Cardiac mapping with catheter shape information

• US 8,948,853 B2
• Filed: 03/10/2011
• Issued: 02/03/2015
• Est. Priority Date: 06/13/2006
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Rhythmia Medical, Inc. (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Greenfield, Pavel, Amariglio, Leon
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US13/044,982
• Publication Number:
  US 20110160574A1
• Time in Patent Office: 1,426 Days
• Field of Search: None
• US Class Current: 600/509
• CPC Class Codes: A61B 2034/2061 using shape-sensors, e.g. fiber shape sensors with Bragg gratings
• 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 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/068 using impedance sensors
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/347 Detecting the frequency distribution of signals
• CPC Class Codes: A61B 5/367 Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/6852 Catheters

Abstract

A non-contact cardiac mapping method is disclosed that includes: (i) inserting a catheter into a heart cavity having an endocardium surface, the catheter including multiple, spatially distributed electrodes; (ii) measuring signals at the catheter electrodes in response to electrical activity in the heart cavity with the catheter spaced from the endocardium surface; and (iii) determining physiological information at multiple locations of the endocardium surface based on the measured signals and positions of the electrodes with respect to the endocardium surface. Related systems and computer programs are also disclosed.

Claims

1. A method comprising:

processing information relating to characteristics of catheter shape;

inserting a catheter into a heart cavity having an endocardium surface, the catheter comprising multiple, spatially distributed electrodes;

moving the catheter to each of multiple, different positions in the heart cavity;

for each of the different catheter positions, measuring signals at the catheter electrodes in response to electrical activity in the heart cavity;

subsequent to processing the information relating to the characteristics of the catheter shape, determining physiological information at multiple locations of the endocardium surface based at least in part on the measured signals and the processed catheter shape information;

using the determined physiological information to guide ablation of one or more selected regions of the heart;

repeating the measurement of catheter electrode signals and the determination of the physiological information after the ablation treatment, and

displaying a difference map comprising information about how the determined physiological information changed in response to the ablation treatment.

2. The method of claim 1, wherein the information relating to characteristics of the catheter shape is processed prior to inserting the catheter into the heart cavity.

3. The method of claim 1, further comprising storing the processed information relating to characteristics of the catheter shape.

4. The method of claim 1, wherein determining the physiological information at multiple locations of the endocardium surface based at least in part on the measured signals and the processed catheter shape information comprises accessing the stored processed catheter shape information.

5. The method of claim 1, wherein the catheter is configured to assume multiple different shapes.

6. The method of claim 1, further comprising, subsequent to inserting the catheter into the heart cavity, deploying the multiple, spatially distributed electrodes into a specified electrode arrangement.

7. The method of claim 1, wherein processing information relating to the characteristics of the catheter shape comprises processing information relating to the relative arrangement of the multiple, spatially distributed electrodes.

8. The method of claim 1, wherein processing information relating to the characteristics of the catheter shape comprises determining locations of the electrodes based on a location of the catheter.

9. The method of claim 8, wherein determining physiological information at multiple locations of the endocardium surface based at least in part on the measured signals and the processed catheter shape information comprises determining physiological information based at least in part on the determined locations of the electrodes.

10. The method of claim 1, wherein processing the information relating to characteristics of the catheter shape comprises processing information relating to the distribution of the electrodes on the catheter.

11. The method claim 1, further comprising:

determining a position and orientation of the catheter within the heart cavity;

wherein processing information relating to characteristics of the catheter shape comprises determining positions of the catheter electrodes based on information about the distribution of the electrodes on the catheter and the determined position and orientation of the catheter within the heart cavity.

12. The method of claim 1, wherein processing information relating to characteristics of the catheter shape comprises partially computing one or more transformation functions.

13. The method of claim 12, further comprising processing information relating to characteristics of the endocardium surface.

14. The method of claim 13, wherein processing information relating to characteristics of the endocardium surface comprises partially computing one or more transformation functions for converting the signals measured at the catheter electrodes to estimates of the physiological information at the endocardium surface.

15. The method of claim 13, wherein each transformation function is associated with a different position within the heart cavity.

16. The method of claim 13, wherein each transformation function is associated with a different position and orientation of the catheter within the heart cavity.

17. The method of claim 1, wherein the catheter is hollow.

18. The method of claim 1, wherein:

determining the physiological information comprises determining electrical potential values at the multiple locations of endocardium surface at each of one or more different phases of the heart beat cycle, and

displaying the information related to at least some of the determined physiological information comprises displaying electrical potential values at the multiple locations of endocardium surface at each of one or more different phases of the heart beat cycle.

19. The method of claim 1, wherein:

determining the physiological information comprises determining a maximum voltage amplitude for one or more heart beat cycles at different ones of the endocardium surface locations; and

displaying the information related to at least some of the determined physiological information comprises displaying information related to the maximum voltage amplitude at different ones of the endocardium surface locations.

20. The method of claim 1, wherein:

determining the physiological information comprises determining a frequency representation of electrical activity at multiple locations of the endocardium surface during the heart beat cycle, wherein the frequency representation is computed based on electrical potential values at the multiple locations of endocardium surface at different phases of the heart beat cycle; and

displaying the information related to at least some of the determined physiological information comprises displaying information related to the determined frequency representation.

21. The method of claim 1, wherein:

determining the physiological information comprises determining an activation time for each of different locations of the endocardium surface; and

displaying the information related to at least some of the determined physiological information comprises displaying information related to the determined activation time for each of different locations of the endocardium surface.

22. A system comprising:

a catheter configured to be inserted into a heart cavity having an endocardium surface and to move to each of multiple positions in the heart cavity, the catheter comprising;

multiple, spatially distributed electrodes, the multiple electrodes configured to measure signals in response to electrical activity in the heart cavity;

repeat the measurement of catheter electrode signals after ablation treatment

a processing unit configured to;

process information relating to characteristics of the catheter shape; and

subsequent to processing the information relating to the characteristics of the catheter shape, determine physiological information at multiple locations of the endocardium surface based at least in part on the measured signals and the processed catheter shape information and repeat the determination of the physiological information after the ablation treatment; and

a display device configured to display a difference map comprising information about how the determined physiological information changed in response to the ablation treatment.

23. The system of claim 22, wherein the catheter is configured to assume multiple different shapes.

24. The system of claim 22, wherein the processing unit is further configured to process information relating to the arrangement of the multiple, spatially distributed electrodes relative to the catheter.

25. The system of claim 22, wherein the processing unit is further configured to partially compute one or more transformation functions.

26. A method comprising:

processing information relating to characteristics of catheter shape;

inserting a catheter into a heart cavity having an endocardium surface, the catheter comprising multiple, spatially distributed electrodes;

moving the catheter to each of multiple, different positions in the heart cavity;

for each of the different catheter positions, measuring signals at the catheter electrodes in response to electrical activity in the heart cavity;

subsequent to processing the information relating to the characteristics of the catheter shape, determining a frequency representation of electrical activity at multiple locations of the endocardium surface during the heart beat cycle, wherein the frequency representation is computed based on electrical potential values at the multiple locations of endocardium surface at different phases of the heart beat cycle; and

displaying information related to at least some of the determined frequency representation.

27. The method of claim 26, wherein the information relating to characteristics of the catheter shape is processed prior to inserting the catheter into the heart cavity.

28. The method of claim 26, further comprising storing the processed information relating to characteristics of the catheter shape.

29. The method of claim 26, wherein determining the frequency representation of electrical activity comprises accessing the stored processed catheter shape information.

30. The method of claim 26, wherein the catheter is configured to assume multiple different shapes.

31. The method of claim 26, wherein processing information relating to the characteristics of the catheter shape comprises processing information relating to the relative arrangement of the multiple, spatially distributed electrodes.

32. The method of claim 26, wherein processing information relating to the characteristics of the catheter shape comprises determining locations of the electrodes based on a location of the catheter.

33. The method of claim 26, wherein processing the information relating to characteristics of the catheter shape comprises processing information relating to the distribution of the electrodes on the catheter.

34. The method claim 26, further comprising:

determining a position and orientation of the catheter within the heart cavity;

wherein processing information relating to characteristics of the catheter shape comprises determining positions of the catheter electrodes based on information about the distribution of the electrodes on the catheter and the determined position and orientation of the catheter within the heart cavity.

35. The method of claim 26, wherein processing information relating to characteristics of the catheter shape comprises partially computing one or more transformation functions.

36. A system comprising:

a catheter configured to be inserted into a heart cavity having an endocardium surface and to move to each of multiple positions in the heart cavity, the catheter comprising;

multiple, spatially distributed electrodes, the multiple electrodes configured to measure signals in response to electrical activity in the heart cavity;

a processing unit configured to;

process information relating to characteristics of the catheter shape; and

subsequent to processing the information relating to the characteristics of the catheter shape, determine a frequency representation of electrical activity at multiple locations of the endocardium surface during the heart beat cycle, wherein the frequency representation is computed based on electrical potential values at the multiple locations of endocardium surface at different phases of the heart beat cycle; and

a display device configured to display information related to at least some of the determined frequency representation.

37. The system of claim 36, wherein the catheter is configured to assume multiple different shapes.

38. The system of claim 36, wherein the processing unit is further configured to process information relating to the arrangement of the multiple, spatially distributed electrodes relative to the catheter.

39. The system of claim 36, wherein the processing unit is further configured to partially compute one or more transformation functions.