|Número de publicación||USRE44736 E1|
|Tipo de publicación||Concesión|
|Número de solicitud||US 13/027,489|
|Fecha de publicación||28 Ene 2014|
|Fecha de presentación||15 Feb 2011|
|Fecha de prioridad||29 May 2002|
|También publicado como||CA2487140A1, CA2487140C, EP1508051A1, US6904307, US7133714, US20040046557, US20060119361, USRE42856, WO2003102614A1|
|Número de publicación||027489, 13027489, US RE44736 E1, US RE44736E1, US-E1-RE44736, USRE44736 E1, USRE44736E1|
|Inventores||Parag Karmarkar, Ingmar Viohl|
|Cesionario original||MRI Interventions, Inc.|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (239), Otras citas (52), Citada por (11), Clasificaciones (6), Eventos legales (4)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
Notice: More than one reissue application has been filed for the reissue of U.S. Pat. No. 6,904,307. The reissue applications are U.S. application Ser. No. 11/810,679 filed Jun. 6, 2007 which issued on Oct. 18, 2011 as U.S. Pat. No. Re. 42,856 E, and the present application (U.S. application Ser. No. 13/027,489), which is a divisional reissue of U.S application Ser. No. 11/810,679.
This application claims the benefit of U.S provisional application Ser. No 60/383,828, filed May 29, 2002, which is hereby incorporated herein in its entirety by this reference.
Leads (catheters) for a wide variety of medical procedures, such as Deep Brain Stimulation (DBS) and cardiac interventions, are typically placed into the body of a subject under stereotactic guidance, fluoroscopy, or other methods. Stereotactic guidance is a static method based on high resolution images taken prior to the procedure and does not take into account displacement of the brain caused by the loss of cerebral spinal fluid (CSF), blood or simple brain tissue displacement by the surgical tool. It is therefore often necessary to perform a real time physiological localization of the target area to augment and verify the previously obtained stereotactic data by observing the patients response to stimulation through the DBS electrodes or by recording and displaying (visual or audible) the action potentials of individual neurons along the path way to the target zone using microelectrodes. These additional steps are time consuming; resulting in procedures between 6-8 hours with a failure rate still remaining between 20-30%.
Cardiac procedures are mainly performed using X-ray fluoroscopy. Because X-ray shadows are the superposition of contributions from many structures, and since the discrimination of different soft tissues is not great, it is often very difficult to determine exactly where the catheter is within the heart. In addition, the borders of the heart are generally not accurately defined, so it is generally not possible to know whether the catheter has penetrated the wall of the heart. Furthermore, lesions are invisible under x-ray fluoroscopy. Thus, it is very difficult to discern whether tissue has been adequately ablated.
The systems and methods disclosed herein may simplify the manufacturing process for magnetic resonance probes, increase patient safety, reduce if not eliminate tissue heating, and facilitate the performance of multiple functions during MRI interventional procedures such as Deep Brain Stimulation, Electrophysiological Mapping, and/or RF Ablation.
In an embodiment, a magnetic resonance probe may include a plurality of center conductors, at least some center conductors including a conductive core and an insulator disposed at least partially about the core along at least a portion of the core. A first dielectric layer may be disposed at least partially about the plurality of center conductors in a proximal portion of the probe. An outer conductive layer may be at least partially disposed about the first dielectric layer. A plurality of electrodes may be included, at least one electrode being coupled to one of the center conductors and disposed at least partly on a probe surface.
In an embodiment, a probe may include a second dielectric layer at least partially disposed about the outer conductor. In an embodiment, the plurality of center conductors may be magnetic resonance-compatible. In an embodiment, at least one insulator may have a thickness up to about 100 microns. In an embodiment, at least some center conductors may form a first pole of a dipole antenna, and the outer conductive layer may form a second pole of the dipole antenna. In an embodiment, a probe can include a plurality of radially expandable arms. In an embodiment, at least one electrode may be at least partly disposed on an arm.
In an embodiment, an interface circuit may be electrically coupled to the probe, the interface circuit including a signal splitter that directs a signal received from the probe to a magnetic resonance pathway and an electrophysiology pathway, a high-pass filter disposed in the magnetic resonance pathway, a low-pass filter disposed in the electrophysiology pathway, a connector disposed in the magnetic resonance pathway for connecting to a magnetic resonance scanner, and a connector disposed in the electrophysiology pathway for connecting to at least one of a tissue stimulator, a biopotential recording system, and an ablation energy source.
Embodiments of the disclosed systems and methods will be apparent from the following more particular description of exemplary embodiments as illustrated in the accompanying drawings, in which some reference characters refer to the same parts throughout the various views. The drawings are not necessarily to scale, nor are individual elements necessarily in relative proportion to other elements, emphasis instead being placed upon illustrating principles of the disclosed systems and methods.
The disclosed systems and methods relate to the guidance and visualization of diagnostic and therapeutic procedures performed under Magnetic Resonance Imaging (MRI). Such procedures in general benefit from the excellent soft tissue contrast obtainable with MRI. Examples of such applications are Deep Brain Stimulation (DBS) for the treatment of movement disorders (Parkinson's disease, Essential tremor, etc.) and other neurological disorders benefiting from electrical stimulations of section of the brain, as well as the diagnosis and treatment of cardiac arrhythmias including but not limited to atrial fibrillation and ventricular tachycardia.
Real time Magnetic Resonance Imaging can overcome both the inaccuracies of stereotactic planning and the lack of soft tissue contrast as found in X-ray fluoroscopy. The use of Magnetic Resonance Imaging guided interventions can therefore result in shortened procedure times and increased success rates.
Some conditions that may benefit from MRI-guided DBS include Parkinson's disease, essential tremor, and multiple sclerosis. Parkinson's disease is a progressive neurological disorder in regions of the midbrain containing a cluster of neurons known as the “substantia nigra.” These neurons produce the chemical dopamine, a neurotransmitter (messenger) responsible for transmitting signals between the substantia nigra and several clusters of neurons that comprise the basal ganglia and is vital for normal movement. When dopamine levels drop below 80%, symptoms of Parkinson's disease begin to emerge causing nerve cells of the basal ganglia to fire out of control; resulting in tremor, muscle stiffness or rigidity, slowness of movement (bradykinesia) and loss of balance. Although medication masks some symptoms for a limited period, generally four to eight years in most patients, they begin causing dose-limiting side effects. Eventually the medications lose their effectiveness, leaving the patient unable to move, speak or swallow. Several preventive and restorative strategies such as neural cell transplantation, neural growth factors, gene therapy techniques and surgical therapies (including DBS), have shown promise in animal studies and human clinical trials. Important links to the cause (including genetic susceptibility and the role of toxic agents) are becoming established. Leading scientists describe Parkinson's as the neurological disorder most likely to produce a breakthrough therapy and/or cure within this decade. Parkinson's disease afflicts approximately 1 million Americans, nearly 40 percent of whom are under the age of 60. Roughly 60,000 cases of PD are diagnosed each year. It is estimated that Parkinson's disease costs society $25 billion or more annually.
Essential tremor (ET) is considered the most common neurological movement disorder affecting nearly 10 million people in the United States. ET is a chronic condition characterized by involuntary, rhythmic tremor of a body part, most typically the hands and arms, often the head and voice, but rarely the legs. ET is generally considered a slowly progressive disorder, although many individuals may have a mild form of ET throughout life that never requires treatment. The most common form of ET affects the arms and hands, usually bilaterally, and is most prominent with the arms held against gravity (postural tremor) or in action (kinetic tremor) such as when writing or drinking from a cup. Unlike patients with Parkinson's disease, patients with ET rarely exhibit a tremor when the arm is at rest. Pharmacological treatment for ET includes a class of drugs called Beta-adrenergic blocking agents (such as propranolol), benefiting about 50 to 60 percent of patients. Primidone (MYSOLINE) is commonly regarded as the most effective drug. Side effects of these drugs include: bradycardia (slow heart rate), hypotension (low blood pressure), dizziness, fatigue, depression, diarrhea, nausea and/or sexual dysfunction. Surgical treatment of ET has for years involved placing a lesion in certain cluster of cells called the thalamus. This procedure, called stereotaxic thalamotomy has been quite effective in substantially reducing tremor intensity, although there is a finite risk of stroke or other surgical complications and bilateral thalamotomies increase the risk of speech impairment (dysarthria). The recent development of high frequency stimulation of the thalamus (deep brain stimulation) has provided a safer and more effective surgical strategy for treating ET. This procedure involves the placement of an electrode in a region of the thalamus (Ventral Intermediate Nucleus or VIM).
Multiple sclerosis (MS) tends to begin in young adulthood and affects about 500,000 people in the United States. Worldwide, the incidence rate is approximately 0.01% with Northern Europe and the northern US having the highest prevalence with more than 30 cases per 100,000 people. MS is a chronic, progressive, degenerative disorder that affects nerve fibers in the brain and spinal cord. A fatty substance (called myelin) surrounds and insulates nerve fibers and facilitates the conduction of nerve impulse transmissions. MS is characterized by intermittent damage to myelin (called demyelination) caused by the destruction of specialized cells (oligodendrocytes) that form the substance. Demyelination causes scarring and hardening (sclerosis, plague) of nerve fibers usually in the spinal cord, brain stem, and optic nerves, which slows nerve impulses and results in weakness, numbness, pain, and vision loss. MS can affect any part of the central nervous system. When it affects the cerebellum or the cerebellum's connections to other parts of the brain, severe tremor can result. Since the sub cortical gray matter also contains myelinated nerve fibers, plaques can also be found in the striatum, pallidum and thalamus. This may be the pathological basis for the other movement disorders seen in a small proportion of patients with MS. Because different nerves are affected at different times, MS symptoms often exacerbate (worsen), improve, and develop in different areas of the body. Early symptoms of the disorder may include vision changes (e.g., blurred vision, blind spots) and muscle weakness. MS can progress steadily or cause acute attacks (exacerbations) followed by partial or complete reduction in symptoms (remission). Most patients with the disease have a normal lifespan.
In a typical DBS procedure, a stereotactic frame, e.g. an Ieksell frame, is attached (bolted) to the patient prior to any portion of the surgical intervention. This is often done in a separate small operating room, either under sedation (Midazolam, Fentanyl, Propofol) and/or local anesthesia (Lidocaine). After the frame is attached, the patient is transferred to the table of the imaging system (CT or MR) and the patient's head is immobilized. A box containing fiduciary markers is fitted on to the frame. These markers will show up in subsequent images in precisely known locations, allowing an accurate mapping between the frame coordinates and brain structures. Based on these detailed images and coordinate mappings, the trajectory for the surgery using a planning software program.
Typical targets for the procedure include regions in the Thalamus, the Globus Pallidum Internus (Gpi) and the Subthalamic Nucleus (SNT). The target selection strongly depends on the disease and symptoms treated. DBS in the GPi seems to be very effective for drug-induced dyskinesia and helps control tremor and bradykinesia. DBS in the SNT seem to be most effective as measured by ability of patients to reduce their medications, however, there is a potential for increasing dyskinesia. The Thalamus is not necessarily a good target for patients with Parkinson's disease but has been found to improve conditions for patients with Essential Tremor and movement disorder caused by Multiple Sclerosis.
Once the target has been effectively localized and noted to be in a safe location, effort must be placed on a safe entry and trajectory to the target. MRI surface images of the cerebral cortex in combination with the DBS planning scans can be useful to avoid injuries to cerebral arteries or veins at the initial drill holes and due to passage of the DBS electrode, resulting in a catastrophic hemorrhage. With the stereotactic software system, trajectory slices are possible so that every stage of the trajectory can be visualized in terms of its potential harm as an electrode is passed toward the target. Fine adjustments to the entry point can be made to avoid these critical structures or avoid passage through the ventricular system in the patient with large ventricles.
Entry point coordinates are not directly utilized during operative planning but are used by the computer system in creating the trajectory itself. An estimate of accuracy can then be obtained and is usually accurate within several hundred microns and always less than 0.5 cm accuracy so that the results from imaging and planning can be used effectively during the surgical procedure.
Once the planning process is completed, the patient is transferred to the operating room and a hole is drilled into the patient's skull (0.5″ to 1.0″). At this point, most surgery centers will perform a real time physiological localization of the target area to augment and verify the previously obtained stereotactic data by observing the patients response to stimulation through the DBS electrodes or by recording and displaying (visual or audible) the action potentials of individual neurons along the path way to the target zone using microelectrodes. The additional step is considered necessary because the shape of the brain and the position of anatomical structures can change during neuro-surgical procedures. Such changes can be due to differences between the patient's position in acquisition and during surgery, reduction in volume due to tissue resection or cyst drainage, tissue displacement by the instruments used, changes in blood and extra cellular fluid volumes, or loss of cerebrospinal fluid when the skull is opened. The amount of brain shift can in a severe case be a centimeter or more and is in most cases between 1 and 2 mm.
In addition to the brain shift phenomenon, some subsection of specific nuclei cannot yet be identified by anatomic means, again requiring a physiological determination of the target area. Given these “uncertainties,” several target runs may be required before the desired results are achieved. Throughout the procedure, responses from the patient are necessary to determine if the target area has been reached and if there are any unwanted site effects. Once the target area has been correctly identified, the microelectrode is removed and replaced with the DBS electrode. Stimulation voltage levels are determined by observing the patient and the physiological response. Once all parameters have been correctly adjusted, the DBS electrode is anchored in the skull, a pacemaker is implanted subcutaneously in the subclavicular region and the lead is tunneled under the scalp up the back of the neck to the top of the head.
One of the major shortcomings with stereotactic DBS is the requirement of sub millimeter accuracy in electrode placement for the electrical stimulation of target areas deep inside the brain. As pointed out, brain shifts of 1 to 2 mm can routinely occur between the acquisition of images for the stereotactic surgery and the surgery itself and is either caused by patient transport (misregistration, image distortion), loss of fluid (blood, CSF) or simple tissue displacement by the instruments used. A long recognized solution to these issues has been to perform real time MRI guided surgery. To this end a variety of MRI systems have been developed. “Open MRI” systems which are typically operated at field strength ranging from 0.12 T (Odin) to 1.0 T (Philips) offer a clear advantage in patient access over the closed bore systems ranging in field strength from 1.0 T to 3.0 T. However, these high field short bore systems outperform the low field systems in Signal-to-Noise Ratio since the SNR depends linearly on field strength. Higher SNR translates directly into resolution and/or imaging speed. Efforts have been undertaken to increase the field strength of these open systems (Philips 1.0 T), however, it is not clear that much higher magnetic fields are desirable or achievable due to considerable mechanical challenges of stabilizing the separated pole faces of these magnets and the fact that these magnets are not easily shielded and have a larger fringe field than comparable “closed bore” systems. Furthermore, significant progress has been made to increase the patient access in high field systems as well. Traditionally, whole body 3 T MRI systems have had a length in access of 2 m. Over the past few years dedicated head scanners (Allegra, Siemens) have been developed and have reduced the system length to 1.25 m, allowing relatively easy access to the patient's head. Similar progress has been made in whole body scanners at 1.5 T. Since the actual magnet is significantly shorter (68 to 80 cm) than the overall system further improvements in patient access can be expected. Image quality, speed and patient access are now at a point where true interventional MRI is feasible. All major OEM's have recognized the need for a fully integrated MRI operating room and have made significant progress towards this goal. Siemens has introduced the “BrainSuite”, a fully integrated MRI suite for neuro-surgery. Philips, Siemens and GE have also introduced XMRI systems, combining 1.5 T or 3 T whole body systems with an X-Ray fluoroscopy with a patient table/carrier linking both systems.
Atrial fibrillation and ventricular tachyarrhythmias occurring in patients with structurally abnormal hearts are of great concern in contemporary cardiology. They represent the most frequently encountered tachycardias, account for the most morbidity and mortality, and, despite much progress, remain therapeutic challenges.
Atrial fibrillation affects a larger population than ventricular tachyarrhythmias, with a prevalence of approximately 0.5% in patients 50-59 years old, increasing to 8.8% in patients in their 80's. Framingham data indicate that the age-adjusted prevalence has increased substantially over the last 30 years, with over 2 million people in the United States affected. Atrial fibrillation usually accompanies disorders such as coronary heart disease, cardiomyopathies, and the postoperative state, but occurs in the absence of any recognized abnormality in 10% of cases. Although it may not carry the inherent lethality of a ventricular tachyarrhythmia, it does have a mortality twice that of control subjects. Symptoms which occur during atrial fibrillation result from the often rapid irregular heart rate and the loss of atrioventricular (AV) synchrony. These symptoms, side effects of drugs, and most importantly, thrombo-embolic complications in the brain (leading to approximately 75,000 strokes per year), make atrial fibrillation a formidable challenge.
Two strategies have been used for medically managing patients with atrial fibrillations. The first involves rate control and anticoagulation, and the second involves attempts to restore and maintain sinus rhythm. The optimal approach is uncertain. In the majority of patients, attempts are made to restore sinus rhythm with electrical or pharmacologic cardioversion. Current data suggest anticoagulation is needed for 3 to 4 weeks prior to and 2 to 4 weeks following cardioversion to prevent embolization associated with the cardioversion. Chronic antiarrhythmic therapy may be indicated once sinus rhythm is restored. Overall, pharmacologic, therapy is successful in maintaining sinus rhythm in 30 to 50% of patients over one to two years of follow-up. A major disadvantage of antiarrhythmic therapy is the induction of sustained, and sometimes lethal, arrhythmias (proarrhythmia) in up to 10% of patients.
If sinus rhythm cannot be maintained, several approaches are used to control the ventricular response to atrial fibrillation. Pharmacologic agents which slow conduction through the AV node are first tried. When pharmacologic approaches to rate control fail, or result in significant side effects, ablation of the AV node, and placement of a permanent pacemaker may be considered. The substantial incidence of thromboembolic strokes makes chronic anticoagulation important, but bleeding complications are not unusual, and anticoagulation cannot be used in all patients.
In addition to medical management approaches, surgical therapy of atrial fibrillation has also been performed. The surgical-maze procedure, developed by Cox, is an approach for suppressing atrial fibrillation while maintaining atrial functions. This procedure involves creating multiple linear incisions in the left and night atria. These surgical incisions create lines that block conduction and compartmentalize the atrium into distinct segments that remain in communication with the sinus node. By reducing the mass of atrial tissue in each segment, the mass of atrial tissue is insufficient to sustain the multiple reentrant rotors, which are the basis for atrial fibrillation. Surgical approaches to the treatment of atrial fibrillation result in an efficacy of >95% and a low incidence of complications. However, despite these encouraging results, this procedure has not gained widespread acceptance because of the long duration of recovery and risks associated with cardiac surgery.
Invasive studies of the electrical activities of the heart (electrophysiologic studies) have also been used in the diagnosis and therapy of arrhythmias. Focal atrial tachycardias, AV-nodal reentrant tachycardias, accessory pathways, atrial flutter, and idiopathic ventricular tachycardia can be cured by selective destruction of critical electrical pathways with radiofrequency (RF) catheter ablation. Electrophysiologists have attempted to replicate the maze procedure using RF catheter ablation. The procedure is arduous, requiring general anesthesia and procedure durations often greater than 12 hours, with exposure to ionizing x-ray irradiation for over 2 hours. Some patients have sustained cerebrovascular accidents. One of the main limitations of the procedure is the difficulty associated with creating and confirming the presence of continuous linear lesions in the atrium. If the linear lesions have gaps, then activation can pass through the gap and complete a reentrant circuit, thereby sustaining atrial fibrillation or flutter. This difficulty contributes significantly to the long procedure durations discussed above.
Creating and confirming continuous linear lesions and morbidity could be facilitated by improved minimally-invasive techniques for imaging lesions created in the atria. Such an imaging technique may allow the procedure to be based purely on anatomic findings.
The major technology for guiding placement of a catheter is x-ray fluoroscopy. For electrophysiologic studies and ablation, frame rates of 7-15 per second are generally used which allows an operator to see x-ray-derived shadows of the catheters inside the body. Since x-rays traverse the body from one side to the other, all of the structures that are traversed by the x-ray beam contribute to the image. The image, therefore is a superposition of shadows from the entire thickness of the body. Using one projection, therefore, it is only possible to know the position of the catheter perpendicular to the direction of the beam. In order to gain information about the position of the catheter parallel to the beam, it is necessary to use a second beam that is offset at some angle from the original beam, or to move the original beam to another angular position. The intracardiac electrogram may be used to guide the catheters to the proper cardiac tissue.
Intracardiac ultrasound has been used to overcome deficiencies in identifying soft tissue structures. With ultrasound it is possible to determine exactly where the walls of the heart are with respect to a catheter and the ultrasound probe, but the ultrasound probe is mobile, so there can be doubt where the absolute position of the probe is with respect to the heart.
Neither x-ray fluoroscopy nor intracardiac ultrasound have the ability to accurately and reproducibly identify areas of the heart that have been ablated.
A system known as “non-fluoroscopic electro-anatomic mapping” (U.S. Pat. No. 5,391,199 to Ben-Haim), was developed to allow more accurate positioning of catheters within the heart. That system uses weak magnetic fields and a calibrated magnetic field detector to track the location of a catheter in 3D-space. The system can mark the position of a catheter, but the system relies on having the heart not moving with respect to a marker on the body. The system does not obviate the need for initial placement using x-ray fluoroscopy, and cannot directly image ablated tissue.
Embodiments of fixed, steerable, cooled and Multi Electrode Array probes are described that may incorporate multiple functions, such as the recording of MRI imaging signals, bio potentials (electrophysiological, neurological) and cooling. The probes can significantly reduce heating-induced injury in materials surrounding them and can be easily visualized under MRI or X-ray. Disclosed embodiments are illustrative and not meant to be limiting. Drawings illustrate exemplary embodiments and design principles; absolute or relative dimensions are not to be inferred therefrom as necessarily pertaining to a particular embodiment.
With continued reference to
As described above, a plurality of center conductors may be provided. A center conductor may include a conductive core. A center conductor may include an insulator disposed at least partially about the core along at least a portion of the core. The insulator may be disposed about the core to prevent contact between various cores. The insulator may be disposed along the entire length of the core or along one or portions thereof. In an embodiment, an insulator may be disposed about substantially the entire length of a core except for a distal portion for coupling to an electrode. Insulator may be selectively disposed about core, such as discontinuously or on only a selected aspect of a core, such as an aspect that faces another core. Thus, insulator may be disposed about one or more cores so that one or more center conductors may be touching but cores are not in contact.
The insulator can facilitate positioning a center conductors in close proximity to another center conductor. For example, two center conductors may touch but not have the respective cores be in contact. Such close arrangement of center conductors can permit electrical coupling between the center conductors of high-frequency energy, such as magnetic resonance energy, while preventing coupling of low-frequency energy between the center conductors. Coupling the center conductors for high-frequency energy facilitates receiving magnetic resonance signals with the center conductors because the center conductors so coupled can act as a single electrical entity with respect to the high-frequency energy. Thus, the electrical length of the distal portion 7 of the probe 100 can be preserved, because magnetic resonance energy can be conducted straight through the plurality of center conductors, without allowing the magnetic resonance energy to pass separately through various conductors, thereby creating interference, or causing the high-frequency energy to move through a longer path, thereby unbalancing a magnetic resonance antenna. In contrast, a thin insulating layer can be sufficient to prevent coupling between conductors of the low-frequency signals that may be conducted along selected center conductors. For example, low-frequency coupling may not be desirable when the probe 100 is being operated to measure an electrical potential between two electrodes contacting various tissue regions. If the center conductors were permitted to couple this low-frequency energy, then the potential measurement could be distorted, lost in excessive noise, or attenuated entirely. Similarly, ablation energy delivered along the probe 100 could be shorted between center conductors if the center conductors were permitted to couple low frequency energy.
Thus, the wire insulation is preferably sufficiently thin so that the center conductors are electrically coupled through the insulator at high frequency (e.g., above 10 MHz) but are isolated at frequencies below 0.5 MHz.
Accordingly, insulator properties may be selected to facilitate coupling of high-frequency energy between center conductors, while lessening or inhibiting coupling of low-frequency energy. Properties include the material or materials from which the insulator is made, the thickness of the insulator, the number of layers of insulator, the strength of the magnetic field in which the probe 100 may be immersed, among others.
Because the insulator can prevent coupling of low-frequency energy between the center conductors, the center conductors can be brought into very close proximity to one another, also termed “tightly coupled” to one another. The center conductors may be tightly coupled, for example, by twisted around one another. Twisting or otherwise tight-coupling the center conductors facilitates keeping the center conductors in close proximity in the distal portion 7 of the probe 100, where there may be no, e.g., first dielectric layer to keep the center conductors closely apposed. In addition, because reactive elements need not be interposed between the center conductors to decouple low-frequency energy, manufacture of the probe is simplified. Furthermore, the absence of reactive elements can permit the achievement of small probe diameters. For example, a probe having an outer of diameter of about 15 French or less, suitable for, among other uses, cardiac catheterization, observation, and/or ablation, can be readily constructed using systems and methods disclosed herein. Moreover, deep brain stimulation with a magnetic resonance probe is facilitated, because the diameter can be reduced to, for example, 4 French or less, 3 French or less, 2 French or less, 1.3 French or less, 1 French or less, 0.5 French or less, or even 0.1 French or less. The outer diameter can be affected by the thickness of the center conductor core, thickness of insulator, and thicknesses of other layers that may be included. In an embodiment, wire may be used having a thickness of 56 AWG to 16 AWG as well as thinner and/or thicker wire.
A preferred insulator thickness may be determined as follows. The inductance L and capacitance C between a twisted pair of wires per unit length is given by the equations:
where ε0=8.854 pF/m, d is the bare wire diameter in meters, D is the insulated wire diameter in meters, and εr is the relative dielectric constant of the insulating material. In one illustrative embodiment, a 33 AWG magnet wire was used, the wire having a nominal bare wire diameter of 0.0071″ (0.00018034 m) and an insulated diameter of 0.0078″ (0.00019812 m) and an approximate dielectric constant of εr=2. Thus, the insulator thickness was about 17.78 microns, or about 8.89 microns on a side. In this exemplary case the estimated capacitance per unit length is 89 pF/m. This corresponds to a capacitive impedance Zc=1/(2*π*f) of about 28 Ω/m at 63.86 MHz and giving a good coupling at the high frequency range. Because the impedance scales inversely with frequency, the low frequency impedance at 100 kHz is estimated to be 14 kΩ/m. An impedance of 10 kΩ/m or greater is sufficient in most applications to provide sufficient decoupling. The high frequency impedance is preferably kept below 100 Ω/m.
The impedance can also be controlled by the choice of dielectric material. Typical materials include polyurethane resins, polyvinyl acetal resins, polyurethane resins with a polyimide (nylon) overcoat, THEIC modified polyester, THEIC modified polyester with a polyamideimide (AI) overcoat, THEIC modified polyester, oxide-based shield coat and a polyamideimide (AI) overcoat, aromatic polyimide resin, bondable thermoplastic phenoxy overcoat, glass fiber, All Wood Insulating Crepe Paper, Thermally Upgraded Electrical Grade Crepe Kraft Paper, High Temperature Aramid Insulating Paper, and combinations of these. The length of the proximal portion can be modified by selecting dielectric materials for the first dielectric layer and/or second dielectric layers. For example, a material with a high dielectric constant can be incorporated in one or more dielectric layers, thereby decreasing the electrical length of the proximal portion and facilitating use of a probe in a relatively shallow anatomic location. Examples of materials with appropriate dielectric constants include ceramics.
An insulator disposed at least partially about a center conductor core may have a thickness in a range up to about 2,000 microns, preferably up to about 500 microns, more preferably up to about 200 microns, still more preferably up to about 100 microns, yet more preferably in a range between about 1 micron and about 100 microns. An insulator may have a thickness in the range of about 5 microns to about 80 microns. An insulator may a thickness in the range of about 8 microns to about 25 microns. An insulator may a thickness in the range of about 10 microns to about 20 microns.
A core may have an insulator disposed about it by dipping the core in insulator. A core may have an insulator disposed about it by extruding an insulator over the core. A core may have an insulator disposed about it by sliding the core into an insulator or sliding an insulator over a core. A core may have an insulator disposed about it by spraying.
A core may be formed of wire. The wire is preferably thin, to promote small probe size, and may in one embodiment be thin insulated copper wires (33 AWG), at times silver coated. In preferred embodiments, the center conductors are formed of magnetic-resonance compatible material. Preferably, the materials are highly conducting, such as silver clad copper. The outer conductive layer may also be formed of wire, such as braided wire. Other preferred materials include a super elastic material, copper, gold, silver, platinum, iridium, MP35N, tantalum, titanium, Nitinol, L605, gold-platinum-iridium, gold-copper-iridium, and gold-platinum.
As mentioned previously, the plurality of center conductors 2 in the distal portion 7 of the probe 100 may form a first pole of a dipole (loopless) magnetic resonance antenna, while the outer conductive layer 12 in the proximal portion 8 of the probe 100 can form the second pole. As discussed above, the length of the distal portion, or first pole, is preferably approximately the “quarter-wave” length, typically about 3 cm to about 15 cm. The proximal portion or second pole can be of the same length, so that the dipole antenna is balanced. A balanced dipole antenna can provide slightly improved signal quality compared to an unbalanced dipole antenna. However, a proximal portion of approximately even 15 cm may be impractical, because a user might want to introduce a magnetic resonance probe into body structures deeper than 15 cm. In practice, it has been found, fortuitously, that lengthening the proximal portion or second pole, while unbalancing the antenna and slightly degrading image quality, permits visualization of a substantial length of the antenna, which facilitates tracking and localization of the antenna. A significant complication of unbalancing the antenna, namely heating effects during the transmission mode, can be avoided by decoupling the antenna with, for example, a PIN diode, as described below.
The circuits shown in
The MRI system typically alternates between a transmit and receive state during the acquisition of an image. During the transmit phase relatively large amounts of RF energy at the operating frequency of the system, such as about 63.86 MHz, are transmitted into the body. This energy could potentially harm the sensitive receiver electronics and more importantly, the patient, if the imaging antenna, in this case the probe, would be allowed to pick up this RF energy. The antenna function of the probe therefore is preferably turned off so that the probe becomes incapable of receiving RF energy at the MRI system operating frequency. During the receive phase, in contrast, the body emits the RF energy absorbed during the transmit phase at the same frequency, i.e., 63.86 MHz. A significant amount of the transmitted energy is typically lost due to inefficiencies of the transmitter or has been converted into heat by the body. The RF signal emitted by the body containing the image information is typically therefore many orders of magnitude smaller than the original signal send out by the transmitter. In order to receive this small signal, the antenna function of the probe is preferably turned on so that the probe becomes a highly efficient receiver for RF signals at the MRI systems operating frequency. The alternating state of the probe from being a poor RF antenna (receiver) during the transmit phase to being a good RF antenna (receiver) during the receive phase is called T/R (Transmit/Receive) switching and may be facilitated via a control signal send by the MRI system on the center conductor of connector 15 in
During the transmit phase, the positive voltage on the center conductor of connector 15 with respect to the system ground 14 may cause the PIN diode 21 to be conductive and can therefore short the top end of capacitors 23 to ground. The capacitors 23 in combination with the proximal length of the probe form a transmission line; thus, the impedance at the top of the capacitor 23 can be transformed via this transmission line to an impedance ZJ at the junction J connecting the poles of the electric dipole antenna in
With continued reference to
The T/R switching voltages are preferably not passed onto the probe since the switching voltage, which can have a frequency around 1 kHz, may cause unwanted stimulation of the organ or tissue under examination. To combat this, capacitors 23, providing a high-pass filter function, can block propagation of the T/R switching voltage into the probe.
With further reference to
Electrophysiological (EP) signals may be measured independently of the Transmit/Receive state of the MRI system because these signals are typically in a frequency range far below the MRI signal frequency and are separate from the MRI signal via a filter, such as the signal split and low-pass filter depicted in
As depicted in
With further reference to
Probes disclosed herein can facilitate three dimensional electro-anatomical imaging. As depicted in
An electrode can be disposed on an arm. An electrode may be affixed to an arm. An electrode may be glued or bonded to an arm. An arm may include more than one electrode. A basket probe with, e.g., 8 expandable ribs and each carrying, e.g., 8 electrodes is depicted.
Steerable probes may be modified for MR compatibility by using non-magnetic materials. Steerable probes may be modified for MR compatibility by using materials which create few or no susceptibility artifacts. Appropriate materials include, e.g., polymers/plastics, metals—Nitinol, copper, silver or gold, gold platinum alloy, MP35N alloy, etc. An exemplary design of the probes is shown in
Alternatively, as shown in
Additional teachings regarding construction of magnetic resonance probes, selection of materials, preferable dimensions of components, and electrical properties of probes are provided, e.g., in U.S. Pat. Nos. 5,928,145, 6,263,229, 6,549,800, and in U.S. patent application Publication Ser. Nos. US 2002/0,045,816 A1, US 2002/0,161,421 A1, US 2003/0,028,095 A1, and US 2003/0,050,557 A1, all of which patents and patent application publications are hereby incorporated herein in their entireties by this reference.
While the disclosed systems and methods have been described in connection with embodiments shown and described in detail, various modifications and improvements thereon will become readily apparent to those skilled in the art. Accordingly, the spirit and scope of the present disclosure is limited only by the following claims.
|Patente citada||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US3871382||15 Feb 1973||18 Mar 1975||Pacesetter Syst||Heart stimulator system for rapid implantation and removal with improved integrity|
|US3968802||24 Ene 1975||13 Jul 1976||Medtronic, Inc.||Cautery protection circuit for a heart pacemaker|
|US4295467||24 May 1979||20 Oct 1981||Inverness International Corp.||Electrolysis apparatus with retractable probe|
|US4431005||7 May 1981||14 Feb 1984||Mccormick Laboratories, Inc.||Method of and apparatus for determining very accurately the position of a device inside biological tissue|
|US4445501||7 May 1981||1 May 1984||Mccormick Laboratories, Inc.||Circuits for determining very accurately the position of a device inside biological tissue|
|US4572198||18 Jun 1984||25 Feb 1986||Varian Associates, Inc.||Catheter for use with NMR imaging systems|
|US4633181||11 Ago 1983||30 Dic 1986||Regents Of The University Of Calif.||Apparatus and method for increasing the sensitivity of a nuclear magnetic resonance probe|
|US4643186||30 Oct 1985||17 Feb 1987||Rca Corporation||Percutaneous transluminal microwave catheter angioplasty|
|US4654880||26 Jun 1986||31 Mar 1987||Minnesota Mining And Manufacturing Company||Signal transmission system|
|US4672972||10 Sep 1986||16 Jun 1987||Berke Howard R||Solid state NMR probe|
|US4682125||10 Feb 1986||21 Jul 1987||The Regents Of The University Of California||RF coil coupling for MRI with tuned RF rejection circuit using coax shield choke|
|US4689621||31 Mar 1986||25 Ago 1987||The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration||Temperature responsive transmitter|
|US4754752||27 Jul 1987||5 Jul 1988||Robert Ginsburg||Vascular catheter|
|US4757820||12 Mar 1986||19 Jul 1988||Kabushiki Kaisha Toshiba||Ultrasound therapy system|
|US4766381||12 Ago 1987||23 Ago 1988||Vanderbilt University||Driven inversion spin echo magnetic resonance imaging|
|US4799499||8 Ago 1986||24 Ene 1989||Bisping Hans Juergen||Implantable electrode with active fixation means|
|US4813429||5 May 1987||21 Mar 1989||Biodan Medical Systems Ltd.||Catheter and probe|
|US4823812||5 May 1987||25 Abr 1989||Biodan Medical Systems Ltd.||Applicator for insertion into a body opening for medical purposes|
|US4832023||3 Jun 1987||23 May 1989||Mcm Laboratories, Inc.||Method and apparatus for reducing blockage in body channels|
|US4858623||13 Jul 1987||22 Ago 1989||Intermedics, Inc.||Active fixation mechanism for lead assembly of an implantable cardiac stimulator|
|US4859950||17 May 1988||22 Ago 1989||Elscint Ltd||Balun circuit for radio frequency coils in magnetic resonance systems|
|US4932411||18 Dic 1986||12 Jun 1990||Siemens Aktiengesellschaft||Intervivo coil for a nuclear magnetic resonance tomographic apparatus|
|US4951672||22 Dic 1987||28 Ago 1990||General Electric Company||Controlled impedance monitoring lead wires|
|US4960106||27 Abr 1988||2 Oct 1990||Olympus Optical Co., Ltd.||Endoscope apparatus|
|US4989608||28 Abr 1989||5 Feb 1991||Ratner Adam V||Device construction and method facilitating magnetic resonance imaging of foreign objects in a body|
|US5019075||31 Jul 1990||28 May 1991||The Beth Israel Hospital||Method and apparatus for angioplasty|
|US5095911||18 May 1990||17 Mar 1992||Cardiovascular Imaging Systems, Inc.||Guidewire with imaging capability|
|US5099208||5 Oct 1989||24 Mar 1992||Vanderbilt University||Method for magnetic resonance imaging and related apparatus|
|US5125896||10 Oct 1990||30 Jun 1992||C. R. Bard, Inc.||Steerable electrode catheter|
|US5167233||7 Ene 1991||1 Dic 1992||Endosonics Corporation||Dilating and imaging apparatus|
|US5170789||3 Oct 1989||15 Dic 1992||Perinchery Narayan||Insertable NMR coil probe|
|US5178618||16 Ene 1991||12 Ene 1993||Brigham And Womens Hospital||Method and device for recanalization of a body passageway|
|US5190046||1 May 1992||2 Mar 1993||Shturman Cardiology Systems, Inc.||Ultrasound imaging balloon catheter|
|US5209233||11 Feb 1991||11 May 1993||Picker International, Inc.||Temperature sensing and control system for cardiac monitoring electrodes|
|US5211165||3 Sep 1991||18 May 1993||General Electric Company||Tracking system to follow the position and orientation of a device with radiofrequency field gradients|
|US5217010||28 May 1991||8 Jun 1993||The Johns Hopkins University||Ecg amplifier and cardiac pacemaker for use during magnetic resonance imaging|
|US5246438||9 Ene 1992||21 Sep 1993||Sensor Electronics, Inc.||Method of radiofrequency ablation|
|US5271400||1 Abr 1992||21 Dic 1993||General Electric Company||Tracking system to monitor the position and orientation of a device using magnetic resonance detection of a sample contained within the device|
|US5300108||5 Ene 1993||5 Abr 1994||Telectronics Pacing Systems, Inc.||Active fixation lead with a dual-pitch, free spinning compound screw|
|US5307808||1 Abr 1992||3 May 1994||General Electric Company||Tracking system and pulse sequences to monitor the position of a device using magnetic resonance|
|US5307814||17 Sep 1991||3 May 1994||Medrad, Inc.||Externally moveable intracavity probe for MRI imaging and spectroscopy|
|US5315025||29 Mar 1991||24 May 1994||Imperial Chemical Industries Plc||Fungicides|
|US5318025||1 Abr 1992||7 Jun 1994||General Electric Company||Tracking system to monitor the position and orientation of a device using multiplexed magnetic resonance detection|
|US5323776||15 Oct 1992||28 Jun 1994||Picker International, Inc.||MRI compatible pulse oximetry system|
|US5323778||5 Nov 1991||28 Jun 1994||Brigham & Women's Hospital||Method and apparatus for magnetic resonance imaging and heating tissues|
|US5333095||3 May 1993||26 Jul 1994||Maxwell Laboratories, Inc., Sierra Capacitor Filter Division||Feedthrough filter capacitor assembly for human implant|
|US5334193||13 Nov 1992||2 Ago 1994||American Cardiac Ablation Co., Inc.||Fluid cooled ablation catheter|
|US5348010||24 Sep 1992||20 Sep 1994||Medrea, Inc., Pennsylvania Corp., Pa.||Intracavity probe and interface device for MRI imaging and spectroscopy|
|US5352979||7 Ago 1992||4 Oct 1994||Conturo Thomas E||Magnetic resonance imaging with contrast enhanced phase angle reconstruction|
|US5355087||11 Feb 1991||11 Oct 1994||Medrad, Inc.||Intracavity probe and interface device for MRI imaging and spectroscopy|
|US5358515||16 Ago 1990||25 Oct 1994||Deutsches Krebsforschungzentrum Stiftung Des Offentlichen Rechts||Microwave hyperthermia applicator|
|US5363845||13 Ago 1993||15 Nov 1994||Medical Advances, Inc.||Breast coil for magnetic resonance imaging|
|US5365928||25 Nov 1992||22 Nov 1994||Medrad, Inc.||Endorectal probe with planar moveable MRI coil|
|US5370644||16 Jul 1993||6 Dic 1994||Sensor Electronics, Inc.||Radiofrequency ablation catheter|
|US5398683||16 Jul 1993||21 Mar 1995||Ep Technologies, Inc.||Combination monophasic action potential/ablation catheter and high-performance filter system|
|US5400787||24 Nov 1993||28 Mar 1995||Magna-Lab, Inc.||Inflatable magnetic resonance imaging sensing coil assembly positioning and retaining device and method for using the same|
|US5413104||9 Nov 1993||9 May 1995||Drager Medical Electronics B.V.||Invasive MRI transducers|
|US5419325||23 Jun 1994||30 May 1995||General Electric Company||Magnetic resonance (MR) angiography using a faraday catheter|
|US5433717||23 Mar 1993||18 Jul 1995||The Regents Of The University Of California||Magnetic resonance imaging assisted cryosurgery|
|US5437277||14 Feb 1994||1 Ago 1995||General Electric Company||Inductively coupled RF tracking system for use in invasive imaging of a living body|
|US5441483 *||8 Nov 1993||15 Ago 1995||Avitall; Boaz||Catheter deflection control|
|US5443066||2 Sep 1994||22 Ago 1995||General Electric Company||Invasive system employing a radiofrequency tracking system|
|US5443489||23 Sep 1994||22 Ago 1995||Biosense, Inc.||Apparatus and method for ablation|
|US5447156||4 Abr 1994||5 Sep 1995||General Electric Company||Magnetic resonance (MR) active invasive devices for the generation of selective MR angiograms|
|US5451232||5 Oct 1993||19 Sep 1995||Medrad, Inc.||Probe for MRI imaging and spectroscopy particularly in the cervical region|
|US5462055||23 Ago 1994||31 Oct 1995||Northrop Grumman Corporation||MRI/hyperthermia dual function antenna system|
|US5476095||1 Mar 1994||19 Dic 1995||Medrad, Inc.||Intracavity probe and interface device for MRI imaging and spectroscopy|
|US5498261||20 Dic 1991||12 Mar 1996||Advanced Cardiovascular Systems, Inc.||Thermal angioplasty system|
|US5507743||16 Ago 1994||16 Abr 1996||Zomed International||Coiled RF electrode treatment apparatus|
|US5512825||25 Nov 1994||30 Abr 1996||The Johns Hopkins University||Method of minimizing dead-periods in magnetic resonance imaging pulse sequences and associated apparatus|
|US5514173||4 Abr 1994||7 May 1996||Rebell; Allan K.||Active fixation lead with a dual-pitch, free spinning compound screw|
|US5540679||1 Jul 1994||30 Jul 1996||Boston Scientific Corporation||Device and method for heating tissue in a patient's body|
|US5540959||21 Feb 1995||30 Jul 1996||Howard J. Greenwald||Process for preparing a coated substrate|
|US5545201||29 Mar 1995||13 Ago 1996||Pacesetter, Inc.||Bipolar active fixation lead for sensing and pacing the heart|
|US5558093||2 Mar 1995||24 Sep 1996||Cardiovascular Imaging Systems, Inc.||Guidewire with imaging capability|
|US5578008||14 Oct 1993||26 Nov 1996||Japan Crescent, Inc.||Heated balloon catheter|
|US5588432||10 Jul 1995||31 Dic 1996||Boston Scientific Corporation||Catheters for imaging, sensing electrical potentials, and ablating tissue|
|US5590657||6 Nov 1995||7 Ene 1997||The Regents Of The University Of Michigan||Phased array ultrasound system and method for cardiac ablation|
|US5620476||13 Nov 1995||15 Abr 1997||Pacesetter, Inc.||Implantable medical device having shielded and filtered feedthrough assembly and methods for making such assembly|
|US5623241||17 Abr 1995||22 Abr 1997||Magna-Lab, Inc.||Permanent magnetic structure|
|US5629622||11 Jul 1995||13 May 1997||Hewlett-Packard Company||Magnetic field sense system for the protection of connected electronic devices|
|US5647361||1 Mar 1993||15 Jul 1997||Fonar Corporation||Magnetic resonance imaging method and apparatus for guiding invasive therapy|
|US5662108||12 Abr 1995||2 Sep 1997||Endocardial Solutions, Inc.||Electrophysiology mapping system|
|US5682897||12 Sep 1996||4 Nov 1997||Cardiovascular Imaging Systems, Inc.||Guidewire with imaging capability|
|US5685878||13 Nov 1995||11 Nov 1997||C.R. Bard, Inc.||Snap fit distal assembly for an ablation catheter|
|US5697958||7 Jun 1995||16 Dic 1997||Intermedics, Inc.||Electromagnetic noise detector for implantable medical devices|
|US5699801||1 Jun 1995||23 Dic 1997||The Johns Hopkins University||Method of internal magnetic resonance imaging and spectroscopic analysis and associated apparatus|
|US5706810||2 Jun 1995||13 Ene 1998||The Regents Of The University Of California||Magnetic resonance imaging assisted cryosurgery|
|US5715825||10 Jun 1996||10 Feb 1998||Boston Scientific Corporation||Acoustic imaging catheter and the like|
|US5716390||9 Ago 1996||10 Feb 1998||Pacesetter, Inc.||Reduced diameter active fixation pacing lead using concentric interleaved coils|
|US5722998||7 Jun 1995||3 Mar 1998||Intermedics, Inc.||Apparatus and method for the control of an implantable medical device|
|US5741321||11 Ene 1996||21 Abr 1998||Medtronic, Inc.||Active fixation medical electrical lead having improved turning tool|
|US5751539||30 Abr 1996||12 May 1998||Maxwell Laboratories, Inc.||EMI filter for human implantable heart defibrillators and pacemakers|
|US5759202||28 Abr 1997||2 Jun 1998||Sulzer Intermedics Inc.||Endocardial lead with lateral active fixation|
|US5769800||15 Mar 1995||23 Jun 1998||The Johns Hopkins University Inc.||Vest design for a cardiopulmonary resuscitation system|
|US5775338||10 Ene 1997||7 Jul 1998||Scimed Life Systems, Inc.||Heated perfusion balloon for reduction of restenosis|
|US5779669||28 Oct 1996||14 Jul 1998||C. R. Bard, Inc.||Steerable catheter with fixed curve|
|US5782891||15 Abr 1996||21 Jul 1998||Medtronic, Inc.||Implantable ceramic enclosure for pacing, neurological, and other medical applications in the human body|
|US5792055||19 Nov 1996||11 Ago 1998||Schneider (Usa) Inc.||Guidewire antenna|
|US5827997||30 Sep 1994||27 Oct 1998||Chung; Deborah D. L.||Metal filaments for electromagnetic interference shielding|
|US5833608||31 Mar 1997||10 Nov 1998||Biosense, Inc.||Magnetic determination of position and orientation|
|US5836992||18 Sep 1997||17 Nov 1998||Medtronic, Inc.||Filtered feedthrough assembly for implantable medical device|
|US5840031||7 Jun 1995||24 Nov 1998||Boston Scientific Corporation||Catheters for imaging, sensing electrical potentials and ablating tissue|
|US5864234||22 Abr 1997||26 Ene 1999||U.S. Philips Corporation||Image synthesizing method for forming a composite image from basic images|
|US5868674||22 Nov 1996||9 Feb 1999||U.S. Philips Corporation||MRI-system and catheter for interventional procedures|
|US5879347||25 Abr 1997||9 Mar 1999||Gynecare, Inc.||Apparatus for controlled thermal treatment of tissue|
|US5891134||24 Sep 1996||6 Abr 1999||Goble; Colin||System and method for applying thermal energy to tissue|
|US5896267||10 Jul 1997||20 Abr 1999||Greatbatch-Hittman, Inc.||Substrate mounted filter for feedthrough devices|
|US5905627||10 Sep 1997||18 May 1999||Maxwell Energy Products, Inc.||Internally grounded feedthrough filter capacitor|
|US5916162||18 Ago 1997||29 Jun 1999||U.S. Philips Corporation||Invasive device for use in a magnetic resonance imaging apparatus|
|US5928145||25 Abr 1996||27 Jul 1999||The Johns Hopkins University||Method of magnetic resonance imaging and spectroscopic analysis and associated apparatus employing a loopless antenna|
|US5928159||23 Abr 1997||27 Jul 1999||Neothermia Corporation||Apparatus and method for characterization and treatment of tumors|
|US5938609||1 Ago 1997||17 Ago 1999||Cardiovascular Imaging Systems, Inc.||Guidewire with imaging capability|
|US5938692||26 Mar 1996||17 Ago 1999||Urologix, Inc.||Voltage controlled variable tuning antenna|
|US5959829||18 Feb 1998||28 Sep 1999||Maxwell Energy Products, Inc.||Chip capacitor electromagnetic interference filter|
|US5964705||22 Ago 1997||12 Oct 1999||Image-Guided Drug Delivery System, Inc.||MR-compatible medical devices|
|US5973906||17 Mar 1998||26 Oct 1999||Maxwell Energy Products, Inc.||Chip capacitors and chip capacitor electromagnetic interference filters|
|US5978204||18 Nov 1996||2 Nov 1999||Maxwell Energy Products, Inc.||Capacitor with dual element electrode plates|
|US6004269||7 Jun 1995||21 Dic 1999||Boston Scientific Corporation||Catheters for imaging, sensing electrical potentials, and ablating tissue|
|US6008980||13 Nov 1997||28 Dic 1999||Maxwell Energy Products, Inc.||Hermetically sealed EMI feedthrough filter capacitor for human implant and other applications|
|US6011995||29 Dic 1997||4 Ene 2000||The Regents Of The University Of California||Endovascular device for hyperthermia and angioplasty and method for using the same|
|US6026316||15 May 1997||15 Feb 2000||Regents Of The University Of Minnesota||Method and apparatus for use with MR imaging|
|US6027500||5 May 1998||22 Feb 2000||Buckles; David S.||Cardiac ablation system|
|US6031375||26 Nov 1997||29 Feb 2000||The Johns Hopkins University||Method of magnetic resonance analysis employing cylindrical coordinates and an associated apparatus|
|US6045532||7 Ago 1998||4 Abr 2000||Arthrocare Corporation||Systems and methods for electrosurgical treatment of tissue in the brain and spinal cord|
|US6055457||13 Mar 1998||25 Abr 2000||Medtronic, Inc.||Single pass A-V lead with active fixation device|
|US6066136||8 Jun 1998||23 May 2000||Sulzer Osypka Gmbh||Ablation catheter with a plurality of poles|
|US6101417||12 May 1998||8 Ago 2000||Pacesetter, Inc.||Implantable electrical device incorporating a magnetoresistive magnetic field sensor|
|US6128522||22 May 1998||3 Oct 2000||Transurgical, Inc.||MRI-guided therapeutic unit and methods|
|US6129670||29 May 1998||10 Oct 2000||Burdette Medical Systems||Real time brachytherapy spatial registration and visualization system|
|US6141594||22 Jul 1998||31 Oct 2000||Cardiac Pacemakers, Inc.||Single pass lead and system with active and passive fixation elements|
|US6159560||24 Nov 1999||12 Dic 2000||Stevenson; Robert A.||Process for depositing a metal coating on a metallic component of an electrical structure|
|US6171240||5 Dic 1997||9 Ene 2001||Picker International, Inc.||MRI RF catheter coil|
|US6171241||11 Jun 1998||9 Ene 2001||The Johns Hopkins University School Of Medicine||Method for measuring myocardial motion and the like|
|US6188219||22 Ene 1999||13 Feb 2001||The Johns Hopkins University||Magnetic resonance imaging method and apparatus and method of calibrating the same|
|US6226545||7 Oct 1998||1 May 2001||David John Gilderdale||RF coil structure for intra-cavity use in magnetic resonance imaging|
|US6236205||16 Dic 1998||22 May 2001||U.S. Philips Corporation||MR device provided with a medical instrument, and method of determining the position of the medical instrument|
|US6238390||27 May 1998||29 May 2001||Irvine Biomedical, Inc.||Ablation catheter system having linear lesion capabilities|
|US6263229||13 Nov 1998||17 Jul 2001||Johns Hopkins University School Of Medicine||Miniature magnetic resonance catheter coils and related methods|
|US6272370||7 Ago 1998||7 Ago 2001||The Regents Of University Of Minnesota||MR-visible medical device for neurological interventions using nonlinear magnetic stereotaxis and a method imaging|
|US6275369||14 Dic 1999||14 Ago 2001||Robert A. Stevenson||EMI filter feedthough terminal assembly having a capture flange to facilitate automated assembly|
|US6280385||13 Oct 1998||28 Ago 2001||Simag Gmbh||Stent and MR imaging process for the imaging and the determination of the position of a stent|
|US6284971||24 Nov 1999||4 Sep 2001||Johns Hopkins University School Of Medicine||Enhanced safety coaxial cables|
|US6332089||14 Feb 1997||18 Dic 2001||Biosense, Inc.||Medical procedures and apparatus using intrabody probes|
|US6390996||9 Nov 1998||21 May 2002||The Johns Hopkins University||CPR chest compression monitor|
|US6408202||3 Nov 1999||18 Jun 2002||The Johns Hopkins University||Transesophageal magnetic resonance analysis method and apparatus|
|US6414835||1 Mar 2000||2 Jul 2002||Medtronic, Inc.||Capacitive filtered feedthrough array for an implantable medical device|
|US6424234||15 Sep 1999||23 Jul 2002||Greatbatch-Sierra, Inc.||Electromagnetic interference (emi) filter and process for providing electromagnetic compatibility of an electronic device while in the presence of an electromagnetic emitter operating at the same frequency|
|US6428537||22 May 1998||6 Ago 2002||Scimed Life Systems, Inc.||Electrophysiological treatment methods and apparatus employing high voltage pulse to render tissue temporarily unresponsive|
|US6456481||31 May 2001||24 Sep 2002||Greatbatch-Sierra, Inc.||Integrated EMI filter-DC blocking capacitor|
|US6459935||13 Jul 2000||1 Oct 2002||Avx Corporation||Integrated filter feed-thru|
|US6473291||28 Mar 2001||29 Oct 2002||Gb Aquisition Co., Inc.||Low inductance four terminal capacitor lead frame|
|US6493591||19 Jul 2000||10 Dic 2002||Medtronic, Inc.||Implantable active fixation lead with guidewire tip|
|US6529103||7 Sep 2000||4 Mar 2003||Greatbatch-Sierra, Inc.||Internally grounded feedthrough filter capacitor with improved ground plane design for human implant and other applications|
|US6535766||26 Ago 2000||18 Mar 2003||Medtronic, Inc.||Implanted medical device telemetry using integrated microelectromechanical filtering|
|US6539253||5 Dic 2000||25 Mar 2003||Medtronic, Inc.||Implantable medical device incorporating integrated circuit notch filters|
|US6549800||14 Abr 2000||15 Abr 2003||Johns Hopkins Unversity School Of Medicine||Methods for in vivo magnetic resonance imaging|
|US6556009||11 Dic 2000||29 Abr 2003||The United States Of America As Represented By The Department Of Health And Human Services||Accelerated magnetic resonance imaging using a parallel spatial filter|
|US6566978||7 Dic 2000||20 May 2003||Greatbatch-Sierra, Inc.||Feedthrough capacitor filter assemblies with leak detection vents|
|US6567259||20 Sep 2002||20 May 2003||Greatbatch-Sierra, Inc.||Monolithic ceramic capacitor with barium titinate dielectric curie point optimized for active implantable medical devices operating at 37° C.|
|US6567703||8 Nov 2000||20 May 2003||Medtronic, Inc.||Implantable medical device incorporating miniaturized circuit module|
|US6593884||7 Jul 1999||15 Jul 2003||Super Dimension Ltd.||Intrabody navigation system for medical applications|
|US6606513||1 Feb 2001||12 Ago 2003||Surgi-Vision, Inc.||Magnetic resonance imaging transseptal needle antenna|
|US6628980||26 Mar 2001||30 Sep 2003||Surgi-Vision, Inc.||Apparatus, systems, and methods for in vivo magnetic resonance imaging|
|US6633780||5 Jun 2000||14 Oct 2003||The Johns Hopkins University||Cardiac shock electrode system and corresponding implantable defibrillator system|
|US6643903||16 Mar 2001||11 Nov 2003||Greatbatch-Sierra, Inc.||Process for manufacturing an EMI filter feedthrough terminal assembly|
|US6654628||3 Nov 2000||25 Nov 2003||The Johns Hopkins University||Methods to assess vascular endothelial function|
|US6675033||24 Mar 2000||6 Ene 2004||Johns Hopkins University School Of Medicine||Magnetic resonance imaging guidewire probe|
|US6675779||13 Jun 2002||13 Ene 2004||Stant Manufacturing Inc.||Dual float valve for fuel tank vent with liquid carryover filter|
|US6687550||1 Jun 2001||3 Feb 2004||Pacesetter, Inc.||Active fixation electrode lead having an electrical coupling mechanism|
|US6690963||24 Ene 1995||10 Feb 2004||Biosense, Inc.||System for determining the location and orientation of an invasive medical instrument|
|US6701176||29 Oct 1999||2 Mar 2004||Johns Hopkins University School Of Medicine||Magnetic-resonance-guided imaging, electrophysiology, and ablation|
|US6714809||20 Nov 2001||30 Mar 2004||Surgi-Vision, Inc.||Connector and guidewire connectable thereto|
|US6765780||27 Feb 2003||20 Jul 2004||Greatbatch-Sierra, Inc.||EMI feedthrough filter terminal assembly having surface mounted, internally grounded hybrid capacitor|
|US6771067||3 Abr 2001||3 Ago 2004||The United States Of America As Represented By The Department Of Health And Human Services||Ghost artifact cancellation using phased array processing|
|US6829509||19 Feb 2002||7 Dic 2004||Biophan Technologies, Inc.||Electromagnetic interference immune tissue invasive system|
|US6847837||13 Oct 1998||25 Ene 2005||Simag Gmbh||MR imaging method and medical device for use in method|
|US6868288||9 Nov 2001||15 Mar 2005||Medtronic, Inc.||Implanted medical device telemetry using integrated thin film bulk acoustic resonator filtering|
|US6876885||11 Ene 2002||5 Abr 2005||Medtronic, Inc.||Implantable bifurcated gastrointestinal lead with active fixation|
|US6882248||29 Ene 2003||19 Abr 2005||Greatbatch-Sierra, Inc.||EMI filtered connectors using internally grounded feedthrough capacitors|
|US6898454||2 Abr 2001||24 May 2005||The Johns Hopkins University||Systems and methods for evaluating the urethra and the periurethral tissues|
|US6904307||29 May 2003||7 Jun 2005||Surgi-Vision, Inc.||Magnetic resonance probes|
|US6925328||2 Ago 2001||2 Ago 2005||Biophan Technologies, Inc.||MRI-compatible implantable device|
|US6931286||25 Abr 2003||16 Ago 2005||Medtronic, Inc.||Delivery of active fixation implatable lead systems|
|US6949929||17 Feb 2004||27 Sep 2005||Biophan Technologies, Inc.||Magnetic resonance imaging interference immune device|
|US6952613||11 Ene 2002||4 Oct 2005||Medtronic, Inc.||Implantable gastrointestinal lead with active fixation|
|US6971391||24 Feb 2003||6 Dic 2005||Nanoset, Llc||Protective assembly|
|US6985347||12 Feb 2004||10 Ene 2006||Greatbatch-Sierra, Inc.||EMI filter capacitors designed for direct body fluid exposure|
|US6999818||15 Abr 2004||14 Feb 2006||Greatbatch-Sierra, Inc.||Inductor capacitor EMI filter for human implant applications|
|US7012192||30 Mar 2005||14 Mar 2006||Stevenson Robert A||Feedthrough terminal assembly with lead wire bonding pad for human implant applications|
|US7013180||30 Abr 2002||14 Mar 2006||Medtronic, Inc.||Conditioning of coupled electromagnetic signals on a lead|
|US7038900||10 May 2004||2 May 2006||Greatbatch-Sierra, Inc.||EMI filter terminal assembly with wire bond pads for human implant applications|
|US7047074||19 Feb 2002||16 May 2006||Biophan Technologies, Inc.||Electromagnetic interference immune tissue invasive system|
|US7092766||19 Nov 2003||15 Ago 2006||Pacesetter, Inc.||Active fixation lead with multiple density|
|US7113387||24 May 2005||26 Sep 2006||Greatbatch-Sierra, Inc.||EMI filter capacitors designed for direct body fluid exposure|
|US7133714||7 Jun 2005||7 Nov 2006||Surgi-Vision, Inc.||Magnetic resonance imaging probes|
|US7155271||28 Abr 2003||26 Dic 2006||Johns Hopkins University School Of Medicine||System and method for magnetic-resonance-guided electrophysiologic and ablation procedures|
|US7236816||24 Abr 2002||26 Jun 2007||Johns Hopkins University||Biopsy and sampling needle antennas for magnetic resonance imaging-guided biopsies|
|US7310216||14 Jul 2005||18 Dic 2007||Greatbatch-Sierra, Inc.||EMI filter terminal assembly with wire bond pads for human implant applications|
|US7363090||1 May 2007||22 Abr 2008||Greatbatch Ltd.||Band stop filter employing a capacitor and an inductor tank circuit to enhance MRI compatibility of active implantable medical devices|
|US7412276||2 Mar 2004||12 Ago 2008||Johns Hopkins University School Of Medicine||Brain therapy|
|US7422568||1 Abr 2003||9 Sep 2008||The Johns Hopkins University||Device, systems and methods for localized heating of a vessel and/or in combination with MR/NMR imaging of the vessel and surrounding tissue|
|US20020040185||2 Abr 2001||4 Abr 2002||Ergin Atalar||Systems and methods for evaluating the urethra and the periurethral tissues|
|US20020055678||12 Jul 2001||9 May 2002||Scott Greig C.||Electrode probe coil for MRI|
|US20020095197||11 Jul 2001||18 Jul 2002||Lardo Albert C.||Application of photochemotherapy for the treatment of cardiac arrhythmias|
|US20020097050||11 Dic 2000||25 Jul 2002||Peter Kellman||Accelerated magnetic resonance imaging using a parallel spatial filter|
|US20020161421||20 Nov 2001||31 Oct 2002||Chris Lee||Connector and guidewire connectable thereto|
|US20020167315||3 Abr 2001||14 Nov 2002||The Government Of The United States Of America||Ghost artifact cancellation using phased array processing|
|US20020177771||14 Feb 2002||28 Nov 2002||Michael Guttman||Real-time, interactive volumetric magnetic resonance imaging|
|US20020192688||4 Abr 2002||19 Dic 2002||Xiaoming Yang||Imaging nucleic acid delivery|
|US20030028094||24 Abr 2002||6 Feb 2003||Ananda Kumar||Biopsy and sampling needle antennas for magnetic resonance imaging-guided biopsies|
|US20030028095||11 Abr 2002||6 Feb 2003||Steve Tulley||Magnetic resonance imaging probe|
|US20030050557||15 Abr 2002||13 Mar 2003||Susil Robert C.||Systems and methods for magnetic-resonance-guided interventional procedures|
|US20030199755||28 Abr 2003||23 Oct 2003||Johns Hopkins University School Of Medicine||System and method for magnetic-resonance-guided electrophysiologic and ablation procedures|
|US20040015079||11 Mar 2003||22 Ene 2004||Teratech Corporation||Ultrasound probe with integrated electronics|
|US20040024434||1 Abr 2003||5 Feb 2004||The Johns Hopkins University School Of Medicine||Device, systems and methods for localized heating of a vessel and/or in combination with MR/NMR imaging of the vessel and surrounding tissue|
|US20040046557||29 May 2003||11 Mar 2004||Parag Karmarkar||Magnetic resonance probes|
|US20040167392||2 Mar 2004||26 Ago 2004||Halperin Henry R.||Brain therapy|
|US20040263173||8 Jul 2004||30 Dic 2004||Biophan Technologies, Inc.||Magnetic resonance imaging interference immune device|
|US20040263174||8 Jul 2004||30 Dic 2004||Biophan Technologies, Inc.||Magnetic resonance imaging interference immune device|
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|US20060100506||22 Dic 2005||11 May 2006||Johns Hopkins University School Of Medicine||System and method for magnetic-resonance-guided electrophysiologic and ablation procedures|
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|US20080058635||26 Oct 2007||6 Mar 2008||Johns Hopkins University School Of Medicine||Mri-guided therapy methods and related systems|
|EP0145430B1||3 Dic 1984||29 May 1991||Cochlear Corporation||Signal transmission system|
|EP0243573A2||12 Ene 1987||4 Nov 1987||National Aeronautics And Space Administration||Temperature responsive transmitter|
|EP0466424A1||8 Jul 1991||15 Ene 1992||Cardiometrics, Inc.||Torqueable guide wire assembly with male and female connectors|
|EP0498996B1||16 Dic 1991||5 Mar 1997||Picker International, Inc.||Apparatus and methods for non-invasive examination|
|EP0557127A2||19 Feb 1993||25 Ago 1993||Scimed Life Systems, Inc.||Intravascular imaging guide wire apparatus and methods for use and manufacture|
|EP0673621B1||18 Mar 1994||4 Mar 1998||Schneider (Europe) Ag||A magnetic resonance imaging system for tracking a medical appliance|
|EP0930509B1||8 Dic 1998||17 Mar 2004||Philips Electronics N.V.||MR device comprising a medical instrument and method for determining the location of the medical instrument|
|EP1021730B1||13 Oct 1998||2 Abr 2003||Simag GmbH||MR imaging system and vena cava filter therefor|
|JP06070902A||Título no disponible|
|WO1999019739A1||13 Oct 1998||22 Abr 1999||Andreas Melzer||Mr imaging method and medical device for use in method|
|WO2002083016A1||15 Abr 2002||24 Oct 2002||Surgi-Vision, Inc.||Systems and methods for magnetic-resonance-guided interventional procedures|
|WO2006031317A2||9 Ago 2005||23 Mar 2006||The Johns Hopkins University||Implantable mri compatible stimulation leads and antennas and related systems and methods|
|1||Atalar et al., "High Resolution Intravascular MRI and MRS by Using a Catheter Receiver Coil," Magnetic Resonance in Medicine 36:596-605 (1996).|
|2||Balanis, Constantine A., "Advanced Engineering Electromagnetics," John Wiley & Sons, Inc., Chapters 1, 2, and 7 (1989).|
|3||Bauernfeind et al., "Chronic Nonparoxysmal Sinus Tachycardia in Otherwise Healthy Persons", Ann. Intern. Med. 91: 702-710 (1979).|
|4||Chen et al.; "Right Atrial Focal Atrial Fibrillation: Electrophysiologic Characteristics and Radiofrequency Catheter Ablation," J. Cardiovasc. Electrophysiol. 10: 323-335 (1999).|
|5||Chorro et al, "Transcatheter Ablation of the Sinus Node in Dogs Using High Frequency Current," European Heart J. 11:82-89 (1990).|
|6||Cox et al., "Modification of the Maze Procedure for Atrial Flutter and Atrial Fibrillation, II: Surgical Technique of the Maze III Procedure", J. Thorac. Cardiovasc. Surg. 110: 485-495 (1995).|
|7||Edelman et al.; "Magnetic Resonance Imaging," NEJM. 328:708-716 (1993).|
|8||Gabriel, C., S. Gabriel and E. Cortout, "The Dielectric Properties of Biological Tissues: I Literature Survey," Phys. Med. Biol. 41:2231-2249 (1996).|
|9||Gabriel, S. et al., "The Dielectric Properties of Biological Tissues: II Measurements in the Frequency Range 10 Hz to 20 GHz," Phys. Med. Biol. 41:2251-2269 (1996).|
|10||Gabriel, S. et al., "The Dielectric Properties of Biological Tissues: III Parametric Models for the Dielectric Spectrum of Tissues," Phys. Med. Biol. 41:2271-2293 (1996).|
|11||Garrey, W.E., "The Nature of Fibrillary Contraction of the Heart-Its Relation to Tissue Mass and Form," Am. J. Physiol.,33: 397-414 (1914).|
|12||Garrey, W.E., "The Nature of Fibrillary Contraction of the Heart—Its Relation to Tissue Mass and Form," Am. J. Physiol.,33: 397-414 (1914).|
|13||Garwood et al.; "Magnetic Resonance Imaging with Adiabatic Pulses Using a Single Surface Coil for RF Transmission and Signal Detection," Magnetic Resonance in Medicine 9: 25-34 (1989).|
|14||Haines et al., "Primary Atrial Fibrillation Ablation (PAFA) in a chronic Atrial Fibrillation Model", Circulation, 92(8): 1-265 (#1261) (1995).|
|15||Haissaguerre et al. "Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the pulmonary Veins," New Engl.-J. Med. 339:659-666 (1998).|
|16||Hoult, D.I. et al, "The Signal-To-Noise Ratio of the Nuclear Magnetic Resonance Experiment", Journal of Magnetic Resonance, 24:71-85(1976).|
|17||Hoult, D.I., "Rotating Frame Zeugmatography", Phil. Trans. R. Soc. Lond. B., 289, 543-547 (1980).|
|18||Hsieh et al., "Double Multielectrode Mapping Catheters Facilitate Radiofrequency Catheter Ablation of Focal Atrial Fibrillation Originating From Pulmonary Veins", J. Cardio-Vasc. Electrophysiol. 10: 136-144 (1999).|
|19||International Search Report, PCT Application No. PCT/US03/17086, mailed Sep. 29, 2003.|
|20||Jais et al., "A Focal Source of Atrial Fibrillation Treated by Discrete Radiofrequency Ablation", Circulation, 95:572-576 (1997).|
|21||Jerwzewski, A. et al., "Development of an MRI-Compatible Catheter for Pacing the Heart: Initial In Vitro and In Vivo Results" JMRI, ISHRM (US), vol. 6 (No. 6), p. 948-949, Jun. 14, 1996.|
|22||Jolesz et al., "Interventional Magnetic Resonance Therapy," Seminars in Interventional Radiology, 12(1):20-27 (1995).|
|23||Kalman et al., "Radiofrequency Catheter Modification of Sinus Pacemaker Function Guided by Intracardiac Echocardiography," Circulation 192:3070-3081 (1995).|
|24||Kalman, Jonathan et al, "Cristal Tachycardia-Relationship of Right Atrial Tachycardias to the Crista Terminalis Identified using Intracardiac Echocardiography", Pacing and Clinical Electrophysiology, 18(4), 261 (1995).|
|25||Kalman, Jonathan et al, "Cristal Tachycardia—Relationship of Right Atrial Tachycardias to the Crista Terminalis Identified using Intracardiac Echocardiography", Pacing and Clinical Electrophysiology, 18(4), 261 (1995).|
|26||Kalman, Jonathan et al., "Biophysical Characteristics of Radiofrequency Lesion Formation in Vivo: Dynamics of Catheter Tip-Tissue Contact Evaluated by Intracardiac Echocardiography", Am. Heart J. 133(1), 8-18 (1997).|
|27||Karmarkar, P.V., "An Active MRI Intramyocardial Injection Catheter,"Proc. Intl. Soc. Mag. Reson. Med., 11:311 (2003).|
|28||Kay et al. "Radiofrequency Ablation for Treatment of Primary Atrial Tachycardias," J. Am. Coll. Cardiol. 21(4):901-909 (1993).|
|29||Kumar, Ananda, "MR Imaging with a Biopsy Needle", Proc. Intl. Soc. Mag. Reson. Med. 9, 2148 (2001).|
|30||Lee et al.; "Catheter Modification of the Atrioventricular Junction with Radiofrequency Energy for Control of Atrioventricular Nodal Reentry Tachycardia," Circulation, 83(3): 827-835 (1991).|
|31||Lesh, Michael et al., "Radiofrequency Catheter Ablation of Atrial Arrhythmias", Circulation 89(3),1074-1089 (1994).|
|32||Luchinger, Roger Christoph, "Safety Aspects of Cardiac Pacemakers in Magnetic Resonance Imaging," a dissertation submitted to the Swiss Federal Institute of Technology Zurich, Zurich, Switzerland (2002).|
|33||McKinnon et al. "Towards Visible Guidewire Antennas for Interventional MRI" Proc. Soc. Mag. Res., 1:429 (1994).|
|34||Mitchell, Mark et al., "Morphological and Physiological Characteristics of Discontinuous Linear Atrial Ablations During Atrial Pacing and Atrial Fibrillation", Pace, 20 vol. 20 (Part II), 202 (1997).|
|35||Moe et al.; "Atrial Fibrillation as a Self-Sustaining Arrhythmia Independent of Focal Discharge," American Heart Journal, 58: 59-70 (1959).|
|36||Moe G.K. "On the Multiple Wavelet Hypothesis of Atrial Fibrillation," Arch. Int. Pharmacodyn. Ther. 140:183-199 (1962).|
|37||Natale et al.; "Catheter Ablation Approach on the Right side Only for Paroxysmal Atrial Fibrillation Therapy", American Heart Association, Circulation, 92(8): 1265 (1995).|
|38||Ocali, Ogan et al., "Intravascular Magnetic Resonance Imaging Using a Loopless Catheter Antenna", MRM, 37, 112-118 (1997).|
|39||Preliminary Statement for U.S. Appl. No. 11/314,241 including Declaration and Invention Disclosure dated Dec. 22, 2005; 11 Sheets.|
|40||Prystowsky et at "Management of Patients with Atrial Fibrillation: A Statement for Healthcare Professionals from the Subcommittee on Electrocardiography and Electrophysiology," American Heart Association, Circulation 93(6):1262-1277 (1996).|
|41||Quick, H.H. et al., "Endourethral MRI", Intl. Soc. Mag. Reson. Med., 1, 142 (2000).|
|42||Roguin, Ariel, et al., "Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe," American Heart Association, Circulation-Journal of the American Heart Association, 110(5) 475-482, Dallas, Texas, USA (Aug. 3, 2004, originally published online Jul. 26, 2004).|
|43||Roguin, Ariel, et al., "Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe," American Heart Association, Circulation—Journal of the American Heart Association, 110(5) 475-482, Dallas, Texas, USA (Aug. 3, 2004, originally published online Jul. 26, 2004).|
|44||Silverman et al.; "Interactive MR-guided Biopsy in an Open-Configuration MR Imaging System," Radiology, 197: 175-181 (1995).|
|45||Susil et al., "A Combined Electrophysiology/MR Antenna Catheter," International Society of Magnetic Resonance Imaging in Medicine, Ninth Scientific Meeting, Glasgow 542 (Apr. 2001).|
|46||Susil, R., "Interventional MRI: Targeting, Monitoring, and Assessment of Minimally Invasive Therapies," Doctoral Dissertation, Johns Hopkins University, 1-229 (2005).|
|47||Susil, Robert C. et al., "Multifunctional Interventional Devices for use in MRI," Provisional U.S. Appl. No. 60/283,725, (filed Apr. 13, 2001).|
|48||Swartz, John et al., "A Catheter-based Curative Approach to Atrial Fibrillation in Humans", Circulation, Abstracts From the 67th Scientific Sessions, 90(4) 1-335 (1994).|
|49||Tracy et al. "Radiofrequency Catheter Ablation of Ectopic Atrial Tachycardia Using Paced Activation Sequence Mapping," J. Am. Coll. Cardio. 21(4):910-917 (1993).|
|50||West, Theodore et al., "Minimal Mass Required for Induction of a Sustained Arrhythmia in Isolated Atrial Segments", Am. J. Physiol., 202, 232-236 (1962).|
|51||Zimmerman et al., "Artifacts and Hazards in NMR Imaging Due to Metal Implants and Cardiac Pacemakers," Diagn. Imag. Clin. Med. 53:53-56 (1984).|
|52||Zipes, D., "Atrial Fibrillation: a Tachycardia-Induced Atrial Cardiomopathy," Circulation 95(3):562-564 (1997).|
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