US20070244479A1 - Electrophysiology Therapy Catheter - Google Patents
Electrophysiology Therapy Catheter Download PDFInfo
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- US20070244479A1 US20070244479A1 US11/734,191 US73419107A US2007244479A1 US 20070244479 A1 US20070244479 A1 US 20070244479A1 US 73419107 A US73419107 A US 73419107A US 2007244479 A1 US2007244479 A1 US 2007244479A1
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- catheter
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- 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
- A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/053—Measuring electrical impedance or conductance of a portion of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/053—Measuring electrical impedance or conductance of a portion of the body
- A61B5/0538—Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters
Definitions
- the parent invention relates to electrophysiology apparatus which is used to measure and to visualize electrical activity occurring in a patient's heart.
- the system can display both a visual map of the underlying electrical activity originating in a chamber of a patient's heart and the location of a therapy catheter located within a heart chamber.
- the electrophysiology apparatus includes several subsystems including: a therapy catheter system, a measurement catheter system and a computer based signal acquisition, control and display system.
- cardiac tachyarrhythmias are caused by conduction defects which interfere with the normal propagation of electrical signals in a patient's heart. These arrhythmias may be treated electrically, pharmacologically or surgically.
- the optimal therapeutic approach to treat a particular tachyarrhythmia depends upon the nature and location of the underlying conduction defect. For this reason electrophysiologic mapping is used to explore the electrical activity of the heart during a tachyarrhythmic episode.
- the typical electrophysiologic mapping procedure involves positioning an electrode system within the heart. Electrical measurements are made which reveal the electrical propagation of activity in the heart. If ablation is the indicated therapy then a therapy catheter is positioned at the desired location within the heart and energy is delivered to the therapy catheter to ablate the tissue.
- the electrophysiology apparatus of the invention is partitioned into several interconnected subsystems.
- the measurement catheter system introduces a modulated electric field into the heart chamber.
- the blood volume and the moving heart wall surface modify the applied electric field.
- Electrode sites within the heart chamber passively monitor the modifications to the field and a dynamic representation of the location of the interior wall of the heart is developed for display to the physician.
- Electrophysiologic signals generated by the heart itself are also measured at electrode sites within the heart and these signals are low pass filtered and displayed along with the dynamic wall representation. This composite dynamic electrophysiologic map may be displayed and used to diagnose the underlying arrhythmia.
- a therapy catheter system can also be introduced into the heart chamber.
- a modulated electrical field delivered to an electrode on this therapy catheter can be used to show the location of the therapy catheter within the heart.
- the therapy catheter location can be displayed on the dynamic electrophysiologic map in real time along with the other diagnostic information.
- the therapy catheter location can be displayed along with the intrinsic or provoked electrical activity of the heart to show the relative position of the therapy catheter tip to the electrical activity originating within the heart itself. Consequently the dynamic electrophysiology map can be used by the physician to guide the therapy catheter to any desired location within the heart.
- the dynamic electrophysiologic map is produced in a step-wise process.
- the interior shape of the heart is determined. This information is derived from a sequence of geometric measurements related to the modulation of the applied electric field. Knowledge of the dynamic shape of the heart is used to generate a representation of the interior surface of the heart.
- the intrinsic electrical activity of the heart is measured.
- the signals of physiologic origin are passively detected and processed such that the magnitude of the potentials on the wall surface may be displayed on the wall surface representation.
- the measured electrical activity may be displayed on the wall surface representation in any of a variety of formats.
- a location current may be delivered to a therapy catheter within the same chamber. The potential sensed from this current may be processed to determine the relative or absolute location of the therapy catheter within the chamber.
- FIG. 1 is a schematic block diagram of the electrophysiology apparatus
- FIG. 2 is a block diagram representing the partitioning of the electrophysiology apparatus
- FIG. 3 is a diagram of an illustrative balloon electrode set implementation of the measurement catheter and a therapy catheter;
- FIG. 4 is a schematic diagram of an illustrative basket electrode set implementation of the measurement catheter
- FIG. 5 is a flow chart showing the wall surface generation process
- FIG. 6 is a schematic diagram of a row of electrodes of the balloon catheter and their use in measuring distance to the heart chamber wall;
- FIG. 7 is a screen display representing the motion of the cardiac wall surface
- FIG. 8 is a schematic block diagram of the portion of the electrophysiology apparatus which implements the body orientation generation process
- FIG. 9 is a flow charting showing the body orientation generation process
- FIG. 10 is a flow chart showing the wall electrogram generation process
- FIG. 11 is a representative screen display showing wall electrogram information
- FIG. 12 is a representative screen display showing wall electrogram information
- FIG. 13 is a representative screen display showing wall electrogram information
- FIG. 14 is a flow chart showing the site electrogram generation process.
- FIG. 15 is a flow chart showing the movable electrode location process.
- FIG. 16 is a schematic block diagram of the therapy catheter system
- FIG. 17 is a schematic diagram of the laser delivery embodiment of the therapy catheter.
- FIG. 18 is a schematic diagram of a microwave delivery embodiment of the therapy catheter
- FIG. 19 is a schematic diagram of a chemical delivery embodiment of the therapy catheter.
- FIG. 20 is a schematic diagram of the angioplasty catheter embodiment of the therapy catheter.
- FIG. 1 shows the electrophysiologic apparatus 10 connected to a patient 12 .
- a monitoring catheter system 14 is placed in the heart 16 to generate a display of the electrical activity of the heart 16 .
- a therapy catheter 18 may be inserted into the heart to perform ablation or other corrective treatment.
- the monitoring catheter 14 has a proximal end 20 which may be manipulated by the attending physician, and a distal end 22 which carries a monitoring catheter electrode set 44 . In general the distal end 22 of the monitoring catheter 14 will be relatively small and will float freely in the heart chamber.
- the therapy catheter 18 has a distal end 24 which carries a therapy catheter electrode set 46 .
- the therapy catheter also has proximal end 26 which can be manipulated by the attending physician.
- the electrode sets located on the catheters are coupled to an interface system 28 , through appropriate cables.
- the cable 30 connects the monitoring catheter electrode set 44 to the interface system 28 while cable 32 connects the therapy catheter electrode set 46 to the interface system 28 .
- the interface system 28 contains a number of subsystems which are controlled by a computer 34 .
- the data collected by the interface system 28 is manipulated by the computer 34 and displayed on a display device 36 .
- Surface electrodes represented by electrode 40 may also be coupled to the electrophysiology apparatus 10 for several purposes via an appropriate cable 42 .
- a therapy generator 38 is connected to the therapy catheter electrode 60 and to the therapy surface ground 70 , through the interface system 28 .
- the skin surface electrode cable 42 couples the ECG surface electrodes 74 to the ECG system 39 , which may be a subsystem of interface system 28 .
- FIG. 2 is a schematic diagram showing an illustrative segmentation of the electrode sets and their electrical connections to subsystems in the electrophysiology apparatus 10 .
- the monitoring electrode set 44 contains a subset of passive electrodes 48 which are connected to a signal conditioner 50 .
- the monitoring electrode set 44 also contains a subset of active electrodes 52 which are connected to a signal generator 54 through a switch 59 .
- the signal generator 54 is controlled by the computer 34 . In operation, the signal generator 54 generates a burst of (4800 Hz for example) signals which are supplied to the active electrode set 52 . This energy sets up an electric field within the heart 16 chamber.
- the electrical potentials present on the passive electrode set 48 represent the summation of the underlying electrophysiological signals generated by the heart and the field induced by the burst.
- the signal conditioner 50 separates these two components. The preferred technique is to separate the signals based upon their frequency.
- the high pass section 56 of the signal conditioner extracts the induced field signals as modulated by the blood volume and the changing position of the chamber walls 125 .
- the signals are amplified with a gain of approximately 500 from passive electrodes 48 with amplifier 151 .
- the signals are high pass filtered at roughly 1200 Hz by filter 153 .
- the 4800 Hz signal is extracted by demodulator 155 .
- the individual signals are converted to digital format by the analog to digital converter 157 before being sent to the computer 34 .
- the low pass section 58 of the signal conditioner 50 extracts physiologic signals. First, signal drift is reduced with a 0.01 Hz high pass filter 143 . Next, a programmable gain amplifier 145 amplifies the signals. Then a low pass filter 147 removes extraneous high frequency noise and the signal from the induced field. Finally, the physiologic signals are converted to digital format by the analog to digital converter 149 before being sent to the computer 34 .
- the therapy catheter electrode set 46 includes at least one therapy delivery electrode 60 , and preferably one or more monitoring electrodes 62 , and one or more locator electrodes 68 .
- the therapy delivery electrode 60 cooperates with the ground electrode 70 , which is generally a skin patch electrode, to deliver ablation energy to the heart. These electrodes are coupled to the ablation energy generator 38 which is shown as an RF current source.
- a locator electrode 68 is provided which is preferably proximate the delivery electrode 60 , but can be a separate electrode site located near the distal end 24 of the therapy catheter 18 . This electrode site is coupled with an active electrode 52 through a switch 59 to the signal generator 54 .
- the electric field coupled to the therapy catheter 18 permits the physician to track and visualize the location of the locator electrode 68 on the display device 36 .
- the therapy catheter electrode set 46 can also be used to monitor the physiologic signals generated at the chamber wall 125 by a low pass signal conditioner 141 which is similar to the low pass section 58 of the signal conditioner 50 . These digitized signals are then sent to the computer 34 .
- At least one electrode pair 119 of surface electrodes 40 are also coupled to the signal generator 54 through switch 59 .
- Each electrode 89 and 115 are placed opposite each other on the body surface with the heart 16 in-between them.
- the induced field is sensed by passive electrodes 48 and conditioned by the high pass section 56 of the signal conditioner 50 . This field helps the computer 34 align or orient the passive electrodes 48 to the body for better visualization of the heart on the monitor 36 .
- the ECG subsystem 39 accepts signals from standard ECG skin electrodes 74 . It also contains a low pass section similar to the low pass section 58 of signal conditioner 50 . In general, the passive electrode set 48 and active electrode set 52 will reside on a single catheter, however it should be recognized that other locations and geometries are suitable as well. Both basket and balloon devices are particularly well suited to this application.
- FIG. 3 shows an electrode configuration on a balloon catheter 94 which has an inflatable balloon 96 which underlies an array or set of passive electrodes 48 typified by passive electrode 72 .
- passive electrodes 48 can be organized into rows, typified by row 123 , and columns, typified by column 121 .
- a pair of active excitation electrodes 52 are typified by proximal electrode 92 and distal electrode 98 .
- the balloon catheter 94 configuration can be quite small in comparison with the basket catheter 80 configuration. This small size is desirable both for insertion into and for use in a heating heart 16 .
- FIG. 3 also shows a movable, reference or therapy catheter system 18 .
- This catheter is shown lying along the interior surface 125 of the heart 16 .
- a pair of electrodes shown as delivery electrode 60 and reference electrode 62 are located a fixed distance apart on the catheter body 64 .
- This auxiliary catheter may be used to supply ablation energy to the tissue during therapy.
- This therapy catheter 18 may be used with either the basket catheter 80 configuration or the balloon catheter 94 configuration.
- FIG. 4 shows an electrode configuration on a basket catheter 80 .
- the limbs of the basket 80 typified by limb 82 carry multiple passive electrode sites typified by electrode 84 .
- a pair of active excitation electrodes are shown on the central shaft 86 of the basket 80 as indicated by excitation electrode 88 .
- the basket catheter 80 electrodes lie gently against the interior surface 125 of the heart 16 urged into position by the resilience of the limbs.
- the basket catheter 80 permits unimpeded flow of blood through the heart during the mapping procedure which is very desirable. This form of catheter also places the electrodes into contact with the heart chamber wall 125 for in-contact mapping of the physiologic potentials of the heart 16 .
- the signal generator 54 can generate a 4800 Hz sinusoidal signal burst on the active electrode set 52 which creates an electric field in the heart.
- the changing position of the chamber walls 125 and the amount of blood within the heart determines the signal strength present at the passive electrode sites 48 .
- the chamber geometry is derived from the electric field as measured at the passive electrode sites 48 which may, or may not be in contact with the walls 125 of the heart.
- the field strength is inversely proportional to the instantaneous physical wall location and the distance from the active electrodes 52 to these walls.
- the potentials on the passive set of electrodes 72 are related to the wall location, but a set of computationally intensive field equations must be solved to ascertain the position of the wall.
- both the basket and balloon approach can be used to generate the dynamic representation of the wall surface.
- the computer 34 operates under the control of a stored program which implements several control functions and further displays data on a display device 36 .
- the principal software processes are the wall surface generation process (WSGP); the body orientation generation process (BOGP); the wall electrogram generation process (WEGP); the site electrogram generation process (SEGP); and the movable electrode location process (MELP).
- FIG. 5 is a flow chart describing the method used to generate the “wall surface” of the interior of the heart 16 .
- the step-wise processes are presented with certain physical parameters which are either known in advance by computation or are measured. This knowledge or information is shown in block 53 , block 55 and block 57 .
- the WSGP process begins at block 41 with the insertion of the monitoring catheter 14 in the heart 16 .
- This catheter 14 places an array of electrodes 44 in a heart 16 chamber. This array must have both passive measurement electrode sites 48 and active interrogation electrode sites 52 located in a known position.
- the process enters a measurement and display loop at block 43 where an interrogation pulse burst is generated by the signal generator 54 seen in FIG. 2 .
- These pulses are generated first with the current source at site 92 and the current sink at site 98 and second with the current source at site 98 and the sink at site 92 as seen in FIG. 3 .
- the signal conditioner 50 uses information on the frequency and timing of the interrogation current from block 53 to demodulate the signals and analog to digital convert the signals received at the passive measurement electrodes 48 .
- the information from block 55 is used. This information includes both the current strength of the interrogation pulse and the location of the interrogation source and sink electrodes. Impedance is voltage divided by current. The voltage offset caused by the location of the current source can be reduced by the two measurements of opposite polarity.
- Block 49 determines how the heart chamber tissue, which has roughly three times the impedance of blood, in combination with the type of electrode array affects the field generated by the interrogation electrodes.
- the blood effects the impedance directly as the field is propagated from the interrogation electrodes to the measurement electrodes.
- the inverse of the measured voltage is proportional to the square root of the distance from the source.
- the impedance of the field generated within the blood volume is modulated by the position of the walls 125 , with their higher impedance, with respect to the location relative to the measurement electrodes.
- the distance from the interrogation electrodes to the heart chamber wall 125 is determined at a point normal to the field generated by the active interrogation electrodes 52 .
- the passive electrodes 48 on the balloon catheter 94 can be positioned in rows 123 and columns 121 with the columns in a line from the top of the balloon 96 near active electrode 92 to the bottom of the balloon 96 near active electrode 98 .
- three configurations are possible: 8 rows and 8 columns, 7 rows and 9 columns, and 6 rows and 10 columns.
- the measurements from any row 123 are treated independently.
- 8 measurements of distance are taken for any selected row of electrodes, giving a total of 64 measurements.
- FIG. 6 is a schematic drawing of the embodiment required to measure the distance 129 from the centroid 127 of the balloon 96 through the passive electrode 131 to the heart chamber wall 125 .
- the passive electrode 131 is one of eight electrodes on a row of electrodes 123 . Starting with electrode 131 and labeling it as electrode A, the other electrodes on the row 123 are labeled B, C, D, E, F, G and H by proceeding around the balloon 96 in a clockwise direction. The measurements of impedance “I” at these electrodes are thus labeled I A , I B , I C , I D , I E , I F and I H .
- the computation can be redone by shifting this direction clockwise one electrode, relabeling electrodes A through H and solving the above equation again. Once the distances for this row of electrodes 123 are determined then the next row distances are determined in the same way until the distances at all 64 electrodes are determined.
- a model of the chamber wall 125 shape can be created in block 51 .
- Various techniques for creating a shape are possible, including cubic spline fits, and best fit of an ellipsoid.
- the positions of the active electrodes 52 and the passive electrodes 48 relative to the heart 16 chamber walls are also determined at this point.
- the loop continues as the method moves back to block 43 . This loop continues at a rate fast enough to visualize the real-time wall motion of the heart chamber, at least at twenty times per second.
- FIG. 7 shows two separate frames of the dynamic representation of the heart wall.
- Wire frame 71 shows the heart at systole while wire frame 73 shows the heart at diastole.
- Path arrow 75 and path arrow 77 represent the dynamic cycling through several intermediate shapes between the systole and diastole representation. These views are useful as they indicate the mechanical pumping motion of the heart to the physician.
- FIG. 8 is a schematic drawing of the apparatus required to perform the body orientation generation process. It shows a patient 12 with at least one pair 119 of skin electrodes 40 attached to the body surface in a stationary position on the body and in a known configuration. These electrodes are typified by example surface electrodes 89 and 115 each of which could be an ECG electrode 74 , an RF generation current sink electrode 70 , or another electrode specifically dedicated to the BOGP. Ideally, electrode 89 and 115 are opposite one another on the body with the heart 16 directly in between them. This pair of electrodes is attached to the signal generator 54 through the switch 59 via an appropriate cable 117 . The distal end 22 of monitoring catheter 14 is situated in the heart 16 where the passive electrodes 48 can measure the signals generated across the electrode 89 and electrode 115 .
- FIG. 9 is a flow chart describing the method used to align the wall surface representation of the WSGP to the body orientation.
- the process begins at step 101 where the monitoring catheter 14 with a set of passive electrodes 48 is inserted into heart 16 chamber and a pair of surface electrodes 119 are attached at a known position on the body 12 .
- the process begins cycling at step 102 where the signal generator 54 generates a signal across the skin electrode 89 and skin electrode 115 .
- the voltage created by the signal generator 54 is measured from passive electrode 48 by the high pass section 56 of the signal conditioner 50 by using the information from block 110 which includes the frequency and timing of the field generated by the signal generator 54 . This voltage information is stored in an array “Y”.
- a regression analysis is performed which creates a vector which lines up with the field generated in step 103 .
- This regression method is the same whether a basket catheter as shown in FIG. 4 or a balloon catheter as shown in FIG. 3 is used.
- the location of each passive electrode 48 is provided to the method by block 110 . This information comes from different sources in each case however. In the case of a basket catheter 80 these three dimensional electrode locations come from the WSGP. In the case of the balloon catheter 94 these three dimensional electrode locations are known a priori. In each case they are saved in an array “X”.
- step 105 the information on the location of the chamber walls 125 from the WSGP 109 can be used to create a three dimensional model of the heart 16 chamber as seen in FIG. 7 .
- this representation can be shown in a known orientation relative to the body in step 106 .
- a specific orientation such as typical radiological orientations RAO (right anterior oblique), LAO (left anterior oblique), or AP (anterior/posterior) can be presented.
- RAO right anterior oblique
- LAO left anterior oblique
- AP anterior/posterior
- FIG. 10 is a flow chart describing the wall electrogram generation process (WEGP). This process begins at block 61 when a monitoring catheter 14 with an array of passive measurement electrodes 48 is placed in a heart chamber 16 and deployed. The process enters a loop at block 63 .
- the frequency of the interrogation pulses generated by the signal generator 54 is provided by block 85 .
- the low pass filter section 58 of the signal conditioner 50 measures the voltage at frequencies lower than the generated interrogation pulses. Typically the highest frequency of the biopotentials is 100 Hz but can be as high as 250 Hz.
- the measurements are contact voltages from the chamber wall 125 tissue contacting the electrodes 84 .
- the measurements are measurements of the field generated throughout the blood volume by the tissue on the chamber wall 125 .
- a model of the array boundary and the chamber wall 125 boundary is created from the information in block 87 .
- This information includes the location of the passive electrodes 48 on the array and the chamber wall 125 locations from the WSGP.
- the array boundary and the chamber wall 125 boundary are the same since they are in contact.
- the locations are determined in three-dimensional space of the sites on the chamber wall where potentials are measured.
- step 65 locations are generated in three-dimensional space of the sites on the chamber wall where potentials are to be determined.
- the potentials are projected on to the sites on the chamber wall specified in step 65 .
- the measured potentials are assigned to these sites.
- a three dimensional technique such as those typically used in field theory is used to generate a representation of the three dimensional field gradients in the blood volume of the heart chamber.
- Two examples of appropriate techniques are a spherical harmonics solution to Laplace's equation, and boundary element analysis. A more detailed description of spherical harmonics is given in the parent disclosure which is incorporated by reference herein.
- the voltage is measured at the passive electrodes 48 on the probe or balloon catheter 94 . From the voltage at the electrodes on the probe and the knowledge that the probe is nonconducting, the voltage and normal current at a previously selected set of nodes on the endocardial surface 125 are determined by the boundary element method in the following manner.
- Laplace's equation is solved by the boundary element method, a specialized finite element method that permits one to restrict the calculations to the two-dimensional probe and endocardial surfaces (and not have to deal with calculations over the blood pool between these two surfaces).
- the system uses a higher-order version of the boundary element method. This system currently uses bicubic splines to represent the probe and endocardial surfaces and bilinear elements and bicubic splines to represent the voltage and the normal current on these surfaces.
- the boundary element method consists of creating and solving a set of linear equations for the voltage and the normal current on the endocardium based on the voltage measurements at the electrodes on the probe.
- Each of the elements in the matrices that are involved in this set consists of two-dimensional integrals, which are calculated by numerical and analytical integration.
- a large number of points are calculated on the three-dimensional chamber surface 125 .
- this is done through interpolation using bilinear or bicubic splines.
- this can be done either by using the model, such as the boundary element method or spherical harmonics to generate more points.
- bilinear or bicubic splines can be used to interpolate between a smaller number of points.
- a representation of the electrical potentials on the surface 125 are used to display the patterns.
- These types of displays include color maps, maps of iso-potential lines, maps of potential gradient lines and others.
- the electro-physiologic information is reconstructed on the dynamic wall surface 125 .
- the measured electrical activity is positioned by the WSGP at the exact location which gives rise to the activity.
- the high resolution of the system creates an enormous amount of information to display.
- Several techniques may be used to display this information to the physician.
- the electrogram data can be shown in false color gray-scale on a two dimensional wall surface representation. In this instance areas of equal potential areas are shown in the same color.
- a vectorized display of data can be shown on a wire grid as shown in FIG.
- FIG. 14 is a flow chart of the site electrogram generation process (SEGP). This process is used to extract and display a time series representation of the electrical activity at a physician selected site.
- FIG. 13 shows a site 97 that has been selected and a time series electrogram 99 is shown on the display device 36 along with the dynamic wall representation.
- SEGP site electrogram generation process
- the user will use the display 36 to determine a location of interest in block 33 which will then be marked on the display device 36 at step 81 .
- the voltage from this location will be collected at block 83 .
- This voltage will be plotted in a wave-form representation 99 in block 31 .
- the loop continues at this point at a rate sufficient to display all of the frequencies of such a time series electrogram 99 , at least 300 points per second.
- the false color and vectorized display images may direct the physician to specific sites on the endocardial surface for further exploration.
- the system may allow the physician to “zoom” in on an area to show the electrical activity in greater detail. Also the physician may select a site on the endocardial wall 125 and display a traditional time series electrogram 99 originating at that site.
- FIG. 15 is a flow-chart of the movable electrode location process (MELP). It begins at block 11 when a catheter with an array of passive measurement electrodes 48 and active electrodes 52 is placed in a heart 16 chamber and deployed. At block 13 a second catheter 18 with at least one electrode is introduced into the same chamber. The process enters a loop at block 15 where the signal generator 54 generates a carrier current between the movable location electrode 68 and an active electrode 52 . At block 17 the high pass section 56 of signal conditioner 50 , using the frequency and timing information of the location signal from block 29 , produces measured voltages from the passive measurement electrodes 48 . At block 19 the information from block 27 is used to determine the location of the electrode 68 where the location current is generated.
- MELP movable electrode location process
- This information includes the strength of the generated location current, the impedances of blood and tissue, the location of the active electrode 52 in use and the location of all the passive measurement electrodes 48 .
- One method for using this information would entail performing a three dimensional triangulation of the point source location signal using four orthogonal passive electrode 48 sites.
- the implementation of step 19 is the same both for the case of a basket system as seen in FIG. 3 and for the case of a balloon system as seen in FIG. 4 .
- two data sets are acquired closely spaced in time such that they are effectively instantaneous relative to the speed of cardiac mechanical activity.
- the data sets could be acquired simultaneously, by driving signals at two different frequencies, and separating them electronically by well known filtering means.
- the first data set is acquired by driving the current carrier from the location electrode 68 to a first sink or active electrode as typified by electrode 98 .
- This electrode is at a known location on the body of the monitoring catheter 14 relative to the array of passive electrodes 48 .
- the location of this first sink electrode is ideally displaced distally from the centroid 127 of the array of electrodes by at least 25 millimeters.
- a second data set is then acquired by driving the current from the location electrode 68 to a second active electrode 92 , located ideally at least 25 millimeters proximally from the centroid 127 of the array of electrodes.
- n is the number of array electrodes
- V pi are the potentials measured from each i th electrode 72
- R i is a vector from the origin (centroid of the array of electrodes 96 ) to the i th probe electrode 72
- R L is the “location vector”, or three dimensional location to be solved for in the minimization
- R a1 , R, a2 are the location vectors of the active sink electrodes (eg.
- Each additional squared parenthetical term requires the probe data set Vpi, another ‘b’ fitting term, and the particular active sink electrode 52 vector R a used during the acquisition of that data set. If the sink electrode 52 is far enough away, for example using a right leg patch electrode, the fourth term in the squared expression for that data set may be deleted as R a becomes very large.
- the method does not require two data sets.
- the first squared expression in the above expression (requiring only data set v pil ) may be sufficiently accurate.
- the non-linear least squares minimization may be performed on the above summation by any of several well-known methods.
- the Levenberg-Marquardt method has been used in practice to accomplish this with efficient and robust results.
- Nominal values for k and b are 70 and 0 respectively, when normalizing the potential values obtained as if the current source were 1 ampere.
- the number of parameters in the minimization for the above expression are six: k, b 1 , b 2 , and the x, y, and z coordinates of vector R L (assuming a Cartesian coordinate system with origin at the center of the array of electrodes 96 ).
- a model of the heart 16 chamber wall is generated from the information provided from the WSGP 25 .
- Such a model can be represented on a display 36 in a manner typified in FIG. 6 .
- a second FIG. representing the distal end of the monitoring catheter 14 can be presented. In this way, the full three dimensional geometry of the chamber and the array catheter can be presented.
- step 23 this geometry is updated repeatedly to provide a dynamic view of the chamber, the monitoring catheter 18 , along with a representation of the distal end 24 of the therapy catheter 18 . If this is then combined with the electrical potentials generated by the WEGP, the therapy catheter can be moved to an electrical site of interest represented by a point in three dimensional space.
- Calibration of the system to insure that physical dimensions are accurately scaled is not a necessity for use of the system in a diagnostic or therapeutic setting.
- the availability of heart geometry in real time can permit various hemodynamic measurements to be made and displayed to the physician as well. These measurements include systolic time intervals, stroke volume and cardiac output.
- Calibration where desired, requires at least two electrodes 60 and 62 a known distance apart placed along the inner-surface of the heart chamber 16 , as shown in FIG. 3 . In general the two electrode sites will each be coupled to the location signal generator 54 .
- the MELP of FIG. 15 can be calibrated by scaling the calculations 50 the distance between computed locations match the known distance apart of the two electrodes 60 and 62 .
- the WSGP of FIG. 5 can be calibrated by scaling the distance measured by the WSGP in the direction of electrodes 60 and 62 to the calibrated distances measured by MELP.
- the WEGP of FIG. 10 and SEGP of FIG. 14 can be calibrated to those measurements by computing the voltages at the same locations on the chamber wall 125 where electrodes 60 and 62 are located. These computed voltages can then be scaled to match the physically measured voltages from electrodes 60 and 62 . Therapy Catheter
- FIG. 16 is a schematic diagram of the therapy catheter system.
- the therapy catheter 18 has both a distal end 24 and a proximal end 26 .
- a handle 163 is on the proximal end 26 which allows the user to manipulate the distal end 24 and position it in the heart 16 . Referring to FIG. 1 , this handle also permits the therapy catheter 18 to connect to the interface system 28 of the electrophysiologic apparatus 10 through the cable 32 .
- the location current is generated by the signal generator 54 through the switch 59 and subsequently through the wire 177 of cable 32 which is connected directly to the locator electrode 68 .
- the therapy catheter system also includes a therapy generator 38 which is connected to the therapy catheter handle 163 via therapy supply line 161 .
- the therapy supply line 161 extends through the handle 163 , through the catheter body 64 , to the therapy deployment apparatus 60 at the distal end 24 of the catheter.
- the locator electrode 68 is in close proximity to the therapy deployment apparatus 60 in order to determine its location within the heart 16 .
- FIG. 17 shows an embodiment of the therapy catheter 18 using laser energy to supply the therapy.
- This laser catheter 165 includes the location wire 177 which connects the interface system 28 to the locator electrode 68 at the catheter's distal end 24 .
- the therapy supply line 161 is a fiber optic cable 167 and the therapy deployment apparatus 60 is a fiber optic terminator 169 which directs the laser energy to the site of therapy delivery.
- FIG. 18 shows an embodiment of the therapy catheter 18 using microwave energy to supply the therapy.
- This microwave catheter 171 includes the location wire 177 which connects the interface system 28 to the locator electrode 68 at the catheter's distal end 24 .
- the therapy supply line 161 is a microwave wave guide 173 and the therapy deployment apparatus 60 is a microwave emitter 175 which directs the microwave energy to the site of therapy delivery.
- FIG. 19 shows an embodiment of the therapy catheter 18 using a chemical to supply the therapy.
- This chemical deliver catheter 181 includes the location wire 177 which connects the interface system 28 to the locator electrode 68 at the catheter's distal end 24 .
- the therapy supply line 161 is a chemical filled lumen 183 .
- This lumen extends to the distal end 24 of the chemical delivery catheter 181 where a needle 185 is used to infuse the chemical into the heart chamber wall 125 .
- the needle 185 is withdrawn into the catheter body through withdrawal action 187 .
- the chemical delivery needle 185 can be deployed through the reverse of withdrawal action 187 .
- Potential chemicals to be used in the therapeutic delivery process include formaldehyde and alcohol.
- Each of the therapy catheters 18 shown in FIG. 17 through FIG. 19 as well as the radio frequency catheter shown in FIG. 2 can be miniaturized and inserted into the coronary arterial tree.
- the location signal generated at locator electrode 68 can still be sensed by the passive electrodes 48 even though the signal is coming from the epicardium of the heart 16 rather than from within the heart chamber.
- the movable electrode location process of FIG. 15 can be used in this instance to help determine the location of the distal end 24 of the therapy catheter 18 in the coronary arterial tree and whether it is close to a site of abnormal electrical activity. Assuming that a site of ischemia will commonly be a site of abnormal electrical activity, the MELP will also enable more rapid location of potential sites for angioplasty.
- FIG. 20 shows an embodiment of the therapy catheter 18 using balloon inflation to supply the therapy.
- This angioplasty catheter 191 includes the location wire 177 which connects the interface system 28 to the locator electrode 68 at the catheter's distal end 24 .
- the therapy supply line 161 is an inflation media supply lumen 193 and the therapy deployment apparatus 60 is an angioplasty balloon 195 .
- a site of interest would be determined after viewing the wall electrogram generated by the WEGP of FIG. 10 .
- the angioplasty therapy catheter 191 would be positioned in the coronary arterial tree and its position determined relative to the site of interest.
- the balloon 195 would be deployed to open the artery.
- the electrical activity of the site would be reviewed to determine whether the underlying tissue 125 was now receiving a proper blood supply and thus was no longer electrically abnormal.
Abstract
A mapping catheter is positioned in a heart chamber, and active electrode sites are activated to impose an electric field within the chamber. The blood volume and wall motion modulates the electric field, which is detected by passive electrode sites on the preferred catheter. Electrophysiology measurements, as well as geometry measurements, are taken from the passive electrodes and used to display a map of intrinsic heart activity.
Description
- This is a Divisional Application of U.S. Ser. No. 09/005,105, filed Jan. 9, 1998, entitled “Electrophysiology Mapping System;” which was a Continuation-In-Part of U.S. Ser. No. 08/387,832, officially filed May 26, 1995 and entitled “Endocardial Mapping System and Catheter Probe”; which is a national stage application based upon international application PCT/US93/09015, filed Sep. 23, 1993; which in turn is a Continuation-In-Part of both U.S. Ser. No. 07/950,448, filed Sep. 23, 1992 (now U.S. Pat. No. 5,291,549) and U.S. Ser. No. 07/949,690, also filed Sep. 23, 1992 (now U.S. Pat. No. 5,311,866). The parent application, Ser. No. 08/387,832, is incorporated by reference herein.
- The parent invention relates to electrophysiology apparatus which is used to measure and to visualize electrical activity occurring in a patient's heart. The system can display both a visual map of the underlying electrical activity originating in a chamber of a patient's heart and the location of a therapy catheter located within a heart chamber. The electrophysiology apparatus includes several subsystems including: a therapy catheter system, a measurement catheter system and a computer based signal acquisition, control and display system.
- Many cardiac tachyarrhythmias are caused by conduction defects which interfere with the normal propagation of electrical signals in a patient's heart. These arrhythmias may be treated electrically, pharmacologically or surgically. The optimal therapeutic approach to treat a particular tachyarrhythmia depends upon the nature and location of the underlying conduction defect. For this reason electrophysiologic mapping is used to explore the electrical activity of the heart during a tachyarrhythmic episode. The typical electrophysiologic mapping procedure involves positioning an electrode system within the heart. Electrical measurements are made which reveal the electrical propagation of activity in the heart. If ablation is the indicated therapy then a therapy catheter is positioned at the desired location within the heart and energy is delivered to the therapy catheter to ablate the tissue.
- There are numerous problems associated with these electrophysiologic diagnostic and therapeutic procedures. First the testing goes on within a beating heart. The motion of the diagnostic catheter and treatment catheter can injure the heart and provoke bouts of arrhythmia which interfere with the collection of diagnostic information. During the delivery of ablation therapy it is common to use fluoroscopic equipment to visualize the location of the catheters. Many physicians are concerned about routine occupational exposure to X-rays. In addition, the traditional mapping techniques do not provide a high resolution view of the electrical activity of the heart which makes it difficult to precisely locate the source of the arrhythmia.
- The electrophysiology apparatus of the invention is partitioned into several interconnected subsystems. The measurement catheter system introduces a modulated electric field into the heart chamber. The blood volume and the moving heart wall surface modify the applied electric field. Electrode sites within the heart chamber passively monitor the modifications to the field and a dynamic representation of the location of the interior wall of the heart is developed for display to the physician. Electrophysiologic signals generated by the heart itself are also measured at electrode sites within the heart and these signals are low pass filtered and displayed along with the dynamic wall representation. This composite dynamic electrophysiologic map may be displayed and used to diagnose the underlying arrhythmia.
- A therapy catheter system can also be introduced into the heart chamber. A modulated electrical field delivered to an electrode on this therapy catheter can be used to show the location of the therapy catheter within the heart. The therapy catheter location can be displayed on the dynamic electrophysiologic map in real time along with the other diagnostic information. Thus the therapy catheter location can be displayed along with the intrinsic or provoked electrical activity of the heart to show the relative position of the therapy catheter tip to the electrical activity originating within the heart itself. Consequently the dynamic electrophysiology map can be used by the physician to guide the therapy catheter to any desired location within the heart.
- The dynamic electrophysiologic map is produced in a step-wise process. First,the interior shape of the heart is determined. This information is derived from a sequence of geometric measurements related to the modulation of the applied electric field. Knowledge of the dynamic shape of the heart is used to generate a representation of the interior surface of the heart.
- Next, the intrinsic electrical activity of the heart is measured. The signals of physiologic origin are passively detected and processed such that the magnitude of the potentials on the wall surface may be displayed on the wall surface representation. The measured electrical activity may be displayed on the wall surface representation in any of a variety of formats. Finally, a location current may be delivered to a therapy catheter within the same chamber. The potential sensed from this current may be processed to determine the relative or absolute location of the therapy catheter within the chamber.
- These various processes can occur sequentially or simultaneously several hundred times a second to give a continuous image of heart activity and the location of the therapy device.
- An exemplary and illustrative form of the invention is shown in the drawings and identical reference numerals refer to equivalent structure throughout.
-
FIG. 1 is a schematic block diagram of the electrophysiology apparatus; -
FIG. 2 is a block diagram representing the partitioning of the electrophysiology apparatus; -
FIG. 3 is a diagram of an illustrative balloon electrode set implementation of the measurement catheter and a therapy catheter; -
FIG. 4 is a schematic diagram of an illustrative basket electrode set implementation of the measurement catheter; -
FIG. 5 is a flow chart showing the wall surface generation process; -
FIG. 6 is a schematic diagram of a row of electrodes of the balloon catheter and their use in measuring distance to the heart chamber wall; -
FIG. 7 is a screen display representing the motion of the cardiac wall surface; -
FIG. 8 is a schematic block diagram of the portion of the electrophysiology apparatus which implements the body orientation generation process; -
FIG. 9 is a flow charting showing the body orientation generation process; -
FIG. 10 is a flow chart showing the wall electrogram generation process; -
FIG. 11 is a representative screen display showing wall electrogram information; -
FIG. 12 is a representative screen display showing wall electrogram information; -
FIG. 13 is a representative screen display showing wall electrogram information; -
FIG. 14 is a flow chart showing the site electrogram generation process; and -
FIG. 15 is a flow chart showing the movable electrode location process. -
FIG. 16 is a schematic block diagram of the therapy catheter system; -
FIG. 17 is a schematic diagram of the laser delivery embodiment of the therapy catheter; -
FIG. 18 is a schematic diagram of a microwave delivery embodiment of the therapy catheter; -
FIG. 19 is a schematic diagram of a chemical delivery embodiment of the therapy catheter; and -
FIG. 20 is a schematic diagram of the angioplasty catheter embodiment of the therapy catheter. -
FIG. 1 shows theelectrophysiologic apparatus 10 connected to apatient 12. In a typical procedure amonitoring catheter system 14 is placed in theheart 16 to generate a display of the electrical activity of theheart 16. After diagnosis atherapy catheter 18 may be inserted into the heart to perform ablation or other corrective treatment. - The monitoring
catheter 14 has aproximal end 20 which may be manipulated by the attending physician, and adistal end 22 which carries a monitoring catheter electrode set 44. In general thedistal end 22 of themonitoring catheter 14 will be relatively small and will float freely in the heart chamber. Thetherapy catheter 18 has adistal end 24 which carries a therapy catheter electrode set 46. The therapy catheter also hasproximal end 26 which can be manipulated by the attending physician. - The electrode sets located on the catheters are coupled to an
interface system 28, through appropriate cables. Thecable 30 connects the monitoring catheter electrode set 44 to theinterface system 28 whilecable 32 connects the therapy catheter electrode set 46 to theinterface system 28. Theinterface system 28 contains a number of subsystems which are controlled by acomputer 34. The data collected by theinterface system 28 is manipulated by thecomputer 34 and displayed on adisplay device 36. Surface electrodes represented byelectrode 40 may also be coupled to theelectrophysiology apparatus 10 for several purposes via anappropriate cable 42. Atherapy generator 38 is connected to thetherapy catheter electrode 60 and to thetherapy surface ground 70, through theinterface system 28. The skinsurface electrode cable 42 couples theECG surface electrodes 74 to theECG system 39, which may be a subsystem ofinterface system 28. -
FIG. 2 is a schematic diagram showing an illustrative segmentation of the electrode sets and their electrical connections to subsystems in theelectrophysiology apparatus 10. For example the monitoring electrode set 44 contains a subset ofpassive electrodes 48 which are connected to asignal conditioner 50. The monitoring electrode set 44 also contains a subset ofactive electrodes 52 which are connected to asignal generator 54 through aswitch 59. Thesignal generator 54 is controlled by thecomputer 34. In operation, thesignal generator 54 generates a burst of (4800 Hz for example) signals which are supplied to the active electrode set 52. This energy sets up an electric field within theheart 16 chamber. The electrical potentials present on the passive electrode set 48 represent the summation of the underlying electrophysiological signals generated by the heart and the field induced by the burst. Thesignal conditioner 50 separates these two components. The preferred technique is to separate the signals based upon their frequency. - The
high pass section 56 of the signal conditioner extracts the induced field signals as modulated by the blood volume and the changing position of thechamber walls 125. First, the signals are amplified with a gain of approximately 500 frompassive electrodes 48 withamplifier 151. Next, the signals are high pass filtered at roughly 1200 Hz byfilter 153. Then the 4800 Hz signal is extracted bydemodulator 155. Finally, the individual signals are converted to digital format by the analog todigital converter 157 before being sent to thecomputer 34. - The
low pass section 58 of thesignal conditioner 50 extracts physiologic signals. First, signal drift is reduced with a 0.01 Hzhigh pass filter 143. Next, aprogrammable gain amplifier 145 amplifies the signals. Then alow pass filter 147 removes extraneous high frequency noise and the signal from the induced field. Finally, the physiologic signals are converted to digital format by the analog todigital converter 149 before being sent to thecomputer 34. - The therapy catheter electrode set 46 includes at least one
therapy delivery electrode 60, and preferably one ormore monitoring electrodes 62, and one ormore locator electrodes 68. Thetherapy delivery electrode 60 cooperates with theground electrode 70, which is generally a skin patch electrode, to deliver ablation energy to the heart. These electrodes are coupled to theablation energy generator 38 which is shown as an RF current source. Alocator electrode 68 is provided which is preferably proximate thedelivery electrode 60, but can be a separate electrode site located near thedistal end 24 of thetherapy catheter 18. This electrode site is coupled with anactive electrode 52 through aswitch 59 to thesignal generator 54. In use, the electric field coupled to thetherapy catheter 18 permits the physician to track and visualize the location of thelocator electrode 68 on thedisplay device 36. The therapy catheter electrode set 46 can also be used to monitor the physiologic signals generated at thechamber wall 125 by a lowpass signal conditioner 141 which is similar to thelow pass section 58 of thesignal conditioner 50. These digitized signals are then sent to thecomputer 34. - At least one
electrode pair 119 ofsurface electrodes 40 are also coupled to thesignal generator 54 throughswitch 59. Eachelectrode heart 16 in-between them. The induced field is sensed bypassive electrodes 48 and conditioned by thehigh pass section 56 of thesignal conditioner 50. This field helps thecomputer 34 align or orient thepassive electrodes 48 to the body for better visualization of the heart on themonitor 36. - The
ECG subsystem 39 accepts signals from standardECG skin electrodes 74. It also contains a low pass section similar to thelow pass section 58 ofsignal conditioner 50. In general, the passive electrode set 48 and active electrode set 52 will reside on a single catheter, however it should be recognized that other locations and geometries are suitable as well. Both basket and balloon devices are particularly well suited to this application. -
FIG. 3 shows an electrode configuration on aballoon catheter 94 which has aninflatable balloon 96 which underlies an array or set ofpassive electrodes 48 typified bypassive electrode 72. Thesepassive electrodes 48 can be organized into rows, typified byrow 123, and columns, typified bycolumn 121. A pair ofactive excitation electrodes 52 are typified byproximal electrode 92 anddistal electrode 98. Theballoon catheter 94 configuration can be quite small in comparison with thebasket catheter 80 configuration. This small size is desirable both for insertion into and for use in aheating heart 16. -
FIG. 3 also shows a movable, reference ortherapy catheter system 18. This catheter is shown lying along theinterior surface 125 of theheart 16. A pair of electrodes shown asdelivery electrode 60 andreference electrode 62 are located a fixed distance apart on thecatheter body 64. This auxiliary catheter may be used to supply ablation energy to the tissue during therapy. Thistherapy catheter 18 may be used with either thebasket catheter 80 configuration or theballoon catheter 94 configuration. -
FIG. 4 shows an electrode configuration on abasket catheter 80. The limbs of thebasket 80, typified bylimb 82 carry multiple passive electrode sites typified byelectrode 84. A pair of active excitation electrodes are shown on thecentral shaft 86 of thebasket 80 as indicated byexcitation electrode 88. Thebasket catheter 80 electrodes lie gently against theinterior surface 125 of theheart 16 urged into position by the resilience of the limbs. Thebasket catheter 80 permits unimpeded flow of blood through the heart during the mapping procedure which is very desirable. This form of catheter also places the electrodes into contact with theheart chamber wall 125 for in-contact mapping of the physiologic potentials of theheart 16. - Returning to
FIG. 1 andFIG. 2 these figures show one illustrative partitioning of system functions. In use, thesignal generator 54 can generate a 4800 Hz sinusoidal signal burst on the active electrode set 52 which creates an electric field in the heart. The changing position of thechamber walls 125 and the amount of blood within the heart determines the signal strength present at thepassive electrode sites 48. For purposes of this disclosure the chamber geometry is derived from the electric field as measured at thepassive electrode sites 48 which may, or may not be in contact with thewalls 125 of the heart. In the case of thebasket electrodes 84 which lie on theheart surface 125 the field strength is inversely proportional to the instantaneous physical wall location and the distance from theactive electrodes 52 to these walls. In the case of the balloon catheter the potentials on the passive set ofelectrodes 72 are related to the wall location, but a set of computationally intensive field equations must be solved to ascertain the position of the wall. In general, both the basket and balloon approach can be used to generate the dynamic representation of the wall surface. - The
computer 34 operates under the control of a stored program which implements several control functions and further displays data on adisplay device 36. The principal software processes are the wall surface generation process (WSGP); the body orientation generation process (BOGP); the wall electrogram generation process (WEGP); the site electrogram generation process (SEGP); and the movable electrode location process (MELP). -
FIG. 5 is a flow chart describing the method used to generate the “wall surface” of the interior of theheart 16. The step-wise processes are presented with certain physical parameters which are either known in advance by computation or are measured. This knowledge or information is shown inblock 53, block 55 andblock 57. The WSGP process begins atblock 41 with the insertion of themonitoring catheter 14 in theheart 16. Thiscatheter 14 places an array ofelectrodes 44 in aheart 16 chamber. This array must have both passivemeasurement electrode sites 48 and activeinterrogation electrode sites 52 located in a known position. The process enters a measurement and display loop atblock 43 where an interrogation pulse burst is generated by thesignal generator 54 seen inFIG. 2 . These pulses are generated first with the current source atsite 92 and the current sink atsite 98 and second with the current source atsite 98 and the sink atsite 92 as seen inFIG. 3 . Atblock 45 thesignal conditioner 50 uses information on the frequency and timing of the interrogation current fromblock 53 to demodulate the signals and analog to digital convert the signals received at thepassive measurement electrodes 48. Atblock 47 the information fromblock 55 is used. This information includes both the current strength of the interrogation pulse and the location of the interrogation source and sink electrodes. Impedance is voltage divided by current. The voltage offset caused by the location of the current source can be reduced by the two measurements of opposite polarity. This information is used to determine the impedance which the chamber and the blood contained in that chamber imposes on the field generated by the interrogation current. The knowledge fromblock 57 is used next.Block 49 determines how the heart chamber tissue, which has roughly three times the impedance of blood, in combination with the type of electrode array affects the field generated by the interrogation electrodes. - In a system as shown as the basket in
FIG. 4 the blood effects the impedance directly as the field is propagated from the interrogation electrodes to the measurement electrodes. In general, if a point current course is used within a chamber the inverse of the measured voltage is proportional to the square root of the distance from the source. With the distance from eachelectrode 84 to bothexcitation electrodes 88 computed from the measured voltage and the known location of theelectrodes 84 relative to each other, the locations of eachelectrode 84 can be determined. - In a system as shown in
FIG. 3 the impedance of the field generated within the blood volume is modulated by the position of thewalls 125, with their higher impedance, with respect to the location relative to the measurement electrodes. Using this knowledge and the measurements fromblock 47 the distance from the interrogation electrodes to theheart chamber wall 125 is determined at a point normal to the field generated by theactive interrogation electrodes 52. - The
passive electrodes 48 on theballoon catheter 94 can be positioned inrows 123 andcolumns 121 with the columns in a line from the top of theballoon 96 nearactive electrode 92 to the bottom of theballoon 96 nearactive electrode 98. In a preferred embodiment three configurations are possible: 8 rows and 8 columns, 7 rows and 9 columns, and 6 rows and 10 columns. In each such embodiment the measurements from anyrow 123 are treated independently. Using the 8 row, 8 column embodiment as an example, 8 measurements of distance are taken for any selected row of electrodes, giving a total of 64 measurements. -
FIG. 6 is a schematic drawing of the embodiment required to measure thedistance 129 from thecentroid 127 of theballoon 96 through thepassive electrode 131 to theheart chamber wall 125. Thepassive electrode 131 is one of eight electrodes on a row ofelectrodes 123. Starting withelectrode 131 and labeling it as electrode A, the other electrodes on therow 123 are labeled B, C, D, E, F, G and H by proceeding around theballoon 96 in a clockwise direction. The measurements of impedance “I” at these electrodes are thus labeled IA, IB, IC, ID, IE, IF and IH. To compute thedistance 129 in the direction ofelectrode 131 the following equation is computed:
ln(D A)=c0+c1*ln(I A)+c2*ln(I B)+c3*ln(I C) +c4*ln(I D)+c5*ln(I E)+c4*ln(I F)+c3ln(I G)+c2*ln(I H)
where DA is the desireddistance 129 and c0 through c5 are optimized parameters. A typical vector of these parameters is (c0, c1, c2, c3, c4, c5)=(3.26, −0.152, −0.124, −0.087, −0.078, −0.066). - Once the
distance 129 in the direction ofelectrode 131 is determined then the computation can be redone by shifting this direction clockwise one electrode, relabeling electrodes A through H and solving the above equation again. Once the distances for this row ofelectrodes 123 are determined then the next row distances are determined in the same way until the distances at all 64 electrodes are determined. - Returning to
FIG. 5 , with multiple wall locations in space determined by this method, a model of thechamber wall 125 shape can be created inblock 51. Various techniques for creating a shape are possible, including cubic spline fits, and best fit of an ellipsoid. The positions of theactive electrodes 52 and thepassive electrodes 48 relative to theheart 16 chamber walls are also determined at this point. The loop continues as the method moves back to block 43. This loop continues at a rate fast enough to visualize the real-time wall motion of the heart chamber, at least at twenty times per second. - There are numerous display formats or images which can be used to present the dynamic endocardial wall surface to the physician. It appears that one of the most useful is to unfold the endocardial surface and project it onto a plane. Wire grid shapes representing a perspective view of the interior of the heart chamber are useful as well. It appears that each individual physician will develop preferences with respect to preferred output image formats. In general, different views of the endocardial surface will be available or may be used for diagnosis of arrythmia and the delivery of therapy. One distinct advantage of the present invention is that the image of the heart wall is not static or artificial. In this system the image is a measured property of the heart wall, and is displayed in motion.
-
FIG. 7 shows two separate frames of the dynamic representation of the heart wall.Wire frame 71 shows the heart at systole whilewire frame 73 shows the heart at diastole.Path arrow 75 andpath arrow 77 represent the dynamic cycling through several intermediate shapes between the systole and diastole representation. These views are useful as they indicate the mechanical pumping motion of the heart to the physician. -
FIG. 8 is a schematic drawing of the apparatus required to perform the body orientation generation process. It shows a patient 12 with at least onepair 119 ofskin electrodes 40 attached to the body surface in a stationary position on the body and in a known configuration. These electrodes are typified byexample surface electrodes ECG electrode 74, an RF generationcurrent sink electrode 70, or another electrode specifically dedicated to the BOGP. Ideally,electrode heart 16 directly in between them. This pair of electrodes is attached to thesignal generator 54 through theswitch 59 via anappropriate cable 117. Thedistal end 22 ofmonitoring catheter 14 is situated in theheart 16 where thepassive electrodes 48 can measure the signals generated across theelectrode 89 andelectrode 115. -
FIG. 9 is a flow chart describing the method used to align the wall surface representation of the WSGP to the body orientation. The process begins atstep 101 where themonitoring catheter 14 with a set ofpassive electrodes 48 is inserted intoheart 16 chamber and a pair ofsurface electrodes 119 are attached at a known position on thebody 12. The process begins cycling atstep 102 where thesignal generator 54 generates a signal across theskin electrode 89 andskin electrode 115. Atstep 103 the voltage created by thesignal generator 54 is measured frompassive electrode 48 by thehigh pass section 56 of thesignal conditioner 50 by using the information fromblock 110 which includes the frequency and timing of the field generated by thesignal generator 54. This voltage information is stored in an array “Y”. - At step 104 a regression analysis is performed which creates a vector which lines up with the field generated in
step 103. This regression method is the same whether a basket catheter as shown inFIG. 4 or a balloon catheter as shown inFIG. 3 is used. The location of eachpassive electrode 48 is provided to the method byblock 110. This information comes from different sources in each case however. In the case of abasket catheter 80 these three dimensional electrode locations come from the WSGP. In the case of theballoon catheter 94 these three dimensional electrode locations are known a priori. In each case they are saved in an array “X”. The regression to compute the orientation vector uses the standard regression equation for the computation of a slope:
b=Σxy/Σx 2
where “X” is the array of elertrode locations, “Y” is the array of measured voltages and “b” is the orientation vector. If more than one pair of skin electrodes are used then an orthogonal set of orientation vectors can be created and any rotation of themonitoring catheter 14 relative to thebody 12 can be detected. - In
step 105 the information on the location of thechamber walls 125 from theWSGP 109 can be used to create a three dimensional model of theheart 16 chamber as seen inFIG. 7 . By combining this model with the computed orientation fromstep 104 and the known location of theskin electrodes 108 this representation can be shown in a known orientation relative to the body instep 106. In step 107 a specific orientation such as typical radiological orientations RAO (right anterior oblique), LAO (left anterior oblique), or AP (anterior/posterior) can be presented. By repeatedly showing this view a dynamic representation can be presented which matches the view shown on a standard fluoroscopic display. Thus such an image can be presented without the need for using ionizing radiation. -
FIG. 10 is a flow chart describing the wall electrogram generation process (WEGP). This process begins atblock 61 when amonitoring catheter 14 with an array ofpassive measurement electrodes 48 is placed in aheart chamber 16 and deployed. The process enters a loop atblock 63. The frequency of the interrogation pulses generated by thesignal generator 54 is provided byblock 85. With this knowledge the lowpass filter section 58 of thesignal conditioner 50 measures the voltage at frequencies lower than the generated interrogation pulses. Typically the highest frequency of the biopotentials is 100 Hz but can be as high as 250 Hz. - In the case of a basket system as seen in
FIG. 4 the measurements are contact voltages from thechamber wall 125 tissue contacting theelectrodes 84. - In the case of a balloon system as seen in
FIG. 3 the measurements are measurements of the field generated throughout the blood volume by the tissue on thechamber wall 125. Atstep 65, a model of the array boundary and thechamber wall 125 boundary is created from the information inblock 87. This information includes the location of thepassive electrodes 48 on the array and thechamber wall 125 locations from the WSGP. - In the case of a basket system as seen in
FIG. 4 , the array boundary and thechamber wall 125 boundary are the same since they are in contact. The locations are determined in three-dimensional space of the sites on the chamber wall where potentials are measured. - In the case of the balloon system as seen in
FIG. 3 , the array boundary and thechamber wall 125 boundary are different. Duringstep 65, locations are generated in three-dimensional space of the sites on the chamber wall where potentials are to be determined. - At
step 66, the potentials are projected on to the sites on the chamber wall specified instep 65. In the case of a basket system as seen inFIG. 4 , the measured potentials are assigned to these sites. - In case of a balloon system as seen in
FIG. 3 , a three dimensional technique such as those typically used in field theory is used to generate a representation of the three dimensional field gradients in the blood volume of the heart chamber. Two examples of appropriate techniques are a spherical harmonics solution to Laplace's equation, and boundary element analysis. A more detailed description of spherical harmonics is given in the parent disclosure which is incorporated by reference herein. - For the boundary element method in the mapping system of the invention, the voltage is measured at the
passive electrodes 48 on the probe orballoon catheter 94. From the voltage at the electrodes on the probe and the knowledge that the probe is nonconducting, the voltage and normal current at a previously selected set of nodes on theendocardial surface 125 are determined by the boundary element method in the following manner. - It is known that the voltage in the blood pool between the probe and the endocardium satisfies Laplace's equation that states that the net current flow across any specific boundary is zero. To find the voltage and/or normal current on the endocardium, one must find the solution of Laplace's equation in the blood pool and calculate the values of this solution on the endocardium. Standard finite element and finite difference methods can be used to find the solution to Laplace's equation, but they have large computational overhead for generating and keeping track of a three-dimensional grid in the whole blood pool. In the mapping system of the invention, Laplace's equation is solved by the boundary element method, a specialized finite element method that permits one to restrict the calculations to the two-dimensional probe and endocardial surfaces (and not have to deal with calculations over the blood pool between these two surfaces). In order to create an accurate map of the endocardial voltage and/or normal current based on the voltage information from a limited number of electrodes on the probe, the system uses a higher-order version of the boundary element method. This system currently uses bicubic splines to represent the probe and endocardial surfaces and bilinear elements and bicubic splines to represent the voltage and the normal current on these surfaces.
- The boundary element method consists of creating and solving a set of linear equations for the voltage and the normal current on the endocardium based on the voltage measurements at the electrodes on the probe. Each of the elements in the matrices that are involved in this set consists of two-dimensional integrals, which are calculated by numerical and analytical integration.
- Using Laplace's equation with data given on the probe is a so-called “ill-posed” problem. For such problems, all solution procedures, including the boundary element method, are ill conditioned, that is, small errors in the measured voltage on the probe surface can result in large errors in the calculated voltage and/or normal current on the endocardium. To minimize the errors on the endocardium, options for regularization or constraints have been included in the software code. For example: the user can choose parameters that cause the code to add equations for known or expected values of the voltage and/or normal current on the endocardium. This capability is often but not exclusively used to add equations that take into account the voltage and/or normal current of the map of the previous instant(s) in time (the previous “frame(s)”). This process uses historical data from the previous frame to constrain the values subsequently computed.
- The solution of the set of the boundary element equations and regularizing equations (if any) is normally accomplished by singular value decomposition but there is an option to solve the linear system by decomposition (Gaussian elimination) or direct or inherent methods. When singular value decomposition is used, there is an option to turn off the influence of high-frequency errors (that is, do a type of regularization) by setting various small singular values to zero, the result of which can be an increase in the accuracy of the calculated voltage and normal current on the endocardium.
- In
block 67, a large number of points are calculated on the three-dimensional chamber surface 125. In the case of a basket catheter as seen inFIG. 4 , this is done through interpolation using bilinear or bicubic splines. In the case of a balloon catheter as seen inFIG. 3 , this can be done either by using the model, such as the boundary element method or spherical harmonics to generate more points. Alternatively, bilinear or bicubic splines can be used to interpolate between a smaller number of points. - In block 69 a representation of the electrical potentials on the
surface 125 are used to display the patterns. These types of displays include color maps, maps of iso-potential lines, maps of potential gradient lines and others. The electro-physiologic information is reconstructed on thedynamic wall surface 125. In general the measured electrical activity is positioned by the WSGP at the exact location which gives rise to the activity. The high resolution of the system creates an enormous amount of information to display. Several techniques may be used to display this information to the physician. For example the electrogram data can be shown in false color gray-scale on a two dimensional wall surface representation. In this instance areas of equal potential areas are shown in the same color. Also a vectorized display of data can be shown on a wire grid as shown inFIG. 11 where the distance between any two dots typified bydot pair FIG. 12 gradient lines typified byline 135 represent the change in potential over the chamber wall surface. Those areas with the largest change per unit area have the longest gradient lines oriented in the direction of steepest change. InFIG. 13 iso-potential lines typified byline 95 represent equal electrical potential. In this representation the closeness of lines represents more active electrical areas. -
FIG. 14 is a flow chart of the site electrogram generation process (SEGP). This process is used to extract and display a time series representation of the electrical activity at a physician selected site.FIG. 13 shows asite 97 that has been selected and a time series electrogram 99 is shown on thedisplay device 36 along with the dynamic wall representation. Returning toFIG. 14 this process begins atblock 76 when a catheter with an array with bothpassive measurement electrodes 48 andactive electrodes 52 is placed in a heart chamber and deployed. The process enters a loop at 78. The inputs to the method include the wall locations fromblock 37. Then thewall electrogram generator 35 provides the electrical potentials on this surface at 79. The user will use thedisplay 36 to determine a location of interest inblock 33 which will then be marked on thedisplay device 36 atstep 81. The voltage from this location will be collected atblock 83. This voltage will be plotted in a wave-form representation 99 inblock 31. The loop continues at this point at a rate sufficient to display all of the frequencies of such a time series electrogram 99, at least 300 points per second. - The false color and vectorized display images may direct the physician to specific sites on the endocardial surface for further exploration. The system may allow the physician to “zoom” in on an area to show the electrical activity in greater detail. Also the physician may select a site on the
endocardial wall 125 and display a traditional time series electrogram 99 originating at that site. -
FIG. 15 is a flow-chart of the movable electrode location process (MELP). It begins atblock 11 when a catheter with an array ofpassive measurement electrodes 48 andactive electrodes 52 is placed in aheart 16 chamber and deployed. At block 13 asecond catheter 18 with at least one electrode is introduced into the same chamber. The process enters a loop atblock 15 where thesignal generator 54 generates a carrier current between themovable location electrode 68 and anactive electrode 52. Atblock 17 thehigh pass section 56 ofsignal conditioner 50, using the frequency and timing information of the location signal fromblock 29, produces measured voltages from thepassive measurement electrodes 48. Atblock 19 the information fromblock 27 is used to determine the location of theelectrode 68 where the location current is generated. This information includes the strength of the generated location current, the impedances of blood and tissue, the location of theactive electrode 52 in use and the location of all thepassive measurement electrodes 48. One method for using this information would entail performing a three dimensional triangulation of the point source location signal using four orthogonalpassive electrode 48 sites. The implementation ofstep 19 is the same both for the case of a basket system as seen inFIG. 3 and for the case of a balloon system as seen inFIG. 4 . In this preferred implementation, two data sets are acquired closely spaced in time such that they are effectively instantaneous relative to the speed of cardiac mechanical activity. Alternatively, the data sets could be acquired simultaneously, by driving signals at two different frequencies, and separating them electronically by well known filtering means. - The first data set is acquired by driving the current carrier from the
location electrode 68 to a first sink or active electrode as typified byelectrode 98. This electrode is at a known location on the body of themonitoring catheter 14 relative to the array ofpassive electrodes 48. The location of this first sink electrode is ideally displaced distally from thecentroid 127 of the array of electrodes by at least 25 millimeters. A second data set is then acquired by driving the current from thelocation electrode 68 to a secondactive electrode 92, located ideally at least 25 millimeters proximally from thecentroid 127 of the array of electrodes. - The location algorithm is performed by minimizing the following equation:
Where n is the number of array electrodes, where k, b1 and b2 are fitting parameters, Vpi are the potentials measured from each ith electrode 72, Ri is a vector from the origin (centroid of the array of electrodes 96) to the ith probe electrode 72, RL is the “location vector”, or three dimensional location to be solved for in the minimization, and Ra1, R,a2 are the location vectors of the active sink electrodes (eg. 92 and 98) which are known at locations on the axis of the array ofpassive electrodes 48. - Additional data sets could be incorporated, following the same logic as above. Each additional squared parenthetical term requires the probe data set Vpi, another ‘b’ fitting term, and the particular
active sink electrode 52 vector Ra used during the acquisition of that data set. If thesink electrode 52 is far enough away, for example using a right leg patch electrode, the fourth term in the squared expression for that data set may be deleted as Ra becomes very large. - It is also noted that the method does not require two data sets. The first squared expression in the above expression (requiring only data set vpil) may be sufficiently accurate.
- The non-linear least squares minimization may be performed on the above summation by any of several well-known methods. The Levenberg-Marquardt method has been used in practice to accomplish this with efficient and robust results. Nominal values for k and b are 70 and 0 respectively, when normalizing the potential values obtained as if the current source were 1 ampere. The number of parameters in the minimization for the above expression are six: k, b1, b2, and the x, y, and z coordinates of vector RL (assuming a Cartesian coordinate system with origin at the center of the array of electrodes 96).
- At step 21 a model of the
heart 16 chamber wall is generated from the information provided from theWSGP 25. Such a model can be represented on adisplay 36 in a manner typified inFIG. 6 . Once this surface is rendered, within this surface a second FIG. representing the distal end of themonitoring catheter 14 can be presented. In this way, the full three dimensional geometry of the chamber and the array catheter can be presented. - In
step 23 this geometry is updated repeatedly to provide a dynamic view of the chamber, the monitoringcatheter 18, along with a representation of thedistal end 24 of thetherapy catheter 18. If this is then combined with the electrical potentials generated by the WEGP, the therapy catheter can be moved to an electrical site of interest represented by a point in three dimensional space. - Calibration of the system to insure that physical dimensions are accurately scaled is not a necessity for use of the system in a diagnostic or therapeutic setting. However, the availability of heart geometry in real time can permit various hemodynamic measurements to be made and displayed to the physician as well. These measurements include systolic time intervals, stroke volume and cardiac output. Calibration, where desired, requires at least two
electrodes 60 and 62 a known distance apart placed along the inner-surface of theheart chamber 16, as shown inFIG. 3 . In general the two electrode sites will each be coupled to thelocation signal generator 54. The MELP ofFIG. 15 can be calibrated by scaling thecalculations 50 the distance between computed locations match the known distance apart of the twoelectrodes electrodes chamber wall 125, the WSGP ofFIG. 5 can be calibrated by scaling the distance measured by the WSGP in the direction ofelectrodes FIG. 10 and SEGP ofFIG. 14 can be calibrated to those measurements by computing the voltages at the same locations on thechamber wall 125 whereelectrodes electrodes -
FIG. 16 is a schematic diagram of the therapy catheter system. Thetherapy catheter 18 has both adistal end 24 and aproximal end 26. Ahandle 163 is on theproximal end 26 which allows the user to manipulate thedistal end 24 and position it in theheart 16. Referring toFIG. 1 , this handle also permits thetherapy catheter 18 to connect to theinterface system 28 of theelectrophysiologic apparatus 10 through thecable 32. The location current is generated by thesignal generator 54 through theswitch 59 and subsequently through thewire 177 ofcable 32 which is connected directly to thelocator electrode 68. The therapy catheter system also includes atherapy generator 38 which is connected to the therapy catheter handle 163 viatherapy supply line 161. Thetherapy supply line 161 extends through thehandle 163, through thecatheter body 64, to thetherapy deployment apparatus 60 at thedistal end 24 of the catheter. Thelocator electrode 68 is in close proximity to thetherapy deployment apparatus 60 in order to determine its location within theheart 16. -
FIG. 17 shows an embodiment of thetherapy catheter 18 using laser energy to supply the therapy. Thislaser catheter 165 includes thelocation wire 177 which connects theinterface system 28 to thelocator electrode 68 at the catheter'sdistal end 24. In this instance thetherapy supply line 161 is afiber optic cable 167 and thetherapy deployment apparatus 60 is afiber optic terminator 169 which directs the laser energy to the site of therapy delivery. -
FIG. 18 shows an embodiment of thetherapy catheter 18 using microwave energy to supply the therapy. Thismicrowave catheter 171 includes thelocation wire 177 which connects theinterface system 28 to thelocator electrode 68 at the catheter'sdistal end 24. In this instance thetherapy supply line 161 is amicrowave wave guide 173 and thetherapy deployment apparatus 60 is amicrowave emitter 175 which directs the microwave energy to the site of therapy delivery. -
FIG. 19 shows an embodiment of thetherapy catheter 18 using a chemical to supply the therapy. This chemical delivercatheter 181 includes thelocation wire 177 which connects theinterface system 28 to thelocator electrode 68 at the catheter'sdistal end 24. In this instance thetherapy supply line 161 is a chemical filledlumen 183. This lumen extends to thedistal end 24 of thechemical delivery catheter 181 where aneedle 185 is used to infuse the chemical into theheart chamber wall 125. During introduction of thechemical delivery catheter 181 into the heart chamber theneedle 185 is withdrawn into the catheter body throughwithdrawal action 187. Once the location of thedistal end 24 is determined to be at the site of interest thechemical delivery needle 185 can be deployed through the reverse ofwithdrawal action 187. Potential chemicals to be used in the therapeutic delivery process include formaldehyde and alcohol. - Each of the
therapy catheters 18 shown inFIG. 17 throughFIG. 19 as well as the radio frequency catheter shown inFIG. 2 can be miniaturized and inserted into the coronary arterial tree. The location signal generated atlocator electrode 68 can still be sensed by thepassive electrodes 48 even though the signal is coming from the epicardium of theheart 16 rather than from within the heart chamber. Thus the movable electrode location process ofFIG. 15 can be used in this instance to help determine the location of thedistal end 24 of thetherapy catheter 18 in the coronary arterial tree and whether it is close to a site of abnormal electrical activity. Assuming that a site of ischemia will commonly be a site of abnormal electrical activity, the MELP will also enable more rapid location of potential sites for angioplasty. -
FIG. 20 shows an embodiment of thetherapy catheter 18 using balloon inflation to supply the therapy. Thisangioplasty catheter 191 includes thelocation wire 177 which connects theinterface system 28 to thelocator electrode 68 at the catheter'sdistal end 24. In this instance thetherapy supply line 161 is an inflationmedia supply lumen 193 and thetherapy deployment apparatus 60 is anangioplasty balloon 195. In use, a site of interest would be determined after viewing the wall electrogram generated by the WEGP ofFIG. 10 . Next theangioplasty therapy catheter 191 would be positioned in the coronary arterial tree and its position determined relative to the site of interest. Next, when thedistal end 24 of theangioplasty catheter 191 was at the proper location theballoon 195 would be deployed to open the artery. Finally, the electrical activity of the site would be reviewed to determine whether theunderlying tissue 125 was now receiving a proper blood supply and thus was no longer electrically abnormal.
Claims (3)
1. A therapy catheter comprising:
a) a lead body having a distal end and having a proximal end;
b) a locator electrode proximate said distal end;
c) a set of therapy electrodes located hear said distal end.
2. A therapy catheter comprising:
a) a lead body having a distal end and having a proximal end;
b) a locator electrode proximate said distal end;
c) a drug delivery lumen located proximate said distal end.
3. A therapy catheter comprising:
a) a lead body having a distal end and having a proximal end;
b) a locator electrode proximate said distal end;
c) a fiber optic cable coupled to said distal end for directing laser energy to an ablation site.
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
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US11/734,191 US20070244479A1 (en) | 1992-09-23 | 2007-04-11 | Electrophysiology Therapy Catheter |
US12/131,750 US20080234564A1 (en) | 1992-09-23 | 2008-06-02 | Electrophysiology therapy catheter |
US14/249,188 US8945110B2 (en) | 1992-09-23 | 2014-04-09 | Apparatus for contactless electrophysiology studies |
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
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US07/950,448 US5297549A (en) | 1992-09-23 | 1992-09-23 | Endocardial mapping system |
US07/949,690 US5311866A (en) | 1992-09-23 | 1992-09-23 | Heart mapping catheter |
US38783295A | 1995-05-26 | 1995-05-26 | |
US510598A | 1998-01-09 | 1998-01-09 | |
US54794500A | 2000-04-12 | 2000-04-12 | |
US11/734,191 US20070244479A1 (en) | 1992-09-23 | 2007-04-11 | Electrophysiology Therapy Catheter |
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US54794500A Division | 1992-09-23 | 2000-04-12 |
Related Child Applications (1)
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US12/131,750 Division US20080234564A1 (en) | 1992-09-23 | 2008-06-02 | Electrophysiology therapy catheter |
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US20070244479A1 true US20070244479A1 (en) | 2007-10-18 |
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US09/548,102 Expired - Fee Related US7189208B1 (en) | 1992-09-23 | 2000-04-12 | Method for measuring heart electrophysiology |
US11/734,191 Abandoned US20070244479A1 (en) | 1992-09-23 | 2007-04-11 | Electrophysiology Therapy Catheter |
US12/131,750 Abandoned US20080234564A1 (en) | 1992-09-23 | 2008-06-02 | Electrophysiology therapy catheter |
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US09/548,102 Expired - Fee Related US7189208B1 (en) | 1992-09-23 | 2000-04-12 | Method for measuring heart electrophysiology |
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US12/131,750 Abandoned US20080234564A1 (en) | 1992-09-23 | 2008-06-02 | Electrophysiology therapy catheter |
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---|---|---|---|---|
US20090163904A1 (en) * | 2005-12-06 | 2009-06-25 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and Method for Assessing Coupling Between an Electrode and Tissue |
US20090171345A1 (en) * | 2007-12-28 | 2009-07-02 | Miller Stephan P | System and method for measurement of an impedance using a catheter such as an ablation catheter |
US20090171235A1 (en) * | 2007-12-28 | 2009-07-02 | Clint Schneider | Method and apparatus for complex impedance compensation and for determining tissue morphology based on phase angle |
US20090275827A1 (en) * | 2005-12-06 | 2009-11-05 | Aiken Robert D | System and method for assessing the proximity of an electrode to tissue in a body |
US20090306655A1 (en) * | 2008-06-09 | 2009-12-10 | Stangenes Todd R | Catheter assembly with front-loaded tip and multi-contact connector |
US20100069921A1 (en) * | 2006-12-06 | 2010-03-18 | Miller Stephan P | System and method for assessing lesions in tissue |
US20100168735A1 (en) * | 2005-12-06 | 2010-07-01 | Don Curtis Deno | System and method for assessing coupling between an electrode and tissue |
US20100168550A1 (en) * | 2008-12-31 | 2010-07-01 | Byrd Israel A | Multiple shell construction to emulate chamber contraction with a mapping system |
US20100228247A1 (en) * | 2005-12-06 | 2010-09-09 | Saurav Paul | Assessment of electrode coupling of tissue ablation |
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US8911439B2 (en) | 2009-11-11 | 2014-12-16 | Holaira, Inc. | Non-invasive and minimally invasive denervation methods and systems for performing the same |
US8974445B2 (en) | 2009-01-09 | 2015-03-10 | Recor Medical, Inc. | Methods and apparatus for treatment of cardiac valve insufficiency |
US20150119674A1 (en) * | 2013-10-25 | 2015-04-30 | Ablative Solutions, Inc. | Intravascular catheter with peri-vascular nerve activity sensors |
US9149328B2 (en) | 2009-11-11 | 2015-10-06 | Holaira, Inc. | Systems, apparatuses, and methods for treating tissue and controlling stenosis |
US9204927B2 (en) | 2009-05-13 | 2015-12-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for presenting information representative of lesion formation in tissue during an ablation procedure |
US9237925B2 (en) | 2011-04-22 | 2016-01-19 | Ablative Solutions, Inc. | Expandable catheter system for peri-ostial injection and muscle and nerve fiber ablation |
US9254163B2 (en) | 2005-12-06 | 2016-02-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US9254360B2 (en) | 2012-10-29 | 2016-02-09 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheter with deflection surface support structures |
US9278196B2 (en) | 2011-08-24 | 2016-03-08 | Ablative Solutions, Inc. | Expandable catheter system for vessel wall injection and muscle and nerve fiber ablation |
US9301713B2 (en) | 2013-11-19 | 2016-04-05 | Pacesetter, Inc. | Method and system to assess mechanical dyssynchrony based on motion data collected by a navigation system |
US9302099B2 (en) | 2014-05-05 | 2016-04-05 | Pacesetter, Inc. | System and method for evaluating lead stability of an implantable medical device |
US9301795B2 (en) | 2012-10-29 | 2016-04-05 | Ablative Solutions, Inc. | Transvascular catheter for extravascular delivery |
US9314191B2 (en) | 2013-11-19 | 2016-04-19 | Pacesetter, Inc. | Method and system to measure cardiac motion using a cardiovascular navigation system |
US9339618B2 (en) | 2003-05-13 | 2016-05-17 | Holaira, Inc. | Method and apparatus for controlling narrowing of at least one airway |
US9364170B2 (en) | 2014-05-05 | 2016-06-14 | Pacesetter, Inc. | Method and system to characterize motion data based on neighboring map points |
US9380940B2 (en) | 2014-05-05 | 2016-07-05 | Pacesetter, Inc. | Method and system for displaying a three dimensional visualization of cardiac motion |
US9398933B2 (en) | 2012-12-27 | 2016-07-26 | Holaira, Inc. | Methods for improving drug efficacy including a combination of drug administration and nerve modulation |
US9492226B2 (en) | 2005-12-06 | 2016-11-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Graphical user interface for real-time RF lesion depth display |
US9554849B2 (en) | 2012-10-29 | 2017-01-31 | Ablative Solutions, Inc. | Transvascular method of treating hypertension |
US9700233B2 (en) | 2014-05-05 | 2017-07-11 | Pacesetter, Inc. | Method and system to equalizing cardiac cycle length between map points |
US9700372B2 (en) | 2002-07-01 | 2017-07-11 | Recor Medical, Inc. | Intraluminal methods of ablating nerve tissue |
US9763591B2 (en) | 2014-05-05 | 2017-09-19 | Pacesetter, Inc. | Method and system to subdivide a mapping area for mechanical activation analysis |
US9795441B2 (en) | 2011-04-22 | 2017-10-24 | Ablative Solutions, Inc. | Methods of ablating tissue using a catheter injection system |
US9814406B2 (en) | 2013-11-19 | 2017-11-14 | Pacesetter, Inc. | Method and system to identify motion data associated with consistent electrical and mechanical behavior for a region of interest |
US9861823B2 (en) | 2014-05-05 | 2018-01-09 | Pacesetter, Inc. | Cardiac resynchronization system and method |
US9895076B2 (en) | 2014-05-05 | 2018-02-20 | Pacesetter, Inc. | Method and system to determine cardiac cycle length in connection with cardiac mapping |
US9949652B2 (en) | 2013-10-25 | 2018-04-24 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
US10105077B2 (en) | 2014-05-05 | 2018-10-23 | Pacesetter, Inc. | Method and system for calculating strain from characterization data of a cardiac chamber |
US10118004B2 (en) | 2011-08-24 | 2018-11-06 | Ablative Solutions, Inc. | Expandable catheter system for fluid injection into and deep to the wall of a blood vessel |
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US10285647B2 (en) | 2014-05-05 | 2019-05-14 | Pacesetter Inc. | Method and system to automatically assign map points to anatomical segments and determine mechanical activation time |
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US8155910B2 (en) | 2005-05-27 | 2012-04-10 | St. Jude Medical, Atrial Fibrillation Divison, Inc. | Robotically controlled catheter and method of its calibration |
US8784336B2 (en) | 2005-08-24 | 2014-07-22 | C. R. Bard, Inc. | Stylet apparatuses and methods of manufacture |
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US9521961B2 (en) | 2007-11-26 | 2016-12-20 | C. R. Bard, Inc. | Systems and methods for guiding a medical instrument |
US8388541B2 (en) | 2007-11-26 | 2013-03-05 | C. R. Bard, Inc. | Integrated system for intravascular placement of a catheter |
US9649048B2 (en) | 2007-11-26 | 2017-05-16 | C. R. Bard, Inc. | Systems and methods for breaching a sterile field for intravascular placement of a catheter |
US8781555B2 (en) | 2007-11-26 | 2014-07-15 | C. R. Bard, Inc. | System for placement of a catheter including a signal-generating stylet |
US10524691B2 (en) | 2007-11-26 | 2020-01-07 | C. R. Bard, Inc. | Needle assembly including an aligned magnetic element |
US8849382B2 (en) | 2007-11-26 | 2014-09-30 | C. R. Bard, Inc. | Apparatus and display methods relating to intravascular placement of a catheter |
US10751509B2 (en) | 2007-11-26 | 2020-08-25 | C. R. Bard, Inc. | Iconic representations for guidance of an indwelling medical device |
US10449330B2 (en) | 2007-11-26 | 2019-10-22 | C. R. Bard, Inc. | Magnetic element-equipped needle assemblies |
US8532734B2 (en) * | 2008-04-18 | 2013-09-10 | Regents Of The University Of Minnesota | Method and apparatus for mapping a structure |
US8340751B2 (en) * | 2008-04-18 | 2012-12-25 | Medtronic, Inc. | Method and apparatus for determining tracking a virtual point defined relative to a tracked member |
US8663120B2 (en) * | 2008-04-18 | 2014-03-04 | Regents Of The University Of Minnesota | Method and apparatus for mapping a structure |
US8260395B2 (en) * | 2008-04-18 | 2012-09-04 | Medtronic, Inc. | Method and apparatus for mapping a structure |
WO2009129477A1 (en) * | 2008-04-18 | 2009-10-22 | Medtronic, Inc. | Method and apparatus for mapping a structure |
US8494608B2 (en) * | 2008-04-18 | 2013-07-23 | Medtronic, Inc. | Method and apparatus for mapping a structure |
US8839798B2 (en) * | 2008-04-18 | 2014-09-23 | Medtronic, Inc. | System and method for determining sheath location |
US9901714B2 (en) | 2008-08-22 | 2018-02-27 | C. R. Bard, Inc. | Catheter assembly including ECG sensor and magnetic assemblies |
US8437833B2 (en) | 2008-10-07 | 2013-05-07 | Bard Access Systems, Inc. | Percutaneous magnetic gastrostomy |
WO2010054320A1 (en) * | 2008-11-07 | 2010-05-14 | Cardioinsight Technologies, Inc. | Visualization of physiological data for virtual electrodes |
WO2010054409A1 (en) * | 2008-11-10 | 2010-05-14 | Cardioinsight Technologies, Inc. | Visualization of electrophysiology data |
US8175681B2 (en) | 2008-12-16 | 2012-05-08 | Medtronic Navigation Inc. | Combination of electromagnetic and electropotential localization |
EP3542713A1 (en) | 2009-06-12 | 2019-09-25 | Bard Access Systems, Inc. | Adapter for a catheter tip positioning device |
US9532724B2 (en) | 2009-06-12 | 2017-01-03 | Bard Access Systems, Inc. | Apparatus and method for catheter navigation using endovascular energy mapping |
EP2266459A1 (en) * | 2009-06-24 | 2010-12-29 | Cortius B.V. i.o. | Inverse imaging of electrical activity of a heart muscle |
WO2011019760A2 (en) | 2009-08-10 | 2011-02-17 | Romedex International Srl | Devices and methods for endovascular electrography |
US8494614B2 (en) | 2009-08-31 | 2013-07-23 | Regents Of The University Of Minnesota | Combination localization system |
US8494613B2 (en) | 2009-08-31 | 2013-07-23 | Medtronic, Inc. | Combination localization system |
EP2517622A3 (en) | 2009-09-29 | 2013-04-24 | C. R. Bard, Inc. | Stylets for use with apparatus for intravascular placement of a catheter |
US8355774B2 (en) * | 2009-10-30 | 2013-01-15 | Medtronic, Inc. | System and method to evaluate electrode position and spacing |
CN102821679B (en) | 2010-02-02 | 2016-04-27 | C·R·巴德股份有限公司 | For the apparatus and method that catheter navigation and end are located |
US8706209B2 (en) | 2010-02-05 | 2014-04-22 | 3Dt Holdings, Llc | Devices, systems, and methods for measuring parallel tissue conductance, luminal cross-sectional areas, fluid velocity, and/or determining plaque vulnerability using temperature |
US20110213260A1 (en) * | 2010-02-26 | 2011-09-01 | Pacesetter, Inc. | Crt lead placement based on optimal branch selection and optimal site selection |
JP5980201B2 (en) | 2010-05-28 | 2016-08-31 | シー・アール・バード・インコーポレーテッドC R Bard Incorporated | Insertion guidance system for needles and medical components |
WO2011150376A1 (en) | 2010-05-28 | 2011-12-01 | C.R. Bard, Inc. | Apparatus for use with needle insertion guidance system |
BR112013002431B1 (en) | 2010-08-20 | 2021-06-29 | C.R. Bard, Inc | SYSTEM FOR RECONFIRMING THE POSITION OF A CATHETER INSIDE A PATIENT |
EP2632360A4 (en) | 2010-10-29 | 2014-05-21 | Bard Inc C R | Bioimpedance-assisted placement of a medical device |
US10517667B2 (en) * | 2014-05-16 | 2019-12-31 | Biosense Webster (Israel) Ltd. | Catheter tip with microelectrodes |
AU2012246723C9 (en) | 2011-04-22 | 2014-08-28 | Topera, Inc. | Basket style cardiac mapping catheter having an atraumatic basket tip for detection of cardiac rhythm disorders |
EP2729064A4 (en) | 2011-07-05 | 2015-03-25 | Cardioinsight Technologies Inc | Localization for electrocardiographic mapping |
KR20140051284A (en) | 2011-07-06 | 2014-04-30 | 씨. 알. 바드, 인크. | Needle length determination and calibration for insertion guidance system |
US9734938B2 (en) | 2011-10-06 | 2017-08-15 | 3Dt Holdings, Llc | Devices and systems for obtaining conductance data and methods of manufacturing and using the same |
US11373780B2 (en) | 2011-10-06 | 2022-06-28 | 3Dt Holdings, Llc | Methods to generate elongated wires having a metallic substrate thereon and devices comprising the same |
US9066672B2 (en) | 2011-10-27 | 2015-06-30 | 3Dt Holdings, Llc | Single injection methods for obtaining conductance measurements within luminal organs using impedance devices |
US10159531B2 (en) | 2012-04-05 | 2018-12-25 | C. R. Bard, Inc. | Apparatus and methods relating to intravascular positioning of distal end of catheter |
US11759268B2 (en) | 2012-04-05 | 2023-09-19 | C. R. Bard, Inc. | Apparatus and methods relating to intravascular positioning of distal end of catheter |
JP2015516846A (en) | 2012-04-05 | 2015-06-18 | バード・アクセス・システムズ,インコーポレーテッド | Device and system for navigating and positioning a central venous catheter within a patient |
US9295399B2 (en) | 2012-06-20 | 2016-03-29 | Intermountain Invention Management, Llc | Atrial fibrillation treatment systems and methods |
US9675257B2 (en) | 2013-03-15 | 2017-06-13 | 3Dt Holdings, Llc | Impedance devices and methods to use the same to obtain luminal organ measurements |
US10568686B2 (en) * | 2013-11-21 | 2020-02-25 | Biosense Webster (Israel) Ltd. | Multi-electrode balloon catheter with circumferential and point electrodes |
CN105979868B (en) | 2014-02-06 | 2020-03-10 | C·R·巴德股份有限公司 | Systems and methods for guidance and placement of intravascular devices |
US10973584B2 (en) | 2015-01-19 | 2021-04-13 | Bard Access Systems, Inc. | Device and method for vascular access |
WO2016181318A1 (en) | 2015-05-12 | 2016-11-17 | Navix International Limited | Lesion assessment by dielectric property analysis |
JP2018520718A (en) | 2015-05-12 | 2018-08-02 | ナヴィックス インターナショナル リミテッドNavix International Limited | Contact quality evaluation by dielectric property analysis |
US11039888B2 (en) | 2015-05-12 | 2021-06-22 | Navix International Limited | Calculation of an ablation plan |
US10278616B2 (en) | 2015-05-12 | 2019-05-07 | Navix International Limited | Systems and methods for tracking an intrabody catheter |
US10271795B2 (en) | 2015-06-12 | 2019-04-30 | C. R. Bard, Inc. | Systems and methods for confirmation of prior catheter tip placement |
US10349890B2 (en) | 2015-06-26 | 2019-07-16 | C. R. Bard, Inc. | Connector interface for ECG-based catheter positioning system |
US9895073B2 (en) | 2015-07-29 | 2018-02-20 | Biosense Webster (Israel) Ltd. | Dual basket catheter |
US11344213B2 (en) * | 2015-12-18 | 2022-05-31 | Intel Corporation | Noise resilient, low-power heart rate sensing techniques |
US11000207B2 (en) | 2016-01-29 | 2021-05-11 | C. R. Bard, Inc. | Multiple coil system for tracking a medical device |
EP3383259A1 (en) * | 2016-02-16 | 2018-10-10 | St. Jude Medical, Cardiology Division, Inc. | Methods and systems for electrophysiology mapping using medical images |
CN114903591A (en) | 2016-03-21 | 2022-08-16 | 华盛顿大学 | Virtual reality or augmented reality visualization of 3D medical images |
EP3484362A1 (en) | 2016-07-14 | 2019-05-22 | Navix International Limited | Characteristic track catheter navigation |
US11266467B2 (en) | 2016-10-25 | 2022-03-08 | Navix International Limited | Systems and methods for registration of intra-body electrical readings with a pre-acquired three dimensional image |
WO2018092063A1 (en) | 2016-11-16 | 2018-05-24 | Navix International Limited | Real-time display of treatment-related tissue changes using virtual material |
US11010983B2 (en) | 2016-11-16 | 2021-05-18 | Navix International Limited | Tissue model dynamic visual rendering |
WO2018092070A1 (en) | 2016-11-16 | 2018-05-24 | Navix International Limited | Esophagus position detection by electrical mapping |
WO2018092062A1 (en) | 2016-11-16 | 2018-05-24 | Navix International Limited | Real-time display of tissue deformation by interactions with an intra-body probe |
WO2018092071A1 (en) | 2016-11-16 | 2018-05-24 | Navix International Limited | Estimators for ablation effectiveness |
US11730395B2 (en) | 2017-01-12 | 2023-08-22 | Navix International Limited | Reconstruction of an anatomical structure from intrabody measurements |
US11311204B2 (en) | 2017-01-12 | 2022-04-26 | Navix International Limited | Systems and methods for reconstruction of intrabody electrical readings to anatomical structure |
US11471067B2 (en) | 2017-01-12 | 2022-10-18 | Navix International Limited | Intrabody probe navigation by electrical self-sensing |
CN111050641B (en) | 2017-08-17 | 2023-06-09 | 纳维斯国际有限公司 | Remote imaging based on field gradients |
US20190350489A1 (en) * | 2018-05-21 | 2019-11-21 | Biosense Webster (Israel) Ltd. | Scaling impedance location measurements of a balloon catheter |
US10992079B2 (en) | 2018-10-16 | 2021-04-27 | Bard Access Systems, Inc. | Safety-equipped connection systems and methods thereof for establishing electrical connections |
US11045628B2 (en) | 2018-12-11 | 2021-06-29 | Biosense Webster (Israel) Ltd. | Balloon catheter with high articulation |
US20230011001A1 (en) * | 2019-12-02 | 2023-01-12 | The Johns Hopkins University | System and method for real-time guidance of an electrophysiology catheter for targeting a location of origin of an arrhythmia |
US11950930B2 (en) | 2019-12-12 | 2024-04-09 | Biosense Webster (Israel) Ltd. | Multi-dimensional acquisition of bipolar signals from a catheter |
US11517218B2 (en) | 2019-12-20 | 2022-12-06 | Biosense Webster (Israel) Ltd. | Selective graphical presentation of electrophysiological parameters |
US11950841B2 (en) | 2020-09-22 | 2024-04-09 | Biosense Webster (Israel) Ltd. | Basket catheter having insulated ablation electrodes and diagnostic electrodes |
US11950840B2 (en) | 2020-09-22 | 2024-04-09 | Biosense Webster (Israel) Ltd. | Basket catheter having insulated ablation electrodes |
US11918383B2 (en) | 2020-12-21 | 2024-03-05 | Biosense Webster (Israel) Ltd. | Visualizing performance of catheter electrodes |
Citations (98)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3954098A (en) * | 1975-01-31 | 1976-05-04 | Dick Donald E | Synchronized multiple image tomographic cardiography |
US4173228A (en) * | 1977-05-16 | 1979-11-06 | Applied Medical Devices | Catheter locating device |
US4304239A (en) * | 1980-03-07 | 1981-12-08 | The Kendall Company | Esophageal probe with balloon electrode |
US4380237A (en) * | 1979-12-03 | 1983-04-19 | Massachusetts General Hospital | Apparatus for making cardiac output conductivity measurements |
US4431005A (en) * | 1981-05-07 | 1984-02-14 | Mccormick Laboratories, Inc. | Method of and apparatus for determining very accurately the position of a device inside biological tissue |
US4444195A (en) * | 1981-11-02 | 1984-04-24 | Cordis Corporation | Cardiac lead having multiple ring electrodes |
US4478223A (en) * | 1982-12-06 | 1984-10-23 | Allor Douglas R | Three dimensional electrocardiograph |
US4522212A (en) * | 1983-11-14 | 1985-06-11 | Mansfield Scientific, Inc. | Endocardial electrode |
US4559951A (en) * | 1982-11-29 | 1985-12-24 | Cardiac Pacemakers, Inc. | Catheter assembly |
US4572186A (en) * | 1983-12-07 | 1986-02-25 | Cordis Corporation | Vessel dilation |
US4572206A (en) * | 1982-04-21 | 1986-02-25 | Purdue Research Foundation | Method and apparatus for measuring cardiac output |
US4573473A (en) * | 1984-04-13 | 1986-03-04 | Cordis Corporation | Cardiac mapping probe |
US4613866A (en) * | 1983-05-13 | 1986-09-23 | Mcdonnell Douglas Corporation | Three dimensional digitizer with electromagnetic coupling |
US4628937A (en) * | 1984-08-02 | 1986-12-16 | Cordis Corporation | Mapping electrode assembly |
US4641649A (en) * | 1985-10-30 | 1987-02-10 | Rca Corporation | Method and apparatus for high frequency catheter ablation |
US4649924A (en) * | 1984-08-14 | 1987-03-17 | Consiglio Nazionale Delle Ricerche | Method for the detection of intracardiac electrical potential fields |
US4660571A (en) * | 1985-07-18 | 1987-04-28 | Cordis Corporation | Percutaneous lead having radially adjustable electrode |
US4674518A (en) * | 1985-09-06 | 1987-06-23 | Cardiac Pacemakers, Inc. | Method and apparatus for measuring ventricular volume |
US4697595A (en) * | 1984-07-24 | 1987-10-06 | Telectronics N.V. | Ultrasonically marked cardiac catheters |
US4699147A (en) * | 1985-09-25 | 1987-10-13 | Cordis Corporation | Intraventricular multielectrode cardial mapping probe and method for using same |
US4706670A (en) * | 1985-11-26 | 1987-11-17 | Meadox Surgimed A/S | Dilatation catheter |
US4721115A (en) * | 1986-02-27 | 1988-01-26 | Cardiac Pacemakers, Inc. | Diagnostic catheter for monitoring cardiac output |
US4750494A (en) * | 1981-05-12 | 1988-06-14 | Medtronic, Inc. | Automatic implantable fibrillation preventer |
US4777955A (en) * | 1987-11-02 | 1988-10-18 | Cordis Corporation | Left ventricle mapping probe |
US4821731A (en) * | 1986-04-25 | 1989-04-18 | Intra-Sonix, Inc. | Acoustic image system and method |
US4840182A (en) * | 1988-04-04 | 1989-06-20 | Rhode Island Hospital | Conductance catheter |
US4890623A (en) * | 1988-03-14 | 1990-01-02 | C. R. Bard, Inc. | Biopotential sensing device and method for making |
US4898181A (en) * | 1985-10-15 | 1990-02-06 | Kessler M | Method of illustrating electrocardiographic values |
US4898176A (en) * | 1988-06-22 | 1990-02-06 | The Cleveland Clinic Foundation | Continuous cardiac output by impedance measurements in the heart |
US4899750A (en) * | 1988-04-19 | 1990-02-13 | Siemens-Pacesetter, Inc. | Lead impedance scanning system for pacemakers |
US4911174A (en) * | 1989-02-13 | 1990-03-27 | Cardiac Pacemakers, Inc. | Method for matching the sense length of an impedance measuring catheter to a ventricular chamber |
US4922912A (en) * | 1987-10-21 | 1990-05-08 | Hideto Watanabe | MAP catheter |
US4940064A (en) * | 1986-11-14 | 1990-07-10 | Desai Jawahar M | Catheter for mapping and ablation and method therefor |
US4945305A (en) * | 1986-10-09 | 1990-07-31 | Ascension Technology Corporation | Device for quantitatively measuring the relative position and orientation of two bodies in the presence of metals utilizing direct current magnetic fields |
US4945342A (en) * | 1987-10-16 | 1990-07-31 | Instit Straumann | Electrical cable for performing stimulations and/or measurements inside a human or animal body and method of manufacturing the cable |
US4951682A (en) * | 1988-06-22 | 1990-08-28 | The Cleveland Clinic Foundation | Continuous cardiac output by impedance measurements in the heart |
US5000190A (en) * | 1988-06-22 | 1991-03-19 | The Cleveland Clinic Foundation | Continuous cardiac output by impedance measurements in the heart |
US5005587A (en) * | 1989-11-13 | 1991-04-09 | Pacing Systems, Inc. | Braid Electrode leads and catheters and methods for using the same |
US5025786A (en) * | 1988-07-21 | 1991-06-25 | Siegel Sharon B | Intracardiac catheter and method for detecting and diagnosing myocardial ischemia |
US5029588A (en) * | 1989-06-15 | 1991-07-09 | Cardiovascular Imaging Systems, Inc. | Laser catheter with imaging capability |
US5042486A (en) * | 1989-09-29 | 1991-08-27 | Siemens Aktiengesellschaft | Catheter locatable with non-ionizing field and method for locating same |
US5054496A (en) * | 1988-07-15 | 1991-10-08 | China-Japan Friendship Hospital | Method and apparatus for recording and analyzing body surface electrocardiographic peak maps |
US5054492A (en) * | 1990-12-17 | 1991-10-08 | Cardiovascular Imaging Systems, Inc. | Ultrasonic imaging catheter having rotational image correlation |
US5056517A (en) * | 1989-07-24 | 1991-10-15 | Consiglio Nazionale Delle Ricerche | Biomagnetically localizable multipurpose catheter and method for magnetocardiographic guided intracardiac mapping, biopsy and ablation of cardiac arrhythmias |
US5058583A (en) * | 1990-07-13 | 1991-10-22 | Geddes Leslie A | Multiple monopolar system and method of measuring stroke volume of the heart |
US5081993A (en) * | 1987-11-11 | 1992-01-21 | Circulation Research Limited | Methods and apparatus for the examination and treatment of internal organs |
US5090411A (en) * | 1990-01-31 | 1992-02-25 | Kabushiki Kaisha Toshiba | Ultrasonic diagnosis apparatus |
US5156151A (en) * | 1991-02-15 | 1992-10-20 | Cardiac Pathways Corporation | Endocardial mapping and ablation system and catheter probe |
US5158092A (en) * | 1987-10-27 | 1992-10-27 | Christian Glace | Method and azimuthal probe for localizing the emergence point of ventricular tachycardias |
US5161536A (en) * | 1991-03-22 | 1992-11-10 | Catheter Technology | Ultrasonic position indicating apparatus and methods |
US5211165A (en) * | 1991-09-03 | 1993-05-18 | General Electric Company | Tracking system to follow the position and orientation of a device with radiofrequency field gradients |
US5220924A (en) * | 1989-09-28 | 1993-06-22 | Frazin Leon J | Doppler-guided retrograde catheterization using transducer equipped guide wire |
US5228442A (en) * | 1991-02-15 | 1993-07-20 | Cardiac Pathways Corporation | Method for mapping, ablation, and stimulation using an endocardial catheter |
US5237996A (en) * | 1992-02-11 | 1993-08-24 | Waldman Lewis K | Endocardial electrical mapping catheter |
US5255678A (en) * | 1991-06-21 | 1993-10-26 | Ecole Polytechnique | Mapping electrode balloon |
US5273038A (en) * | 1990-07-09 | 1993-12-28 | Beavin William C | Computer simulation of live organ |
US5282471A (en) * | 1991-07-31 | 1994-02-01 | Kabushiki Kaisha Toshiba | Ultrasonic imaging system capable of displaying 3-dimensional angiogram in real time mode |
US5295484A (en) * | 1992-05-19 | 1994-03-22 | Arizona Board Of Regents For And On Behalf Of The University Of Arizona | Apparatus and method for intra-cardiac ablation of arrhythmias |
US5297549A (en) * | 1992-09-23 | 1994-03-29 | Endocardial Therapeutics, Inc. | Endocardial mapping system |
US5305745A (en) * | 1988-06-13 | 1994-04-26 | Fred Zacouto | Device for protection against blood-related disorders, notably thromboses, embolisms, vascular spasms, hemorrhages, hemopathies and the presence of abnormal elements in the blood |
US5311866A (en) * | 1992-09-23 | 1994-05-17 | Endocardial Therapeutics, Inc. | Heart mapping catheter |
US5324284A (en) * | 1992-06-05 | 1994-06-28 | Cardiac Pathways, Inc. | Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method |
US5323781A (en) * | 1992-01-31 | 1994-06-28 | Duke University | Methods for the diagnosis and ablation treatment of ventricular tachycardia |
US5325860A (en) * | 1991-11-08 | 1994-07-05 | Mayo Foundation For Medical Education And Research | Ultrasonic and interventional catheter and method |
US5341807A (en) * | 1992-06-30 | 1994-08-30 | American Cardiac Ablation Co., Inc. | Ablation catheter positioning system |
US5345936A (en) * | 1991-02-15 | 1994-09-13 | Cardiac Pathways Corporation | Apparatus with basket assembly for endocardial mapping |
US5360006A (en) * | 1990-06-12 | 1994-11-01 | University Of Florida Research Foundation, Inc. | Automated method for digital image quantitation |
US5372138A (en) * | 1988-03-21 | 1994-12-13 | Boston Scientific Corporation | Acousting imaging catheters and the like |
US5377678A (en) * | 1991-09-03 | 1995-01-03 | General Electric Company | Tracking system to follow the position and orientation of a device with radiofrequency fields |
US5385146A (en) * | 1993-01-08 | 1995-01-31 | Goldreyer; Bruce N. | Orthogonal sensing for use in clinical electrophysiology |
US5391199A (en) * | 1993-07-20 | 1995-02-21 | Biosense, Inc. | Apparatus and method for treating cardiac arrhythmias |
US5409000A (en) * | 1993-09-14 | 1995-04-25 | Cardiac Pathways Corporation | Endocardial mapping and ablation system utilizing separately controlled steerable ablation catheter with ultrasonic imaging capabilities and method |
US5411025A (en) * | 1992-06-30 | 1995-05-02 | Cordis Webster, Inc. | Cardiovascular catheter with laterally stable basket-shaped electrode array |
US5433198A (en) * | 1993-03-11 | 1995-07-18 | Desai; Jawahar M. | Apparatus and method for cardiac ablation |
US5458126A (en) * | 1994-02-24 | 1995-10-17 | General Electric Company | Cardiac functional analysis system employing gradient image segmentation |
US5500012A (en) * | 1992-07-15 | 1996-03-19 | Angeion Corporation | Ablation catheter system |
US5551426A (en) * | 1993-07-14 | 1996-09-03 | Hummel; John D. | Intracardiac ablation and mapping catheter |
US5553611A (en) * | 1994-01-06 | 1996-09-10 | Endocardial Solutions, Inc. | Endocardial measurement method |
US5558091A (en) * | 1993-10-06 | 1996-09-24 | Biosense, Inc. | Magnetic determination of position and orientation |
US5588432A (en) * | 1988-03-21 | 1996-12-31 | Boston Scientific Corporation | Catheters for imaging, sensing electrical potentials, and ablating tissue |
US5601084A (en) * | 1993-06-23 | 1997-02-11 | University Of Washington | Determining cardiac wall thickness and motion by imaging and three-dimensional modeling |
US5617854A (en) * | 1994-06-22 | 1997-04-08 | Munsif; Anand | Shaped catheter device and method |
US5622174A (en) * | 1992-10-02 | 1997-04-22 | Kabushiki Kaisha Toshiba | Ultrasonic diagnosis apparatus and image displaying system |
US5662108A (en) * | 1992-09-23 | 1997-09-02 | Endocardial Solutions, Inc. | Electrophysiology mapping system |
US5669382A (en) * | 1996-11-19 | 1997-09-23 | General Electric Company | System for measuring myocardium in cardiac images |
US5687737A (en) * | 1992-10-09 | 1997-11-18 | Washington University | Computerized three-dimensional cardiac mapping with interactive visual displays |
US5697377A (en) * | 1995-11-22 | 1997-12-16 | Medtronic, Inc. | Catheter mapping system and method |
US5713363A (en) * | 1991-11-08 | 1998-02-03 | Mayo Foundation For Medical Education And Research | Ultrasound catheter and method for imaging and hemodynamic monitoring |
US5722402A (en) * | 1994-10-11 | 1998-03-03 | Ep Technologies, Inc. | Systems and methods for guiding movable electrode elements within multiple-electrode structures |
US5738096A (en) * | 1993-07-20 | 1998-04-14 | Biosense, Inc. | Cardiac electromechanics |
US5797396A (en) * | 1995-06-07 | 1998-08-25 | University Of Florida Research Foundation | Automated method for digital image quantitation |
US5824005A (en) * | 1995-08-22 | 1998-10-20 | Board Of Regents, The University Of Texas System | Maneuverable electrophysiology catheter for percutaneous or intraoperative ablation of cardiac arrhythmias |
US5830209A (en) * | 1992-02-05 | 1998-11-03 | Angeion Corporation | Multi-fiber laser catheter |
US5840031A (en) * | 1993-07-01 | 1998-11-24 | Boston Scientific Corporation | Catheters for imaging, sensing electrical potentials and ablating tissue |
US5871019A (en) * | 1996-09-23 | 1999-02-16 | Mayo Foundation For Medical Education And Research | Fast cardiac boundary imaging |
US5908446A (en) * | 1994-07-07 | 1999-06-01 | Cardiac Pathways Corporation | Catheter assembly, catheter and multi-port introducer for use therewith |
US6095976A (en) * | 1997-06-19 | 2000-08-01 | Medinol Ltd. | Method for enhancing an image derived from reflected ultrasound signals produced by an ultrasound transmitter and detector inserted in a bodily lumen |
US6603996B1 (en) * | 2000-06-07 | 2003-08-05 | Graydon Ernest Beatty | Software for mapping potential distribution of a heart chamber |
Family Cites Families (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5433729A (en) * | 1991-04-12 | 1995-07-18 | Incontrol, Inc. | Atrial defibrillator, lead systems, and method |
US5255679A (en) * | 1992-06-02 | 1993-10-26 | Cardiac Pathways Corporation | Endocardial catheter for mapping and/or ablation with an expandable basket structure having means for providing selective reinforcement and pressure sensing mechanism for use therewith, and method |
WO1994006349A1 (en) * | 1992-09-23 | 1994-03-31 | Endocardial Therapeutics, Inc. | Endocardial mapping system |
DE69432148T2 (en) | 1993-07-01 | 2003-10-16 | Boston Scient Ltd | CATHETER FOR IMAGE DISPLAY, DISPLAY OF ELECTRICAL SIGNALS AND ABLATION |
US6690963B2 (en) * | 1995-01-24 | 2004-02-10 | Biosense, Inc. | System for determining the location and orientation of an invasive medical instrument |
US5848972A (en) | 1995-09-15 | 1998-12-15 | Children's Medical Center Corporation | Method for endocardial activation mapping using a multi-electrode catheter |
DE19622078A1 (en) | 1996-05-31 | 1997-12-04 | Siemens Ag | Active current localising appts. for heart |
US20040006268A1 (en) * | 1998-09-24 | 2004-01-08 | Super Dimension Ltd Was Filed In Parent Case | System and method of recording and displaying in context of an image a location of at least one point-of-interest in a body during an intra-body medical procedure |
US7343195B2 (en) * | 1999-05-18 | 2008-03-11 | Mediguide Ltd. | Method and apparatus for real time quantitative three-dimensional image reconstruction of a moving organ and intra-body navigation |
US6443894B1 (en) * | 1999-09-29 | 2002-09-03 | Acuson Corporation | Medical diagnostic ultrasound system and method for mapping surface data for three dimensional imaging |
US6650927B1 (en) * | 2000-08-18 | 2003-11-18 | Biosense, Inc. | Rendering of diagnostic imaging data on a three-dimensional map |
US20030093067A1 (en) * | 2001-11-09 | 2003-05-15 | Scimed Life Systems, Inc. | Systems and methods for guiding catheters using registered images |
DE10210648A1 (en) * | 2002-03-11 | 2003-10-02 | Siemens Ag | Medical 3-D imaging method for organ and catheter type instrument portrayal in which 2-D ultrasound images, the location and orientation of which are known, are combined in a reference coordinate system to form a 3-D image |
US7477763B2 (en) * | 2002-06-18 | 2009-01-13 | Boston Scientific Scimed, Inc. | Computer generated representation of the imaging pattern of an imaging device |
US7713210B2 (en) * | 2004-11-23 | 2010-05-11 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Method and apparatus for localizing an ultrasound catheter |
-
2000
- 2000-04-12 US US09/548,102 patent/US7189208B1/en not_active Expired - Fee Related
-
2007
- 2007-04-11 US US11/734,191 patent/US20070244479A1/en not_active Abandoned
-
2008
- 2008-06-02 US US12/131,750 patent/US20080234564A1/en not_active Abandoned
Patent Citations (100)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3954098A (en) * | 1975-01-31 | 1976-05-04 | Dick Donald E | Synchronized multiple image tomographic cardiography |
US4173228A (en) * | 1977-05-16 | 1979-11-06 | Applied Medical Devices | Catheter locating device |
US4380237A (en) * | 1979-12-03 | 1983-04-19 | Massachusetts General Hospital | Apparatus for making cardiac output conductivity measurements |
US4304239A (en) * | 1980-03-07 | 1981-12-08 | The Kendall Company | Esophageal probe with balloon electrode |
US4431005A (en) * | 1981-05-07 | 1984-02-14 | Mccormick Laboratories, Inc. | Method of and apparatus for determining very accurately the position of a device inside biological tissue |
US4750494A (en) * | 1981-05-12 | 1988-06-14 | Medtronic, Inc. | Automatic implantable fibrillation preventer |
US4444195A (en) * | 1981-11-02 | 1984-04-24 | Cordis Corporation | Cardiac lead having multiple ring electrodes |
US4572206A (en) * | 1982-04-21 | 1986-02-25 | Purdue Research Foundation | Method and apparatus for measuring cardiac output |
US4572206B1 (en) * | 1982-04-21 | 1991-01-01 | Purdue Research Foundation | |
US4559951A (en) * | 1982-11-29 | 1985-12-24 | Cardiac Pacemakers, Inc. | Catheter assembly |
US4478223A (en) * | 1982-12-06 | 1984-10-23 | Allor Douglas R | Three dimensional electrocardiograph |
US4613866A (en) * | 1983-05-13 | 1986-09-23 | Mcdonnell Douglas Corporation | Three dimensional digitizer with electromagnetic coupling |
US4522212A (en) * | 1983-11-14 | 1985-06-11 | Mansfield Scientific, Inc. | Endocardial electrode |
US4572186A (en) * | 1983-12-07 | 1986-02-25 | Cordis Corporation | Vessel dilation |
US4573473A (en) * | 1984-04-13 | 1986-03-04 | Cordis Corporation | Cardiac mapping probe |
US4697595A (en) * | 1984-07-24 | 1987-10-06 | Telectronics N.V. | Ultrasonically marked cardiac catheters |
US4628937A (en) * | 1984-08-02 | 1986-12-16 | Cordis Corporation | Mapping electrode assembly |
US4649924A (en) * | 1984-08-14 | 1987-03-17 | Consiglio Nazionale Delle Ricerche | Method for the detection of intracardiac electrical potential fields |
US4660571A (en) * | 1985-07-18 | 1987-04-28 | Cordis Corporation | Percutaneous lead having radially adjustable electrode |
US4674518A (en) * | 1985-09-06 | 1987-06-23 | Cardiac Pacemakers, Inc. | Method and apparatus for measuring ventricular volume |
US4699147A (en) * | 1985-09-25 | 1987-10-13 | Cordis Corporation | Intraventricular multielectrode cardial mapping probe and method for using same |
US4898181A (en) * | 1985-10-15 | 1990-02-06 | Kessler M | Method of illustrating electrocardiographic values |
US4641649A (en) * | 1985-10-30 | 1987-02-10 | Rca Corporation | Method and apparatus for high frequency catheter ablation |
US4706670A (en) * | 1985-11-26 | 1987-11-17 | Meadox Surgimed A/S | Dilatation catheter |
US4721115A (en) * | 1986-02-27 | 1988-01-26 | Cardiac Pacemakers, Inc. | Diagnostic catheter for monitoring cardiac output |
US4821731A (en) * | 1986-04-25 | 1989-04-18 | Intra-Sonix, Inc. | Acoustic image system and method |
US4945305A (en) * | 1986-10-09 | 1990-07-31 | Ascension Technology Corporation | Device for quantitatively measuring the relative position and orientation of two bodies in the presence of metals utilizing direct current magnetic fields |
US4940064A (en) * | 1986-11-14 | 1990-07-10 | Desai Jawahar M | Catheter for mapping and ablation and method therefor |
US4945342A (en) * | 1987-10-16 | 1990-07-31 | Instit Straumann | Electrical cable for performing stimulations and/or measurements inside a human or animal body and method of manufacturing the cable |
US4922912A (en) * | 1987-10-21 | 1990-05-08 | Hideto Watanabe | MAP catheter |
US5158092A (en) * | 1987-10-27 | 1992-10-27 | Christian Glace | Method and azimuthal probe for localizing the emergence point of ventricular tachycardias |
US4777955A (en) * | 1987-11-02 | 1988-10-18 | Cordis Corporation | Left ventricle mapping probe |
US5081993A (en) * | 1987-11-11 | 1992-01-21 | Circulation Research Limited | Methods and apparatus for the examination and treatment of internal organs |
US4890623A (en) * | 1988-03-14 | 1990-01-02 | C. R. Bard, Inc. | Biopotential sensing device and method for making |
US5588432A (en) * | 1988-03-21 | 1996-12-31 | Boston Scientific Corporation | Catheters for imaging, sensing electrical potentials, and ablating tissue |
US5372138A (en) * | 1988-03-21 | 1994-12-13 | Boston Scientific Corporation | Acousting imaging catheters and the like |
US4840182A (en) * | 1988-04-04 | 1989-06-20 | Rhode Island Hospital | Conductance catheter |
US4899750A (en) * | 1988-04-19 | 1990-02-13 | Siemens-Pacesetter, Inc. | Lead impedance scanning system for pacemakers |
US5305745A (en) * | 1988-06-13 | 1994-04-26 | Fred Zacouto | Device for protection against blood-related disorders, notably thromboses, embolisms, vascular spasms, hemorrhages, hemopathies and the presence of abnormal elements in the blood |
US5000190A (en) * | 1988-06-22 | 1991-03-19 | The Cleveland Clinic Foundation | Continuous cardiac output by impedance measurements in the heart |
US4898176A (en) * | 1988-06-22 | 1990-02-06 | The Cleveland Clinic Foundation | Continuous cardiac output by impedance measurements in the heart |
US4951682A (en) * | 1988-06-22 | 1990-08-28 | The Cleveland Clinic Foundation | Continuous cardiac output by impedance measurements in the heart |
US5054496A (en) * | 1988-07-15 | 1991-10-08 | China-Japan Friendship Hospital | Method and apparatus for recording and analyzing body surface electrocardiographic peak maps |
US5025786A (en) * | 1988-07-21 | 1991-06-25 | Siegel Sharon B | Intracardiac catheter and method for detecting and diagnosing myocardial ischemia |
US4911174A (en) * | 1989-02-13 | 1990-03-27 | Cardiac Pacemakers, Inc. | Method for matching the sense length of an impedance measuring catheter to a ventricular chamber |
US5029588A (en) * | 1989-06-15 | 1991-07-09 | Cardiovascular Imaging Systems, Inc. | Laser catheter with imaging capability |
US5056517A (en) * | 1989-07-24 | 1991-10-15 | Consiglio Nazionale Delle Ricerche | Biomagnetically localizable multipurpose catheter and method for magnetocardiographic guided intracardiac mapping, biopsy and ablation of cardiac arrhythmias |
US5220924A (en) * | 1989-09-28 | 1993-06-22 | Frazin Leon J | Doppler-guided retrograde catheterization using transducer equipped guide wire |
US5042486A (en) * | 1989-09-29 | 1991-08-27 | Siemens Aktiengesellschaft | Catheter locatable with non-ionizing field and method for locating same |
US5005587A (en) * | 1989-11-13 | 1991-04-09 | Pacing Systems, Inc. | Braid Electrode leads and catheters and methods for using the same |
US5090411A (en) * | 1990-01-31 | 1992-02-25 | Kabushiki Kaisha Toshiba | Ultrasonic diagnosis apparatus |
US5360006A (en) * | 1990-06-12 | 1994-11-01 | University Of Florida Research Foundation, Inc. | Automated method for digital image quantitation |
US5273038A (en) * | 1990-07-09 | 1993-12-28 | Beavin William C | Computer simulation of live organ |
US5058583A (en) * | 1990-07-13 | 1991-10-22 | Geddes Leslie A | Multiple monopolar system and method of measuring stroke volume of the heart |
US5054492A (en) * | 1990-12-17 | 1991-10-08 | Cardiovascular Imaging Systems, Inc. | Ultrasonic imaging catheter having rotational image correlation |
US5156151A (en) * | 1991-02-15 | 1992-10-20 | Cardiac Pathways Corporation | Endocardial mapping and ablation system and catheter probe |
US5228442A (en) * | 1991-02-15 | 1993-07-20 | Cardiac Pathways Corporation | Method for mapping, ablation, and stimulation using an endocardial catheter |
US5345936A (en) * | 1991-02-15 | 1994-09-13 | Cardiac Pathways Corporation | Apparatus with basket assembly for endocardial mapping |
US5161536A (en) * | 1991-03-22 | 1992-11-10 | Catheter Technology | Ultrasonic position indicating apparatus and methods |
US5255678A (en) * | 1991-06-21 | 1993-10-26 | Ecole Polytechnique | Mapping electrode balloon |
US5282471A (en) * | 1991-07-31 | 1994-02-01 | Kabushiki Kaisha Toshiba | Ultrasonic imaging system capable of displaying 3-dimensional angiogram in real time mode |
US5211165A (en) * | 1991-09-03 | 1993-05-18 | General Electric Company | Tracking system to follow the position and orientation of a device with radiofrequency field gradients |
US5377678A (en) * | 1991-09-03 | 1995-01-03 | General Electric Company | Tracking system to follow the position and orientation of a device with radiofrequency fields |
US5713363A (en) * | 1991-11-08 | 1998-02-03 | Mayo Foundation For Medical Education And Research | Ultrasound catheter and method for imaging and hemodynamic monitoring |
US5325860A (en) * | 1991-11-08 | 1994-07-05 | Mayo Foundation For Medical Education And Research | Ultrasonic and interventional catheter and method |
US5323781A (en) * | 1992-01-31 | 1994-06-28 | Duke University | Methods for the diagnosis and ablation treatment of ventricular tachycardia |
US5830209A (en) * | 1992-02-05 | 1998-11-03 | Angeion Corporation | Multi-fiber laser catheter |
US5237996A (en) * | 1992-02-11 | 1993-08-24 | Waldman Lewis K | Endocardial electrical mapping catheter |
US5295484A (en) * | 1992-05-19 | 1994-03-22 | Arizona Board Of Regents For And On Behalf Of The University Of Arizona | Apparatus and method for intra-cardiac ablation of arrhythmias |
US5324284A (en) * | 1992-06-05 | 1994-06-28 | Cardiac Pathways, Inc. | Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method |
US5341807A (en) * | 1992-06-30 | 1994-08-30 | American Cardiac Ablation Co., Inc. | Ablation catheter positioning system |
US5411025A (en) * | 1992-06-30 | 1995-05-02 | Cordis Webster, Inc. | Cardiovascular catheter with laterally stable basket-shaped electrode array |
US5500012A (en) * | 1992-07-15 | 1996-03-19 | Angeion Corporation | Ablation catheter system |
US5662108A (en) * | 1992-09-23 | 1997-09-02 | Endocardial Solutions, Inc. | Electrophysiology mapping system |
US5311866A (en) * | 1992-09-23 | 1994-05-17 | Endocardial Therapeutics, Inc. | Heart mapping catheter |
US5297549A (en) * | 1992-09-23 | 1994-03-29 | Endocardial Therapeutics, Inc. | Endocardial mapping system |
US5701897A (en) * | 1992-10-02 | 1997-12-30 | Kabushiki Kaisha Toshiba | Ultrasonic diagnosis apparatus and image displaying system |
US5622174A (en) * | 1992-10-02 | 1997-04-22 | Kabushiki Kaisha Toshiba | Ultrasonic diagnosis apparatus and image displaying system |
US5687737A (en) * | 1992-10-09 | 1997-11-18 | Washington University | Computerized three-dimensional cardiac mapping with interactive visual displays |
US5385146A (en) * | 1993-01-08 | 1995-01-31 | Goldreyer; Bruce N. | Orthogonal sensing for use in clinical electrophysiology |
US5433198A (en) * | 1993-03-11 | 1995-07-18 | Desai; Jawahar M. | Apparatus and method for cardiac ablation |
US5601084A (en) * | 1993-06-23 | 1997-02-11 | University Of Washington | Determining cardiac wall thickness and motion by imaging and three-dimensional modeling |
US5840031A (en) * | 1993-07-01 | 1998-11-24 | Boston Scientific Corporation | Catheters for imaging, sensing electrical potentials and ablating tissue |
US5551426A (en) * | 1993-07-14 | 1996-09-03 | Hummel; John D. | Intracardiac ablation and mapping catheter |
US5738096A (en) * | 1993-07-20 | 1998-04-14 | Biosense, Inc. | Cardiac electromechanics |
US5391199A (en) * | 1993-07-20 | 1995-02-21 | Biosense, Inc. | Apparatus and method for treating cardiac arrhythmias |
US5409000A (en) * | 1993-09-14 | 1995-04-25 | Cardiac Pathways Corporation | Endocardial mapping and ablation system utilizing separately controlled steerable ablation catheter with ultrasonic imaging capabilities and method |
US5558091A (en) * | 1993-10-06 | 1996-09-24 | Biosense, Inc. | Magnetic determination of position and orientation |
US5553611A (en) * | 1994-01-06 | 1996-09-10 | Endocardial Solutions, Inc. | Endocardial measurement method |
US5458126A (en) * | 1994-02-24 | 1995-10-17 | General Electric Company | Cardiac functional analysis system employing gradient image segmentation |
US5617854A (en) * | 1994-06-22 | 1997-04-08 | Munsif; Anand | Shaped catheter device and method |
US5908446A (en) * | 1994-07-07 | 1999-06-01 | Cardiac Pathways Corporation | Catheter assembly, catheter and multi-port introducer for use therewith |
US5722402A (en) * | 1994-10-11 | 1998-03-03 | Ep Technologies, Inc. | Systems and methods for guiding movable electrode elements within multiple-electrode structures |
US5797396A (en) * | 1995-06-07 | 1998-08-25 | University Of Florida Research Foundation | Automated method for digital image quantitation |
US5824005A (en) * | 1995-08-22 | 1998-10-20 | Board Of Regents, The University Of Texas System | Maneuverable electrophysiology catheter for percutaneous or intraoperative ablation of cardiac arrhythmias |
US5697377A (en) * | 1995-11-22 | 1997-12-16 | Medtronic, Inc. | Catheter mapping system and method |
US5871019A (en) * | 1996-09-23 | 1999-02-16 | Mayo Foundation For Medical Education And Research | Fast cardiac boundary imaging |
US5669382A (en) * | 1996-11-19 | 1997-09-23 | General Electric Company | System for measuring myocardium in cardiac images |
US6095976A (en) * | 1997-06-19 | 2000-08-01 | Medinol Ltd. | Method for enhancing an image derived from reflected ultrasound signals produced by an ultrasound transmitter and detector inserted in a bodily lumen |
US6603996B1 (en) * | 2000-06-07 | 2003-08-05 | Graydon Ernest Beatty | Software for mapping potential distribution of a heart chamber |
Cited By (123)
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US9700372B2 (en) | 2002-07-01 | 2017-07-11 | Recor Medical, Inc. | Intraluminal methods of ablating nerve tissue |
US9707034B2 (en) | 2002-07-01 | 2017-07-18 | Recor Medical, Inc. | Intraluminal method and apparatus for ablating nerve tissue |
US10953170B2 (en) | 2003-05-13 | 2021-03-23 | Nuvaira, Inc. | Apparatus for treating asthma using neurotoxin |
US9339618B2 (en) | 2003-05-13 | 2016-05-17 | Holaira, Inc. | Method and apparatus for controlling narrowing of at least one airway |
US9339325B2 (en) | 2005-12-06 | 2016-05-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing lesions in tissue |
US8406866B2 (en) | 2005-12-06 | 2013-03-26 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing coupling between an electrode and tissue |
US20100168735A1 (en) * | 2005-12-06 | 2010-07-01 | Don Curtis Deno | System and method for assessing coupling between an electrode and tissue |
US9492226B2 (en) | 2005-12-06 | 2016-11-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Graphical user interface for real-time RF lesion depth display |
US20100228247A1 (en) * | 2005-12-06 | 2010-09-09 | Saurav Paul | Assessment of electrode coupling of tissue ablation |
US20090275827A1 (en) * | 2005-12-06 | 2009-11-05 | Aiken Robert D | System and method for assessing the proximity of an electrode to tissue in a body |
US20110118727A1 (en) * | 2005-12-06 | 2011-05-19 | Fish Jeffrey M | System and method for assessing the formation of a lesion in tissue |
US9610119B2 (en) | 2005-12-06 | 2017-04-04 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing the formation of a lesion in tissue |
US11517372B2 (en) | 2005-12-06 | 2022-12-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing lesions in tissue |
US10182860B2 (en) | 2005-12-06 | 2019-01-22 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US9173586B2 (en) | 2005-12-06 | 2015-11-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing coupling between an electrode and tissue |
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US9283025B2 (en) | 2005-12-06 | 2016-03-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US8755860B2 (en) | 2005-12-06 | 2014-06-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Method for displaying catheter electrode-tissue contact in electro-anatomic mapping and navigation system |
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US20090163904A1 (en) * | 2005-12-06 | 2009-06-25 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and Method for Assessing Coupling Between an Electrode and Tissue |
US20100069921A1 (en) * | 2006-12-06 | 2010-03-18 | Miller Stephan P | System and method for assessing lesions in tissue |
US8403925B2 (en) | 2006-12-06 | 2013-03-26 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing lesions in tissue |
US10660690B2 (en) | 2007-12-28 | 2020-05-26 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for measurement of an impedance using a catheter such as an ablation catheter |
US20090171345A1 (en) * | 2007-12-28 | 2009-07-02 | Miller Stephan P | System and method for measurement of an impedance using a catheter such as an ablation catheter |
US20090171235A1 (en) * | 2007-12-28 | 2009-07-02 | Clint Schneider | Method and apparatus for complex impedance compensation and for determining tissue morphology based on phase angle |
US8290578B2 (en) | 2007-12-28 | 2012-10-16 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Method and apparatus for complex impedance compensation |
US11896284B2 (en) | 2007-12-28 | 2024-02-13 | St. Jude Medical, Atrial Fibrillation Division, Inc | System and method for measurement of an impedance using a catheter such as an ablation catheter |
US10555685B2 (en) | 2007-12-28 | 2020-02-11 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Method and apparatus for determining tissue morphology based on phase angle |
US11058879B2 (en) | 2008-02-15 | 2021-07-13 | Nuvaira, Inc. | System and method for bronchial dilation |
US8489192B1 (en) | 2008-02-15 | 2013-07-16 | Holaira, Inc. | System and method for bronchial dilation |
US9125643B2 (en) | 2008-02-15 | 2015-09-08 | Holaira, Inc. | System and method for bronchial dilation |
US8731672B2 (en) | 2008-02-15 | 2014-05-20 | Holaira, Inc. | System and method for bronchial dilation |
US11937868B2 (en) | 2008-05-09 | 2024-03-26 | Nuvaira, Inc. | Systems, assemblies, and methods for treating a bronchial tree |
US8821489B2 (en) | 2008-05-09 | 2014-09-02 | Holaira, Inc. | Systems, assemblies, and methods for treating a bronchial tree |
US8808280B2 (en) | 2008-05-09 | 2014-08-19 | Holaira, Inc. | Systems, assemblies, and methods for treating a bronchial tree |
US8961507B2 (en) | 2008-05-09 | 2015-02-24 | Holaira, Inc. | Systems, assemblies, and methods for treating a bronchial tree |
US9668809B2 (en) | 2008-05-09 | 2017-06-06 | Holaira, Inc. | Systems, assemblies, and methods for treating a bronchial tree |
US8961508B2 (en) | 2008-05-09 | 2015-02-24 | Holaira, Inc. | Systems, assemblies, and methods for treating a bronchial tree |
US10149714B2 (en) | 2008-05-09 | 2018-12-11 | Nuvaira, Inc. | Systems, assemblies, and methods for treating a bronchial tree |
US8206385B2 (en) | 2008-06-09 | 2012-06-26 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter assembly with front-loaded tip and multi-contact connector |
US20090306655A1 (en) * | 2008-06-09 | 2009-12-10 | Stangenes Todd R | Catheter assembly with front-loaded tip and multi-contact connector |
US20100168550A1 (en) * | 2008-12-31 | 2010-07-01 | Byrd Israel A | Multiple shell construction to emulate chamber contraction with a mapping system |
US9307931B2 (en) | 2008-12-31 | 2016-04-12 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Multiple shell construction to emulate chamber contraction with a mapping system |
US8974445B2 (en) | 2009-01-09 | 2015-03-10 | Recor Medical, Inc. | Methods and apparatus for treatment of cardiac valve insufficiency |
US10675086B2 (en) | 2009-05-13 | 2020-06-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for presenting information representative of lesion formation in tissue during an ablation procedure |
US9204927B2 (en) | 2009-05-13 | 2015-12-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for presenting information representative of lesion formation in tissue during an ablation procedure |
US20100305423A1 (en) * | 2009-06-02 | 2010-12-02 | Huisun Wang | Catheter having distal sealing member |
US8535272B2 (en) | 2009-06-02 | 2013-09-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Sealing member for a catheter |
US8167845B2 (en) | 2009-06-02 | 2012-05-01 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter having distal sealing member |
US9005195B2 (en) | 2009-10-27 | 2015-04-14 | Holaira, Inc. | Delivery devices with coolable energy emitting assemblies |
US9931162B2 (en) | 2009-10-27 | 2018-04-03 | Nuvaira, Inc. | Delivery devices with coolable energy emitting assemblies |
US9649153B2 (en) | 2009-10-27 | 2017-05-16 | Holaira, Inc. | Delivery devices with coolable energy emitting assemblies |
US8740895B2 (en) | 2009-10-27 | 2014-06-03 | Holaira, Inc. | Delivery devices with coolable energy emitting assemblies |
US9675412B2 (en) | 2009-10-27 | 2017-06-13 | Holaira, Inc. | Delivery devices with coolable energy emitting assemblies |
US8932289B2 (en) | 2009-10-27 | 2015-01-13 | Holaira, Inc. | Delivery devices with coolable energy emitting assemblies |
US9017324B2 (en) | 2009-10-27 | 2015-04-28 | Holaira, Inc. | Delivery devices with coolable energy emitting assemblies |
US8777943B2 (en) | 2009-10-27 | 2014-07-15 | Holaira, Inc. | Delivery devices with coolable energy emitting assemblies |
US9649154B2 (en) | 2009-11-11 | 2017-05-16 | Holaira, Inc. | Non-invasive and minimally invasive denervation methods and systems for performing the same |
US11712283B2 (en) | 2009-11-11 | 2023-08-01 | Nuvaira, Inc. | Non-invasive and minimally invasive denervation methods and systems for performing the same |
US8911439B2 (en) | 2009-11-11 | 2014-12-16 | Holaira, Inc. | Non-invasive and minimally invasive denervation methods and systems for performing the same |
US10610283B2 (en) | 2009-11-11 | 2020-04-07 | Nuvaira, Inc. | Non-invasive and minimally invasive denervation methods and systems for performing the same |
US11389233B2 (en) | 2009-11-11 | 2022-07-19 | Nuvaira, Inc. | Systems, apparatuses, and methods for treating tissue and controlling stenosis |
US9149328B2 (en) | 2009-11-11 | 2015-10-06 | Holaira, Inc. | Systems, apparatuses, and methods for treating tissue and controlling stenosis |
US11717345B2 (en) | 2011-04-22 | 2023-08-08 | Ablative Solutions, Inc. | Methods of ablating tissue using a catheter injection system |
US9795441B2 (en) | 2011-04-22 | 2017-10-24 | Ablative Solutions, Inc. | Methods of ablating tissue using a catheter injection system |
US9237925B2 (en) | 2011-04-22 | 2016-01-19 | Ablative Solutions, Inc. | Expandable catheter system for peri-ostial injection and muscle and nerve fiber ablation |
US11007008B2 (en) | 2011-04-22 | 2021-05-18 | Ablative Solutions, Inc. | Methods of ablating tissue using a catheter injection system |
US11007346B2 (en) | 2011-04-22 | 2021-05-18 | Ablative Solutions, Inc. | Expandable catheter system for peri-ostial injection and muscle and nerve fiber ablation |
US10172663B2 (en) | 2011-04-22 | 2019-01-08 | Ablative Solutions, Inc. | Expandable catheter system for peri-ostial injection and muscle and nerve fiber ablation |
US10485951B2 (en) | 2011-08-24 | 2019-11-26 | Ablative Solutions, Inc. | Catheter systems and packaged kits for dual layer guide tubes |
US11752303B2 (en) | 2011-08-24 | 2023-09-12 | Ablative Solutions, Inc. | Catheter systems and packaged kits for dual layer guide tubes |
US11007329B2 (en) | 2011-08-24 | 2021-05-18 | Ablative Solutions, Inc. | Expandable catheter system for fluid injection into and deep to the wall of a blood vessel |
US9278196B2 (en) | 2011-08-24 | 2016-03-08 | Ablative Solutions, Inc. | Expandable catheter system for vessel wall injection and muscle and nerve fiber ablation |
US11759608B2 (en) | 2011-08-24 | 2023-09-19 | Ablative Solutions, Inc. | Intravascular fluid catheter with minimal internal fluid volume |
US10118004B2 (en) | 2011-08-24 | 2018-11-06 | Ablative Solutions, Inc. | Expandable catheter system for fluid injection into and deep to the wall of a blood vessel |
US10576246B2 (en) | 2011-08-24 | 2020-03-03 | Ablative Solutions, Inc. | Intravascular fluid catheter with minimal internal fluid volume |
US11202889B2 (en) | 2012-10-29 | 2021-12-21 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheter with support structures |
US9554849B2 (en) | 2012-10-29 | 2017-01-31 | Ablative Solutions, Inc. | Transvascular method of treating hypertension |
US10226278B2 (en) | 2012-10-29 | 2019-03-12 | Ablative Solutions, Inc. | Method for painless renal denervation using a peri-vascular tissue ablation catheter with support structures |
US11944373B2 (en) | 2012-10-29 | 2024-04-02 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheters |
US10350392B2 (en) | 2012-10-29 | 2019-07-16 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheter with support structures |
US9301795B2 (en) | 2012-10-29 | 2016-04-05 | Ablative Solutions, Inc. | Transvascular catheter for extravascular delivery |
US10405912B2 (en) | 2012-10-29 | 2019-09-10 | Ablative Solutions, Inc. | Transvascular methods of treating extravascular tissue |
US10736656B2 (en) | 2012-10-29 | 2020-08-11 | Ablative Solutions | Method for painless renal denervation using a peri-vascular tissue ablation catheter with support structures |
US9320850B2 (en) | 2012-10-29 | 2016-04-26 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheter with unique injection fitting |
US10881458B2 (en) | 2012-10-29 | 2021-01-05 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheters |
US9539047B2 (en) | 2012-10-29 | 2017-01-10 | Ablative Solutions, Inc. | Transvascular methods of treating extravascular tissue |
US9254360B2 (en) | 2012-10-29 | 2016-02-09 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheter with deflection surface support structures |
US10945787B2 (en) | 2012-10-29 | 2021-03-16 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheters |
US9526827B2 (en) | 2012-10-29 | 2016-12-27 | Ablative Solutions, Inc. | Peri-vascular tissue ablation catheter with support structures |
US9398933B2 (en) | 2012-12-27 | 2016-07-26 | Holaira, Inc. | Methods for improving drug efficacy including a combination of drug administration and nerve modulation |
US10420481B2 (en) | 2013-10-25 | 2019-09-24 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
US10736524B2 (en) | 2013-10-25 | 2020-08-11 | Ablative Solutions, Inc. | Intravascular catheter with peri-vascular nerve activity sensors |
US11751787B2 (en) | 2013-10-25 | 2023-09-12 | Ablative Solutions, Inc. | Intravascular catheter with peri-vascular nerve activity sensors |
US10022059B2 (en) | 2013-10-25 | 2018-07-17 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
US10881312B2 (en) | 2013-10-25 | 2021-01-05 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
US20150119674A1 (en) * | 2013-10-25 | 2015-04-30 | Ablative Solutions, Inc. | Intravascular catheter with peri-vascular nerve activity sensors |
US11937933B2 (en) | 2013-10-25 | 2024-03-26 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
US9949652B2 (en) | 2013-10-25 | 2018-04-24 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
US9931046B2 (en) * | 2013-10-25 | 2018-04-03 | Ablative Solutions, Inc. | Intravascular catheter with peri-vascular nerve activity sensors |
US10517666B2 (en) | 2013-10-25 | 2019-12-31 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
US11510729B2 (en) | 2013-10-25 | 2022-11-29 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
US9814406B2 (en) | 2013-11-19 | 2017-11-14 | Pacesetter, Inc. | Method and system to identify motion data associated with consistent electrical and mechanical behavior for a region of interest |
US9314191B2 (en) | 2013-11-19 | 2016-04-19 | Pacesetter, Inc. | Method and system to measure cardiac motion using a cardiovascular navigation system |
US9301713B2 (en) | 2013-11-19 | 2016-04-05 | Pacesetter, Inc. | Method and system to assess mechanical dyssynchrony based on motion data collected by a navigation system |
US9380940B2 (en) | 2014-05-05 | 2016-07-05 | Pacesetter, Inc. | Method and system for displaying a three dimensional visualization of cardiac motion |
US9895076B2 (en) | 2014-05-05 | 2018-02-20 | Pacesetter, Inc. | Method and system to determine cardiac cycle length in connection with cardiac mapping |
US9763591B2 (en) | 2014-05-05 | 2017-09-19 | Pacesetter, Inc. | Method and system to subdivide a mapping area for mechanical activation analysis |
US9861823B2 (en) | 2014-05-05 | 2018-01-09 | Pacesetter, Inc. | Cardiac resynchronization system and method |
US9700233B2 (en) | 2014-05-05 | 2017-07-11 | Pacesetter, Inc. | Method and system to equalizing cardiac cycle length between map points |
US10105077B2 (en) | 2014-05-05 | 2018-10-23 | Pacesetter, Inc. | Method and system for calculating strain from characterization data of a cardiac chamber |
US9364170B2 (en) | 2014-05-05 | 2016-06-14 | Pacesetter, Inc. | Method and system to characterize motion data based on neighboring map points |
US9302099B2 (en) | 2014-05-05 | 2016-04-05 | Pacesetter, Inc. | System and method for evaluating lead stability of an implantable medical device |
US10285647B2 (en) | 2014-05-05 | 2019-05-14 | Pacesetter Inc. | Method and system to automatically assign map points to anatomical segments and determine mechanical activation time |
US11399759B2 (en) | 2016-05-03 | 2022-08-02 | Acutus Medical, Inc. | Cardiac mapping system with efficiency algorithm |
EP3973908A1 (en) * | 2016-05-03 | 2022-03-30 | Acutus Medical Inc. | Cardiac mapping system with efficiency algorithm |
US10849685B2 (en) | 2018-07-18 | 2020-12-01 | Ablative Solutions, Inc. | Peri-vascular tissue access catheter with locking handle |
US11826577B2 (en) | 2021-02-25 | 2023-11-28 | Medtronic, Inc. | Impedance measurement circuit architecture |
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