MX2018013282A - Metodo y sistema para la deteccion de brechas en lineas de ablacion. - Google Patents

Metodo y sistema para la deteccion de brechas en lineas de ablacion.

Info

Publication number
MX2018013282A
MX2018013282A MX2018013282A MX2018013282A MX2018013282A MX 2018013282 A MX2018013282 A MX 2018013282A MX 2018013282 A MX2018013282 A MX 2018013282A MX 2018013282 A MX2018013282 A MX 2018013282A MX 2018013282 A MX2018013282 A MX 2018013282A
Authority
MX
Mexico
Prior art keywords
tissue
ablation
pacing
gap
gap detection
Prior art date
Application number
MX2018013282A
Other languages
English (en)
Inventor
Berman Dror
Pressman Assaf
Original Assignee
Biosense Webster Israel Ltd
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
Application filed by Biosense Webster Israel Ltd filed Critical Biosense Webster Israel Ltd
Publication of MX2018013282A publication Critical patent/MX2018013282A/es

Links

Classifications

    • 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
    • A61B18/1206—Generators therefor
    • A61B18/1233—Generators therefor with circuits for assuring patient safety
    • 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
    • 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
    • A61B5/24—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
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
    • A61B2017/00044—Sensing electrocardiography, i.e. ECG
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00075—Motion
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00357—Endocardium
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • 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
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A61B2018/00654—Sensing and controlling the application of energy with feedback, i.e. closed loop control with individual control of each of a plurality of energy emitting elements
    • 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
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00702—Power or energy
    • 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
    • A61B2018/00791—Temperature
    • A61B2018/00821—Temperature measured by a thermocouple
    • 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
    • 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
    • A61B2018/00875—Resistance or impedance
    • 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
    • A61B2018/00904—Automatic detection of target tissue
    • 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
    • A61B18/1206—Generators therefor
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/126—Generators therefor characterised by the output polarity bipolar
    • 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
    • A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
    • 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
    • A61B5/6885—Monitoring or controlling sensor contact pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • 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
    • A61N1/371—Capture, i.e. successful stimulation

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Physics & Mathematics (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Cardiology (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Robotics (AREA)
  • Vascular Medicine (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Surgical Instruments (AREA)

Abstract

En la presente descripción se describe un método y sistema para la detección de brechas en líneas de ablación; se implementan microelectrodos en una punta distal de un catéter para facilitar la detección localizada de brechas a lo largo de una línea de ablación; se usa un protocolo de estimulación para pasar en secuencia a través de cada uno de los pares de microelectrodos en una ubicación del tejido; si hay tejido vivo presente, la señal de estimulación se desplaza a través del tejido vivo para generar impulsos en el corazón; un operador verá una señal de captura y sabrá que hay una brecha en la línea de ablación;el electrodo de ablación se usa, después, para extirpar el tejido en la brecha; por lo tanto, la estimulación y la ablación se realizan en el mismo lugar sin la necesidad de alternar entre instrumentos y/o catéteres; en una implementación, un sensor de fuerza puede automatizar el protocolo de estimulación al determinar cuál par de microelectrodos está en contacto con el tejido; además, la señalización entre pares de microelectrodos puede determinar el contacto entre el catéter y el tejido.
MX2018013282A 2017-10-31 2018-10-30 Metodo y sistema para la deteccion de brechas en lineas de ablacion. MX2018013282A (es)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US15/799,254 US11484359B2 (en) 2017-10-31 2017-10-31 Method and system for gap detection in ablation lines

Publications (1)

Publication Number Publication Date
MX2018013282A true MX2018013282A (es) 2019-05-20

Family

ID=64331606

Family Applications (1)

Application Number Title Priority Date Filing Date
MX2018013282A MX2018013282A (es) 2017-10-31 2018-10-30 Metodo y sistema para la deteccion de brechas en lineas de ablacion.

Country Status (11)

Country Link
US (1) US11484359B2 (es)
EP (2) EP3878390B1 (es)
JP (1) JP7262970B2 (es)
KR (1) KR20190049518A (es)
CN (1) CN109717948A (es)
AU (1) AU2018236711A1 (es)
BR (1) BR102018071733A2 (es)
CA (1) CA3022459A1 (es)
IL (1) IL261992B (es)
MX (1) MX2018013282A (es)
RU (1) RU2018137791A (es)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20210401492A1 (en) * 2019-02-21 2021-12-30 St. Jude Medical, Cardiology Division, Inc. Systems and methods for assessing ablation lesions
US20240115312A1 (en) 2022-10-04 2024-04-11 Biosense Webster (Israel) Ltd. Detection of electrophysiological (ep) conduction gaps in ablation line

Family Cites Families (26)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5545161A (en) * 1992-12-01 1996-08-13 Cardiac Pathways Corporation Catheter for RF ablation having cooled electrode with electrically insulated sleeve
US5391199A (en) 1993-07-20 1995-02-21 Biosense, Inc. Apparatus and method for treating cardiac arrhythmias
US5558091A (en) 1993-10-06 1996-09-24 Biosense, Inc. Magnetic determination of position and orientation
US5876336A (en) 1994-10-11 1999-03-02 Ep Technologies, Inc. Systems and methods for guiding movable electrode elements within multiple-electrode structure
US6690963B2 (en) 1995-01-24 2004-02-10 Biosense, Inc. System for determining the location and orientation of an invasive medical instrument
US5697377A (en) 1995-11-22 1997-12-16 Medtronic, Inc. Catheter mapping system and method
US5836874A (en) * 1996-04-08 1998-11-17 Ep Technologies, Inc. Multi-function electrode structures for electrically analyzing and heating body tissue
ES2236791T3 (es) 1996-02-15 2005-07-16 Biosense Webster, Inc. Procedimiento de calibracion de una sonda.
US6177792B1 (en) 1996-03-26 2001-01-23 Bisense, Inc. Mutual induction correction for radiator coils of an objects tracking system
US5944022A (en) 1997-04-28 1999-08-31 American Cardiac Ablation Co. Inc. Catheter positioning system
US6264653B1 (en) * 1999-09-24 2001-07-24 C. R. Band, Inc. System and method for gauging the amount of electrode-tissue contact using pulsed radio frequency energy
US6172499B1 (en) 1999-10-29 2001-01-09 Ascension Technology Corporation Eddy current error-reduced AC magnetic position measurement system
US7542807B2 (en) * 2001-12-04 2009-06-02 Endoscopic Technologies, Inc. Conduction block verification probe and method of use
US20040092806A1 (en) 2001-12-11 2004-05-13 Sagon Stephen W Microelectrode catheter for mapping and ablation
US7918850B2 (en) 2006-02-17 2011-04-05 Biosense Wabster, Inc. Lesion assessment by pacing
EP3000390A1 (en) 2007-03-26 2016-03-30 Boston Scientific Limited High resolution electrophysiology catheter
US10492729B2 (en) 2007-05-23 2019-12-03 St. Jude Medical, Cardiology Division, Inc. Flexible high-density mapping catheter tips and flexible ablation catheter tips with onboard high-density mapping electrodes
US8535308B2 (en) 2007-10-08 2013-09-17 Biosense Webster (Israel), Ltd. High-sensitivity pressure-sensing probe
US8357152B2 (en) 2007-10-08 2013-01-22 Biosense Webster (Israel), Ltd. Catheter with pressure sensing
US9655677B2 (en) 2010-05-12 2017-05-23 Shifamed Holdings, Llc Ablation catheters including a balloon and electrodes
EP2802282A1 (en) * 2012-01-10 2014-11-19 Boston Scientific Scimed, Inc. Electrophysiology system
US9314299B2 (en) * 2012-03-21 2016-04-19 Biosense Webster (Israel) Ltd. Flower catheter for mapping and ablating veinous and other tubular locations
US9974608B2 (en) * 2013-08-27 2018-05-22 Biosense Webster (Israel) Ltd. Determining absence of contact for a catheter
US9314208B1 (en) 2014-10-28 2016-04-19 Biosense Webster (Israel) Ltd. Basket catheter with microelectrode array distal tip
US10588692B2 (en) 2015-11-06 2020-03-17 Biosense Webster (Israel) Ltd. Pulmonary vein isolation gap finder
US10383543B2 (en) 2015-11-11 2019-08-20 Biosense Webster (Israel) Ltd. Symmetric short contact force sensor with four coils

Also Published As

Publication number Publication date
EP3878390A1 (en) 2021-09-15
JP2019080926A (ja) 2019-05-30
IL261992B (en) 2022-02-01
KR20190049518A (ko) 2019-05-09
US20190125438A1 (en) 2019-05-02
RU2018137791A (ru) 2020-04-27
EP3476347B1 (en) 2021-05-05
JP7262970B2 (ja) 2023-04-24
CN109717948A (zh) 2019-05-07
CA3022459A1 (en) 2019-04-30
BR102018071733A2 (pt) 2019-06-04
US11484359B2 (en) 2022-11-01
AU2018236711A1 (en) 2019-05-16
EP3476347A1 (en) 2019-05-01
EP3878390B1 (en) 2024-03-06
EP3878390C0 (en) 2024-03-06
IL261992A (en) 2019-02-28

Similar Documents

Publication Publication Date Title
WO2018102429A3 (en) Detecting and using body tissue electrical signals
EP2923666A3 (en) Temperature measurement in catheter
US8406875B2 (en) Routing of pacing signals
WO2016154274A3 (en) Systems and methods of determining location using a medical device
ATE533399T1 (de) Medizinische messvorrichtung zur bioelektrischen impedanzmessung
WO2009100814A8 (de) Vorrichtung und methode zum positionieren einer kanüle für die nervenblockade
MX2013005494A (es) Sistema para determinar la calidad de una estructura osea de un individuo.
MX2018013282A (es) Metodo y sistema para la deteccion de brechas en lineas de ablacion.
WO2019089919A3 (en) Systems and methods for tissue characterization
EP2984986A3 (en) Line of block detection
WO2011057289A3 (en) System and method for targeting catheter electrodes
ATE527945T1 (de) Medizinisches behandlungssystem auf energiebasis
WO2012074794A3 (en) Apparatus and method for treatment of pain with body impedance analyzer
WO2010123895A3 (en) Apparatus and method for the detection and treatment of atrial fibrillation
EP2674125B1 (en) Gated sampling of electrocardiogram signals during ablation waveform zero-crossing
ATE517656T1 (de) Vorrichtung zur nervenstimulation
WO2009140359A3 (en) Tissue lesion evaluation
WO2012094613A3 (en) Devices and methods for treatment of heart failure and associated conditions
CO2019007422A2 (es) Sistema y método para monitorear y determinar los parámetros de los pacientes a partir de la forma de onda venosa detectada
FR3034643B1 (fr) Systeme medical destine a penetrer dans une structure anatomique d'un patient
MX2020013650A (es) Sistema y metodo para ajustar la potencia disponible por sonda durante un procedimiento de ablacion.
WO2018217798A3 (en) PREDICTION OF INJURY MATURATION USING LOCAL IMPEDANCE
JP2020006089A5 (es)
BR112015028147A2 (pt) aparelho de eletro cirurgia, em particular para a ablação de uma massa de tecido do corpo de um paciente humano ou animal
IL273333B (en) A cable and a system and method for monitoring continuity associated therewith