Systems and methods for high-resolution mapping of tissue

• US 9,510,905 B2
• Filed: 06/10/2016
• Issued: 12/06/2016
• Est. Priority Date: 11/19/2014
• Status: Active Grant

• Current Assignee: EPIX Therapeutics, Inc. (Medtronic Plc)
• Original Assignee: Advanced Cardiac Therapeutics, Inc. (Medtronic Plc)
• Inventors: Panescu, Dorin, Koblish, Josef Vincent, Johnson, Jessi E.
• Primary Examiner(s): FOWLER, DANIEL WAYNE
• Application Number:
  US15/179,891
• Publication Number:
  US 20160278857A1
• Time in Patent Office: 179 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 18/0218 with open-end cryogenic probe, e.g. for spraying fluid directly on tissue or via a tissue-contacting porous tip
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00044 Sensing electrocardiography, i.e. ECG
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• 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 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/0066 without feedback, i.e. open loop control
• CPC Class Codes: A61B 2018/00732 Frequency
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 5/0538 : invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6858 : with a distal basket, e.g. expandable basket

Abstract

According to some embodiments, methods and systems of enhancing a map of a targeted anatomical region comprise receiving mapping data from a plurality of mapping electrodes, receiving high-resolution mapping data from a high-resolution roving electrode configured to be moved to locations between the plurality of mapping electrodes, wherein the mapping system is configured to supplement, enhance or refine a map of the targeted anatomical region or to directly create a high-resolution three-dimensional map using the processor receiving the data obtained from the plurality of mapping electrodes and from the high-resolution roving electrode.

Claims

1. A method of enhancing a map of a targeted anatomical region, the method comprising:

receiving mapping data from a first mapping device or system, the first mapping device or system comprising a plurality of mapping electrodes;

receiving mapping data from a second mapping device or system, the second mapping device or system being configured to be moved to locations between the plurality of mapping electrodes of the first mapping system to obtain said mapping data, wherein the second mapping device or system comprises a first electrode member and a second electrode member, the first electrode member being separated from the second electrode member by at least one electrically insulating gap, a width of the electrically insulating gap being between 0.1 mm and 1 mm, wherein the second mapping device or system is configured to also deliver ablative energy to tissue of the targeted anatomical region via the first and second electrode members;

wherein the first electrode member and the second electrode member of the second mapping device or s stem function like a single electrode at frequencies within an operating radiofrequency (RF) frequency range such that the first and second electrode members collectively provide the ablative energy to tissue;

wherein the first and second electrode members function as separate electrodes at mapping frequencies that are outside the operating RF frequency range, thereby facilitating high-resolution mapping; and

wherein the second mapping device or system comprises a roving system that can be selectively positioned along a targeted anatomical region of a subject;

processing the mapping data obtained by the first and second mapping devices or systems using a processor;

wherein the second mapping device or system is configured to supplement and refine a map of the targeted anatomical region; and

creating an enhanced three-dimensional map using the processor with the data obtained by the first and second mapping devices or systems.

2. The method of claim 1, further comprising displaying the enhanced three-dimensional map.

3. The method of claim 1, wherein creating an enhanced three-dimensional map comprises aligning or synchronizing the data obtained from the plurality of mapping electrodes of the first mapping device or system and from the second mapping device or system.

4. The method of claim 1, wherein the first mapping device or system comprises at least one expandable member, and wherein at least some of the mapping electrodes are located on the at least one expandable member.

5. The method of claim 1, wherein the targeted anatomical region comprises cardiac tissue.

6. The method of claim 1, wherein the three-dimensional map comprises at least one of an activation map, a propagation velocity map, a voltage map and a rotor map.

7. The method of claim 1, further comprising providing an output associated with the enhanced three-dimensional map.

8. The method of claim 1, wherein the processor is included as part of at least one of the following:

the first mapping device or system, the second mapping device or system and a separate device or system.

9. A method of enhancing a map of a targeted anatomical region, the method comprising:

receiving mapping data from a first mapping device or system, the first mapping device or system comprising a plurality of mapping electrodes;

receiving mapping data from a second mapping device or system, the second mapping device or system being configured to be moved to locations between the plurality of mapping electrodes of the first mapping system to obtain said mapping data, wherein the second mapping device or system comprises a first electrode member separated from a second electrode member by an electrically insulating gap, wherein the first and second electrode members are configured to deliver ablative engery to tissue of the targeted anatomical region;

wherein the first and second electrode portions are configured to be energized as a unitary member at frequencies within an operating frequency range for ablation, wherein the operating frequency range for ablation is between 200 kHz and 10 MHz, and wherein the first and second electrode portions are configured to function as separate electrodes at frequencies that facilitate mapping outside the operating frequency range for ablation;

wherein the second mapping device or system comprises a roving system that can be selectively positioned along a targeted anatomical region of a subject;

processing the mapping data obtained by the first and second mapping devices or systems using at least one processor; and

creating an enhanced three-dimensional map using the at least one processor.

10. The method of claim 9, wherein creating the enhanced three-dimensional map comprises aligning or synchronizing the mapping data obtained from the plurality of mapping electrodes of the first mapping device or system and the mapping data from the second mapping device or system.

11. The method of claim 9, wherein the at least one processor is included as part of at least one of the following:

the first mapping device or system, the second mapping device or system and a separate device or system.

12. The method of claim 9, further comprising displaying the enhanced three-dimensional map.

13. The method of claim 9, further comprising providing an output associated with the enhanced three-dimensional map.

14. The method of claim 9, wherein the first mapping device or system comprises at least one expandable member, and wherein at least some of the plurality of mapping electrodes are located on the at least one expandable member.

15. The method of claim 9, wherein the enhanced three-dimensional map comprises at least one of an activation map, a propagation velocity map, a voltage map and a rotor map.

16. A method of enhancing a map of a targeted anatomical region, the method comprising:

collecting a first mapping data set from a plurality of mapping electrodes included in a first mapping device or system;

collecting a second mapping data set from a high-resolution roving electrode being configured to be moved to locations between the plurality of mapping electrodes; and

generating an enhanced three-dimensional map using the first and second mapping data sets;

wherein the first and second electrode portions are configured to be electrically coupled to each other using a filtering element, the high-resolution roving electrode of the second mapping system being configured to ablate tissue at frequencies within an operating radiofrequency (RF) frequency range for ablation, wherein the electrode comprises first and second electrode portions that are configured to be energized as a unitary member at the frequencies within the operating RF frequency range; and

wherein the first and second electrode portions are configured to function as separate electrodes to collect the second mapping data set at mapping frequencies that are outside the operating RF frequency range.

17. The method of claim 16, wherein generating the enhanced three-dimensional map comprises aligning or synchronizing the first and second mapping data sets using at least one processor.

18. The method of claim 16, further comprising providing an output associated with the enhanced three-dimensional map.

19. The method of claim 16, wherein the first mapping device or system comprises at least one expandable member, and wherein at least some of the plurality of mapping electrodes are located on the at least one expandable member.

20. The method of claim 16, wherein the enhanced three-dimensional map comprises at least one of an activation map, a propagation velocity map, a voltage map and a rotor map.