Detection of reduced-control cardiac zones

• US 10,052,495 B2
• Filed: 09/08/2014
• Issued: 08/21/2018
• Est. Priority Date: 09/08/2013
• Status: Active Grant

• Current Assignee: Tylerton International Holdings Inc.
• Original Assignee: Tylerton International Inc.
• Inventors: Ben-Haim, Shlomo
• Primary Examiner(s): Tabatabai, Abolfazl
• Application Number:
  US14/917,285
• Publication Number:
  US 20160217571A1
• Time in Patent Office: 1,443 Days
• Field of Search: 382128, 382129, 382130, 382131, 382132, 382133, 382134, 600324, 600374, 600450, 600481, 600485, 600508, 600510, 600512
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 6/037 Emission tomography
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61N 2/006 for magnetic stimulation of nerve tissue
• CPC Class Codes: A61N 2/02 using magnetic fields produced by coils, including single turn loops or electromagnets A61N2/12 takes precedence
• CPC Class Codes: G06T 2207/10072 Tomographic images
• CPC Class Codes: G06T 2207/10076 4D tomography; Time-sequential 3D tomography
• CPC Class Codes: G06T 2207/30016 Brain
• CPC Class Codes: G06T 2207/30048 Heart; Cardiac
• CPC Class Codes: G06T 2207/30092 Stomach; Gastric
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G06T 7/0014 using an image reference approach

Abstract

A method of treating cardiac arrhythmia in a heart, including (i) determining that cardiac tissue is viable but with reduced innervation; and (ii) ablating the tissue to reduce a prevalence of arrhythmia in said heart. Optionally, the determining comprises detecting portions of heart wall which lack electrical activity. Optionally, at least some tissue which is viable but lacks nervous control is ablated, for example, to reduce or avoid arrhythmia.

Claims

1. Apparatus comprising circuitry configured to compare portions of a viability image comprising indications of tissue vitality for non-neural tissue within an organ of a patient with portions of a nervous control image comprising indications of autonomic innervation of the non-neural tissue;

and to generate a map indicating portions of the non-neural tissue with viability and reduced autonomic nervous control, based on the comparison.

2. The apparatus of claim 1, wherein the circuitry is configured to identify level of viability of the non-neural tissue in a region based on locations of a tracer selectively taken up by viable tissue of the non-neural tissue.

3. The apparatus of claim 1, wherein the circuitry is configured to identify level of nervous control of the non-neural tissue based on locations of a tracer selectively taken up by nerve endings or tissue which collects adrenaline.

4. The apparatus of claim 1, wherein the viability image and the nervous control image are 4-D images.

5. The apparatus of claim 1, wherein the autonomic nervous control of the portions of the organ with vital non-neural tissue and reduced autonomic nervous control is reduced relative to a normal level of autonomic nervous control.

6. The apparatus of claim 5, wherein the normal level of autonomic nervous control is provided by at least one of the group consisting of:

a map of normal autonomic nervous control activity ranges allowed for imaged portions of the organ, and

one or more thresholds of autonomic nervous control activity for different parts of the organ;

indicating one or more parameter ranges of normal autonomic nervous control.

7. The apparatus of claim 1, wherein the portions of the organ with vital non-neural tissue and reduced autonomic nervous control are reduced in active autonomic innervation relative to a bordering region having a normal level of active autonomic innervation.

8. The apparatus of claim 1, wherein the autonomic innervation comprises innervation by one or more ganglia.

9. The apparatus of claim 1, wherein the viability image and the nervous control image are obtained using dual isotope radioimaging, with a first of the dual isotopes used to identify metabolic activity in the non-neural tissue, and a second of the dual isotopes used to identify autonomic innervation of the non-neural tissue based on at least one of the group consisting of activity of presynaptic neurons, the density of receptors for neurotransmitters, and the number of nerve endings.

10. The apparatus of claim 1, wherein the organ which receives autonomic innervation comprises the heart of the patient.

11. The apparatus of claim 1, wherein the organ which receives autonomic innervation comprises one of the group consisting of:

a liver, a kidney, and an organ of the gastrointestinal tract.

12. A system for treating dysfunction of an organ, comprising:

a modeling unit, comprising circuitry configured to receive functional image data of said organ and determine therefrom a model identifying;

regions of viability of non-neural tissue of the organ, and

regions of reduced autonomic innervation of the non-neural tissue of the organ;

a treatment planning unit, comprising circuitry configured to;

match said model with a disease-treatment template, according to a disease condition modeled in said template, and

provide a treatment plan associated with said template, according to said match.

13. The system of claim 12, wherein said treatment plan comprises an indication selecting a portion of body tissue for ablation.

14. The system according to claim 13, wherein said organ is a heart, and said dysfunction is arrhythmia.

15. The system according to claim 14, wherein said body tissue comprises cardiac tissue.

16. The system according to claim 15, wherein said non-neural tissue comprises the cardiac tissue within a viable region of the organ receiving reduced-innervation.

17. The system according to claim 14, wherein said body tissue comprises non-cardiac tissue.

18. The system according to claim 14, wherein said body tissue comprises neural tissue.

19. The system according to claim 14, wherein said modeled disease condition comprises an indication of potential arrhythmia.

20. The system according to claim 12, wherein said organ is an organ of the gastrointestinal tract.

21. The system according to claim 20, wherein said organ is the stomach.