Systems and methods for determining the likelihood of endocardial barotrauma in tissue during ablation

• US 9,095,349 B2
• Filed: 12/10/2010
• Issued: 08/04/2015
• Est. Priority Date: 12/11/2009
• Status: Active Grant

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Inventors: Fish, Jeffrey M., Byrd, Israel A., Dando, Jeremy D., Geurkink, Christopher J., Lathia, Rohan, Puryear, Harry A., Afonso, Valtino X., Paul, Saurav, Gilmour, Lynn
• Primary Examiner(s): DELLA, JAYMI E
• Application Number:
  US12/964,956
• Publication Number:
  US 20110144657A1
• Time in Patent Office: 1,698 Days
• Field of Search: 606 34- 38
• US Class Current: 1/1
• 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 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2053 Tracking an applied voltage gradient
• CPC Class Codes: A61B 2034/301 for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2090/372 Details of monitor hardware
• CPC Class Codes: A61B 5/036 by means introduced into body tracts A61B5/032 and A61B5/035 take precedence
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter

Abstract

A method and system for determining a likelihood of barotrauma occurring in tissue during formation of a lesion therein is provided. The system includes an electronic control unit (ECU). The ECU is configured to acquire at least one value of at least one component of a complex impedance between an electrode and the tissue. The ECU is configured to calculate an index responsive to the at least one value of the at least one complex impedance component. The index is indicative of a likelihood of barotrauma occurring in the tissue. The method comprises acquiring at least one value of at least one component of a complex impedance between an electrode and the tissue. The method comprises calculating an index responsive to the at least one value of the at least one complex impedance component. The calculated index is indicative of a likelihood of barotrauma occurring in the tissue.

Claims

1. A system for determining a likelihood of barotrauma occurring in a tissue during formation of a lesion in said tissue as a result of an ablation procedure being performed thereon, comprising:

an electronic control unit (ECU) configured to;

acquire at least one value for at least one component of a complex impedance between an electrode and said tissue; and

calculate an index responsive to said at least one value for at least one component of said complex impedance, said index indicative of said likelihood of barotrauma occurring in said tissue;

wherein said ECU is further configured to assess stability of said electrode based on predetermined stability criteria, and said calculated index is responsive to a determination by said ECU that said electrode meets said predetermined stability criteria.

2. The system of claim 1, wherein said electronic control unit is further configured to:

acquire a value for power applied to said tissue during the formation of said lesion in said tissue; and

said calculated index is responsive to said at least one value for at least one component of said complex impedance further using said value for power.

3. The system of claim 1, wherein said electronic control unit is configured to acquire values for first and second components of said complex impedance, said value for said first component of said complex impedance comprising said at least one value for at least one component of said complex impedance, and said calculated index is responsive to said at least one value for at least one component of said complex impedance further using said value for said second component of said complex impedance.

4. The system of claim 3, wherein said first and second complex impedance components collectively comprise two members of the group including the following members:

a resistance between said electrode and said tissue, a reactance between said electrode and said tissue, a phase angle between said electrode and said tissue, and an impedance magnitude between said electrode and said tissue.

5. The system of claim 1, wherein said electrode comprises an ablation electrode on a radio-frequency ablation catheter.

6. The system of claim 1, wherein said electronic control unit is further configured to output said index to a display device.

7. The system of claim 1, wherein said electronic control unit is further configured to evaluate said index to determine said likelihood of barotrauma occurring in said tissue.

8. The system of claim 7, wherein said electronic control unit is further configured to:

generate a signal representative of an indicator corresponding to said determined likelihood of barotrauma occurring in said tissue; and

output said signal to a display device.

9. The system of claim 1, wherein said at least one component of said complex impedance is reactance, and said electronic control unit is configured to calculate one of a change in said reactance between a first reactance value and a second reactance value, and a slope of a line between said first reactance value and said second reactance value, wherein said one of said change in reactance and said slope comprises said index.

10. An article of manufacture, comprising:

a non-transitory computer-readable storage medium encoded with instructions;

determining a likelihood of barotrauma occurring in a tissue during formation of a lesion in said tissue as a result of an ablation procedure being performed thereon;

calculating an index responsive to at least one value of at least one component of a complex impedance between said tissue and an electrode;

assessing stability of said electrode based on predetermined stability criteria; and

said calculated index is responsive to a determination that said electrode meets said predetermined stability criteria.

11. The article of manufacture of claim 10, wherein said instructions encoded on said non-transitory computer-readable storage medium include code for evaluating said index to determine said likelihood of barotrauma occurring in said tissue.

12. The article of manufacture of claim 11, wherein said instructions encoded on said non-transitory computer-readable storage medium include code for:

generating a signal representative of an indicator corresponding to said determined likelihood of barotrauma; and

outputting said signal to a display device.

13. The article of manufacture of claim 10, wherein said at least one component of said complex impedance comprises reactance between said tissue and said electrode, said instructions on said non-transitory computer-readable storage medium including code for calculating said index by calculating at least one of a change in said reactance between a first reactance value and a second reactance value, and a slope of a line between said first reactance value and said second reactance value.

14. A method for determining a likelihood of barotrauma occurring in a tissue during formation of a lesion in said tissue as a result of an ablation procedure being performed thereon, comprising the steps of:

acquiring at least one value for at least one component of a complex impedance between an electrode and said tissue using an electronic control unit (ECU); and

calculating an index using said ECU, responsive to said at least one value for at least one component of said complex impedance, said index indicative of said likelihood of barotrauma occurring in said tissue;

wherein said ECU is further configured to assess stability of said electrode based on predetermined stability criteria, and said calculated index is responsive to a determination by said ECU that said electrode meets said predetermined stability criteria.

15. The method of claim 14 further comprising the step of acquiring a value for the power applied to said tissue during the formation of said lesion in said tissue, and said calculating step comprising calculating said index responsive to said at least one value for at least one component of said complex impedance and said value of said power.

16. The method of claim 14, wherein said step of acquiring at least one value for at least one component of said complex impedance comprises acquiring values for first and second components of said complex impedance, said value for said first component of said complex impedance comprising said at least one value for at least one component of said complex impedance.

17. The method of claim 14 further comprising the step of evaluating said index to determine said likelihood of barotrauma occurring in said tissue.

18. The method of claim 17 further comprising the steps of:

generating a signal representative of said determined likelihood of barotrauma occurring in said tissue; and

outputting said signal to a display device.

19. The method of claim 14, wherein said at least one value for at least one component of said complex impedance is reactance between said electrode and said tissue, and further wherein:

said acquiring step comprising the substeps of;

acquiring a first reactance value corresponding to a first point in time; and

acquiring a second reactance value corresponding to a second point in time subsequent to said first point in time; and

said calculating said index comprises one of;

calculating a change in reactance value between said first and second reactance values by subtracting said first reactance value from said second reactance value, said change in reactance comprising said index; and

calculating a slope of a line between said first and second reactance values by subtracting said first reactance value from said second reactance value, subtracting said first point in time from said second time, and dividing said change in reactance by a change in time between said first and second points in time, said slope comprising said index.

20. An automated guidance system, comprising:

a catheter manipulator assembly;

a catheter associated with said catheter manipulator assembly, said catheter including an electrode associated therewith configured to deliver radiofrequency (RF) power to a tissue in a body; and

a controller configured to control at least one of movement of the catheter and delivery of said RF power to said tissue by said electrode in response to an index calculated from at least one value of at least one component of a complex impedance between said electrode and said tissue;

wherein said controller is configured to control at least one of the movement of the catheter and the delivery of said RF power to said tissue by said electrode in response to said index calculated from said at least one value of said at least one component of said complex impedance, and a value of said RF power applied to said tissue during formation of a lesion in said tissue.

21. The system of claim 20 wherein said catheter manipulator assembly is a robotic catheter manipulator assembly including a robotic catheter device cartridge.

22. The system of claim 20 wherein said catheter further comprises a magnetic element, and said automated catheter manipulator assembly comprises a magnetic field generator configured to generate a magnetic field to control movement of said magnetic element.

23. A system for determining a likelihood of barotrauma occurring in a tissue during formation of a lesion in said tissue as a result of an ablation procedure being performed thereon, comprising:

an electronic control unit (ECU) configured to;

acquire at least one value for at least one component of a complex impedance between an electrode and said tissue; and

calculate an index responsive to said at least one value for at least one component of said complex impedance, said index indicative of said likelihood of barotrauma occurring in said tissue;

wherein said ECU is further configured to acquire a value for power applied to said tissue during the formation of said lesion in said tissue; and

said calculated index is responsive to said at least one value for at least one component of said complex impedance further using said value for power.