System and method for determining sheath location

• US 8,839,798 B2
• Filed: 04/09/2009
• Issued: 09/23/2014
• 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, Giese, Chad, Jannicke, Jeff, Waldhauser, Steven L.
• Primary Examiner(s): Matthews, Christine
• Assistant Examiner(s): MCBRIDE, SHANNON CANTY
• Application Number:
  US12/421,375
• Publication Number:
  US 20090264739A1
• Time in Patent Office: 1,993 Days
• Field of Search: 128/897, 128/899, 600/372, 600/424, 600/373, 600/382, 600/547, 606/129
• US Class Current: 128/897
• CPC Class Codes: A61B 2034/2046 Tracking techniques
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2053 Tracking an applied voltage gradient
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• 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 5/0215 by means inserted into the body catheters A61M25/00
• 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 5/063 using impedance measurements
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: G06V 2201/03 Recognition of patterns in medical or anatomical images
• CPC Class Codes: G06V 2201/034 of medical instruments

Abstract

A system for determining a location of an instrument within an anatomy is provided. The system can include a first instrument, which can define at least one lumen. The system can further include a second instrument, which can be received through the at least one lumen. The system can include at least one electrode, which can be coupled to a distal end of the first instrument. The electrode can be responsive to electrical activity to generate at least one signal. The system can include a sensing unit, which can be in contact with the anatomy to sense electrical activity within the anatomy at a location near the instrument. The sensing unit can be in communication with the electrode to receive the signal. The system can further include a control module that can determine, based on the sensed electrical activity and the signal, the location of the first instrument.

Claims

1. A system for determining a location of an instrument within an anatomy comprising:

a first instrument navigable within the anatomy that defines at least one lumen, and includes a proximal end and a distal end;

a second instrument received through the at least one lumen and navigable within the anatomy relative to the first instrument;

at least one electrode coupled to the distal end of the first instrument, wherein the at least one electrode is responsive to electrical activity to generate at least one signal, wherein the at least one electrode includes a first metal portion and a second polymer portion configured to be slit such that the at least one electrode is slittable from around the second instrument, wherein the first metal portion only partially surrounds the first instrument and the second polymer portion is coupled to the first metal portion;

a sensing unit to sense electrical activity within the anatomy at a location near the at least one electrode, the sensing unit in communication with the at least one electrode to receive the at least one signal;

a control module that determines, based on the sensed electrical activity and the at least one signal, the location of the first instrument.

2. The system of claim 1, further comprising:

a first drive patch adapted to be in contact with the anatomy; and

a second drive patch adapted to be in contact with the anatomy and spaced apart from the first drive patch, the first drive patch and the second drive patch positioned at or near the location.

3. The system of claim 2, further comprising:

a first reference patch adapted to be in contact with the anatomy and spaced apart from the first drive patch and the second drive patch; and

a second reference patch adapted to be in contact with the anatomy and spaced apart from the first drive patch, the second drive patch and the first reference patch, the first reference patch and the second reference patch adapted to be positioned at or near the location.

4. The system of claim 3, wherein the sensing unit generates a voltage between the first drive patch and the second drive patch and the sensed electrical activity comprises voltages sensed between the first reference patch and the second reference patch.

5. The system of claim 4, wherein the at least one electrode of the first instrument is responsive to the voltages between the first drive patch and the second drive patch, and the at least one signal from the at least one electrode comprises at least one voltage sensed by the at least one electrode.

6. The system of claim 5, wherein based on the sensed electrical activity between the first drive patch and the second drive patch, and the at least one signal from the at least one electrode, the control module determines at least one impedance of the at least one electrode of the first instrument.

7. The system of claim 6, wherein the control module determines a position of the second instrument relative to the anatomy based on the at least one impedance of the at least one electrode of the first instrument.

8. The system of claim 4, wherein the second instrument further comprises:

at least one second instrument electrode at a distal end, the at least one second instrument electrode responsive to the voltage to generate at least one second instrument signal that indicates at least one voltage sensed by the at least one second instrument electrode; and

wherein the sensing unit is in communication with the at least one second instrument electrode to receive the at least one second instrument electrode signal, and based on the sensed electrical activity and the at least one second instrument signal, the control module determines at least one impedance of the at least one second instrument electrode of the second instrument.

9. The system of claim 8, further comprising:

a display that displays the position of the first instrument relative to the second instrument;

wherein the control module determines a position of the first instrument relative to the anatomy based on the at least one impedance of the at least one second instrument electrode of the second instrument.

10. The system of claim 1, wherein the second instrument comprises a catheter, balloon catheter, mapping catheter, basket catheter, guide wire, arthroscopic system, cardiac lead, implant or combinations thereof.

11. The system of claim 1, which the first portion and the second portion together completely surround the first instrument.

12. A system for determining a location of an instrument within an anatomy comprising:

a first electrode patch adapted to be in contact with the anatomy;

a second electrode patch adapted to be in contact with the anatomy and spaced apart from the first electrode patch;

a first instrument that is navigable within the anatomy relative to the first electrode patch and the second electrode patch, wherein the first instrument has an outer wall that defines at least one lumen and includes a distal end;

a second instrument received through the at least one lumen and moveable relative to the first instrument and wherein the second instrument is navigable within the anatomy with a second instrument electrode relative to the first instrument, the first electrode patch, and the second electrode patch;

at least one first instrument electrode coupled to the distal end of the first instrument, wherein the at least one first instrument electrode and the second instrument electrode are responsive to electrical activity to each generate at least one signal;

a sensing unit in communication with the first electrode patch and the second electrode patch to generate voltage between the first electrode patch and the second electrode patch, the sensing unit in communication with the at least one first instrument electrode of first instrument to receive the at least one signal and to determine at least one impedance of the at least one first instrument electrode of the first instrument based on the at least one signal; and

a control module that determines, based on the at least one impedance of the at least one first instrument electrode of the first instrument, the location of the first instrument within the anatomy;

wherein the at least one first instrument electrode further comprises;

a metal portion that extends around a circumference of the first instrument on an inner surface; and

a polymeric band that extends around the circumference on an outer surface;

wherein the metal portion and the polymeric band are coupled through the wall of the first instrument.

13. The system of claim 12, wherein the at least one first instrument electrode further comprises:

the metal portion in communication with the sensing unit; and

the polymeric band extending from the metal portion.

14. The system of claim 13, wherein the metal portion comprises a metal electrode that does not circumscribe the circumference of the first instrument.

15. The system of claim 14, wherein the metal electrode has a shape adapted to direct a cutting instrument, the shape selected from the group comprising a triangle, diamond, trapezoid, oval, circle, rectangle and a polygon.

16. The system of claim 14, wherein the metal electrode has a shaped portion configured to position and direct a cutting tool to slit the metal electrode.

17. The system of claim 13, wherein the at least one first instrument electrode is able to be slit so as to no longer extend around the circumference of the first instrument so that the first instrument can be removed without removing the second instrument.

18. The system of claim 12, wherein the at least one first instrument electrode comprises:

the polymeric band in communication with the metal portion via a bore defined through the first instrument; and

a suitable connector coupling the metal portion to the sensing unit.

19. The system of claim 18, wherein the polymeric band is formed over the lumen of the first instrument so that during the forming of the polymeric band at least a portion of a conductive polymer comprising the polymeric band flows through the lumen to contact the metal portion.

20. The system of claim 12, wherein the first instrument defines a bore which receives a portion of the polymeric band to couple to and enable electrical communication between the metal portion and the polymeric band.

21. The system of claim 20, wherein the metal band portion is internally positioned relative to the polymeric band and both are concentric about a center point of the first instrument.

22. A method for determining a location of an instrument within an anatomy comprising:

providing a first instrument that includes at least one lumen and at least one electrode substantially circumscribing the at least one lumen, wherein the at least one electrode is configured to be slit;

inserting a second instrument into the at least one lumen;

inserting the second instrument and at least a portion of the first instrument into the anatomy;

evaluating the location of the first instrument based upon a sensed electrical activity within the anatomy of the at least one electrode substantially circumscribing the at least one lumen; and

slitting the at least one electrode to remove the first instrument from around the second instrument and the anatomy without removing the second instrument;

wherein slitting the at least one electrode includes slitting a polymeric portion that is coupled to a metal portion, wherein the metal portion only partially surrounds the first instrument.

23. The method of claim 22, further comprising:

coupling a first drive patch to the anatomy;

coupling a second drive patch to the anatomy at a location spaced apart from the first drive patch; and

generating voltages in the first drive patch and the second drive patch.

24. The method of claim 23, further comprising:

sensing at least one voltage with the at least one electrode; and

determining, based on the at least one sensed voltage, an impedance of the at least one electrode of the first instrument.