Method and system for characterizing stimulus sites and providing implant guidance

Patent metadata

Field	Value
Publication number	US-9345550-B2
Application number	US-201314069209-A
Country	US
Kind code	B2
Filing date	Oct 31, 2013
Priority date	Oct 31, 2013
Publication date	May 24, 2016
Grant date	May 24, 2016

Abstract

A method and system for characterizing an accessibility of potential left ventricular stimulus sites in connection with surgical planning for transvenous implant of a cardiac medical lead in or near a heart of a patient are provided. The method and system include obtaining image data representative of a coronary venous system for the heart of the patient to receive the lead. The method and system generate a venous map, based on the image data, representative of venous pathways for the heart of the patient. The method and system analyze the venous map to identify pathway features of interest (PFOI) within at least one select region of the venous pathways. The method and system assign scores to the PFOI based on at least one of predetermined feature-complexity relations or physician-entered complexity updates. The method and system display treatment planning information to a user based on the scores.

First claim

What is claimed is:

1. A method for characterizing an accessibility of potential stimulus sites in connection with surgical planning for implant of a cardiac medical lead near a heart of a patient, the method comprising:
obtaining image data representative of a coronary venous system for the heart of the patient to receive the lead;
generating a venous map, based on the image data, representative of venous pathways for the heart of the patient;
analyzing the venous map to identify pathway features of interest (PFOI) within at least one select region of the venous pathways;
assigning scores to the PFOI based on at least one of predetermined feature-complexity relations or physician-entered complexity updates; and
displaying treatment planning information to a user based on the scores, wherein the treatment planning information includes an identification of at least one of implant tools or a type of medical lead saved in a database as suggested to be used to locate an electrode of the medical lead at the corresponding stimulus site.

2. The method of claim 1 , wherein the displaying operation is based on at least one of a surgical planning database or a physician-specific surgical history.

3. The method of claim 1 , further comprising tabulating the scores for a plurality of PFOI at least one of within or upstream of the at least one select region of the venous pathways.

4. The method of claim 1 , wherein the at least one select region is at least one of a pre-defined epicardial region, an identified coronary vein, or a user-selected location of the venous map.

5. The method of claim 1 , further comprising introducing the medical lead along a chosen one of the venous pathways for the heart based on the treatment planning information.

6. The method of claim 1 , wherein the analyzing operation includes identifying at least one of a location, tortuosity, angle, and diameter of potential geometric obstacles in the venous pathways as the PFOI.

7. The method of claim 1 , wherein the analyzing operation includes identifying predetermined shapes within the venous pathways as the PFOI, the PFOI including at least one of branch bifurcations, acute angles, U-turn changes of direction, pathway narrowing, and overall tortuosity of a segment of the venous pathway.

8. The method of claim 1 , further comprising assigning a total value to the at least one select region of the venous pathways, the total value representing risk weights associated with approaching the corresponding select region with the medical lead.

9. The method of claim 1 , further comprising providing a user interface configured to permit the user to designate a first select location, and displaying a total value determine in connection with the first select location, wherein the total value represents an aggregation of the scores for the PFOI that are located upstream of the first select location along a corresponding venous pathway located between the first select location and an upstream origination site.

10. The method of claim 1 , wherein the treatment planning information further includes an identification implant steps that are suggested to be followed to locate an electrode of the medical lead at the corresponding stimulus site.

11. The method of claim 1 , wherein the treatment planning information further includes a comparative representation of the projected accessibility of the potential stimulus sites, the comparative representation displayed as at least one of a color-based heat map or an integer-based map.

12. A procedure guidance (PG) system for characterizing an accessibility of potential stimulus sites in connection with surgical planning for implant of a cardiac medical lead near a heart of a patient, the PG system comprising:
an imaging device configured to obtain image data representative of a coronary venous system for the heart of the patient to receive the lead;
a venous map circuit module configured to generate a venous map, based on the image data, representative of venous pathways for the heart of the patient;
a pathway features of interest (PFOI) identification circuit module configured to analyze the venous map to identify PFOI within at least one select region of the venous pathways;
a scoring circuit module configured to assign scores to the PFOI based on at least one of predetermined feature-complexity relations or physician-entered complexity updates; and
a display device configured to provide treatment planning information to a user based on the scores, wherein the treatment planning information includes an identification of at least one of implant tools or a type of medical lead saved in a database as suggested to be used to locate an electrode of the medical lead at the corresponding stimulus site.

13. The PG system of claim 12 , wherein the imaging device obtains at least one of MRI, CT, fluoroscopy, or ultrasound images of the heart.

14. The PG system of claim 12 , wherein the venous map circuit module performs an automated segmentation analysis of the image data to form the venous map.

15. The PG system of claim 12 , wherein the scoring circuit module aggregates the scores associated with the PFOI along corresponding venous pathways located between the potential stimulus sites and potential upstream origination sites to determine a total value for each of the corresponding venous pathways, the display device displays the total value associated with at least one of the venous pathways.

16. The PG system of claim 12 , wherein the treatment planning information includes an identification of implant tools, a type of medical lead, and an identification of implant steps saved in a database as suggested to be used or followed to locate an electrode of the medical lead at the corresponding stimulus site.

17. The PG system of claim 12 , wherein the treatment planning information further includes an identification of implant steps saved in a database as suggested to be followed to locate an electrode of the medical lead at the corresponding stimulus site.

18. The PG system of claim 12 , wherein the display device displays the treatment planning information overlaid onto an image of the heart, the image including at least one of pre-acquired anatomical, electrical, or functional information related to the heart.

19. The PG system of claim 12 , wherein the treatment planning information is retrieved by the scoring circuit module from at least one of a surgical planning database or a physician-specific surgical history.

20. The PG system of claim 19 , wherein the surgical planning database is updated after the implant of the medical lead with at least one of a final stimulus site, a final lead route, a type of medical lead implanted, a list of tools used to maneuver the lead along the final lead route, or a list of steps taken to maneuver the lead along the final lead route.

21. The PG system of claim 19 , wherein the surgical planning database is updated after the implant of the medical lead with a physician's choices for at least one of tools, type of medical lead, or implant steps to form the physician-specific surgical history in connection with each potential stimulus site.

22. The PG system of claim 19 , wherein at least one of the surgical planning database or the physician-specific surgical history is updated to include at least one of newly available tools, newly available medical leads, newly practiced steps, or newly determined feature-complexity relations.

Assignees

• Pacesetter Inc

Inventors

• Richter Sergio
• Sommer Philipp
• Arnold Edith
• Razavi Hoda
• Nabutovsky Yelena
• Qu Fujian

Classifications

• A61B34/10 Primary

  Computer-aided planning, simulation or modelling of surgical operations · CPC title

• A61N1/37

  Monitoring; Protecting · CPC title

• A61N1/3627

  for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy · CPC title

• A61N1/056

  Transvascular endocardial electrode systems · CPC title

• A61B19/50 Primary

  Human Necessities · mapped topic