Apparatus and method for catheter navigation using endovascular energy mapping

• US 9,532,724 B2
• Filed: 09/22/2011
• Issued: 01/03/2017
• Est. Priority Date: 06/12/2009
• Status: Active Grant

• Current Assignee: BARD Access Systems Incorporated (Becton, Dickinson & Co)
• Original Assignee: BARD Access Systems Incorporated (Becton, Dickinson & Co)
• Inventors: Grunwald, Sorin
• Primary Examiner(s): Heller, Tammie K
• Application Number:
  US13/240,171
• Publication Number:
  US 20120059270A1
• Time in Patent Office: 1,930 Days
• Field of Search: 600/517, 600/521, 600/523
• US Class Current: 1/1
• CPC Class Codes: A61B 2034/2046 Tracking techniques
• CPC Class Codes: A61B 2034/2053 Tracking an applied voltage gradient
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• 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 5/063 using impedance measurements
• CPC Class Codes: A61B 5/25 Bioelectric electrodes therefor
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61M 2025/0166 Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61M 2025/09116 Design of handles or shafts or gripping surfaces thereof for manipulating guide wires
• CPC Class Codes: A61M 25/0026 Multi-lumen catheters with stationary elements catheter assemblies comprising a catheter in combination with a guide tube, sheath or sleeve A61M2025/0681; catheters comprising telescoping coaxial elements A61M2025/0175
• CPC Class Codes: A61M 25/003 characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves catheter tips A61M25/0067
• CPC Class Codes: A61M 25/0102 Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0194 Tunnelling catheters
• CPC Class Codes: A61M 25/09 Guide wires

Abstract

Devices and methods obtain and use endovascular electrograms in a number of clinical applications and settings. In one embodiment, a method for locating an indwelling medical device within a vasculature of a patient includes identifying an endovascular ECG waveform complex from an endovascular ECG signal associated with the indwelling medical device, then calculating an absolute value of the energy of the endovascular ECG waveform complex over a predetermined segment thereof. A position of the medical device within the vasculature is then determined by observation of the absolute value of the energy of the predetermined segment of the endovascular ECG waveform complex.

Claims

1. A system for tracking a location of a medical device within a vasculature of a patient, the system comprising:

an endovascular electrode disposed on the medical device and capable of detecting an endovascular ECG signal;

a display for depicting an image of the endovascular ECG signal;

a storage device including one or more instructions; and

a module including a processor, the module communicatively coupled to the storage device, wherein when the processor executes the one or more instructions, the processor identifies an endovascular ECG waveform complex of the endovascular ECG signal and calculates an absolute value of an energy of the endovascular ECG waveform complex in order to enable determination of a position of the medical device within the vasculature.

2. The system for tracking as defined in claim 1, wherein the display depicts information relating to the absolute value of the energy of the endovascular ECG waveform complex to enable a clinician to determine the location of the medical device within the vasculature.

3. The system for tracking as defined in claim 1, wherein when the processor executes the one or more instructions, the processor identifies a P-wave segment in the endovascular ECG waveform complex, calculates a positive energy value relating to an amount of energy of the P-wave segment above a baseline of the endovascular ECG signal, and calculates a negative energy value relating to the amount of energy of the P-wave segment below a baseline of the endovascular ECG signal in order to assist in determining the location of the medical device within the vasculature.

4. The system for tracking as defined in claim 1, wherein the endovascular ECG signal is detected via a lead II configuration of Einthoven'"'"'s triangle, and wherein a skin ECG signal is detected by the system via a lead III configuration of Einthoven'"'"'s triangle.

5. The system for tracking as defined in claim 1, further comprising a graphical user interface displaying a P-wave indicator on the display, the P-wave indicator highlighting a P-wave of the endovascular ECG waveform complex of the endovascular ECG signal.

6. The system for tracking as defined in claim 1, further comprising a graphical user interface displaying a R-peak indicator on the display, the R-peak indicator highlighting a R-peak of the endovascular ECG waveform complex of the endovascular ECG signal.

7. The system for tracking as defined in claim 1, further comprising a graphical user interface displaying a P-peak indicator on the display, the P-peak indicator highlighting a P-peak of the endovascular ECG waveform complex of the endovascular ECG signal.

8. The system for tracking as defined in claim 1, wherein the display is further designed for depicting an image of a skin ECG signal.

9. The system for tracking as defined in claim 8, further comprising a graphical user interface displaying a R-peak indicator on the display, the R-peak indicator highlighting a (i) R-peak of the endovascular ECG waveform complex of the endovascular ECG signal and (ii) a R-peak of a skin ECG waveform complex of the skin ECG signal.

10. The system for tracking as defined in claim 9, further comprising a graphical user interface displaying a P-peak indicator on the display, the P-peak indicator highlighting (i) a P-peak of the endovascular ECG waveform complex of the endovascular ECG signal and (ii) a P-peak of the skin ECG waveform complex of the skin ECG signal.

11. The system for tracking as defined in claim 8, further comprising a graphical user interface displaying a P-wave indicator on the display, the P-wave indicator highlighting a P-wave of the endovascular ECG waveform complex of the endovascular ECG signal and a P-wave of the skin ECG waveform complex of the skin ECG signal.

12. The system for tracking as defined in claim 8, further comprising a graphical user interface displaying a P-peak indicator on the display, the P-peak indicator highlighting a P-peak of the endovascular ECG waveform complex of the endovascular ECG signal and a P-peak of the skin ECG waveform complex of the skin ECG signal.

13. The system for tracking as defined in claim 12, further comprising a graphical user interface displaying a P-wave indicator on the display, the P-wave indicator highlighting a P-wave of the endovascular ECG waveform complex of the endovascular ECG signal and a P-wave of the skin ECG waveform complex of the skin ECG signal.