Method and apparatus for mapping a structure

• US 9,662,041 B2
• Filed: 06/03/2013
• Issued: 05/30/2017
• Est. Priority Date: 04/18/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Karamanoglu, Mustafa, Mehta, Pooja, Fleming, Ioana, Giese, Chad, Falkner, Phillip, Scanlon, David, Massa, Sean T., Markowitz, H. Toby, Kryger, Michael, Nowak, Karl Evan, Interrante, Victoria
• Primary Examiner(s): Moran, Edward
• Assistant Examiner(s): KIMBALL, JEREMIAH T
• Application Number:
  US13/908,574
• Publication Number:
  US 20130267840A1
• Time in Patent Office: 1,457 Days
• Field of Search: 600523
• 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 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0536 Impedance imaging, e.g. by tomography
• 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 5/066 Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: G06V 2201/03 Recognition of patterns in medical or anatomical images
• CPC Class Codes: G06V 2201/034 of medical instruments

Abstract

An area of a patient can be mapped with a system operable to identify a plurality of locations and save a plurality of locations of a mapping instrument. The mapping instrument can include one or more electrodes that can sense a voltage that can be correlated to a three dimensional location of the electrode at the time of the sensing or measurement. Therefore, a map of an area or volume can be determined based upon the sensing of the plurality of points without the use of an imaging device. An implantable medical device can then be navigated relative to the mapping data.

Claims

1. A method of illustrating mapping data from a patient, comprising:

generating a voltage between a first drive patch and a second drive patch in contact with a patient;

displaying a map of a volume in the patient based at least on a plurality of map data points determined by measuring the generated voltage in the volume in the patient at a plurality of mapping positions;

determining a position of an implantable electrode that is positioned in the patient in the volume;

sensing, with the implantable electrode that is positioned in the patient in the volume, a first voltage at a first real position in the patient in the volume and a second voltage at a second real position in the patient in the volume; and

displaying on a display device an electrode representation superimposed on the displayed map;

wherein the electrode representation illustrates a position of the implantable electrode in the patient in the volume that is an average of at least two of the first real position, the second real position, and a third position;

wherein at least two of the first real position, the second real position, and the third position are different positions.

2. The method of claim 1, wherein the second voltage is acquired after a period of time from the first voltage;

wherein the period of time between the acquisition of the second voltage and the acquisition of the first voltage is enough to substantially eliminate jitter on the display device of the electrode representation.

3. The method of claim 1, further comprising:

generating the map of the volume by;

acquiring a first selected plurality of real positions with a mapping electrode moving within the volume;

determining a first average of the acquired first plurality of real positions;

displaying on the display device a first map representation of the determined first average of the acquired first selected plurality of real positions;

acquiring a second plurality of real positions;

determining a second average position of the acquired second plurality of real positions; and

displaying on the display device a second map representation of the determined second average position;

wherein the first map representation of the first average position and the second map representation of the second average position are illustrated on the display device to show a less than real time position of the electrode on the display device.

9. The method of claim 1, wherein displaying the third representation includes displaying a sphere on the display device.

10. The method of claim 1, wherein the third representation is a smoothed representation of the first real position and the second real position.

4. A method of illustrating mapping data from a patient, comprising:

generating a voltage between a first drive patch and a second drive patch in contact with a patient;

sensing, at a mapping electrode in the patient, a first voltage at a first real position and a second voltage at a second real position in the patient;

displaying a map data of the patient based on the sensed first voltage and sensed second voltage with the mapping electrode;

sensing, at an implantable electrode different than the mapping electrode in the patient, a third voltage at the first real position and a fourth voltage at the second real position in the patient;

determining an average location based on the sensed third voltage at the first real position and the sensed fourth voltage at the second real position; and

displaying on a display device an implantable electrode representation of the implantable electrode at the determined average location superimposed on and relative to the displayed map data;

wherein the displayed implantable electrode representation is only displayed as the determined average location.

5. The method of claim 4, wherein the displayed map data includes at least one illustrated map data point that is an average of the first real position and the second real position.

6. The method of claim 4, wherein the displayed map data is smoothed.

7. The method of claim 4, wherein the determining average location is determined over a selected timespan.

8. The method of claim 4, further comprising:

smoothing the map data by averaging the first real position and the second real position;

wherein displaying the map data includes displaying the smoothed map data.

11. A method of illustrating mapping data from a patient, comprising:

operating a positing sensing unit for driving a current between a first drive patch in contact with a patient and a second drive patch in contact with the patient;

moving a mapping electrode into the patient to determine map data points by sensing with the mapping electrode positioned in the patient over a selected period of time a first voltage at a first real position in the patient of the mapping electrode and a second voltage at a second real position in the patient of the mapping electrode, wherein the first voltage and the second voltage are based on the driven current; and

further operating the position sensing unit for;

determining an average position in the patient between the first real position in the patient of the mapping electrode and the second real position in the patient of the mapping electrode over the selected period of time, and

displaying a determined smooth representation point that is the determined average position in the patient on a display device;

generating a surface for displaying based on the evaluation of the map data points and at least one determined smooth representation point;

moving an implantable electrode in the patient after moving the mapping electrode into the patient and sensing with the implantable electrode a third voltage at a third real position and a fourth voltage at a fourth real position in the patient; and

displaying on a display device a third representation of the third position and a fourth representation of the fourth position superimposed on the generated surface in substantially real time as the third voltage and the fourth voltage are sensed to illustrate a substantially real time motion of the implantable electrode.

12. The method of Claim 11, further comprising:

displaying a map of at least a portion of the patient formed of only points determined with the mapping electrode including a plurality of the determined smooth representation points;

wherein the map is generated by evaluating the map data points including organizing the map data points for display on the display device and the generated surface based on the evaluation of the map data points.

13. The method of claim 11, wherein at least the third real position is different from the fourth real position.

14. The method of Claim 11, wherein the determined smooth representation point includes all sensed voltages over a selected period of time.

15. The method of claim 14, further comprising:

selecting the period of time to be about five seconds.

16. The method of claim 14, further comprising:

averaging all sensed voltages over a selected period of time to determine a smooth representation point.

17. The method of claim 11, wherein displaying the determined smooth representation point includes displaying a sphere.