Multiple sensor input for structure identification

• US 9,131,872 B2
• Filed: 03/08/2012
• Issued: 09/15/2015
• Est. Priority Date: 04/18/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Markowitz, H. Toby, Receveur, Rogier, Michels, Koen, Eick, Olaf, Larik, Vincent
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): KIMBALL, JEREMIAH T
• Application Number:
  US13/415,335
• Publication Number:
  US 20120226110A1
• Time in Patent Office: 1,286 Days
• Field of Search: 600/523, 600/424
• US Class Current: 1/1
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• 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 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/063 using impedance measurements
• CPC Class Codes: A61B 5/066 : Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/304 : Switching circuits
• CPC Class Codes: A61B 5/333 : Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/339 : Displays specially adapted therefor
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 8/06 : Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/4472 : Wireless probes

Abstract

A volume of a patient can be mapped with a system operable to identify a plurality of locations and save a plurality of locations of a mapping instrument. The mapping instrument can include one or more electrodes that can sense a voltage that can be correlated to a three dimensional location of the electrode at the time of the sensing or measurement. Therefore, a map of a volume can be determined based upon the sensing of the plurality of points without the use of other imaging devices. An implantable medical device can then be navigated relative to the mapping data.

Claims

1. A method for determining a location in an anatomical structure of a patient with an instrument having a position element and a temperature sensor, comprising:

determining a plurality of position data points with the position element when the instrument is within the anatomical structure based upon moving the position element to a plurality of positions within the anatomical structure;

sensing a temperature within the anatomical structure with the temperature sensor connected to the instrument rat the determination of the plurality of position data points;

forming a map of the anatomical structure with map based on the position data points determined with the plurality of position data points;

illustrating the formed map with a plurality of map data points with a display device, wherein at least two of the map data points of the plurality of map data points differ based on a difference of the sensed temperature at each respective position data point;

displaying a substantially pristine virtual filled volume superimposed on the illustrated formed map;

generating a disturbed surface of the displayed substantially pristine filled volume including removing a portion of a surface of the substantially pristine filled volume;

determining a location of an identifiable anatomical structure within the anatomical structure based on the map data points and the sensed temperature related to the map data points.

2. The method of claim 1, further comprising:

selecting a first color and a second color to illustrate the difference in the sensed temperature;

wherein the first color is selected for a first value of the sensed temperature and the second color is selected for a second value of the sensed temperature;

wherein the map data points are illustrated in the first color and the second color.

3. The method of claim 2, wherein selecting a first color and a second color includes selecting a plurality of colors;

wherein when the illustrated map data points differ based on the sensed temperature a selected number of the plurality of colors are displayed to illustrate a change in temperature relative to each of the map data points.

4. The method of claim 3, wherein the anatomical structure is a heart of the patient;

and

determining a location of the identifiable anatomical feature includes determining a location of a coronary sinus ostium in the heart based on the difference in the sensed temperature of blood in the heart.

5. The method of claim 4, wherein determining the position of the position element includes detecting a plurality of voltage gradients produced by a plurality of currents generated within the patient.

6. The method of claim 5, wherein the plurality of currents are generated along x-, y-, and z-axes of the patient and evaluation of each gradient detected by the position element determines the position.

7. The method of claim 6, wherein determining the position of the position element includes, with a processor, calculating an impedance based on a voltage measured by the position element and the currents generated within the patient and difference in the sensed temperature of blood in the heart is used by the processor to determining the location of the identifiable anatomical structure.

8. The method of claim 1, wherein illustrating the data points as a map with a display device includes selecting a different blink rate based on a threshold temperature.

9. A method for determining a location in a heart of a patient with a system including a processor, a display, and an instrument having a position element and a temperature sensor, comprising:

determining a position of the position element when the instrument is within the heart;

sensing a temperature at the determined position within the heart with the temperature sensor;

forming a map of the heart with data points obtained by determining the position of the position element without additional image data, where each data point relates to the determined position of the position element and the sensed temperature at the position, wherein the data points are displayed using at least a first color based on a first value of the sensed temperature and a second color different than the first color based on a second value different than the first value of the sensed temperature;

displaying a substantially pristine virtual filled volume superimposed on the formed map;

generating a disturbed surface of the displayed substantially pristine filled volume including removing a portion of a surface of the substantially pristine filled volume; and

determining a location of an anatomical structure within the heart automatically using the processor based on the formed map with the data points that include the determined position and the related sensed temperature, including determining the data points that are higher in temperature than a selected threshold temperature than at least one other data point.

10. The method of claim 9, wherein the first value is warmer than the second value by the selected threshold, and the selected threshold is at least 0.1 degrees.

11. The method of claim 10, wherein determining the location of the anatomical structure includes:

illustrating the formed map;

determining a region of the illustrated map with a warmer condition by at least the threshold; and

identifying the determined region as a coronary sinus ostium of the heart.

12. The method of claim 11, further comprising:

operating a processor to execute instruction to at least form the map including illustrating data points differently based on the first value and the second value.

13. The method of claim 11, wherein the additional image data is selected from at least one of fluoroscopic image data, magnetic resonance imaging (MRI) System image data, computed tomography (CT) Imaging System image data, three-dimensional echo image data, ultrasound (2D, 3D, or 4D) image data, or other imaging systems image data.

14. The method of claim 9, wherein the difference between the first value and the second value is illustrated by data points having a different blink rate.

15. A mapping system for determining a location in an anatomical structure of a patient, comprising:

an instrument configured for insertion into and movement within the anatomical structure of a patient;

a position sensing element disposed on the instrument operable to sense an electrical property within the structure for forming a map without additional image data;

a temperature sensing device including a temperature sensor on the instrument, the temperature sensing device operable to detect a temperature within the structure near a position; and

a processor operable to form a map of the structure by executing instructions for;

determining a plurality of positions based on sensed electrical properties with the positioning element, within the structure determining a temperature value for at least a sub-plurality of the plurality of positions, forming a map based on the determined plurality of positions and the sensed temperature relating to at least the sub-plurality of data points, and automatically determining a location of an anatomical structure within a heart of the patient based at least on the sensed temperatures for at least the sub-plurality of the plurality of positions having a temperature above a threshold difference; and

a display device operable to display the map including the temperature value of the sub-plurality of data points;

wherein the sub-plurality of data points includes a first sub-plurality of data points and a second sub-plurality of data points that are displayed differently on the display device based on differing temperatures; and

the display device is operable to display a substantially pristine virtual filled volume superimposed on the formed map;

wherein the display device is further operable to display a processor-generated, disturbed surface of the displayed substantially pristine filled volume including removing a portion of a surface of the substantially pristine filled volume.

16. The system of claim 15, wherein the position element is operable to detect a voltage produced by a plurality of currents injected along x-, y-, and z-axes within the patient.

17. The system of claim 16, wherein the processor is operable to calculate an impedance based on a voltage measured by the position element and the current injected within the patient.

18. The system of claim 16, wherein the plurality of positions of the map include data points generated only based on the sensed voltage within the patient.

19. The system of claim 18, wherein the instrument is operable to be positioned in a heart of the patient;

wherein the sensed temperature is a temperature of blood in the heart of the patient;

wherein each of the sub-plurality of data points is associated with the sensed temperature.

20. The system of claim 19, wherein the anatomical structure is a coronary sinus ostium.