Robotic surgical system and method for diagnostic data mapping

• US 9,204,935 B2
• Filed: 06/17/2014
• Issued: 12/08/2015
• Est. Priority Date: 05/28/2004
• 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: Hauck, John A., Schweitzer, Jeffrey A., Belhe, Kedar Ravindra
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Morales, Jon Eric C
• Application Number:
  US14/306,972
• Publication Number:
  US 20140371576A1
• Time in Patent Office: 539 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• 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 2034/2072 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 2034/303 specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter
• 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 34/30 Surgical robots
• CPC Class Codes: A61B 34/71 Manipulators operated by drive cable mechanisms
• 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 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/6885 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/7425 Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B

Abstract

A method of generating a diagnosis map of at least a portion of the heart includes inserting an electrode within the portion of a heart, robotically moving the electrode therein, measuring electrophysiology information at a point on the surface of the heart, associating the measured electrophysiology information with position information for the point on the surface of the heart, repeating the measuring and associating steps for a plurality of points on the surface of the heart, thereby generating a plurality of surface diagnostic data points, and generating the diagnosis map therefrom. The electrode may be moved within the heart randomly, pseudo-randomly, or according to one or more predetermined patterns. A three-dimensional model of the portion of the heart may be provided and presented as a graphical representation, either with or without information indicative of the measured electrophysiology information superimposed thereon.

Claims

1. A method of generating a diagnosis map of at least a portion of a heart, comprising the steps of:

inserting an electrode within a portion of a heart;

robotically moving the electrode within the portion of the heart;

detecting position information of the electrode, thereby generating a plurality of location points that define a space occupied by the portion of the heart, the plurality of location points including both location points interior to a surface of the heart and location points on the surface of the heart;

measuring electrophysiology information from the surface of the heart as the electrode is robotically moved within the portion of the heart;

distinguishing the location points interior to a surface of the portion of the heart from the location points on the surface of the portion of the heart;

associating the measured electrophysiology information from the surface of the heart with the location point on the surface of the heart at which the measurement was made as a surface diagnostic data point;

storing the surface diagnostic data point; and

generating a three-dimensional model of the portion of the heart comprising a plurality of surface diagnostic data points.

2. The method of claim 1, further comprising:

presenting a graphical representation of the three-dimensional model of the portion of the heart;

receiving input that identifies one or more target locations on the graphical representation of the three-dimensional model of the portion of the heart; and

robotically moving the electrode to each of the identified target locations.

3. The method of claim 2, further comprising presenting the graphical representation of the three-dimensional model of the portion of the heart with information indicative of the measured electrophysiology information superimposed thereon.

4. The method of claim 2, further comprising treating tissue at each of the identified target locations.

5. The method of claim 4, wherein treating tissue at each of the identified target locations comprises ablating tissue at each of the identified target locations.

6. The method of claim 1, further comprising:

presenting a graphical representation of the three-dimensional model of the portion of the heart;

processing the plurality of surface diagnostic data points to identify one or more surface diagnostic data points that are potential treatment sites; and

flagging the one or more identified potential treatment sites on the graphical representation of the three-dimensional model of the portion of the heart.

7. The method of claim 6, further comprising:

receiving input that selects one or more of the identified potential treatment sites on the graphical representation of the three-dimensional model of the portion of the heart; and

robotically moving the electrode to at least one selected treatment site.

8. The method according to claim 7, further comprising treating tissue at the at least one selected treatment site.

9. The method according to claim 8, wherein treating tissue at the at least one selected treatment site comprises ablating tissue at the at least one selected treatment site.

10. A system for generating a diagnosis map of at least a portion of a heart, comprising:

a catheter for insertion into an interior region of the heart;

a robotic controller operable to move the catheter within the interior region of the heart;

a positional feedback system operable to detect position information of the catheter as the robotic controller moves the catheter within the interior region of the heart, thereby generating a plurality of location points that define a space occupied by the portion of the heart; and

a modeling processor programmed to distinguish those location points that are interior to a surface of the portion of the heart from those location points that are on the surface of the portion of the heart and to define a three-dimensional surface model of the portion of the heart from those location points that are on the surface of the portion of the heart.

11. The system of claim 10, wherein the catheter further comprises a sensor to measure electrophysiological information for at least some of the location points that are on the surface of the portion of the heart, and wherein the modeling processor is further programmed to associate measured electrophysiological information with the location point on the surface of the portion of the heart at which the measurement was made, thereby generating a plurality of surface diagnostic data points.

12. The system of claim 11, further comprising a storage medium for storing the plurality of surface diagnostic data points, and wherein the modeling processor is further programmed to store the plurality of surface diagnostic data points in the storage medium.

13. The system of claim 11, further comprising:

a display device for presenting a graphical representation of the three-dimensional surface model of the portion of the heart; and

an electrophysiology processor programmed to process the measured electrophysiological information to identify one or more surface diagnostic data points that are potential treatment sites and to graphically flag the one or more identified potential treatment sites on the graphical representation of the three-dimensional surface model of the portion of the heart.

14. The system of claim 11, further comprising:

a display device for presenting a graphical representation of the three-dimensional surface model of the portion of the heart; and

a user interface operable to permit a user to select one or more locations on the graphical representation of the three-dimensional surface model of the portion of the heart as one or more target locations, the user interface being coupled to the robotic controller such that the robotic controller operates to cause the catheter to be relocated to the one or more target locations.