System and method for magnetic-resonance-guided electrophysiologic and ablation procedures

• US 8,099,151 B2
• Filed: 12/22/2005
• Issued: 01/17/2012
• Est. Priority Date: 11/04/1998
• Status: Expired due to Fees

• Current Assignee: Johns Hopkins University
• Original Assignee: Johns Hopkins University
• Inventors: Berger, Ronald D., Atalar, Ergin, Lardo, Albert, Calkins, Hugh, Lima, Joao, Halperin, Henry R, McVeigh, Elliot R
• Primary Examiner(s): Chen, Tse
• Assistant Examiner(s): Roy, Baisakhi
• Application Number:
  US11/314,241
• Publication Number:
  US 20060100506A1
• Time in Patent Office: 2,217 Days
• Field of Search: 600410-423, 600/407, 607119-123, 324/307, 324/309, 324/318
• US Class Current: 600/423
• 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 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/418 lymph vessels, ducts or nodes
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: G01R 33/285 Invasive instruments, e.g. catheters or biopsy needles, specially adapted for tracking, guiding or visualization by NMR
• CPC Class Codes: G01R 33/34084 implantable coils or coils being geometrically adaptable to the sample, e.g. flexible coils or coils comprising mutually movable parts
• CPC Class Codes: G01R 33/4808 Multimodal MR, e.g. MR combined with positron emission tomography [PET], MR combined with ultrasound or MR combined with computed tomography [CT]
• CPC Class Codes: G01R 33/5601 involving use of a contrast agent for contrast manipulation, e.g. a paramagnetic, super-paramagnetic, ferromagnetic or hyperpolarised contrast agent

Abstract

A system and method for using magnetic resonance imaging to increase the accuracy of electrophysiologic procedures includes an invasive combined electrophysiology and imaging antenna catheter which includes an RF antenna for receiving magnetic resonance signals and diagnostic electrodes for receiving electrical potentials. The combined electrophysiology and imaging antenna catheter is used in combination with a magnetic resonance imaging scanner to guide and provide visualization during electrophysiologic diagnostic or therapeutic procedures, such as ablation of cardiac arrhythmias. The combined electrophysiology and imaging antenna catheter may further include an ablation tip, and be used as an intracardiac device to deliver energy to selected areas of tissue and visualize the resulting ablation lesions. The antenna utilized in the combined electrophysiology and imaging catheter for receiving MR signals is preferably of the coaxial or “loopless” type. High-resolution images from the antenna may be combined with low-resolution images from surface coils of the MR scanner to produce a composite image. A system for eliminating the pickup of RF energy in which intracardiac wires are detuned by filtering so that they become very inefficient antennas. An RF filtering system is provided for suppressing the MR imaging signal while not attenuating the RF ablative current. Steering means may be provided for steering the invasive catheter under MR guidance. Other ablative methods can be used such as laser, ultrasound, and low temperatures.

Claims

1. A method for performing an electrophysiological procedure on a mammalian patient having a heart comprising:

placing the patient such that the heart is in a main magnetic field of an MRI scanner;

introducing an MR-compatible catheter into the heart;

acquiring a magnetic resonance image of the heart;

using the magnetic resonance image to determine a location of said MR-compatible electrode catheter in the heart, and

at substantially the same time that the image is acquired, simultaneously using said MR-compatible catheter to acquire electrical signals of the heart and attenuating radio frequency energy induced in the catheter by the MRI scanner.

2. The method according to claim 1, wherein said electrical signals are indicative of an electrophysiological state comprise intracardiac electrograms.

3. The method according to claim 1, wherein said MR-compatible catheter is an electrode catheter having a tip comprising gold.

4. The method according to claim 3, wherein said MR-visible material comprises a metal.

5. The method according to claim 1, wherein said MR-compatible catheter comprises an MR-visible material.

6. The method according to claim 1 further comprising attenuating a frequency induced in the catheter by the MRI scanner, wherein the attenuated frequency corresponds to a radio frequency emitted by the scanner.

7. The method according to claim 1 wherein the MR-compatible catheter comprises an intrabody MRI receive antenna, and wherein the step of acquiring a magnetic resonance image of the heart includes acquiring signal data of local tissue using the antenna.

8. The method according to claim 1 wherein the MR-compatible catheter comprises an intrabody MRI receive antenna, and wherein the step of introducing the MR-compatible catheter into the heart includes acquiring signal data of local tissue using the antenna.

9. The method of claim 1 wherein comprises at least one coil, and wherein the method further comprises electronically obtaining data from the coil and guiding the catheter to a target location using the obtained coil data.

10. A method for performing an electrophysiological procedure on a mammalian patient having a heart comprising:

positioning an MR-compatible catheter into the heart;

placing the patient such that the heart is in a main magnetic field of an MRI scanner;

acquiring a magnetic resonance image of the heart;

using the magnetic resonance image to determine a location of said MR-compatible catheter in the heart;

using said MR-compatible catheter to acquire an electrical signal of the heart while the heart is in the main magnetic field of the MRI scanner, and

simultaneously with the acquisition of the electrical signal of the heart attenuating radio frequency energy induced in the catheter by the MRI scanner.

11. The method according to claim 10 wherein said catheter is positioned after the patient is positioned in the MRI scanner.

12. The method according to claim 10 wherein said MR-compatible catheter includes an electrode tip comprising gold.

13. The method according to claim 10 wherein said MR-compatible catheter comprises an MR-visible material.

14. The method according to claim 10 wherein attenuating the RF energy includes attenuating a radio frequency induced in the catheter by the MRI scanner, wherein the attenuated frequency corresponds to a radio frequency emitted by the scanner.

15. The method according to claim 10, wherein the MR-compatible catheter comprises an intrabody antenna, and wherein the step of acquiring a magnetic resonance image of the heart employs signal data obtained from the antenna.

16. The method according to claim 15 wherein the intrabody antenna is on a distal end portion of the catheter.

17. A method for performing an electrophysiological procedure on a mammalian patient having a heart comprising:

placing the patient such that the heart is in a main magnetic field of an MRI scanner;

introducing an MR-compatible electrode catheter into the heart;

using said MR-compatible electrode catheter to acquire electrical signals of the heart while the heart is in the main magnetic field, and

attenuating radio frequency energy induced in the catheter by the MRI scanner during the acquisition of the electrical signals.

18. The method according to claim 17 wherein said electrical signals are indicative of an electrophysiological state and comprise intracardiac electrograms.

19. The method according to claim 17 wherein said MR-compatible electrode catheter includes a tip comprising gold.

20. The method according to claim 17 wherein said MR-compatible electrode catheter comprises an MR-visible material.

21. The method according to claim 17, wherein said MR-visible material comprises a metal.

22. The method according to claim 17 wherein the attenuation of the radio frequency energy includes attenuating a radio frequency induced in the catheter by the MRI scanner, wherein the attenuated frequency corresponds to a radio frequency emitted by the scanner.

23. A method as in claim 17 wherein at substantially the same time that the patient is in the MRI scanner,

acquiring a magnetic resonance image of the heart, and

using the magnetic resonance image to determine a location of said MR-compatible electrode catheter in the heart.

24. The method according to claim 17, wherein the MR-compatible catheter comprises an intrabody antenna, and the method includes acquiring an MR image of the heart using signal data from the antenna.

25. The method according to claim 24, wherein the intrabody antenna is on a distal end portion of the catheter.

26. A method for performing an electrophysiological procedure on a mammalian patient having a heart comprising:

introducing an MR-compatible catheter into the heart;

placing the patient with the catheter such that the heart is in a main magnetic field of an MRI scanner;

attenuating radio frequency energy induced in the MR-compatible catheter by the MRI scanner while the heart is in the main magnetic field.

27. The method according to claim 26 further comprising acquiring electrical signals with the catheter, where the signals are indicative of an electrophysiological state comprise intracardiac electrograms.

28. The method according to claim 26 wherein said MR-compatible catheter includes an electrode tip comprising gold.

29. The method according to claim 26 wherein said MR-compatible catheter comprises an MR-visible material.

30. The method according to claim 29 wherein said MR-visible material comprises a metal.

31. The method according to claim 26 wherein the attenuated frequency corresponds to a radio frequency emitted by the scanner.

32. The method according to claim 26 wherein at substantially the same time that the patient is in the MRI scanner,

acquiring a magnetic resonance image of the heart, and

using the magnetic resonance image to determine a location of said MR-compatible electrode catheter in the heart.

33. The method according to claim 26 wherein filters are applied to attenuate the frequencies.

34. The method according to claim 26, wherein the MR-compatible catheter comprises an intrabody antenna, and the method includes acquiring an MR image of the heart using signal data from the antenna.

35. The method according to claim 34, wherein the intrabody antenna is on a distal end portion of the catheter.