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

• US 9,301,705 B2
• Filed: 12/30/2011
• Issued: 04/05/2016
• Est. Priority Date: 11/04/1998
• Status: Expired due to Term

• Current Assignee: Johns Hopkins University
• Original Assignee: Johns Hopkins University
• Inventors: Halperin, Henry R., Berger, Ronald D., Atalar, Ergin, McVeigh, Elliott R., Lardo, Albert, Lima, Joao, Caikins, Hugh
• Primary Examiner(s): Brutus, Joel F
• Application Number:
  US13/341,266
• Publication Number:
  US 20120101364A1
• Time in Patent Office: 1,558 Days
• Field of Search: 600/407, 600410-411, 324306-309
• US Class Current: 1/1
• 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.

Claims

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

positioning the mammalian 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 by applying static and gradient magnetic fields to the mammalian patient and sensing radio frequency (RF) emissions from precession of protons in the heart excited by the static and the gradient magnetic fields;

using the magnetic resonance image to position said MR-compatible catheter in the heart while continuing to acquire additional magnetic resonance images of the heart,

establishing a conductive connection between the catheter and the heart while the catheter is in the static and gradient magnetic fields, and

monitoring electrical signals in the heart acquired through the conductive connection between the catheter and the heart.

2. The method according to claim 1 further comprising filtering acquired electrical signals to suppress electrical currents induced in the MR-compatible catheter due to the static and gradient magnetic fields.

3. The method according to claim 1 further comprising ablating the heart with the MR-compatible catheter to create ablation lesions in the heart and magnetic resonance imaging the lesions.

4. The method according to claim 3 further comprising viewing an image of the ablation legions to identify an area proximate to the ablation lesions and further ablating the area with the MR-compatible catheter.

5. A method of performing a magnetic resonance-guided procedure comprising:

placing a subject in a magnetic resonance scanner;

acquiring magnetic resonance images of the subject by applying static and gradient magnetic fields to the subject and sensing radio frequency (RF) emissions from precession of protons in the subject excited by the static and the gradient magnetic fields;

identifying a target site in the subject using data about the subject obtained from the magnetic resonance scanner;

introducing into the patient a magnetic resonance probe, wherein the magnetic resonance probe includes (i) a catheter sheath, (ii) a center core within the catheter sheath and is configured to extend from the catheter sheath, wherein the center core is formed of a non-ferromagnetic conductive material and is covered, at least partially, by a first insulating layer coating and wherein a distal end region of the center core forms a first pole of a magnetic resonance dipole antenna;

(iii) a dielectric second insulating layer at least partially covering the catheter sheath, and (iv) a plurality of non-ferromagnetic conductive electrodes on an outer surface of the catheter sheath;

advancing the magnetic resonance probe to the target site; and

performing a procedure on the target site using the magnetic resonance probe in which electrical energy is conducted between the conductive electrodes and the target site and while the magnetic resonance scanner continues to acquire magnetic resonance images of the subject.

6. The method of claim 5, wherein the target site is located in a heart of the patient.

7. The method of claim 5, wherein the magnetic resonance probe is an RF ablation electrode, and the magnetic resonance-guided procedure further comprises ablating heart tissue.