CA2355788A1 - Method and apparatus for mapping a chamber of a heart - Google Patents

Method and apparatus for mapping a chamber of a heart Download PDF

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Publication number
CA2355788A1
CA2355788A1 CA002355788A CA2355788A CA2355788A1 CA 2355788 A1 CA2355788 A1 CA 2355788A1 CA 002355788 A CA002355788 A CA 002355788A CA 2355788 A CA2355788 A CA 2355788A CA 2355788 A1 CA2355788 A1 CA 2355788A1
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CA
Canada
Prior art keywords
chamber
mapping
heart according
sensor
condition
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002355788A
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French (fr)
Other versions
CA2355788C (en
Inventor
Margarita Osadchy
Alexander Goldin
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Biosense Webster Inc
Original Assignee
Biosense, Inc.
Margarita Osadchy
Alexander Goldin
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Biosense, Inc., Margarita Osadchy, Alexander Goldin filed Critical Biosense, Inc.
Publication of CA2355788A1 publication Critical patent/CA2355788A1/en
Application granted granted Critical
Publication of CA2355788C publication Critical patent/CA2355788C/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0062—Arrangements for scanning
    • A61B5/0064—Body surface scanning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
    • A61B5/062—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using magnetic field
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/12—Devices for detecting or locating foreign bodies

Abstract

A method for intracardially mapping a condition such as an electrical or mechanical property of a chamber of a heart with a catheter having a distal tip and at least one condition sensor contained therein or proximate thereto. The at least one sensor is capable of sensing condition information in the chamber and provides the three-dimensional position of the catheter tip in a positional frame of reference.
The method comprises the steps of acquiring first and second images of the chamber.
The images are acquired from different projections and contain topological information of the chamber. The chamber images are registered with the positional frame of reference. The catheter distal tip is advanced into the catheter and is navigated to acquisition points under the guidance of topological information contained in or derived from the images. Condition and position information are acquired at each of the acquisition points, the points being sufficient in number and spacing to permit the generation of a map of the condition in the chamber. The topological information used to guide the navigation of the catheter is preferably a three dimensional reconstruction of the chamber derived from topological information contained in the images.

Claims (57)

1. A method for intracardially mapping a condition of a camber of a heart of a subject, said method comprising the steps of:

a) providing a catheter having a distal tip, said catheter distal tip having at least one sensor contained therein or proximate thereto, said at least one sensor being capable of sensing condition information of said chamber and providing three-dimensional position information of the catheter tip in a positional frame of reference;
b) acquiring a first image of said chamber, said first image taken from a first projection and containing topological information of said chamber;
c) acquiring a second image of said chamber, said second image taken from a second projection different from said first projection, said second image containing topological information of said chamber, d) registering said first image and said second image with said positional frame of reference;
e) advancing said distal tip of said catheter into said chamber;
f) navigating said distal tip of said catheter proximate an acquisition point in said chamber, said navigation guided by topological information contained in or derived from said first and said second images;
g) acquiring condition information and position information at said acquisition point with said at least one sensor;

h) repeating step (f) and (g) at additional acquisition points to generate a map of said condition in said chamber.
2. A method of mapping a chamber of a heart according to claim 1 wherein said condition is an electrical condition.
3. A method of mapping a chamber of a heart according to claim 1 wherein said condition is a mechanical condition.
4. A method of mapping a chamber of a heart according to claim 1 wherein said condition is an electromechanical condition.
5. A method of mapping a chamber of a heart according to claim 1 wherein said chamber is a left ventricle.
6. A method of mapping a chamber of a heart according to claim 1 wherein said at least one sensor comprises a position sensor capable of providing said three-dimensional position information, said position sensor further providing mechanical condition information.
7. A method of mapping a chamber of a heart according to claim 1 wherein said at least one sensor comprises a position sensor capable of providing said three-dimensional position information and an electrode for sensing electrical information.
8. A method of mapping a chamber of a heart according to claim 1 wherein said at least one sensor comprises an electromagnetic sensor, said electromagnetic sensor generating signals responsive to the strength of a magnetic field external to the patient, said signals indicative of the three-dimensional position of the sensor in said frame of reference.
9. A method of mapping a chamber of a heart according to claim 1 wherein said first and said second images of said chamber are contrast-assisted fluoroscopic images.
10. A method of mapping a chamber of a heart according to claim 1 wherein each of said first and said second images depict the chamber at the same phase of the cardiac cycle.
11. A method of mapping a chamber of a heart according to claim 10 wherein each of said first and said second images depict the chamber in end-diastole.
12. A method of mapping a chamber of a heart according to claim 1 wherein said topological information comprises the chamber contour.
13. A method of mapping a chamber of a heart according to claim 1 wherein said first projection and said second projection are separated by an angle of about degrees to about 105 degrees.
14. A method of mapping a chamber of a heart according to claim 1 wherein said first image and said second image are taken from an LAO projection and an RAO
projection.
15. A method of mapping a chamber of a heart according to claim 1 which further comprises acquiring an image of a scaling object from each of said first and said second projections.
16. A method of mapping a chamber of a heart according to claim 15 wherein said images of said scaling object are used to scale said images of said chamber.
17. A method of mapping a chamber of a heart according to claim 1 which further comprises affixing a registration position sensor to said patient prior to acquisition of said first and said second images of said chamber, wherein said chamber images include an image of said registration position sensor.
18. A method of mapping a chamber of a heart according to claim 17 which further comprises determining the three-dimensional position coordinates of said registration position sensor, and using said determined position coordinates to register said images of said chamber in said frame of reference.
19. A method of mapping a chamber of a heart according to claim 1 wherein said topological information used to guide said catheter tip to said acquisition points comprises a reconstruction of said chamber.
20. A method of mapping a chamber of a heart according to claim 19 wherein said reconstruction is a three-dimensional reconstruction.
21. A method of mapping a chamber of a heart according to claim 1 which further comprises the step of creating a map of said chamber from said acquired condition and position information.
22. A method for intracardially mapping a condition of a chamber of a heart of a subject, said method comprising the steps of:

a) providing a mapping catheter having a distal tip, said catheter distal tip having at least one sensor contained therein or proximate thereto, said at least one sensor being capable of sensing condition information of said chamber and providing three-dimensional position information of the catheter tip in a positional frame of reference;

b) providing a reconstruction of topological features of said chamber registered with said positional frame of reference;

c) advancing said distal tip of said catheter into said chamber;

d) navigating said distal tip of said catheter proximate an acquisition point in said chamber, said navigation guided by said topological features of said reconstruction;

e) acquiring condition information and position information at said acquisition point with said at least one sensor;

f) repeating step (d) and (e) at additional acquisition points throughout the chamber to generate a map of said condition in said chamber.
23. A method of mapping a chamber of a heart according to claim 22 wherein said reconstruction is a three dimensional reconstruction.
24. A method of mapping a chamber of a heart according to claim 22 wherein said reconstruction is based on:

a) a first image of said chamber taken from a first projection; and b) a second image of said chamber taken from a second projection;
wherein each of said first and said second images contain topological information of said chamber.
25. A method of mapping a chamber of a heart according to claim 24 wherein said first and said second images of said chamber are contrast-assisted fluoroscopic images.
26. A method of mapping a chamber of a heart according to claim 24 wherein each of said first and said second images depict the chamber at the same phase of the cardiac cycle.
27. A method of mapping a chamber of a heart according to claim 24 wherein each of said first and said second images depict the chamber in end-diastole.
28. A method of mapping a chamber of a heart according to claim 24 wherein said topological information comprises the chamber contour.
29. A method of mapping a chamber of a heart according to claim 24 wherein said first projection and said second projection are separated by an angle of about 75 degrees to about 105 degrees.
30. A method of mapping a chamber of a heart according to claim 24 wherein said first image and said second image are taken from an LAO projection and an RAO projection.
31. A method of mapping a chamber of a heart according to claim 24 which further comprises acquiring an image of a scaling object from each of said first and said second projections.
32. A method of mapping a chamber of a heart according to claim 31 wherein said images of said scaling object are used to scale said images of said chamber.
33. A method of mapping a chamber of a heart according to claim 24 which further comprises affixing a registration position sensor to said patient prior to acquisition of said first and said second images of said chamber, wherein said chamber images include an image of said registration position sensor.
34. A method of mapping a chamber of a heart according to claim 33 which further comprises determining the three-dimensional position coordinates of said registration position sensor, and using said determined position coordinates to register said images of said chamber in said frame of reference.
35. A method of mapping a chamber of a heart according to claim 22 wherein said condition is an electrical condition.
36. A method of mapping a chamber of a heart according to claim 22 wherein said condition is a mechanical condition.
37. A method of mapping a chamber of a heart according to claim 22 wherein said condition is an electromechanical condition.
38. A method of mapping a chamber of a heart according to claim 22 wherein said chamber is a left ventricle.
39. A method of mapping a chamber of a heart according to claim 22 wherein said at least one sensor comprises a position sensor capable of providing said three-dimensional position information, said position sensor further providing mechanical condition information.
40. A method of mapping a chamber of a heart according to claim 22 wherein said at least one sensor comprises a position sensor capable of providing said three-dimensional position information and an electrode for sensing electrical information.
41. A method of mapping a chamber of a heart according to claim 22 wherein said at least one sensor comprises an electromagnetic sensor, said electromagnetic sensor generating signals responsive to the strength of a magnetic field external to the patient, said signals indicative of the three-dimensional position of the sensor in said frame of reference.
42. A method of mapping a chamber of a heart according to claim 22 which further comprises the step of creating a map of said chamber from said acquired condition and position information.
43. Apparatus for intracardially mapping a condition of a chamber of a heart of a subject comprising:
a) a catheter having a distal tip, said catheter distal tip having at least one sensor contained therein or proximate thereto, said at least one sensor being capable of sensing condition information of said chamber and providing three-dimensional position information of the catheter tip in a frame of reference;
b) image processing circuitry for registering a plurality of images of said chamber with said positional frame of reference, said images taken from a plurality of projections relative to said chamber, said images containing topological information of said chamber;~
c) signal processing circuits for acquiring condition information and position information at a plurality of acquisition points in said chamber with said at least one sensor, said condition and position information permitting the generation of a map of said condition in said chamber.
44. Apparatus for mapping a chamber of a heart according to claim 43 wherein said at least one sensor comprises a position sensor capable of providing said three-dimensional position information and an electrode for sensing electrical information.
45. Apparatus for mapping a chamber of a heart according to claim 43 wherein said at least one sensor comprises an electromagnetic sensor, said electromagnetic sensor generating signals responsive to the strength of a magnetic field external to the patient, said signals indicative of the three-dimensional position of the sensor in said frame of reference.
46. Apparatus for mapping a chamber of a heart according to claim 43 which further comprises a scaling object.
47. Apparatus for mapping a chamber of a heart according to claim 43 which further comprises a registration position sensor to register said images with said frame of reference.
48. Apparatus for mapping a chamber of a heart according to claim 43 which further comprises image processing circuits for constructing a reconstruction of said chamber from said topological information contained in said images.
49. Apparatus for mapping a chamber of a heart according to claim 48 wherein said reconstruction is a three-dimensional reconstruction.
50. Apparatus for mapping a chamber of a heart according to claim 43 which further comprises circuits for mapping said condition of said chamber using said condition information and said position information.
51. Apparatus for intracardially mapping a condition of a chamber of a heart of a subject comprising:

a) a catheter having a distal tip, said catheter distal tip having at least one sensor contained therein or proximate thereto, said at least one sensor being capable of sensing condition information of said chamber and providing three-dimensional position information of the catheter tip in a frame of reference;
b) image processing circuits for constructing a topological reconstruction of said chamber registered with said frame of reference;
c) signal processing circuits for acquiring condition information and position information at a plurality of acquisition points in said chamber with said at least one sensor, said condition information and position information permitting the generation of a map of said condition in said chamber.
52. Apparatus for mapping a condition of a chamber of a heart of claim 51 wherein said reconstruction is a three dimensional reconstruction.
53. Apparatus for mapping a condition of a chamber of a heart of claim 51 wherein said image processing circuits construct said topological reconstruction from a plurality of images of said chamber, said images taken from a plurality of projections relative to said chamber, each of said images containing topological information of said chamber.
54. Apparatus for mapping a chamber of a heart according to claim 51 wherein said at least one sensor comprises a position sensor capable of providing said three-dimensional position information and an electrode for sensing electrical information.
55. Apparatus for mapping a chamber of a heart according to claim 51 wherein said at least one sensor comprises an electromagnetic sensor, said electromagnetic sensor generating signals responsive to the strength of a magnetic field external to the patient, said signals indicative of the three-dimensional position of the sensor in said frame of reference.
56. Apparatus for mapping a chamber of a heart according to claim 51 which further comprises a scaling object.
57. Apparatus for mapping a chamber of a heart according to claim 51 which further comprises a registration position sensor to register said images with said frame of reference.
CA002355788A 2000-08-18 2001-08-16 Method and apparatus for mapping a chamber of a heart Expired - Lifetime CA2355788C (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US09/643,667 US6368285B1 (en) 1999-09-21 2000-08-18 Method and apparatus for mapping a chamber of a heart
US09/643,667 2000-08-18

Publications (2)

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CA2355788A1 true CA2355788A1 (en) 2002-02-18
CA2355788C CA2355788C (en) 2009-12-01

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US (1) US6368285B1 (en)
EP (1) EP1189175A1 (en)
JP (1) JP4746793B2 (en)
KR (1) KR100829405B1 (en)
AU (1) AU777116B2 (en)
CA (1) CA2355788C (en)
HK (1) HK1041957A1 (en)
IL (1) IL144908A (en)

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