JP6139518B2 - 心電図マッピングのための位置決め - Google Patents
心電図マッピングのための位置決め Download PDFInfo
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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
-
- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
- A61B5/0036—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room including treatment, e.g., using an implantable medical device, ablating, ventilating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
- A61B5/063—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using impedance measurements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
- A61B5/066—Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
- A61B2034/2053—Tracking an applied voltage gradient
-
- 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
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
-
- 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
- A61N1/3628—Heart stimulators using sub-threshold or non-excitatory signals
-
- 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
- A61N1/3629—Heart stimulators in combination with non-electric therapy
Description
本出願は、2011年7月5日に発明の名称「LOCALIZATION FOR ELECTROCARDIOGRAPHIC MAPPING(心電図マッピングのための位置決め)」でファイルされた米国仮特許出願第61/504547号の優先権の利益を主張するものであり、その内容全体を本明細書に援用する。
Claims (12)
- 患者の組織に電界を発生させるために、物体に結合した電極に供給される位置決め信号を制御して、
前記電界に対応する電気信号の検知に基づいて、検知された電気データをメモリーに格納し、
解剖学的形態と、前記電界の検出に用いられる複数のセンサーとの幾何学的関係を表す幾何学形状データを前記メモリーに格納し、
前記幾何学形状データおよび前記検知された電気信号に基づいて、前記組織に対する解剖学的な膜で、電気信号を再構成し、
前記再構成された電気信号を分析して、前記再構成された電気信号各々の振幅と周波数特性とを、前記位置決め信号に関し比較することに基づいて、前記位置決め信号が印加された絶対位置を決めること
を含む、物体の位置決めを行うためのシステムの作動方法であって、
前記位置決め信号は、前記患者の組織において活動電位を発生させるには不十分である閾値下電気信号を含む、方法。 - 前記再構成された電気信号は、前記患者の心臓の表面全体にわたるそれぞれの位置で複数の再構成された電気信号に対応し、
前記分析することは、前記絶対位置に対応する、位置決めされたマッピング信号を選択することをさらに含む、請求項1に記載の方法。 - 前記位置決め信号が印加された前記位置にインジケーターを含む、前記患者の心臓のグラフィック画面を与えるための出力データを生成することと、
前記再構成された電気信号に基づいて、前記患者の心臓の心電図マップを作成すること
をさらに含み、
前記インジケーターは、前記患者の心臓の前記心電図マップに重ねられる、請求項1に記載の方法。 - 前記電極の移動の間、前記電極の実質的にその時点での位置を反映させるために、実質的にリアルタイムにインジケーターを更新することをさらに含む、請求項3に記載の方法。
- 前記位置決め信号の各印加に応答して生成された、前記再構成された電気信号を分析して、前記位置決め信号が印加された位置を決定し、
前記インジケーターが、前記患者の心臓に対する前記電極の移動に応じて前記心臓の前記グラフィック画面内で移動可能であるような方法で、前記決定された位置に従って、前記インジケーターの表示位置を調節すること
をさらに含む、請求項4に記載の方法。 - 前記検知された電気信号を高域通過濾波し、前記位置決め信号に応答して発生した前記電界に対応する信号成分を抽出することをさらに含み、
前記位置決め信号は、前記患者の心臓の心臓周期と無相関である、請求項1に記載の方法。 - 前記複数のセンサーによって前記電気信号を検知し、
前記再構成された電気信号に基づいて、前記患者の心臓の心電図マップを作成し、
前記心電図マップ上に、前記位置決め信号が印加された前記位置で、カテーテルまたはペーシングリードに対応する可視的なインジケーターを作成すること
をさらに含み、
前記電極は、前記ペーシングリードまたはカテーテルに固定されるか、その一部であり、
前記可視的なインジケーターは、前記心電図マップに重なっている、請求項1に記載の方法。 - 前記位置決め信号は、前記患者の心臓を刺激するのに必要なよりも小さい振幅を有し、前記電界の検知に用いられるサンプリング間隔に従って設定されるパルス幅を有する、閾値下電流パルスを含む、請求項1〜7のいずれか1項に記載の方法。
- 前記位置決め信号が決定される前記位置は、前記患者の心臓に対する三次元の絶対位置である、請求項1〜8のいずれか1項に記載の方法。
- 前記検知された電界は、前記患者の心臓の心外膜表面、前記患者の心臓の心内膜表面または前記患者の心臓の膜のうちの1つにマッピングされた前記再構成された電気信号を供給するようマッピングされる、請求項1〜9のいずれか1項に記載の方法。
- 前記位置決め信号は、異なる時点で印加された閾値下電気信号と閾値上電気信号との組み合わせを含み、
前記閾値下電気信号は、自動制御信号に応答してパルス発生器によって供給され、
前記閾値上電気信号は、ユーザー入力に応答して印加される、請求項1〜10のいずれか1項に記載の方法。 - 請求項1に記載の方法であって、さらに、
ユーザー入力に応答して、閾値上電気信号を印加し、
再構成された電気信号を分析して、前記閾値上電気信号が供給された位置を決定し、
出力データを生成して、前記閾値上電気信号が供給された位置でのグラフィックインジケーターを含む前記患者の心臓のグラフィックな画面を与え、
前記再構成された電気信号を基に前記患者の心臓の心電図マップを作成すること、を含み、
前記グラフィックインジケーターは、前記患者の心臓に対して定位置に、前記患者の心臓の心電図に重ねられる、請求項1に記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161504547P | 2011-07-05 | 2011-07-05 | |
US61/504,547 | 2011-07-05 | ||
PCT/US2012/045582 WO2013006713A2 (en) | 2011-07-05 | 2012-07-05 | Localization for electrocardiographic mapping |
Publications (2)
Publication Number | Publication Date |
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JP2014523776A JP2014523776A (ja) | 2014-09-18 |
JP6139518B2 true JP6139518B2 (ja) | 2017-05-31 |
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JP2014519299A Expired - Fee Related JP6139518B2 (ja) | 2011-07-05 | 2012-07-05 | 心電図マッピングのための位置決め |
Country Status (5)
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US (1) | US10506948B2 (ja) |
EP (1) | EP2729064A4 (ja) |
JP (1) | JP6139518B2 (ja) |
CA (1) | CA2841388A1 (ja) |
WO (1) | WO2013006713A2 (ja) |
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- 2012-07-05 US US14/127,136 patent/US10506948B2/en not_active Expired - Fee Related
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- 2012-07-05 EP EP12807883.9A patent/EP2729064A4/en not_active Withdrawn
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WO2013006713A2 (en) | 2013-01-10 |
JP2014523776A (ja) | 2014-09-18 |
US10506948B2 (en) | 2019-12-17 |
EP2729064A4 (en) | 2015-03-25 |
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