System and method for presenting information representative of lesion formation in tissue during an ablation procedure

• US 9,204,927 B2
• Filed: 12/10/2010
• Issued: 12/08/2015
• Est. Priority Date: 05/13/2009
• Status: Active Grant

• Current Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Original Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Inventors: Afonso, Valtino X., Dragnev, Lubomir V., Shai, Yitzhak I., Paul, Saurav, Cumming, Sarah E.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): FOWLER, DANIEL WAYNE
• Application Number:
  US12/964,910
• Publication Number:
  US 20120029504A1
• Time in Patent Office: 1,824 Days
• Field of Search: 606/27, 606/34, 606/41
• US Class Current: 1/1
• CPC Class Codes: A61B 18/1233 with circuits for assuring patient safety
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00714 Temperature
• CPC Class Codes: A61B 2018/00738 Depth, e.g. depth of ablation
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00892 Voltage
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/0262 using a circulating cryogenic fluid
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• CPC Class Codes: A61B 2034/2046 : Tracking techniques
• CPC Class Codes: A61B 2034/2051 : Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 : Reference field transducer attached to an instrument or patient
• 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 2090/065 : for measuring contact or contact pressure
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 34/25 : User interfaces for surgical systems
• CPC Class Codes: A61B 5/283 : Invasive
• CPC Class Codes: A61B 5/318 : Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/367 : Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
• CPC Class Codes: A61B 5/7203 : for noise prevention, reduction or removal
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

A method and system for presenting information representative of lesion formation is provided. The system comprises an electronic control unit (ECU). The ECU is configured to acquire a value for an ablation description parameter and/or a position signal metric, wherein the value corresponds to a location in the tissue. The ECU is further configured to evaluate the value, assign it a visual indicator of a visualization scheme associated with the parameter/metric corresponding to the value, and generate a marker comprising the visual indicator such that the marker is indicative of the acquired value. The method comprises acquiring a value for the parameter/metric, and evaluating the value. The method further includes assigning a visual indicator of a visualization scheme associated with the parameter/metric corresponding to the value, and generating a marker comprising the visual indicator.

Claims

1. A system for presenting information representative of lesion formation in tissue during an ablation procedure, comprising:

an electronic control unit (ECU) configured to;

acquire a value for at least one of an ablation description parameter and a position signal metric, the value corresponding to a location in said tissue;

evaluate said value;

assign a visual indicator of a visualization scheme associated with said at least one of said ablation description parameter and said position signal metric to said value in response to the evaluation of said value;

generate a marker responsive to the evaluation of said value and assignment of said visual indicator, said marker comprising said visual indicator such that said marker is indicative of said value of said at least one of said ablation description parameter and said position signal metric;

determine said location in said tissue based on a position of a positioning sensor;

correlate said value of said at least one of said ablation description parameter and said position signal metric with said location in said tissue;

superimpose said marker onto a portion of an image or model of said tissue corresponding to said location in said tissue;

control a display device to display said image or model with said marker superimposed thereon;

determine if any preexisting markers are disposed within a predetermined distance of said location; and

generate a marker that combines said generated marker for said location with said preexisting markers disposed within said predetermined distance.

2. The system of claim 1, wherein said position signal metric is representative of the stability of said positioning sensor.

3. The system of claim 1, further comprising a user input device electrically coupled to said ECU, said user input device configured to allow a user to select said at least one of said ablation description parameter and said position signal metric from a plurality of ablation description parameters and at least one position signal metric, and to select said visualization scheme from a plurality of visualization schemes.

4. The system of claim 1, wherein said ECU is further configured to:

assess the stability of said positioning electrode based on predetermined stability criteria; and

control said display device to superimpose said marker responsive to a determination by said ECU that said positioning electrode meets said predetermined stability criteria.

5. The system of claim 1, wherein said ECU is further configured to:

assess the stability of said positioning electrode based on predetermined stability criteria; and

acquire said value of said at least one ablation description parameter and said position signal metric responsive to a determination by said ECU that said positioning electrode meets said predetermined stability criteria.

6. The system of claim 1, wherein said generated marker comprises a visual indicator corresponding to areas of overlap between each of said generated marker for said location and said preexisting markers, wherein said visual indicator corresponding to overlapping areas is different than that of non-overlapping areas.

7. The system of claim 1, wherein said ECU is further configured to:

monitor a cyclic body activity;

associate said position of said positioning sensor corresponding to said location and said acquired value of said at least one ablation description parameter and position signal metric corresponding to said location with a respective phase of said cyclic body activity; and

control said display device to display said image or model with said marker superimposed thereon during said phase of said cyclic body activity.

8. The system of claim 1, wherein said value is a value of a first ablation description parameter or position signal metric, said ECU further configured to:

acquire a value for a second ablation description parameter or position signal metric that is different from said first ablation description parameter or position signal metric;

evaluate said value of said second ablation description parameter or position signal metric;

assign said visual indicator based on a combination of said values of said first ablation description parameter or position signal metric and said second ablation description parameter or position signal metric; and

generate said marker responsive to the evaluation of said values of said first ablation description parameter or position signal metric and said second ablation description parameter or position signal metric.

9. The system of claim 1, wherein said value is a value of a first ablation description parameter or position signal metric, said ECU further configured to:

acquire a value for a second ablation description parameter or position signal metric that is different from said first ablation description parameter or position signal metric;

evaluate said value of said second ablation description parameter or position signal metric;

assign a visual indicator corresponding to said second ablation description parameter or position signal metric to said value in response to the evaluation of said value; and

generate said marker responsive to the evaluation of said values of said first ablation description parameter or position signal metric and said second ablation description parameter or position signal metric, said marker comprising said visual indicators of said values of said first ablation description parameter or position signal metric and said second ablation description parameter or position signal metric.

10. The system of claim 1, wherein said value is a value of an ablation description parameter and said visual indicator is a first visual indicator associated with a first visualization scheme, said ECU further configured to:

acquire a value for a position signal metric;

evaluate said value of said position signal metric;

assign a second visual indicator associated with a second visualization scheme that is different from said first visualization scheme to said value of said position signal metric in response to the evaluation of said value of said position signal metric; and

generate said marker responsive to the evaluation of said values of said ablation description parameter and said position signal metric, said marker comprising said first and second visual indicators such that said marker is indicative of said values of said ablation description parameter and said position signal metric.

11. The system of claim 1, wherein said ablation description parameter comprises a parameter of at least one of:

the power delivered to said tissue during said ablation procedure;

a temperature at an ablation electrode used in said ablation procedure;

an impedance of said tissue;

a detected voltage amplitude;

a degree of contact between a medical device and said tissue;

a proximity of a medical device and said tissue;

an index representative of lesion formation in said tissue;

a likelihood of barotrauma occurring in said tissue;

a predicted lesion depth;

a likelihood of a lesion achieving a predetermined depth;

a predicted temperature of said tissue; and

an intracardiac echocardiograph characteristic.

12. The system of claim 1, wherein said position signal metric comprises one of:

a value of a displacement between two positions of a positioning sensor over a predetermined period of time;

a percentage of displacements between a plurality of positions of a positioning sensor over a predetermined period of time that are within a predetermined radius; and

a stability index.

13. The system of claim 1, wherein said ablation description parameter comprises a parameter of a characteristic monitored by a visualization, navigation, and/or mapping system.

14. The system of claim 13, wherein said characteristic comprises an electrogram.

15. A method for presenting information representative of lesion formation in tissue during an ablation procedure, comprising the steps of:

acquiring a value for at least one of an ablation description parameter and a position signal metric, said value corresponding to a location in said tissue;

evaluating said value;

assigning a visual indicator of a visualization scheme associated with said at least one of said ablation description parameter and said position signal metric to said value;

generating a marker responsive to said evaluation of said value and assignment of said visual indicator, said marker comprising said visual indicator such that said marker is indicative of said value of said at least one of said ablation description parameter and said position signal metric;

determining said location in said tissue based on a position of a positioning sensor;

correlating said value of said at least one of said ablation description parameter and said position signal metric with said location in said tissue;

superimposing said marker onto a portion of an image or model of said tissue corresponding to said location in said tissue;

displaying said image or model with said marker superimposed thereon;

determining if any preexisting markers are disposed within a predetermined distance of said location; and

generating a marker that combines said generated marker for said location with said preexisting markers disposed within said predetermined distance.

16. The method of claim 15, wherein said value is a first value, said method further comprising:

acquiring a second value of said at least one of said ablation description parameter and said position signal metric;

evaluating said second value;

wherein the step of assigning said visual indicator comprises assigning said visual indicator of said visualization scheme base on said first and second values.

17. The method of claim 15, further comprising the step of receiving at least one input signal representative of a user selection of at least one of said visualization scheme and said at least one of said ablation description parameter and position signal metric.

18. The method of claim 17, wherein said at least one input signal is representative of a user selection of a visualization scheme, said method further comprises the step of associating, in response to said at least one input signal, said visualization scheme with said at least one of said ablation description parameter and position signal metric corresponding to said acquired value.

19. The method of claim 15, said method further comprising the step of:

assessing the stability of said positioning sensor based on predetermined stability criteria, and wherein said superimposing step comprises superimposing said marker when said positioning sensor meets said predetermined stability criteria.

20. The method of claim 15, said method further comprising the step of:

assessing the stability of said positioning sensor based on predetermined stability criteria, and wherein said acquiring step comprises acquiring said value when said positioning sensor meets said predetermined stability criteria.

21. A system for presenting information representative of lesion formation in tissue during an ablation procedure, comprising:

an electronic control unit (ECU) configured to;

acquire a position of a positioning sensor associated with a medical device;

determine a location in said tissue corresponding to said position of said positioning sensor;

assess the stability of said positioning sensor based on said position of said positioning sensor and predetermined stability criteria;

acquire a marker indicative of a value of at least one of an ablation description parameter corresponding to said location in said tissue, and a position signal metric corresponding to said location in said tissue and derived from said position of said positioning sensor; and

superimpose said marker onto a portion of an image or model of said tissue corresponding to said location in said tissue only after said positioning sensor meets said predetermined stability criteria.

22. The system of claim 21, wherein said value is a value of an ablation description parameter, said ECU further configured to:

acquire a value for a position signal metric;

evaluate said value of said position signal metric; and

generate said marker responsive to the evaluation of said values of said ablation description parameter and said position signal metric such that said marker is indicative of said values of said ablation description parameter and said position signal metric.

23. The system of claim 22, said marker comprising:

a first visual indicator associated with a first visualization scheme and indicative of said value of an ablation description parameter; and

a second visual indicator associated with a second visualization scheme and indicative of said value of a position signal metric.

24. A method of presenting information representative of lesion formation in tissue during an ablation procedure, comprising:

acquiring a position of a positioning sensor associated with a medical device;

determining a location in said tissue corresponding to said position of said positioning sensor;

assessing the stability of said positioning sensor based on said position of said positioning sensor and predetermined stability criteria;

acquiring a marker indicative of a value of at least one of an ablation description parameter corresponding to said location in said tissue, and a position signal metric corresponding to said location in said tissue and derived from said position of said positioning sensor; and

superimposing said marker onto a portion of an image or model of said tissue corresponding to said location in said tissue only after said positioning sensor meets said predetermined stability criteria.

25. The method of claim 24, wherein said value is a value of an ablation description parameter, the method further comprising:

acquiring a value for a position signal metric;

evaluating said value of said position signal metric; and

generating said marker responsive to the evaluation of said values of said ablation description parameter and said position signal metric such that said marker is indicative of said values of said ablation description parameter and said position signal metric.

26. The method of claim 25, said marker comprising:

a first visual indicator associated with a first visualization scheme and indicative of said value of an ablation description parameter; and

a second visual indicator associated with a second visualization scheme and indicative of said value of a position signal metric.