Multiple shell construction to emulate chamber contraction with a mapping system

• US 9,307,931 B2
• Filed: 12/31/2008
• Issued: 04/12/2016
• Est. Priority Date: 12/31/2008
• Status: Active Grant

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Inventors: Byrd, Israel A., Just, Dale
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): Hankins, Lindsey G
• Application Number:
  US12/347,216
• Publication Number:
  US 20100168550A1
• Time in Patent Office: 2,659 Days
• Field of Search: 607/407, 607/508
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• 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 5/063 using impedance measurements
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/30 Input circuits therefor
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/6885 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/7289 Retrospective gating, i.e. associating measured signals or images with a physiological event after the actual measurement or image acquisition, e.g. by simultaneously recording an additional physiological signal during the measurement or image acquisition

Abstract

A system for constructing multiple shells (electronic models) indicative of the geometry and/or volume of a bodily lumen, such as a heart chamber, is configured to collect a plurality of location data points as the electrode is swept within the chamber. Each of the collected data points has an associated measured cardiac phase at which such point was acquired. The system is configured to segregate the collected electrode locations into sets based on the phase. Each set is characterized by a particular, associated phase of its constituent electrode locations. The system is configured to generate, for each set, a respective shell that will represent the chamber at the associated phase. The shells, once constructed, may be used for or in connection with a variety of diagnostic, mapping, and/or therapeutic procedures. The system is also configured to verify that the electrode is in contact with the heart tissue before using the collected data point in the shell construction (e.g., using a phase angle parameter to verify contact).

Claims

1. A method of processing information, comprising the steps of:

collecting, for at least one sensor, a plurality of sensor locations as the at least one sensor is swept within a heart chamber of a patient;

segregating, using a computer processing apparatus, the collected sensor locations into a plurality of sets in accordance with a respective phase of a cardiac cycle during or at which each sensor location was collected, each set having associated therewith a predetermined phase of the cardiac cycle; and

generating, for each set, a respective geometry of the heart chamber at the associated phase of the cardiac cycle, wherein a first geometry of the plurality of geometries is generated exclusively from a first set of said plurality of sets and a second geometry of the plurality of geometries is generated exclusively from a second set of said plurality of sets, said second set being different from said first set such that sensor locations in said first set are distinct from sensor locations in said second set, the sensor locations in said first set being associated with a first phase of the cardiac cycle during or at which said sensor locations in said first set were collected and the sensor locations in said second set being associated with a second phase of the cardiac cycle during or at which said sensor locations in said second set were collected, wherein said first phase is different from said second phase, and wherein said first phase comprises a first range of phase values and said second phase comprises a second range of phase values different from and non-overlapping with respect to said first range of phase values such that sensor locations in said first set are distinct from sensor locations in said second set by virtue of at least the phase of the cardiac cycle during or at which respective sensor locations were collected.

2. The method of claim 1 further including the step of:

determining if the sensor is in contact with tissue of the heart chamber.

3. The method of claim 2 further comprising the step of forming the sensor by providing a coil configured to detect a magnetic field.

4. The method of claim 3 wherein said forming step further includes the sub-step of providing a catheter with a distal tip electrode wherein the sensor magnetic coil and the distal tip electrode have a geometrical relationship therebetween, and wherein said generating step includes the substep of computing, for at least one of the sets containing phase-associated sensor locations, a plurality of distal tip locations using the sensor locations in accordance with the geometrical relationship.

5. The method of claim 2 further comprising the step of forming the sensor by providing an electrode.

6. The method of claim 5 wherein said determining tissue contact step includes the substeps of:

supplying an excitation signal to the electrode;

measuring a complex impedance of the tissue proximate the electrode; and

determining when the electrode is in contact with the tissue when a component of the measured complex impedance meets predetermined criteria.

7. The method of claim 6 wherein said step of measuring the complex impedance includes the sub-step of sensing an induced signal produced in response to the excitation signal between the electrode and a patch affixed to the patient.

8. The method of claim 7 wherein the sub-step of sensing the induced signal includes measuring the induced signal between the electrode and a patch affixed to the patient.

9. The method of claim 5 wherein said generating step includes the substeps of:

qualifying locations that have been determined to have been collected when the electrode was in contact with tissue of the heart chamber; and

constructing the respective geometries using qualified electrode locations.

10. The method of claim 1 further including the step of:

displaying the plurality of geometries in accordance with a measured phase of the patient'"'"'s cardiac cycle.

11. The method of claim 10 further including the steps of:

acquiring electrophysiologic (EP) data associated with the heart chamber; and

mapping the acquired EP data on the plurality of geometries.

12. The method of claim 11 wherein said EP data comprises electrical activation potential values corresponding to physiological electrical activity.

13. The method of claim 12 wherein the step of acquiring EP data includes the sub-step of acquiring an EP data point at the first phase of the cardiac cycle, and wherein said mapping step includes the sub-step of associating the acquired EP data point to the same anatomic location on both a first one of the geometries corresponding to the first phase and on a second one of the geometries corresponding to the second phase of the cardiac cycle different from the first phase.

14. The method of claim 13 further comprising the steps of:

determining respective positions on the first and second geometries that define the same anatomic location; and

mapping the acquired EP data point to the respective positions.

15. The method of claim 14 wherein said step of determining respective positions include the sub-step of:

defining a least squares regression through corresponding points in said shells.

16. The method of claim 1 further including the steps of:

acquiring cardiac phase information; and

associating the acquired cardiac phase information with the collected sensor locations by synchronizing the respective times during or at which the sensor locations were collected and the phase information was acquired.

17. The method of claim 16 wherein said acquiring step includes the substeps of:

providing a plurality of body surface electrodes on the patient for acquiring respective body surface electrograms;

selecting one or more of the body surface electrograms in accordance with predetermined selection criteria;

processing the selected body surface electrograms to obtain the cardiac phase.

18. The method of claim 17 wherein the predetermined selection criteria includes at least one from the group comprising a target heart chamber whose geometry is to be determined and a disease state of the patient'"'"'s heart.

19. The method of claim 16 wherein said acquiring step includes the substep of:

providing a reference electrode fixed in location in the heart configured to produce a signal indicative of the phase of the cardiac cycle.

20. The method of claim 1 wherein said segregating step comprises the substep of:

identifying, for each cardiac phase for which a set is to be produced, the outermost collected sensor locations.

21. The method of claim 1 further comprising the steps of:

forming the sensor by providing a plurality of electrodes on a distal end of a catheter;

obtaining location information from one or more of the electrodes;

computing a distal location of the catheter using the collected location information in accordance with a geometrical relationship between the one or more electrodes from which location information is obtained and the distal location of the catheter; and

defining the collected sensor location as corresponding to the computed distal location of the catheter.

22. The method of claim 1 wherein said generating step further includes generating said first geometry according to a geometry construction strategy and generating said second geometry according to said geometry construction strategy.

23. The method of claim 1 further including the steps of:

providing a plurality of body surface electrodes on the patient for acquiring respective body surface electrograms;

selecting one or more of the body surface electrograms in accordance with a disease state of the patient'"'"'s heart;

determining the phase of the cardiac cycle of the patient by processing the selected body surface electrograms; and

associating the collected sensor locations with the determined phase of the cardiac cycle during or at which each sensor location was collected.

24. A system for processing information, comprising:

means for collecting, for at least one sensor, a plurality of sensor locations as the at least one sensor is swept within a heart chamber of a patient;

means, including a computer processing apparatus, for segregating the collected sensor locations into a plurality of sets in accordance with a respective phase of a cardiac cycle during or at which each sensor location was collected, each set having associated therewith a predetermined phase of the cardiac cycle; and

means for generating, for each set, a respective geometry of the heart chamber at the associated phase of the cardiac cycle, wherein a first geometry of the plurality of geometries is generated exclusively from a first set of said plurality of sets and a second geometry of the plurality of geometries is generated exclusively from a second set of said plurality of sets, said second set being different from said first set such that sensor locations in said first set are distinct from sensor locations in said second set, the sensor locations in said first set being associated with a first phase of the cardiac cycle during or at which said sensor locations in said first set were collected and the sensor locations in said second set being associated with a second phase of the cardiac cycle during or at which said sensor locations in said second set were collected, wherein said first phase is different from said second phase, and wherein said first phase comprises a first range of phase values and said second phase comprises a second range of phase values different from and non-overlapping with respect to said first range of phase values such that sensor locations in said first set are distinct from sensor locations in said second set by virtue of at least the phase of the cardiac cycle during or at which respective sensor locations were collected.

25. A system for processing information, comprising:

a processing apparatus configured to collect, for at least one sensor, a plurality of sensor locations as the at least one sensor is swept within a heart chamber of a patient, said processing apparatus being further configured to segregate the collected sensor locations into a plurality of sets in accordance with a respective phase of a cardiac cycle during or at which each sensor location was collected, each set having associated therewith a predetermined phase of the cardiac cycle, said apparatus being further configured to generate, for each set, a respective geometry of the heart chamber at the associated phase of the cardiac cycle, wherein a first geometry of the plurality of geometries is generated exclusively from a first set of said plurality of sets and a second geometry of the plurality of geometries is generated exclusively from a second set of said plurality of sets, said second set being different from said first set such that sensor locations in said first set are distinct from sensor locations in said second set, the sensor locations in said first set being associated with a first phase of the cardiac cycle during or at which said sensor locations in said first set were collected and the sensor locations in said second set being associated with a second phase of the cardiac cycle during or at which said sensor locations in said second set were collected, wherein said first phase is different from said second phase, and wherein said first phase comprises a first range of phase values and said second phase comprises a second range of phase values different from and non-overlapping with respect to said first range of phase values such that sensor locations in said first set are distinct from sensor locations in said second set by virtue of at least the phase of the cardiac cycle during or at which respective sensor locations were collected.

26. The system of claim 25 further including a display, said processing apparatus being further configured to display the plurality of geometries in accordance with a measured phase of the patient'"'"'s cardiac cycle.

27. The system of claim 26 wherein said processing apparatus is further configured to superimpose a representation of a catheter on said display of the plurality of geometries.

28. The system of claim 27 wherein said processing apparatus is further configured to track movement of the catheter, said processing apparatus being further configured to synchronize the movement of the catheter to the display of the plurality of geometries.

29. The system of claim 25 further including the steps of:

acquiring electrophysiologic (EP) data associated with the heart chamber; and

mapping the acquired EP data on the plurality of geometries.

30. The system of claim 29 wherein said EP data comprises electrical activation potential values corresponding to physiological electrical activity.