Navigation system for cardiac therapies

• US 7,599,730 B2
• Filed: 11/19/2002
• Issued: 10/06/2009
• Est. Priority Date: 11/19/2002
• Status: Expired due to Fees

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Jascob, Bradley A., Verard, Laurent, Hunter, Mark, Kelley, James
• Primary Examiner(s): Winakur; Eric F
• Assistant Examiner(s): Rozanski; Michael T
• Application Number:
  US10/299,969
• Publication Number:
  US 20040097806A1
• Time in Patent Office: 2,513 Days
• Field of Search: 600/407, 600/424
• US Class Current: 600/424
• 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. An image guided catheter navigation system for guiding a catheter through a region of a patient, said navigation system comprising:

an imaging device operable to generate image data of the region of the patient;

a tracking device operable to track the position of the catheter in the region of the patient;

a controller in communication with said imaging device and said tracking device and operable to superimpose an icon representing the catheter onto the image data of the region of the patient based upon the position tracked by said tracking device;

a display operable to display the image data of the region of the patient with the superimposed icon of the catheter, wherein said catheter provides a function to the region of the patient; and

a statistical atlas accessible by said controller;

wherein said controller is operable to identify a suggested pacing lead site based at least in part on the statistical atlas that is fit to the generated image data of the region of the patient.

2. The image guided catheter navigation system as defined in claim 1 wherein said imaging device is selected from a group comprising a C-arm fluoroscopic imager, a magnetic resonance imager (MRI), a computed tomography (CT) imager, and a positron emission tomography (PET) imager, an isocentric fluoroscopy imager, a bi-plane fluoroscopy imager, an ultrasound imager, a multi-slice computed tomography (MSCT) imager, a high-frequency ultrasound (HIFU) imager, an optical coherence tomography (OCT) imager, an intra-vascular ultrasound imager (IVUS), a 2D, 3D or 4D ultrasound imager, an intra-operative CT imager, an intra-operative MRI imager, and a single photon emission computer tomography (SPECT) imager.

3. The image guided catheter navigation system as defined in claim 1 wherein said tracking device is selected from a group comprising an electromagnetic tracking device, an optical tracking device, a conductive tracking device, a fiberoptic tracking device, and a combination thereof.

4. The image guided catheter navigation system as defined in claim 1 wherein said imaging device is a C-arm fluoroscopic x-ray imaging device operable to generate multiple two-dimensional images of the region of the patient.

5. The image guided catheter navigation system as defined in claim 1 wherein said tracking device is an electromagnetic tracking device having a transmitter coil array operable to generate an electromagnetic field in the region of the patient and a plurality of sensors associated with the catheter operable to sense the electromagnetic field.

6. The image guided catheter navigation system as defined in claim 5 wherein said transmitter coil array is affixed to said imaging device or transmitter coil array is positioned within an OR table where the patient is positioned.

7. The image guided catheter navigation system as defined in claim 1 wherein said tracking device is integrated into said imaging device.

8. The image guided catheter navigation system as defined in claim 1 further comprising a catheter that is operable to deliver a pacing lead to the heart.

9. The image guided catheter navigation system as defined in claim 1 wherein the function of the catheter is selected from a group comprising cardiac lead placement, cardiac drug delivery, cardiac gene delivery, cardiac cell transplantation, cardiac ablation, and cardiac electrical mapping.

10. The image guided catheter navigation system as defined in claim 1 further comprising a gating device operable to detect a physiological event of the patient to generate a physiological signal.

11. The image guided catheter navigation system as defined in claim 10 wherein position of the catheter is detected at a substantially same point in time with respect to said physiological signal.

12. The image guided catheter navigation system as defined in claim 10 wherein said imaging device generates image data gated by the physiological signal.

13. The image guided catheter navigation system as defined in claim 1 wherein said controller is further operable to superimpose the icon of the catheter onto a three-dimensional heart model and said display is operable to display the three-dimensional heart model with the superimposed icon.

14. The image guided catheter navigation system as defined in claim 1 further comprising a dynamic reference frame in communication with said tracking device, said dynamic reference frame operable to identify movement of the patient relative to said tracking device.

15. The image guided catheter navigation system as defined in claim 14 wherein said dynamic reference frame is an external dynamic reference frame attached to the patient.

16. The image guided catheter navigation system as defined in claim 14 wherein said dynamic reference frame is an internal dynamic reference frame attached to the region of the patient.

17. The image guided catheter navigation system as defined in claim 14 further comprising a plurality of landmarks positioned on the patient and operable to register the image data to the position of the catheter.

18. The image guided catheter navigation system as defined in claim 17 wherein said plurality of landmarks is selected from a group comprising artificial landmarks positioned on the patient and anatomical landmarks on the patient.

19. The image guided catheter navigation system as defined in claim 1 wherein said catheter includes at least one sensor selected from a group comprising an electrical sensor, a pressure sensor and an impedance sensor.

20. The image guided catheter navigation system as defined in claim 1 wherein said controller is further operable to identify physical landmarks within a heart of the patient as the catheter is navigated through the heart of the patient.

21. The image guided catheter navigation system as defined in claim 20 wherein said controller is further operable to generate a three-dimensional heart model to be displayed on said display and is further operable to register the three-dimensional heart model in relation to the landmarks identified by said controller.

22. The image guided catheter navigation system as defined in claim 1 wherein the catheter is a steerable catheter having a plurality of tracking sensors operable to be tracked by said tracking device.

23. A method for image guiding a catheter in a region of a patient, said method comprising:

displaying an image of the region of the patient;

navigating the catheter using a tracking device associated with the catheter through the region of the patient;

detecting a location of the catheter in the region of the patient including sensing a field with a tracking system;

displaying the location of the catheter on the image of the region of the patient by superimposing an icon of the catheter on the image;

performing a function with the catheter when the catheter reaches a desired location;

receiving a cyclic physiological signal;

time gating the detection of the location of the catheter to a particular time in the cyclic physiological signal such that the location of the catheter is detected at the same point in time with respect to the physiological signal for each cycle;

identifying landmarks within the region based upon a sensed physiological condition;

registering a three-dimensional heart model with the identified landmarks to provide a patient specific three-dimensional heart model; and

providing a statistical atlas operable to define at least a portion of the three-dimensional heart model;

wherein registering a three-dimensional heart model with the identified landmarks includes registering the statistical atlas to the patient specific three-dimensional heart model.

24. The method as defined in claim 23 further comprising attaching a pacing lead to a heart upon navigating the catheter to the desired location.

25. The method as defined in claim 23 further comprising delivering a drug to a heart upon navigating the catheter to the desired location.

26. The method as defined in claim 23 further comprising transplanting cells with the catheter upon navigating the catheter to the desired location.

27. The method as defined in claim 23 further comprising ablating a portion of a cardiac region with the catheter upon navigating the catheter to the desired location.

28. The method as defined in claim 23 further comprising sensing physiological conditions in a cardiac region with the catheter.

29. The method as defined in claim 23 further comprising identifying a potential lead target site on the three-dimensional heart model and navigating the catheter to the potentential lead target site.

30. The method as defined in claim 23 further comprising generating the image of the region of the patient by use of an imaging device selected from the group comprising a C-arm fluoroscopic imager, a magnetic resonance imager (MRI), a computed tomography (CT) imager, and a positron emission tomography (PET) imager, an isocentric fluoroscopy imager, a bi-plane fluoroscopy imager, an ultrasound imager, a multi-slice computed tomography (MSCT) imager, a high-frequency ultrasound (HIFU) imager, an optical coherence tomography (OCT) imager, an intra-vascular ultrasound imager (IVUS), a 2D, 3D, or 4D ultrasound imager, an intra-operative CT imager, an intra-operative MRI imager, and a single photon emission computer tomography (SPECT) imager.

31. The method as defined in claim 23 further comprising calibrating the image of the region of the patient during a calibration process.

32. The method as defined in claim 23 further comprising:

time gating the generation of the image in the region of the patient to a particular time in the cyclic physiological signal, such that the image is detected at the same point in time with respect to the physiological signal for each cycle.

33. The method as defined in claim 23 further comprising detecting a location of the catheter in the region of the patient by use of an electromagnetic tracking system.

34. The method as defined in claim 23 further comprising adjusting a diameter of the icon of the catheter displayed upon the image.

35. The method as defined in claim 23 further comprising projecting a straight trajectory of the catheter by displaying a straight icon extending from the icon of the catheter.

36. The method as defined in claim 23 further comprising projecting a spline trajectory of the catheter by displaying a curved icon extending from the icon of the catheter.

37. The method as defined in claim 23 further comprising navigating the catheter through a coronary sinus region of a heart by acquiring an anterior/posterior anatomic image of the patient and a lateral anatomic image of the patient.

38. The method as defined in claim 37 further comprising employing a three-dimensional heart model to navigate the catheter to the coronary sinus region of the heart.

39. The method as defined in claim 38 further comprising providing guide points on the three-dimensional heart model to assist the surgeon in guiding the catheter through the coronary sinus region of the heart.

40. The method of claim 23, further comprising:

attaching a dynamic reference frame internally to a wall of the patient'"'"'s heart; and

maintaining the registration of the three-dimensional heart model.

41. A method of navigating a catheter in a patient via a display and tracking system, comprising:

collecting image data of a region of the patient;

accessing a pre-acquired model formed with statistical data of the region of a subject other than the patient;

registering the pre-acquired model to the collected image data of the region of the patient at least in part by matching points in the accessed pre-acquired model with points in the collected image data;

tracking the catheter relative to the region of the patient; and

displaying an icon representative of the catheter relative to the collected image data that is registered to the pre-acquired model.

42. The method of claim 41, further comprising:

determining a physiological characteristic of the patient;

wherein tracking the catheter occurs a plurality of instances at the same phase of the physiological characteristic.

43. The method of claim 41, further comprising:

suggesting a pacing lead site and illustrating the suggested pacing lead site on a three-dimensional heart model formed by registration of the pre-acquired model to the collected image data of the region of the patient.

44. The method of claim 41, further comprising:

suggesting a pacing lead site; and

illustrating the suggested pacing lead site on a generated three-dimensional heart model formed by registering the pre-acquired model to the image data of the patient.