Method for displaying catheter electrode-tissue contact in electro-anatomic mapping and navigation system

• US 8,755,860 B2
• Filed: 01/18/2013
• Issued: 06/17/2014
• Est. Priority Date: 12/06/2005
• Status: Active Grant

• Current Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Original Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Inventors: Paul, Sauray, Cao, Hong
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US13/745,162
• Publication Number:
  US 20130138099A1
• Time in Patent Office: 515 Days
• Field of Search: 600/374, 600/424, 607/125
• US Class Current: 600/374
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2018/00303 active, e.g. with a motor creating vibrations
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/0075 Phase
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00869 Phase
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• 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 5/053 Measuring electrical impedance or conductance of a portion of the body

Abstract

An electrode coupling output system associated with an electrode catheter that provides indication to the physician via the navigation system, concerning the electrical coupling of an electrode, such as an ablative or mapping electrode, with a patient. The indication may be provided by changing the color or other display characteristics of the electrode on the navigation system display or by way of providing a waveform indicating the electrode coupling. In this manner, electrode coupling information is provided to a physician in a manner that minimizes physician distraction.

Claims

1. A method for use in operating an ablation electrode catheter, the method comprising the steps of:

monitoring, via a navigation system, a position of an ablation electrode of the ablation electrode catheter during an ablation procedure;

operating an electrical power system to provide electrical signals to said ablation electrode;

first operating a coupling assessment system to evaluate an initial level of an electrical coupling condition between said ablation electrode and a tissue, said coupling assessment system being operative to compare a contact sensing signal measured between said ablation electrode and a second electrode at least partially through the tissue to distinguish between multiple predetermined ranges of said electrical coupling condition including at least a range of insufficient electrical coupling for said ablation procedure and a range of sufficient electrical coupling for said ablation procedure;

upon identifying said initial level of said electrical coupling condition being within said range of sufficient electrical coupling for said ablation procedure, providing an ablation power signal to the ablation electrode;

second operating said coupling assessment system, subsequent to application of said ablation power signal to the ablation electrode, to identify a change in said initial level of said electrical coupling condition; and

providing an output, via said navigation system, indicating said change in said initial level of said electrical coupling condition.

2. The method as set forth in claim 1, wherein said change in said initial level of said electrical coupling condition provides a measure of lesion formation in the tissue.

3. The method as set forth in claim 1, further comprising:

providing a coupling level output, via said navigation system, indicating said initial level of said electrical coupling condition.

4. The method as set forth in claim 1, wherein operating said electrical power system comprises:

providing said contact sensing signal to said ablation electrode; and

providing said ablation power signal to said ablation electrode.

5. The method as set forth in claim 4, wherein said contact sensing signal and said ablation power signal are provided at first and second different frequencies.

6. The method as set forth in claim 4, wherein said contact sensing signal and said ablation power signal are provided to said ablation electrode at first and second temporally distinct times.

7. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative to distinguish between multiple predetermined ranges of said electrical coupling condition including each of said range of insufficient electrical coupling for a procedure, said range of sufficient electrical coupling for said procedure and a range of elevated coupling.

8. The method as set forth in claim 1, wherein said electrode coupling assessment system is operative for distinguishing between said multiple predetermined ranges of said electrical coupling condition based on an impedance-related value.

9. The as set forth in claim 1, wherein said electrode coupling assessment system is operative for distinguishing between said multiple predetermined ranges of said electrical coupling condition based on a relationship between values related to resistance and reactance components of impedance.

10. The method as set forth in claim 1, wherein providing said output further comprises providing a graphical representation of a position of said ablation electrode relative to the tissue on a display device of said navigation system.

11. The method as set forth in claim 1, wherein providing said output comprises displaying a waveform showing values related to said change in said initial level of said electrical coupling condition versus time on a display device of said navigation system.

12. An apparatus for use in operating an ablation electrode catheter, the apparatus comprising:

an input operative to receiving contact sensing signals indicative of levels of an electrical coupling condition between a first ablation electrode of an electrode catheter and a tissue, wherein each said contact sensing signal is measured between the first ablation electrode and a second electrode;

a processor operative to;

process a first contact sensing signal to determine an initial level of said electrical coupling condition between the first ablation electrode and the tissue, wherein said processor is operative to compare said first contact sensing signal with multiple predetermined ranges of said electrical coupling condition between said first electrode and the tissue, wherein said multiple predetermined ranges include at least a range of insufficient coupling for a procedure and a range of sufficient coupling for the procedure; and

process a second contact sensing signal measured between the first ablation electrode and the second electrode and at least partially through the tissue, subsequent to application of ablation energy to the first ablation electrode, to identify a change in said initial level of said electrical coupling condition; and

an output interface operative to provide an output to a navigation system to indicate said change in said initial level of said electrical coupling condition.

13. The apparatus as set forth in claim 12, wherein said change in said initial level of said electrical coupling condition provides an indication of lesion formation in the tissue.

14. The apparatus as set forth in claim 12, wherein:

said processor is further operative to identify when said initial level of said electrical coupling condition is within said range of sufficient coupling for the procedure; and

said output interface is further operative to provide a sufficient coupling output to the navigation system when said initial level of electrical coupling condition is within said range of sufficient coupling for the procedure.

15. The apparatus as set forth in claim 12, wherein said processor is operative to distinguish between said multiple predetermined ranges of said electrical coupling condition based on the relationship between values related to resistance and reactance components of impedance.

16. The apparatus as set forth in claim 12, wherein said output interface is operative to provide a waveform output showing change in said initial level of said electrical coupling condition versus time.

17. An electrode catheter system comprising:

a first electrode disposed on a catheter;

a second electrode;

an electrical power system configured to provide contact sensing signals and ablation power to said first electrode;

a navigation system for use in monitoring a position of said electrode during a medical procedure; and

a processor operative to;

process at least first and second contact sensing signals measured between said first electrode and said second electrode and at least partially through a tissue to determine at least an initial level and a subsequent level of an electrical coupling condition between the first electrode and the tissue, wherein said processor is operative to compare at least said first contact sensing signal with multiple predetermined ranges of said electrical coupling condition between said first electrode and the tissue, wherein said multiple predetermined ranges include at least a range of insufficient coupling for a procedure and a range of sufficient coupling for the procedure; and

provide information associated with said initial and subsequent levels of said contact coupling condition to said navigation system;

wherein, said navigation system provides an output indicative of a change between said initial level of said electrical coupling condition and said subsequent level of said electrical coupling condition.

18. The electrode catheter system as set forth in claim 17, wherein said change provides an indication of lesion formation in the tissue.

19. The electrode catheter system as set forth in claim 17, wherein said processor is further operative to identify when said initial level of said electrical coupling condition is within said range of sufficient coupling for the procedure.

20. The electrode catheter system as set forth in claim 19, wherein said electrical power system is operative to apply said ablation power to said first electrode after said initial level of said electrical coupling condition is identified within said range of sufficient coupling for the procedure.

21. The electrode catheter system as set forth in claim 20, wherein said processor is operative to process said second contact sensing signal after application of said ablation power to said first electrode.