CA2144973A1 - Endocardial mapping system - Google Patents

Endocardial mapping system

Info

Publication number
CA2144973A1
CA2144973A1 CA002144973A CA2144973A CA2144973A1 CA 2144973 A1 CA2144973 A1 CA 2144973A1 CA 002144973 A CA002144973 A CA 002144973A CA 2144973 A CA2144973 A CA 2144973A CA 2144973 A1 CA2144973 A1 CA 2144973A1
Authority
CA
Canada
Prior art keywords
heart
lead body
electrodes
electrode
patient
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002144973A
Other languages
French (fr)
Other versions
CA2144973C (en
Inventor
Graydon Ernest Beatty
Jonathan Kagan
Jeffrey R. Budd
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
St Jude Medical Atrial Fibrillation Division Inc
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US07/949,690 external-priority patent/US5311866A/en
Priority claimed from US07/950,448 external-priority patent/US5297549A/en
Application filed by Individual filed Critical Individual
Priority to CA2447239A priority Critical patent/CA2447239C/en
Priority to CA002678625A priority patent/CA2678625A1/en
Publication of CA2144973A1 publication Critical patent/CA2144973A1/en
Application granted granted Critical
Publication of CA2144973C publication Critical patent/CA2144973C/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A61B5/6853—Catheters with a balloon
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • 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
    • 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]
    • A61B5/282—Holders for multiple electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A61B5/6858—Catheters with a distal basket, e.g. expandable basket
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/3625—External stimulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/37—Monitoring; Protecting
    • A61N1/3702—Physiological parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/00267—Expandable means emitting energy, e.g. by elements carried thereon having a basket shaped structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/04—Constructional details of apparatus
    • A61B2560/0443—Modular apparatus
    • A61B2560/045—Modular apparatus with a separable interface unit, e.g. for communication
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/04—Arrangements of multiple sensors of the same type
    • A61B2562/043—Arrangements of multiple sensors of the same type in a linear array
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/04—Arrangements of multiple sensors of the same type
    • A61B2562/046—Arrangements of multiple sensors of the same type in a matrix array
    • 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
    • A61B5/30—Input circuits therefor
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00—Metal working
    • Y10T29/49—Method of mechanical manufacture
    • Y10T29/49002—Electrical device making
    • Y10T29/49117—Conductor or circuit manufacturing

Abstract

A system for mapping electrical activity of a patient's heart includes a set of electrodes (19) spaced from the heart wall (18) and a set of electrodes (24, 26) in contact with the heart wall (18). Voltage measurements from the electrodes are used to generate three-dimensional and two-dimensional maps of the electrical activity of the heart.

Claims (12)

1. A method of mapping a volumetric electrical potential distribution of a heart chamber (80) arising from electrical activation in a myocardium as measured from both an electrode array (19) within the endocardial cavity, said electrode array not in contact with the surface of said endocardial, and from a reference electrode (24) at the interior surface of said heart chamber (80) at a known distance from said electrode array (19), said reference electrode (24) in contact with the surface of said heart chamber, and said electrode array (19) together with reference electrode (24) defining a reference position comprising the steps of:
measuring the geometric shape of said heart chamber, and generating volume data from said geometric shape measurement;
computing the position of said electrode array (19) within said heart chamber, from said volume measurement, and from said reference position, and generating array position measurement data;
measuring electrical potentials on said array, and generating electrical potential measurement data;
computing the three-dimensional volumetric electrical field distribution of said heart chamber volume from a solution to LaPlace's equation containing said electrical potential measurements, and said array position measurement data;
displaying said volumetric electrical field distribution.
2. The method of claim 1 wherein said measuring the geometric shape of said heart chamber step comprises the substeps of:
generating a sequence of impedance plethysmographic signals characterizing said heart volume; and generating said volume measurement data from said signals characterizing said heart volume.
3. A mapping catheter of the type having a set of electrodes which may be deployed within a patient's heart, for use in mapping cardiac electrical potentials of a patient's heart comprising:
a set of electrodes (19);
first positioning means coupled to said set of electrodes for spacing a portion of said set of electrodes, defined as a first subset of electrodes, apart from and not in contact with a surface of said patient's heart (12);
second positioning means coupled to said set of electrodes for placing a second predetermined subset of said set of electrodes (24) into contact with a surface of said patient's heart;
third positioning means coupled to said set of electrodes for placing a third predetermined subset of said electrodes (26) into a position in a wall of said patient's heart.
4. The apparatus of claim 3 wherein said set of electrodes exceeds twelve electrodes.
5. The apparatus of claim 3 wherein said first subset of electrodes exceeds one.
6. The apparatus of claim 3 wherein said second subset is at least one.
7. The apparatus of claim 3 wherein said first positioning means is substantially spherical in shape.
8. The apparatus of claim 3 wherein said second positioning means has a substantially cylindrical shape.
9. A catheter assembly (10) for mapping the interior of a patient's heart comprising:
a first set of electrode sites defining a first substantially spherical electrode array (19);
said electrode array (19) sized such that a substantial number of said electrodes are not in contact with the patient's heart;
a second set of electrode sites (24) displaced from said electrode array, located in contact with said patient's heart.
10. A catheter assembly (10) for mapping the electrical potential of the interior of a heart chamber of a patient's heart comprising:
a flexible lead body (72), connected to a deformable lead body (74), said flexible lead body and said deformable lead body having a lumen;
said deformable lead body deformable to a first collapsed position wherein said deformable lead body has a substantially cylindrical shape and, said deformable lead body deformable to a second expanded position wherein said deformable lead body has a substantially spherical shape;
an electrode array (19) having a plurality of electrode sites located on said deformable lead body, wherein said electrode sites form a spherical array of electrode sites when said deformable lead body is in said second expanded position;
a reference catheter (16) having a tip electrode assembly;
said reference catheter (16) being located in said lumen and supported for relative motion with respect to said electrode array such that said tip electrode assembly may be placed into contact with said patient's heart when said array is in said heart chamber.
11. The catheter assembly (10) of claim 10 further comprising:
means for excluding blood (77) from the interior of said deformable lead body when said deformable lead body is in said second expanded position.
12. A method of forming a catheter comprising the steps of:
a) forming a collection of insulated wires each having an interior conductor, and each having an exterior insulation coating;
b) braiding the wires formed in step a) forming braided structure having a central lumen;
c) incorporating the braided structure in a polymeric material forming a flexible lead body;
d) removing said polymeric material from a portion of said flexible lead body exposing said braid of insulated wires forming a deformable lead body;
e) removing insulation from selected locations on selected insulated wires to form electrode sites on said deformable lead body.
CA2144973A 1992-09-23 1993-09-23 Endocardial mapping system Expired - Lifetime CA2144973C (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CA2447239A CA2447239C (en) 1992-09-23 1993-09-23 Endocardial mapping system
CA002678625A CA2678625A1 (en) 1992-09-23 1993-09-23 Endocardial mapping system

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US07/949,690 1992-09-23
US07/950,448 1992-09-23
US07/949,690 US5311866A (en) 1992-09-23 1992-09-23 Heart mapping catheter
US07/950,448 US5297549A (en) 1992-09-23 1992-09-23 Endocardial mapping system
PCT/US1993/009015 WO1994006349A1 (en) 1992-09-23 1993-09-23 Endocardial mapping system

Related Child Applications (2)

Application Number Title Priority Date Filing Date
CA2447239A Division CA2447239C (en) 1992-09-23 1993-09-23 Endocardial mapping system
CA002678625A Division CA2678625A1 (en) 1992-09-23 1993-09-23 Endocardial mapping system

Publications (2)

Publication Number Publication Date
CA2144973A1 true CA2144973A1 (en) 1994-03-31
CA2144973C CA2144973C (en) 2010-02-09

Family

ID=27130293

Family Applications (3)

Application Number Title Priority Date Filing Date
CA002678625A Pending CA2678625A1 (en) 1992-09-23 1993-09-23 Endocardial mapping system
CA2144973A Expired - Lifetime CA2144973C (en) 1992-09-23 1993-09-23 Endocardial mapping system
CA2447239A Expired - Lifetime CA2447239C (en) 1992-09-23 1993-09-23 Endocardial mapping system

Family Applications Before (1)

Application Number Title Priority Date Filing Date
CA002678625A Pending CA2678625A1 (en) 1992-09-23 1993-09-23 Endocardial mapping system

Family Applications After (1)

Application Number Title Priority Date Filing Date
CA2447239A Expired - Lifetime CA2447239C (en) 1992-09-23 1993-09-23 Endocardial mapping system

Country Status (7)

Country Link
US (11) US6826420B1 (en)
EP (1) EP0661948B1 (en)
JP (2) JP3581888B2 (en)
AT (1) ATE160273T1 (en)
CA (3) CA2678625A1 (en)
DE (1) DE69315354T2 (en)
WO (1) WO1994006349A1 (en)

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US20060058692A1 (en) 2006-03-16
US20060058693A1 (en) 2006-03-16
EP0661948B1 (en) 1997-11-19
CA2447239A1 (en) 1994-03-31
US6978168B2 (en) 2005-12-20
US6826421B1 (en) 2004-11-30
CA2144973C (en) 2010-02-09
US20060084972A1 (en) 2006-04-20
CA2447239C (en) 2010-10-19
EP0661948A1 (en) 1995-07-12
US20060084884A1 (en) 2006-04-20
CA2678625A1 (en) 1994-03-31
JP3581888B2 (en) 2004-10-27
US20060084971A1 (en) 2006-04-20
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US7289843B2 (en) 2007-10-30
US8208998B2 (en) 2012-06-26
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US20050101874A1 (en) 2005-05-12
US20060084970A1 (en) 2006-04-20
JP3876344B2 (en) 2007-01-31
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JP2004209262A (en) 2004-07-29
US20060052716A1 (en) 2006-03-09
ATE160273T1 (en) 1997-12-15
US6826420B1 (en) 2004-11-30
WO1994006349A1 (en) 1994-03-31
US20030176799A1 (en) 2003-09-18

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