Method and apparatus for localizing myocardial infarction during catheterization

• US 9,008,746 B2
• Filed: 12/01/2009
• Issued: 04/14/2015
• Est. Priority Date: 06/18/2004
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Pastore, Joseph M., Girouard, Steven D.
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US12/628,390
• Publication Number:
  US 20100081948A1
• Time in Patent Office: 1,960 Days
• Field of Search: 607374-375, 600374-375
• US Class Current: 600/374
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/0265 using electromagnetic means, e.g. electromagnetic flowmeter
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

A catheter with a tissue property sensor provides for localization of myocardial infarction (MI) by utilizing one or more differences between properties of infarcted myocardial tissue and properties of normal myocardial tissue. The tissue property sensor is to be placed on endocardial wall or epicardial wall during catheterization to sense at least one tissue property allowing for detection of MI. In one embodiment, the tissue property sensor includes a contractility sensor and senses a tissue property in various locations on endocardial wall or epicardial wall and detects substantial changes in the tissue property that indicate a boundary between infarcted tissue and normal tissue.

Claims

1. A system for localizing myocardial infarction (MI) in a heart having a cardiac wall, the system comprising:

a catheter including a distal end configured for placement in a location on the cardiac wall;

a myocardial tissue property sensor incorporated into the distal end of the catheter and adapted to be placed in a myocardial region, the myocardial tissue property sensor including at least a portion configured to penetrate into tissue in the myocardial region and a contractility sensor being an accelerometer array including a plurality of accelerometers configured to sense acceleration signals from a plurality of myocardial locations in the myocardial region, the acceleration signals each indicative of a tissue property; and

a tissue property analyzer including an input to receive the acceleration signals and an output indicative of whether the acceleration signals indicate infarcted tissue.

2. The system of claim 1, wherein the tissue property analyzer comprises a motion pattern analyzer to produce a cardiac wall motion pattern for the myocardial region based on the sensed acceleration signals.

3. The system of claim 2, wherein the contractility sensor is adapted to be placed in a plurality of myocardial regions, one at a time, over at least a portion of a cardiac wall, and wherein the tissue property analyzer further comprises a mapping module to produce a contractility map presenting cardiac wall motion patterns for the at least the portion of the cardiac wall.

4. The system of claim 3, wherein the tissue property analyzer further comprises an MI detector adapted to detect the infarcted tissue based on the contractility map.

5. The system of claim 4, wherein the MI detector is adapted to detect the infarcted tissue by identifying dyskinetic regions on the contractility map.

6. The system of claim 4, wherein the MI detector is adapted to detect the infarcted tissue by identifying hypokinetic regions on the contractility map.

7. The system of claim 1, wherein the tissue property analyzer comprises:

a parameter generator to produce a parameter based on the acceleration signals; and

a comparator including a signal input receiving the parameter, a threshold input receiving a predetermined threshold, and an output indicating a detection of infarcted tissue based on a comparison between the parameter and the threshold.

8. The system of claim 1, Therein the distal end of the catheter is configured for endocardial placement.

9. The system of claim 1, wherein the distal end of the catheter is configured for epicardial placement.

10. A method for localizing myocardial infarction (MI) in a heart having a cardiac wall, the method comprising:

placing a myocardial tissue property sensor in a myocardial region on the cardiac wall, the myocardial tissue property sensor including at least a portion configured to penetrate into tissue in the myocardial region and an accelerometer array including a plurality of accelerometers;

sensing a plurality of acceleration signals indicative of myocardial contractility from a plurality of myocardial locations in the myocardial region using the accelerometer array; and

detecting infarcted tissue on the cardiac wall based on the plurality of acceleration signals.

11. The method of claim 10, wherein detecting the infarcted tissue comprises producing a cardiac wall motion pattern for the myocardial region based on the plurality of acceleration signals.

12. The method of claim 10, wherein detecting the infarcted tissue further comprises:

producing a contractility map representing cardiac wall motion patterns for a plurality of myocardial regions; and

detecting the infarcted tissue based on the contractility map.

13. The method of claim 12, wherein detecting the infarcted tissue based on the contractility map comprises identifying dyskinetic or hypokinetic regions on the contractility map.

14. The method of claim 13, wherein detecting the infarcted tissue based on the contractility map comprises identifying one or more regions of the plurality of myocardial regions associated with cardiac wall displacements that are substantially smaller than cardiac wall displacements of other regions of the plurality of myocardial regions.

15. The method of claim 10, wherein placing the accelerometer array on the cardiac wall comprises introducing a catheter into a body having the heart, and the accelerometer array is incorporated into a distal end of the catheter.

16. A system for localizing myocardial infarction (MI), the system comprising:

a catheter including a distal end configured for myocardial placement;

a myocardial contractility sensor adapted to sense signals indicative of myocardial contractility from myocardial locations constituting a myocardial region and including at least a portion configured to penetrate into tissue in the myocardial region, the myocardial contractility sensor incorporated into the distal end of the catheter and adapted to be placed in a plurality of the myocardial regions, one at a time, over at least a portion of a cardiac wall, the myocardial contractility sensor configured to sense signals each indicative of the myocardial contractility for one of the plurality of myocardial locations in one of the plurality of myocardial regions;

a tissue property analyzer receiving the sensed signals, the tissue property analyzer including a tissue property mapping module adapted to produce a contractility map presenting a measure of the myocardial contractility over the at least the portion of the cardiac wall based on the sensed signals.

17. The system of claim 16, wherein the myocardial contractility sensor comprises a plurality of accelerometers.

18. The system of claim 17, wherein the distal end of the catheter is configured for endocardial placement.

19. The system of claim 17, wherein the distal end of the catheter is configured for epicardial placement.

20. The system of claim 17, wherein the tissue property analyzer further comprises a myocardial infarction detector to detect one or more infarcted regions based on the contractility map.