Navigation System for Cardiac Therapies

• US 20120065481A1
• Filed: 11/14/2011
• Published: 03/15/2012
• Est. Priority Date: 11/19/2002
• Status: Active Grant

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Hunter, Mark, Jascob, Bradley A., Verard, Laurent, Kelley, James
• Granted Patent: US 8,467,853 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61B 1/00071 Insertion part of the endoscope body A61B1/0055 takes precedence
• CPC Class Codes: A61B 1/0058 using shape-memory elements
• CPC Class Codes: A61B 1/012 characterised by internal passages or accessories therefor
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• 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 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• 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 5/062 : using magnetic field
• CPC Class Codes: A61B 5/7285 : for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/12 : Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/463 : characterised by displaying multiple images or images and diagnostic data on one display
• CPC Class Codes: A61B 6/541 : involving acquisition triggered by a physiological signal
• CPC Class Codes: A61M 2005/14292 : Computer-based infusion planning or simulation of spatio-temporal infusate distribution

Abstract

An image guided catheter navigation system for navigating a region of a patient includes an imaging device, a tracking device, a controller, and a display. The imaging device generates images of the region of the patient. The tracking device tracks the location of the catheter in the region of the patient. The controller superimposes an icon representing the catheter onto the images generated from the imaging device based upon the location of the catheter. The display displays the image of the region with the catheter superimposed onto the image at the current location of the catheter.

Claims

1. A method for guiding a catheter through a region of a patient with a catheter navigation system, the method comprising:

tracking a location of a tracking device of the catheter while the catheter is within the region of the patient, wherein the catheter further includes at least one sensor;

measuring a physiology at discrete tracked locations within the region of the patient with the at least one sensor as the catheter is moved within the region of the patient, wherein the tracked locations are based on tracking the location of the tracking device;

executing instructions with the catheter navigation system to determine at least one location of a reference point within the region of the patient based on the measured physiology at the discrete tracked locations;

executing instructions with the catheter navigation system to generate a matched model by stretching, rotating, and aligning at least one model reference point in a model to the determined at least one location of the reference point in the region of the patient; and

displaying the matched model.

2. The method of claim 1, wherein the determined at least one reference point includes a plurality of determined reference points.

3. The method of claim 2, wherein the plurality of determined reference points include transition points in a heart of the patient including a transition from the superior vena cava to the right atrium, passing the tricuspid valve into the right ventricle, and a left ventricular apex.

4. The method of claim 1, further comprising:

displaying a catheter icon representing a location of the catheter superimposed on the matched model.

5. The method of claim 4, further comprising:

executing instructions with the catheter navigation system to provide a road map information to direct the catheter through the region of the patient to a suggested target site for a treatment to be delivered by the catheter.

6. A method for guiding a catheter through a region of a patient with a catheter navigation system, the method comprising:

generating a model of the region of the patient;

tracking a tracking device of the catheter while the catheter is within the region of the patient, wherein the catheter further includes a sensor;

measuring a physiology with the at least one sensor of the region of the patient as the catheter is moved within the region of the patient;

determining locations of reference points within the region of the patient based on the measured physiology and the tracked tracking device of the catheter;

executing instructions with a system to generate a matched model by matching the model to the region of the patient by stretching, rotating, and aligning the model at the determined reference points to match the model to the determined reference points; and

displaying the matched model.

7. The method of claim 6, further comprising:

registering the region of the patient with the matched model; and

superimposing a catheter icon representing a position of at least a portion of the catheter on the displayed and registered matched model.

8. The method of claim 7, further comprising:

passing a medical instrument through an open lumen defined by the catheter to the region of the patient.

9. The method of claim 7, further comprising:

delivering at least one of a pharmaceutical agent, a volume of cells, or a genetic therapy through an open lumen defined by the catheter.

10. The method of claim 9, further comprising:

measuring a rhythm of the heart of the patient with an electrocardiogram device operable to determine an activation state or relaxation state of the heart of the patient to enable gated delivery of at least one of the pharmaceutical agent, the volume of cells, or the genetic therapy delivery, at an optimum time of the heart rhythm.

11. The method of claim 9, further comprising:

executing instructions with the system to determine a suggested site for delivery of the at least one of the pharmaceutical agent, the volume of cells, or the genetic therapy; and

displaying an indication of the suggested site.

12. The method of claim 9, further comprising:

displaying a distribution map regarding delivering at least one of the pharmaceutical agent, the volume of cells, or the genetic therapy to illustrate how the at least one of the pharmaceutical agent, the volume of cells, or the genetic therapy is disbursed through the heart.

13. The method of claim 6, wherein the measured physiology includes at least one of an electrical signal morphology change and a pressure signal change.

14. The method of claim 6, wherein the reference points include transition points in a heart of the patient including a transition from the superior vena cava to the right atrium, passing the tricuspid valve into the right ventricle, and a left ventricular apex.

15. The method of claim 6, wherein determining reference points is determined solely by a user.

16. A catheter navigation system method for guiding a catheter through a region of a patient, comprising:

a catheter configured to be moved into the region of the patient, the catheter including,

a plurality of discrete tracking devices, wherein each of the plurality of discrete tracking devices is connected to the catheter and is operable to track a plurality of positions relating to each of the respective plurality of discrete tracking devices, and

a physiology sensor to measure at least a portion of a physiology at the tracked location in the region of the patient;

a display operable to display an image representative of the region of the patient; and

a controller in communication with the plurality of discrete tracking devices and the physiology sensor;

wherein the controller is operable to execute instructions to automatically determine at least one reference point in the region of the patient based on the measured portion of the physiology and a tracked location of the catheter by tracking at least one of the plurality of discrete tracking devices.

17. The image guided catheter navigation system of claim 16, wherein the controller is further operable to automatically match a model of the region of the patient to the determined reference points at least by shrinking, stretching, and rotating the model.

18. The image guided catheter navigation system of claim 17,

wherein the automatic matching is done only within a physiological bounds and reference points outside of the physiological bounds will generate an alert and require intervention to resolve a discrepancy outside of the physiological bounds.

19. The image guided catheter navigation system of claim 17,

wherein the controller is further operable to execute instructions to determine a location of at least a portion of the catheter and superimpose an icon representing the location of at least the portion of the catheter onto the image representative of the region of the patient;

wherein the icon representation is based on determining a location of the catheter in the region of the patient based on the tracked plurality of locations relating to each of the respective plurality of discrete tracking devices.

20. The image guided catheter navigation system of claim 16, further comprising:

an imaging device operable to generate two-dimensional (2D) image data of the region of the patient;

wherein the controller is operable to superimpose the model as a three-dimensional (3D) model on the 2D image data based on the determined reference points.

21. The image guided catheter navigation system of claim 20, wherein the icon representing the catheter is operable to be superimposed on at least one of the three-dimensional (3D) model and the 2D image data.

22. The image guided catheter navigation system of claim 16, further comprising:

wherein the physiology sensor is at least one of an absolute pressure sensor, an electrode for sensing myopotentials, an electrode for sensing action potentials, an accelerometer, or an oxygen saturation sensor.