Systems and methods for determining location of an access needle in a subject

• US 9,468,396 B2
• Filed: 05/04/2012
• Issued: 10/18/2016
• Est. Priority Date: 03/19/2007
• Status: Active Grant

• Current Assignee: University of Virginia
• Original Assignee: University of Virginia Patent Foundation (University of Virginia)
• Inventors: Tucker-Schwartz, Jason M, Mahapatra, Srijoy, Gillies, George T.
• Primary Examiner(s): STIGELL, THEODORE J
• Application Number:
  US13/464,762
• Publication Number:
  US 20120283582A1
• Time in Patent Office: 1,628 Days
• Field of Search: 600/301, 600/485, 600/561, 604 65- 67, 604/272
• US Class Current: 1/1
• CPC Class Codes: A61B 5/02154 by optical transmission
• CPC Class Codes: A61B 5/03 Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs A61B5/205 takes precedence
• 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 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/346 Analysis of electrocardiograms
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/6848 Needles
• CPC Class Codes: A61B 5/7257 using Fourier transforms

Abstract

Systems and methods for epicardial electrophysiology and other procedures are provided in which the location of an access needle may be inferred according to the detection of different pressure frequencies in separate organs, or different locations, in the body of a subject. Methods may include inserting a needle including a first sensor into a body of a subject, and receiving pressure frequency information from the first sensor. A second sensor may be used to provide cardiac waveform information of the subject. A current location of the needle may be distinguished from another location based on an algorithm including the pressure frequency information and the cardiac waveform information.

Claims

1. A system for accessing one or more locations of a subject, said device comprising:

a needle having a distal end and a proximal end;

a first sensor in communication with said needle for sensing pressure frequency in the one or more locations of the subject;

a medical device configured to be inserted in the aperture of the needle; and

a processor configured to;

receive pressure frequency information from the first sensor; and

distinguish a current location of the needle from another location based on an algorithm including the pressure frequency information.

2. The system of claim 1, wherein the current location is a non-pericardial location and the other location is a pericardial location, or vice-versa.

3. The system of claim 1, wherein at least one of the current location and the other location is a thorax of the subject.

4. The system of claim 1, wherein the first sensor is lockable.

5. The system of claim 1, wherein:

the processor is further configured to receive cardiac waveform information of the subject from a second sensor; and

the algorithum includes at least the pressure frequency information and the cardiac waveform information.

6. The system of claim 5, wherein the processor is further configured to:

determine a reference phase based on the cardiac waveform information; and

determine a test phase based on the pressure frequency information,

wherein, said distinguishing is based on the pressure frequency information from the test phase and the cardiac waveform information from the reference phase.

7. The system of claim 6, wherein the reference phase is a cardiac phase of the subject immediately preceding the test phase.

8. The system of claim 5, wherein said distinguishing includes comparing the algorithm results of the pressure frequency information and the cardiac waveform information to a plurality of predetermined threshold values.

9. The system of claim 5, wherein combining the pressure frequency information and the cardiac waveform information includes phase sensitive detection and matched filtering.

10. The system of claim 5, wherein combining the pressure frequency information and the cardiac waveform information includes integrating the pressure frequency information.

11. The system of claim 5, wherein the cardiac waveform information includes information derived from a plurality of cardiac phases of the subject.

12. The system of claim 5, wherein the cardiac waveform information includes at least one of ventricle pressure, arterial pressure, and electrocardiogram (ECG) voltages.

13. The system of claim 1, wherein the medical device comprises at least one of a visualization device, a recording device, a fiber endoscopes, an optical fiber sensor, or an illumination source.

14. A device for inferring the location of a needle in a subject, said device comprising:

a visualization device configured for deployment in an integral body part of the subject, via said needle, and for obtaining visual information therefrom;

a first input configured to receive pressure frequency information from a first sensor disposed on a distal end of the needle;

a second input configured to receive cardiac waveform information of the subject from a second sensor; and

a processor configured to;

receive cardiac waveform information of the subject from a second input;

receive pressure frequency information from the first input; and

distinguish a current location of the needle from another location based on an algorithm including the pressure frequency information and the cardiac waveform information.

15. The device of claim 14, wherein the processor is further configured to:

determine a reference phase based on the cardiac waveform information; and

determine a test phase based on the pressure frequency information,

wherein, said distinguishing is based on the pressure frequency information from the test phase and the cardiac waveform information from the reference phase.

16. A system for accessing one or more locations of a subject, said device comprising:

a needle having a distal end and a proximal end;

a first optical sensor in communication with said needle configured for sensing pressure frequency in the one or more locations of the subject;

a light source optically coupled to the first optical sensor;

a second optical sensor configured to obtain visual information from the distal end of the needle; and

a processor configured to receive pressure frequency information from the first optical sensor and to determine a current location of the needle based at least in part on the pressure frequency information.