Method and apparatus to synchronize a location determination in a structure with a characteristic of the structure

Patent metadata

Field	Value
Publication number	US-9332928-B2
Application number	US-42351109-A
Country	US
Kind code	B2
Filing date	Apr 14, 2009
Priority date	Apr 18, 2008
Publication date	May 10, 2016
Grant date	May 10, 2016

Abstract

An volume of a patient can be mapped with a system operable to identify a plurality of locations and save a plurality of locations of a mapping instrument. The mapping instrument can include one or more electrodes that can sense a voltage that can be correlated to a three dimensional location of the electrode at the time of the sensing or measurement. Therefore, a map of a volume can be determined based upon the sensing of the plurality of points without the use of other imaging devices. An implantable medical device can then be navigated relative to the mapping data.

First claim

What is claimed is:

1. A method of synchronizing a position determination within a volume of a patient and a physiological cycle of the patient, comprising:
determining at least a first portion and a second portion of a physiological cycle of the patient that relate to a surface position of a structure of the patient;
collecting a plurality of map data points based on tracking a mapping instrument at a plurality of three-dimensional locations in the patient at least by detecting an injected current during the determined physiological cycle;
classifying the collected plurality of map data points as in the first portion of the physiological cycle or the second portion of the physiological cycle, wherein a first sub-plurality of the collected plurality of map data points is classified as in the first portion of the physiological cycle and a second sub-plurality of the collected plurality of map data points is classified as in the second portion of the physiological cycle; and
after classifying the collected plurality of map data, only displaying a representation of a shape of the surface with one of:
the first sub-plurality of collected and classified map data points that relates to a first shape of the surface of the structure during the first portion of the physiological cycle, or
the second sub-plurality of collected and classified map data points that relates to a second shape of the surface of the structure during the second portion of the physiological cycle.

2. The method of claim 1 , further comprising:
saving the classified collected plurality of map data; and
successively displaying with a display device for viewing by a user sequentially only the representation of the first sub-plurality of collected and classified map data points and then only the representation of the second sub-plurality of collected and classified map data points;
wherein in the physiological cycle the first portion is immediately prior to the second portion.

3. The method of claim 1 , wherein determining the physiological cycle includes determining the first portion of the physiological cycle and the second portion of the physiological cycle of a cardiac cycle and a respiratory cycle;
wherein the cardiac cycle is determined with an electrocardiogram and the respiratory cycle is determined by measuring an impedance between a first electrode and a second electrode connected to the patient.

4. The method of claim 3 , further comprising:
identifying a plurality of portions of both of the first and the second portions of the physiological cycle.

5. The method of claim 1 , wherein determining the physiological cycle includes connecting an electrocardiogram with the patient to measure the systole and diastole of the patient.

6. The method of claim 5 , wherein displaying includes:
displaying the map data classified as in systole and displaying the map data classified as diastole to illustrate motion of the heart, wherein the heart is the structure.

7. The method of claim 6 , further comprising:
determining a location of a procedure instrument within the subject relative to the displayed at least one of the first sub-plurality of map data and the second sub-plurality of collected and classified map data representative of the surface of the structure;
wherein collecting a plurality of map data includes:
positioning a position element that is an electrode of the mapping instrument at a plurality of locations in a heart of the patient; and
determining a position of the position element in a plurality of successive times at the plurality of locations;

wherein the map data points are collected only with the position element of the mapping instrument as individual map data point with the position element within the patient.

8. The method of claim 7 , wherein determining the physiological cycle includes:
connecting a first electrode and a second electrode to the patient to inject the current into the patient;
measuring an impedance between the first electrode and the second electrode connected to the patient; and
determining the physiological cycle based at least in part on the measured impedance between the first electrode and the second electrode connected to the patient based least in part on a volume of blood in a heart of the patient.

9. The method of claim 1 , further comprising:
tracking a position of a position element in a volume;
collecting positions of the position element;
determining a validity of the collected positions;
generating a map based on the collected positions;
displaying the map on a display device;
wherein tracking the position element, includes at least one of:
selecting between a uni-polar and bi-polar collection of positions;
determining whether an interfering frequency is present during or prior to collecting the positions;
inflating a portion of the instrument;
fixing a location of a first position element relative to a second position element;
moving a flexible member with a first position element relative to a second position element at a fixed position and measuring the position of the first member position element relative to the second position element;
measuring a temperature within the volume at least one of the position element, the first position element, and the second position element; and

displaying on a display device at least one of:
a corrected map data generated by reducing distortion of a measured position of the instrument by determining a scaling factor between two position elements of the instrument;
a pseudo location of an axis electrode relative to the map;
a location of a reference electrode relative to the map;
a location of a feature determined by generating a filled volume and determining curvilinear portions to be displayed relative to the filled volume with the instrument;
a map point determined by generating a virtual point based on a known position of a physical portion of the instrument relative to a position element of the instrument;
a virtual map data point determined based on a geometry of the instrument relative to the position element; and
a location of an introducer through which the instrument or a procedure instrument is passed.

10. A method of synchronizing a position determination within a volume of a patient and a physiological cycle of the patient, comprising:
determining at least a first portion of a physiological cycle of the patient and a second portion of the physiological cycle of the patient;
positioning a mapping instrument in the patient having a position element;
collecting a first plurality of map data points with the position element of the mapping instrument in the patient during the first portion of the determined physiological cycle;
collecting a second plurality of map data points with the position element of the mapping instrument in the patient during the second portion of the determined physiological cycle;
classifying the collected first plurality of map data points as the determined first portion of the physiological cycle and the collected second plurality of map data points as the second portion of the physiological cycle;
after classifying the collected first plurality of map data points and the collected second plurality of map data points, displaying at least one of the first plurality of map data points as a first shape or the second plurality of map data points as a second shape on a display device as representation of a surface of a heart in the patient;
determining a position within the heart at a location of a procedure instrument; and
superimposing an icon on the displayed representation using at least one of the first plurality of map data or the second plurality of map data o

Assignees

• Markowitz H Toby
• Karamanoglu Mustafa
• Mehta Pooja
• Fleming Ioana
• Scanlon David A
• Kryger Michael
• Campbell-Massa Sean
• Giese Chad
• Waldhauser Steven L
• Zhang Shangqian Peter
• Jannicke Jeff
• Falkner Phillip
• Hefner Don
• Warman Eduardo N
• Steeves James
• Receveur Rogier
• Michels Koen
• Eick Olaf
• Larik Vincent
• Medtronic Inc

Inventors

• Markowitz H Toby
• Karamanoglu Mustafa
• Mehta Pooja
• Fleming Ioana
• Scanlon David A
• Kryger Michael
• Campbell-Massa Sean
• Giese Chad
• Waldhauser Steven L
• Zhang Shangqian Peter
• Jannicke Jeff
• Falkner Phillip
• Hefner Don
• Warman Eduardo N
• Steeves James
• Receveur Rogier
• Michels Koen
• Eick Olaf
• Larik Vincent

Classifications

• A61B5/063

  using impedance measurements · CPC title

• A61B5/05

  Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves (measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24) · CPC title

• A61B34/20

  Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis · CPC title

• A61B2017/00026

  Conductivity or impedance, e.g. of tissue · CPC title

• A61B5/06

  Devices, other than using radiation, for detecting or locating foreign bodies {; Determining position of diagnostic devices within or on the body of the patient} · CPC title