System for non-invasive heart treatment

• US 8,696,658 B2
• Filed: 12/14/2009
• Issued: 04/15/2014
• Est. Priority Date: 01/08/2003
• Status: Active Grant

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Cyberheart, Inc. (Siemens AG)
• Inventors: Pankratov, Michail, Benetti, Federico, Vivian, Judie
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US12/637,458
• Publication Number:
  US 20100160775A1
• Time in Patent Office: 1,583 Days
• Field of Search: 606/1, 606 32- 35, 606/41, 600 1- 8, 600425-529, 378/1, 378 63- 65
• US Class Current: 606/33
• CPC Class Codes: A61N 5/10 X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 5/1039 using functional images, e.g. PET or MRI
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1064 for adjusting radiation treatment in response to monitoring
• CPC Class Codes: A61N 5/1084 for delivering multiple intersecting beams at the same time, e.g. gamma knives

Abstract

The invention provides a non-invasive method for treatment of arrhythmia. In a first aspect, a method for treatment of a trial fibrillation in a heart of a patient comprises directing radiation from outside the patient toward one or more target treatment regions of the heart so as to inhibit the a trial fibrillation. The radiation may induce isolation of a pulmonary vein.

Claims

1. A method for treatment of arrhythmia in a heart of a patient, the method comprising:

scanning the heart of the patient so as to produce a scanned heart image;

planning a plurality of radiation beams for transmission toward the scanned heart image so as to induce an arrhythmia-inhibiting lesion pattern; and

treating the patient by directing x-ray radiation or particle radiation from outside the patient toward the heart of the patient per the planned beams so that the arrhythmia-inhibiting lesion pattern is induced in the heart such that the arrhythmia of the patient is inhibited.

2. The method of claim 1, wherein planning the plurality of radiation beams is performed so that the planned beams converge toward the arrhythmia-inhibiting lesion pattern.

3. The method of claim 2, the x-ray or particle radiation directed per the planned beams comprising a plurality of x-ray or particle radiation beams, wherein treating the patient includes directing the x-ray or particle radiation beams from a plurality of angles toward one or more target regions of the heart so as to limit a radiation dose to an identified tissue structure below a healthy level.

4. The method of claim 3, wherein planning the treatment comprises determining the size, shape and location of the one or more target treatment areas.

5. The method of claim 4, wherein planning the treatment further comprises determining a number, intensity, and direction of the planned beams to deliver a sufficient dose for treatment of the arrhythmia.

6. The method of claim 5, wherein system software determines the number, intensity, and direction of the planned beams using the scanned heart image, and wherein the scanning of the heart comprises scanning the patient with computer tomography or magnetic resonance imaging to produce the scanned heart image.

7. The method of claim 1, wherein planning the treatment further comprises percutaneous placement of fiducials or small radiopaque markers to provide three-dimensional localization during treatment.

8. The method of claim 1, wherein treating the patient further comprises tracking motion and respiration of the patient and dynamically registering one or more target treatment region to the heart.

9. The method of claim 1, wherein treating the patient further comprises acquiring a stereo pair of x-ray images to locate one or more target treatment region of the heart prior to delivery of the x-ray or particle radiation.

10. The method of claim 1, wherein the x-ray or particle radiation comprises a first portion of a total radiation treatment and is directed to the patient in a first treatment, and further comprising directing a second portion of the total radiation treatment to the patient in a second treatment, the first treatment and the second being performed on a first day and a second day, respectively, so that the arrhythmia is inhibited in a fractionated radiation procedure.

11. The method of claim 10, further comprising assessing the patient between the first treatment and the second treatment.

12. The method of claim 11, further comprising planning the second treatment based on imaging of the patient after the first treatment.

13. The method of claim 1, wherein the x-ray or particle radiation induces isolation of a first pulmonary vein.

14. The method of claim 1, wherein the x-ray or particle radiation induces one or more linear lesions within the heart so as to inhibit an ectopic electrical pathway.

15. The method of claim 14, wherein the linear lesions correspond to a Maze lesion pattern.

16. A system for treatment of arrhythmia in a heart of a patient, the system comprising:

a computer having software defining a planned plurality of radiation beams for transmission relative to a planning image of the heart so as to induce an arrhythmia-inhibiting lesion pattern; and

a source of particle beam radiation or x-ray radiation coupled to the processor so that the source directs the particle beam radiation or x-ray radiation from outside the patient toward the heart of the patient per the planned beams so that the arrhythmia-inhibiting lesion pattern is induced in the heart such that the arrhythmia of the patient is inhibited.

17. The system of claim 16, further comprising a computer tomography or magnetic resonance imaging system for acquiring the planning image of the heart, the imaging system coupled to the processor.

18. The system of claim 17, further comprising a registration imaging system coupled to the processor so that the processor dynamically registers the planned beams with one or more target treatment regions of the heart of the patient during treatment.

19. The system of claim 16, further comprising a robot supporting the source, the robot moving the source relative to the patient so as to orient the x-ray or particle radiation toward the heart per the planned beams.

20. The system of claim 16, wherein the planned radiation beams defined by the software are configured to converge on one or more target treatment region of the heart.

21. The system of claim 20, wherein the planned radiation beams defined by the software are configured to ablate linear lesions within the heart sufficient to inhibit an electrical pathway.

22. The system of claim 21, wherein the linear lesions correspond to a Maze lesion pattern.

23. The system of claim 16, wherein the planned beams are configured to effect bilateral pulmonary vein isolation.

24. The system of claim 16, wherein the planned radiation beams are configured to target at least one ectopic focus of the heart.

25. The system of claim 16, wherein the planned radiation beams defined by the software are configured to avoid exceeding a tolerance of an identified tissue structure adjacent to the one or more target regions.

26. The system of claim 16, wherein the planned radiation beams defined by the software comprise a number, intensity, and direction of the planned beams.

27. The system of claim 16, wherein the radiation source comprises a plurality of gamma radiation sources that emit gamma radiation directed at target points at a center of radiation focus, wherein the plurality of gamma radiation sources are included in a shielded array unit.

28. The system of claim 16, wherein the system wherein the radiation source comprises a linear accelerator mounted to a highly maneuverable robotic arm having six degrees of freedom.

29. The system of claim 28, wherein the computer further comprises an image guidance system comprising two fixed diagnostics fluoroscopes to provide a stationary frame of reference for locating the heart of the patient relative to the robotic arm and the linear accelerator.

30. The system of claim 16, wherein the source is included in a stereotactic system.