Impedance based anatomy generation

• US 9,113,809 B2
• Filed: 01/20/2012
• Issued: 08/25/2015
• Est. Priority Date: 05/08/2009
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Rhythmia Medical, Inc. (Boston Scientific Corporation)
• Inventors: Harlev, Doron, Csendes, Alpar, Badics, Zsolt
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US13/354,750
• Publication Number:
  US 20120130267A1
• Time in Patent Office: 1,313 Days
• Field of Search: 600/547, 600/549, 600/523, 600/529, 600/544
• US Class Current: 1/1
• CPC Class Codes: A61B 2562/04 Arrangements of multiple sensors of the same type
• CPC Class Codes: A61B 5/0044 for the heart
• CPC Class Codes: A61B 5/0536 Impedance imaging, e.g. by tomography
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/4869 Determining body composition
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart

Abstract

Methods and systems for the determination and representation of a chamber anatomy are disclosed herein.

Claims

1. A method comprising:

inserting a catheter into a heart, the catheter comprising three or more electrodes;

causing current to flow between at least some of the three or more electrodes and measuring an electrical signal, generated from the current flow, at each of one or more of the three or more electrodes;

determining a representation of a chamber anatomy structure of at least a portion of the heart based on the measured electrical signals; and

displaying at least a portion of the determined representation of the chamber anatomy structure with a first visual indicia indicative of areas having a distortion field and a confidence measure satisfying a threshold and a second visual indicia indicative of areas having a distortion field and a confidence measure that does not satisfy the threshold, the confidence measure being based at least in part on a proximity of the three or more electrodes on the catheter to a portion of the surface of the heart.

2. The method of claim 1, further comprising:

measuring cardiac signals at electrodes of the three or more electrodes in response to electrical activity in the heart;

determining physiological information based on the measured cardiac signals;

displaying the physiological information on the determined representation of the chamber anatomy structure in the areas having the distortion field and the confidence measure satisfying the threshold; and

prohibiting display of the physiological information on the determined representation of the chamber anatomy structure in the areas having the distortion field and the confidence measure that does not satisfy the threshold.

3. The method of claim 1, wherein displaying at least a portion of the determined representation of the chamber anatomy structure comprises displaying a mesh having a plurality of faces with faces of the mesh being opaque for the determined areas of the surface corresponding to the areas having the distortion field and the confidence measure satisfying the threshold and transparent, gray, or semi-transparent for other areas of the surface.

4. The method of claim 1, wherein displaying at least a portion of the determined representation of the chamber anatomy structure comprises displaying a mesh having a plurality of faces with faces of the mesh being opaque for the determined areas of the surface corresponding to the areas having the distortion field and the confidence measure satisfying the threshold and transparent, gray, or semi-transparent for the areas having the distortion field and the confidence measure that do not satisfy the threshold.

5. The method of claim 1, wherein displaying at least a portion of the determined representation of the chamber anatomy structure comprises displaying a mesh having a plurality of faces and applying the first visual indicia to faces of the mesh for the determined areas having the distortion field and the confidence measure satisfying the threshold and applying the second visual indicia to faces of the mesh for the areas of the surface not corresponding to the areas having the distortion field and the confidence measure that do not satisfy the threshold.

6. The method of claim 1, wherein the first and second visual indicias differentiate valid areas of the surface corresponding to the endocardial boundary from other areas of the surface.

7. The method of claim 1, further comprising:

measuring cardiac signals at electrodes of the three or more electrodes in response to electrical activity in the heart;

determining physiological information based on the measured cardiac signals; and

displaying at least some of the physiological information.

8. A method comprising:

inserting a catheter into a heart, the catheter comprising three or more electrodes;

for each of a plurality of catheter locations, causing current to flow between at least some of the three or more electrodes and measuring an electrical signal, generated from the current flow, at each of one or more of the three or more electrodes;

generating a representation of a chamber anatomy structure of at least a portion of the heart based on locations of the catheter and the electrical signal measurements, the generation being based at least in part on a data selection criteria associated with a proximity of the three or more electrodes on the catheter to a portion of the surface of the heart; and

displaying at least a portion of the determined representation of the chamber anatomy structure.

9. The method of claim 8, further comprising determining the proximity of the three or more electrodes on the catheter to a portion of the surface of the heart based at least in part on the measured electrical signals.

10. The method of claim 8, further comprising:

for each of the plurality of catheter locations, determining a local surface of at least a portion of the heart based on the measured electrical signals; and

determining valid and invalid areas of the local surface based on a determined distance between the catheter and the surface of the heart, the valid areas having determined distances between the catheter and the surface that are less than a threshold distance;

wherein determining the representation of the chamber anatomy structure comprises determining the representation of the chamber anatomy structure based on multiple ones of the valid areas of the local surfaces.

11. The method of claim 8, further comprising:

measuring cardiac signals at electrodes of the three or more electrodes in response to electrical activity in the heart;

determining physiological information based on the measured cardiac signals; and

displaying the physiological information.

12. The method of claim 11, wherein the determination of the representation of the chamber anatomy structure accounts for a change in conductivity at the cardiac chamber boundary.

13. The method of claim 12, wherein the determination of the representation of the chamber anatomy structure accounts for a first conductivity inside the cardiac chamber boundary and a second conductivity outside the cardiac chamber boundary.

14. The method of claim 8, wherein determining the representation of the chamber anatomy structure comprises determining the representation of the chamber anatomy structure based at least in part on impedance information generated based on the measured signals.

15. The method of claim 14, wherein the impedance information is based on a conductivity or permittivity contrast between blood and surrounding tissue.

16. The method of claim 14, wherein the impedance information comprises complex impedance information based on both a permittivity contrast and a conductivity contrast between blood and surrounding tissue.

17. The method of claim 8, wherein determining the representation of the chamber anatomy structure comprises, determining a closed and parameterized surface based on the measured signals, the surface representing a surface at which the conductivity value changes.

18. The method of claim 17, wherein the surface provides a boundary between a region represented by a first conductivity inside the surface and a region represented by a second conductivity outside the surface, the first conductivity being different from the second conductivity.

19. The method of claim 17, wherein determining the representation of the chamber anatomy structure further comprises, for each of the plurality of catheter locations determining a surface and selecting one or more regions of the surface corresponding to an expected boundary of the heart.

20. A system comprising:

a catheter comprising two or more electrodes configured to inject a current and to measure electrical signals from the injected current;

a processing unit configured to determine a representation of a chamber anatomy structure of at least a portion of the heart based on the measured electrical signals; and

a display unit configured to send a signal to a display device to cause the display device to display at least a portion of the determined representation of the chamber anatomy structure with a first visual indicia indicative of areas having a distortion field and confidence measure satisfying a threshold and a second visual indicia indicative of areas having a distortion field and confidence measure that does not satisfy the threshold, the confidence measure being based at least in part on a proximity of electrodes on the catheter to a portion of the surface of the heart.

21. The system of claim 20, wherein the processing unit is further configured to determine physiological information based on measured cardiac signals.

22. The system of claim 20, wherein the display unit is further configured to cause the display device to:

display physiological information on the determined representation of the chamber anatomy structure in the areas having the distortion field and confidence measure satisfying the threshold; and

prohibit display of the physiological information on the determined representation of the chamber anatomy structure in the areas having the distortion field and confidence measure that does not satisfy the threshold.

23. The system of claim 20, wherein the display unit is further configured to cause the display device to display a mesh having a plurality of faces with faces of the mesh being opaque for the determined areas of the surface corresponding to the areas having the distortion field and confidence measure satisfying the threshold and transparent, gray, or semi-transparent for other areas of the surface.

24. The system of claim 20, wherein the display unit is further configured to cause the display device to display a mesh having a plurality of faces with faces of the mesh being opaque for the determined areas of the surface corresponding to the areas having the distortion field and confidence measure satisfying the threshold and transparent, gray, or semi-transparent for the areas having the distortion field and confidence measure that does not satisfy the threshold.

25. The system of claim 20, wherein the display unit is further configured to cause the display device to display a mesh having a plurality of faces and applying the first visual indicia to faces of the mesh for the determined areas having the distortion field and confidence measure satisfying the threshold and applying the second visual indicia to faces of mesh for areas of the surface not corresponding to the areas having the distortion field and confidence measure that does not satisfy the threshold.

26. The system of claim 20, wherein the first and second visual indicias differentiate valid areas of the surface corresponding to the endocardial boundary from other areas of the surface.

27. A system comprising:

a catheter comprising two or more electrodes configured to inject a current and to measure electrical signals from the injected current;

a processing unit configured to determine a representation of a chamber anatomy structure of at least a portion of the heart based on locations of the catheter and the electrical signal measurements, the generation being based at least in part on a data selection criteria associated with differences between an electric field in the presence of an inhomogeneity and an homogeneous medium, and a proximity of the two or more electrodes on the catheter to a portion of the surface of the heart; and

a display unit configured to send a signal to cause a display device to display at least a portion of the determined representation of the chamber anatomy structure.

28. The system of claim 27, wherein the processing unit is further configured to determine the proximity of the two or more electrodes on the catheter to a portion of the surface of the heart based at least in part on electrical signal measurements.

29. The system of claim 27, wherein the processing unit is further configured to:

for each of the plurality of catheter locations, determine a local surface of at least a portion of the heart based on the measured electrical signals;

determine valid and invalid areas of the local surface based on a determined distance between the catheter and the surface of the heart, the valid areas having determined distances between the catheter and the surface that are less than a threshold distance; and

determine the representation of the chamber anatomy structure based on multiple ones of the valid areas of the local surfaces.

30. The system of claim 27, wherein the processing unit is further configured to:

determine physiological information based on measured cardiac signals; and

display the physiological information on the representation of the chamber anatomy structure.

31. The system of claim 27, wherein the processing unit is further configured to determine the representation of the chamber anatomy structure by accounting for a change in conductivity at the cardiac chamber boundary.

32. The system of claim 27, wherein the processing unit is further configured to determine the representation of the chamber anatomy structure by being based at least in part on impedance information generated based on the measured signals.

33. The system of claim 32, wherein the impedance information is based on a conductivity contrast or permittivity contrast between blood and surrounding tissue.

34. The system of claim 32, wherein the impedance information comprises complex impedance information based on both a permittivity contrast and a conductivity contrast between blood and surrounding tissue.