

a temperature sensor;

wherein the processor operable to augment a map on the display device, wherein the processor is operable to at least one of;

determine a position of at least one of the first or second position elements that is positioned to sense a voltage formed in the volume;

determine a position of an input impedance reference electrode and display it on the display device relative to the map; and

determine a pseudo position of an axis electrode on the display device relative to the map.