WO2006066124A1 - Method and system of treatment of cardiac arrhythmias using 4d imaging - Google Patents

Method and system of treatment of cardiac arrhythmias using 4d imaging Download PDF

Info

Publication number
WO2006066124A1
WO2006066124A1 PCT/US2005/045762 US2005045762W WO2006066124A1 WO 2006066124 A1 WO2006066124 A1 WO 2006066124A1 US 2005045762 W US2005045762 W US 2005045762W WO 2006066124 A1 WO2006066124 A1 WO 2006066124A1
Authority
WO
WIPO (PCT)
Prior art keywords
images
cardiac
ecg
interventional
image
Prior art date
Application number
PCT/US2005/045762
Other languages
French (fr)
Inventor
Jasbir S. Sra
Original Assignee
Medtronic, Inc.
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 Medtronic, Inc. filed Critical Medtronic, Inc.
Priority to EP05854468A priority Critical patent/EP1830732A1/en
Priority to JP2007546966A priority patent/JP2008523921A/en
Priority to CA002591594A priority patent/CA2591594A1/en
Publication of WO2006066124A1 publication Critical patent/WO2006066124A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/46—Arrangements for interfacing with the operator or the patient
    • A61B6/461—Displaying means of special interest
    • A61B6/466—Displaying means of special interest adapted to display 3D data
    • 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
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/503—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5235—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5238—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image
    • 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
    • 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
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00694—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body
    • A61B2017/00703—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body correcting for movement of heart, e.g. ECG-triggered
    • 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
    • A61B2018/00636—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
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7271—Specific aspects of physiological measurement analysis
    • A61B5/7285—Specific aspects of physiological measurement analysis for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal
    • A61B5/7289—Retrospective gating, i.e. associating measured signals or images with a physiological event after the actual measurement or image acquisition, e.g. by simultaneously recording an additional physiological signal during the measurement or image acquisition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/504—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of blood vessels, e.g. by angiography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5247—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound

Definitions

  • This invention relates generally to methods and systems for treatment of atrial fibrillation and other cardiac arrhythmias and, in particular, to methods and systems utilizing 3D digital images for cardiac interventional procedures in such treatment and for the planning of such procedures.
  • Heart rhythm problems or cardiac arrhythmias are a major cause of mortality and morbidity.
  • An example of different rhythm problems encountered in clinical practice include atrial fibrillation (AF), cardiac arrest or sudden cardiac death (SCD) due to ventricular tachycardia/ventricular fibrillation (VT/VF), atrial flutter and other forms of atrial and ventricular arrhythmias.
  • AF atrial fibrillation
  • SCD sudden cardiac death
  • VT/VF ventricular tachycardia/ventricular fibrillation
  • atrial flutter other forms of atrial and ventricular arrhythmias.
  • cardiac electrophysiology has evolved into a clinical tool to diagnose these cardiac arrhythmias.
  • multipolar catheters are positioned inside the heart and electrical recordings are made from the different chambers of the heart.
  • Arrhythmias can be initiated in the laboratory using programmed electrical stimulation.
  • Atrial fibrillation is dysrhythmia of the atria or the upper chambers of the heart in which the atria stop contracting as they begin to fibrillate or quiver. Atrial fibrillation is the most common sustained arrhythmia encountered in clinical practice and, recent data suggests, the most common arrhythmia related cause of hospital admissions. Estimates indicate that 2.2 million people in the United States alone have AF and that 160,000 new cases are diagnosed every year. Patients with AF have a high incidence of such complications as stroke, and heart failure and bear an ominous prognosis of higher overall and cardiovascular mortality.
  • premature atrial contractions can act as triggers and initiate paroxysms of AF. These premature ectopic beats have been shown to originate predominantly in the pulmonary veins. Inability to reproducibly identify the precise location of these trigger sites limits catheter ablation of trigger sites of AF. Because of the critical role of the pulmonary veins in the generation of AF, and as infrequent and nonreproducible premature atrial contractions limit the utility of trigger site ablation, a variety of surgical and nonsurgical catheter ablation techniques have been used to isolate the pulmonary veins from the left atrium. Intraoperative complete isolation of the pulmonary veins using various energy sources in patients undergoing open heart surgery has led to successful termination of AF in over 80% of patients.
  • SCD Sudden cardiac death
  • VT is reentry associated with myocardial scarring.
  • these reentrant circuits are quite broad because of the nature of the scarring.
  • the success rate of VT ablation would increase considerably if it were possible to interrupt these broad reentrant circuits using lesions transecting these circuits. This would require: 1) precise identification of the margins of scarring, 2) the ability to identify and return precisely to areas of interest and, 3) the ability to visualize the lesion lines created.
  • a method allowing precise anatomical delineation of the ventricle would make this possible.
  • Atrial flutter Several other arrhythmias such as atrial flutter, atrial tachycardia, and tachycardia involving accessory connections between the atria and ventricles are also extremely common and cause significant morbidity and some risk of higher mortality.
  • the mechanism of atrial flutter has also been identified. Ablation between the tricuspid annulus and inferior vena cava, forming an anatomical barrier around the flutter circuit, can terminate atrial flutter. Precise identification of this anatomy would thus help significantly.
  • precise location and identification of areas such as the crista terminalis in the right atrium, which is a common source of atrial tachycardia, would be useful.
  • a number of new techniques are aimed at improving the resolution and acquisition of cardiac activation maps during electrophysiology studies. Although helpful in many instances, inability to accurately relate electrophysiologic information to a specific anatomical location in the heart limits their ability to treat complex arrhythmias such as AF, VT and other arrhythmias.
  • the image created is not an exact replication of the anatomy of specific locations in the cardiac chamber. Degree of resolution of the image is totally operator-dependent and limited by the time available to acquire data points.
  • CT imaging is a fast and accurate way to delineate the anatomy of any organ.
  • MRI magnetic resonance imaging
  • x-ray systems The ability to collect volumes of data at short acquisition times allows for 3-D reconstruction of images resulting in true depictions and more understandable anatomic images.
  • mapping and ablation catheters need to be navigated to the appropriate sites for successful results during the intervention procedure an to avoid complications such as perforation of the heart during the procedure as the exact orientation and location of the catheter is not possible in a still image.
  • One aspect of this invention provides a method for treatment of a heart arrhythmia, preferably atrial fibrillation, in a patient using 4D imaging.
  • the method has the steps of (1) obtaining cardiac digital data from a medical imaging system utilizing an electrocardiogram (ECG) gated protocol; (2) generating a series of three-dimensional (3D) images of a cardiac chamber and its surrounding structures from this cardiac digital data, the data being gated at select ECG trigger points having correspondence with different phases of the cardiac cycle; (3) registering these 3D images with an interventional system; (4) acquiring ECG signals from the patient in real-time; (5) transmitting these ECG signals to the interventional system; (6) synchronizing the registered 3D images with certain corresponding trigger points on the transmitted ECG signals such that a 4D image covering the different phases of the cardiac cycle is generated; (7) visualizing this 4D image upon the interventional system in real-time; (8) visualizing a catheter over the 4D image also upon the interventional system; (9) navigating the catheter within the cardiac chamber utilizing the 4
  • the medical imaging system is a computer tomography (CT) system. Also preferred is where the imaging system is a magnetic resonance imaging (MRI) system or one utilizing ultrasound. Most desirable is where the method also includes the step of visualizing the 4D image over a computer workstation of the interventional system.
  • CT computer tomography
  • MRI magnetic resonance imaging
  • the method also includes the step of visualizing the 4D image over a computer workstation of the interventional system.
  • the 3D images are of the left atrium and pulmonary veins. More preferred is where the catheter is one adapted for mapping and ablation. Most preferred is where the step of generating 3D images from the cardiac digital data uses a protocol optimized for 3D imaging of the left atrium and pulmonary veins.
  • interventional system is a fluoroscopic system.
  • embodiments having the additional step of continuously updating and adjusting the synchronization of the registered 3D images with the trigger points on the transmitted ECG signals during an interventional procedure are also highly desired.
  • Another aspect of this invention finds a system for providing treatment of a heart arrhythmia in a patient.
  • This system has a medical imaging system for obtaining cardiac digital data utilizing an electrocardiogram (ECG) gated protocol; an image generation system for generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points that correspond to different phases of the cardiac cycle; an ECG monitor for acquiring ECG signals from the patient in real-time and for transmitting these ECG signals to an interventional system; a workstation for registering the 3D images with an interventional system and for then synchronizing these registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image that is visualized upon the interventional system in real-time; and a catheter apparatus for treating heart tissue within the cardiac chamber at select locations, the catheter apparatus having a catheter visualized upon the interventional system over the 4D image.
  • ECG electrocardiogram
  • the medical imaging system is a computer tomography (CT) system.
  • CT computer tomography
  • the 3D images are of the left atrium and pulmonary veins.
  • the catheter is adapted for mapping and ablation.
  • the image generation system generates 3D images from the cardiac digital data utilizing a protocol optimized for 3D imaging of the left atrium and pulmonary veins.
  • the interventional system is a fluoroscopic system.
  • the workstation continuously updates and adjusts the synchronization of the registered 3D images with the trigger points on the transmitted ECG signals during an interventional procedure.
  • a method for planning treatment of a patient's heart arrhythmia.
  • This method includes the steps of (1) obtaining cardiac digital data from a medical imaging system utilizing an electrocardiogram (ECG) gated protocol; (2) generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle; (3) registering the 3D images with an interventional system; (4) acquiring ECG signals from the patient in real-time; (5) transmitting the ECG signals to the interventional system; (6) synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image; and (7) visualizing the 4D image upon the interventional system in real-time.
  • ECG electrocardiogram
  • the system comprises a medical imaging system for obtaining cardiac digital data utilizing an electrocardiogram (ECG) gated protocol; an image generation system for generating a series of three-dimensional (3D) images of a cardiac chamber and its surrounding structures from the cardiac digital data at select ECG trigger points corresponding to different phases of the cardiac cycle; an ECG monitor for acquiring ECG signals from the patient in real-time and for transmitting the ECG signals to an interventional system; and a workstation for registering the 3D images with an interventional system and for synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image that is visualized upon the interventional system in real-time.
  • ECG electrocardiogram
  • FIG. 1 is a schematic overview of a system for treatment of a heart arrhythmia in accordance with this invention.
  • FIG. 2A depicts 3D cardiac images of the left atrium.
  • FIG. 2B illustrates localization of a standard mapping and ablation catheter in realtime over an endocardial view of the left atrium registered upon an interventional system.
  • FIG. 3 is a flow diagram of a method for treatment of atrial fibrillation and other cardiac arrhythmias in accordance with this invention.
  • FIG. 4 is an example of 3D images of the left ventricle that are depicted as being synchronized to the systole (contraction) and diastole (relaxation) phases of the cardiac cycle.
  • the drawings illustrate embodiments of a system and method for treating heart arrhythmia in a patient using 4D imaging in accordance with this invention.
  • the embodiments shown enable an electrophysiologist, cardiologist and/or surgeon to plan in advance and to later perform an interventional procedure such as atrial fibrillation ablation in a manner that makes the procedure simpler and more efficacious while decreasing the risk of complications.
  • 3D images are obtained of a cardiac chamber such as the left atrium and its adjacent pulmonary veins. These images include detailed 3D models and endocardial views (i.e., navigator or views from the inside) of the chamber.
  • a mapping/ablation catheter may be seen over these images so that the practitioner can navigate the catheter to strategic locations within the left atrium such as the left atrial-pulmonary vein junctions in a manner where the orientation and location of the catheter is better understood to avoid complications such as perforation of the heart during the procedure.
  • FIG. 1 an schematic overview of an exemplary system 10 for treatment of a heart arrhythmia in a patient in accordance with this invention.
  • System 10 includes CT imaging system 12 having a scanner 14 and a first ECG monitor 16 that outputs ECG trigger points corresponding with different phases of the cardiac cycle to scanner 14 through a scanner interface board 18 utilizing a ECG gated protocol.
  • a suitable example of scanner interface board 18 is a Gantry interface board.
  • Scanner 14 therefore utilizes ECG-gated acquisition to image the heart at different phases of the cardiac cycle such as when the heart is free of motion and its diastolic phase, as well as in multiple phases of systole and early diastole.
  • Scanner 14 outputs cardiac digital data 20, including ECG signal time-stamps associated with such data generated by the gating protocol, to image generation system 22.
  • Image generation is performed using one or more optimized 3D protocols for automated image segmentation of the cardiac digital data for the left atrium and such surrounding structures as the pulmonary veins.
  • a series of gated 3D images 24 corresponding to the selected ECG trigger points are thus generated having quantitative features of the left atrium such as its contour, orientation and thickness as well as providing endocardial or
  • 3D images 24 may be in any one of several formats, including but not limited to: a wire mess geometric model, a set of surface contours, a segmented volume of binary images, and a DICOM (Digital Imaging and Communications in Medicine) object using the radiation therapy DICOM object standard.
  • 3D images 24 are exported from image generation system 22 and registered with workstation 26 of fluoroscopic system 28.
  • ECG signals 30 are generated by second ECG monitor 32 and transmitted by ECG monitor 32 to workstation 26.
  • ECG signals 30 contain data referable to an ECG being performed on the patient in real-time using ECG monitor 32 during the interventional procedure.
  • Workstation 26 includes patient interface unit 34 that places ECG signals 30 in communication with 3D images 24.
  • Interface unit 34 is a processing unit that analyzes
  • FIG. 2A A detailed 3D model of the left atrium and the pulmonary veins, including endocardial or inside views, is seen in FIG. 2A.
  • the distance and orientation of the pulmonary veins and other strategic areas can be calculated in advance from such images.
  • 3D images of this type are used to generate 4D imaging in accordance with this invention, thereby creating a roadmap for use during an ablation procedure.
  • a catheter apparatus 36 having a mapping/ablation catheter 38 is delivered to the left atrium typically using a transeptal catheterization.
  • Catheter 38 is continuously localized on fluoroscopic system 28 whereby catheter 38 is visualized over 4D image 40. Having catheter 38 seen over 4D image 40 in real-time enables the practitioner to safely and accurately navigate catheter 38 in real-time to the appropriate sites within the left atrium and its surrounding structures where radio- frequency energy can be delivered to ablate heart tissue in treatment of atrial fibrillation.
  • FIG. 2B illustrates localization of a standard mapping and ablation catheter over an endocardial view of the left atrium registered upon an interventional system.
  • FIG. 3 illustrates a schematic overview of the method for treating a heart arrhythmia using 4D imaging in accordance with this invention.
  • the CT scanning system is used to obtain cardiac digital data.
  • the CT imaging system is automated to acquire a continuous sequence of data of the patient's heart.
  • a shorter scanning time using a faster scanner and synchronization of the CT scanning with a gated ECG signal of the patient at select trigger points reduces the motion artifacts in a beating organ like the heart and provides displacement profiles of the heart at different phases of the cardiac cycle.
  • the ability to collect a volume of data in a short acquisition time allows reconstruction of cardiac images in more accurate geometric depictions, thereby making them easier to understand.
  • step 120 the data-set acquired by the CT imaging system is segmented and a series of 3D images of the left atrium and surrounding pulmonary veins is generated using protocols optimized for those structures.
  • the 3D images identify and visualize the desired views of the left atrium at select points within the cardiac cycle.
  • the 3D images are then exported and registered with an interventional system such as one using fluoroscopy.
  • the transfer of 3D images, including 3D model and navigator views, can occur in several formats such as DICOM format or object and geometric wire mesh model.
  • the registration method transfonns the coordinates in the CT images into the coordinates in the fluoroscopic system. Information acquired by the CT scanning system will in this manner be integrated in real-time with imaging of the left atrium by the fluoroscopic system. Once these coordinates are locked in between the 3D images and the fluoroscopic views, the 3D models and navigator views can be seen from different perspectives on the fluoroscopic system.
  • ECG signals are acquired from the patient at the time of the interventional procedure.
  • step 180 the interface unit analyzes the ECG signals received and synchronizes these signals with the gated 3D images to generate a 4D image.
  • Several trigger points are recognized on both the real-time ECG and the ECG time-stamped 3D images and a zero time differential between these values is calculated.
  • this 4D image comprising multiple views of the left atrium can then be viewed sequentially in synchronization with the various phases of the cardiac cycle in real-time on the interventional system.
  • the synchronization of the 3D images with the real-time ECG signals is continuously updated and adjusted during the interventional procedure.
  • the invention further involves the location of a mapping/ablation catheter over the fluoroscopic system and, in particular, over the registered 4D image of the left atrium and surrounding structures. The catheter is then navigated to the appropriate site within the left atrium in a less risky and efficient manner to perform the necessary ablation procedure in treatment of the patient's arrhythmia.
  • FIG. 4 is an example of 3D images depicting relaxation (diastole) and contraction (systole) of the left ventricle.
  • the different displacement profiles are shown synchronized to a ECG signal where different trigger points are shown as small lines transecting the different phases of the cardiac cycle as shown by the horizontal line.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Optics & Photonics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Cardiology (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Human Computer Interaction (AREA)
  • Plasma & Fusion (AREA)
  • Otolaryngology (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

A method is provided for treating a heart arrhythmia having the steps of obtaining cardiac digital data from a medical imaging system utilizing an ECG gated protocol; generating a series of 3D images of a cardiac chamber and its surrounding structures, preferably the left atrium and pulmonary veins, from this cardiac digital data at select ECG trigger points that correspond to different phases of the cardiac cycle; registering these 3D images with an interventional system; acquiring ECG signals from the patient in real-time; transmitting these ECG signals to the interventional system; synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image; visualizing this 4D image upon the interventional system in real-time; visualizing a catheter over the 4D image upon the interventional system; navigating the catheter within the cardiac chamber utilizing the 4D image; and using the catheter to treat the cardiac chamber, preferably with ablation.

Description

METHOD AND SYSTEM OF TREATMENT OF CARDIAC ARRHYTHMIAS
USING 4D IMAGING
FIELD OF THE INVENTION
This invention relates generally to methods and systems for treatment of atrial fibrillation and other cardiac arrhythmias and, in particular, to methods and systems utilizing 3D digital images for cardiac interventional procedures in such treatment and for the planning of such procedures.
BACKGROUND OF THE INVENTION
Heart rhythm problems or cardiac arrhythmias are a major cause of mortality and morbidity. An example of different rhythm problems encountered in clinical practice include atrial fibrillation (AF), cardiac arrest or sudden cardiac death (SCD) due to ventricular tachycardia/ventricular fibrillation (VT/VF), atrial flutter and other forms of atrial and ventricular arrhythmias. During the past 20 years, cardiac electrophysiology has evolved into a clinical tool to diagnose these cardiac arrhythmias. During electrophysiology studies multipolar catheters are positioned inside the heart and electrical recordings are made from the different chambers of the heart. Arrhythmias can be initiated in the laboratory using programmed electrical stimulation. Careful study of surface ECG and data from intracavitary electrograms is used conventionally to treat these arrhythmias. However, essential to the management of any cardiac rhythm problem is a thorough understanding of the mechanism of its initiation and sustenance. A short discussion of these arrhythmias and their mechanisms is thus useful in understanding the complexity of the problem and how the invention presented will help facilitate the treatment of these arrhythmias.
Atrial fibrillation is dysrhythmia of the atria or the upper chambers of the heart in which the atria stop contracting as they begin to fibrillate or quiver. Atrial fibrillation is the most common sustained arrhythmia encountered in clinical practice and, recent data suggests, the most common arrhythmia related cause of hospital admissions. Estimates indicate that 2.2 million people in the United States alone have AF and that 160,000 new cases are diagnosed every year. Patients with AF have a high incidence of such complications as stroke, and heart failure and bear an ominous prognosis of higher overall and cardiovascular mortality.
Recently it has been shown that premature atrial contractions can act as triggers and initiate paroxysms of AF. These premature ectopic beats have been shown to originate predominantly in the pulmonary veins. Inability to reproducibly identify the precise location of these trigger sites limits catheter ablation of trigger sites of AF. Because of the critical role of the pulmonary veins in the generation of AF, and as infrequent and nonreproducible premature atrial contractions limit the utility of trigger site ablation, a variety of surgical and nonsurgical catheter ablation techniques have been used to isolate the pulmonary veins from the left atrium. Intraoperative complete isolation of the pulmonary veins using various energy sources in patients undergoing open heart surgery has led to successful termination of AF in over 80% of patients. Trying to replicate this procedure nonsurgically is lengthy and labor intensive. Usually two catheters are positioned inside the left atrium guided by fluoroscopy. As the left atrium-pulmonary vein junction cannot be seen, the catheters are swept around and only electrical signals are used to guide the catheters to locations to which heat is delivered. As true anatomy is not visualized, the success rate of this procedure is low and only a limited number of patients qualify for this procedure. A method, based on an anatomically based model using transvenous catheters, which enables the rapid encircling of the pulmonary veins with a series of accurately placed radio-frequency lesions or lesions using other forms of energy such as microwave, cryoablation, laser and others, would offer a less invasive alternative to surgery.
Sudden cardiac death (SCD) is defined as an unexpected natural death from cardiac causes within a short period of time. Most such deaths are caused by VT/VF. It is estimated that SCD accounts for approximately 300,000 cardiac deaths in the United States alone each year. SCD is the most common and often the first manifestation of coronary artery disease and may be responsible for approximately 50% of deaths from cardiovascular disease in the United States. The most commonly encountered form of VT typically originates in the vicinity of a healed myocardial infarction. The mechanism of
VT is reentry associated with myocardial scarring. However, these reentrant circuits are quite broad because of the nature of the scarring. The success rate of VT ablation would increase considerably if it were possible to interrupt these broad reentrant circuits using lesions transecting these circuits. This would require: 1) precise identification of the margins of scarring, 2) the ability to identify and return precisely to areas of interest and, 3) the ability to visualize the lesion lines created. A method allowing precise anatomical delineation of the ventricle would make this possible.
Several other arrhythmias such as atrial flutter, atrial tachycardia, and tachycardia involving accessory connections between the atria and ventricles are also extremely common and cause significant morbidity and some risk of higher mortality. The mechanism of atrial flutter has also been identified. Ablation between the tricuspid annulus and inferior vena cava, forming an anatomical barrier around the flutter circuit, can terminate atrial flutter. Precise identification of this anatomy would thus help significantly. Similarly, precise location and identification of areas such as the crista terminalis in the right atrium, which is a common source of atrial tachycardia, would be useful.
A number of new techniques are aimed at improving the resolution and acquisition of cardiac activation maps during electrophysiology studies. Although helpful in many instances, inability to accurately relate electrophysiologic information to a specific anatomical location in the heart limits their ability to treat complex arrhythmias such as AF, VT and other arrhythmias. The image created is not an exact replication of the anatomy of specific locations in the cardiac chamber. Degree of resolution of the image is totally operator-dependent and limited by the time available to acquire data points.
A number of modalities exist for medical diagnostic imaging. The most common ones for delineating anatomy include computer tomography (CT), magnetic resonance imaging (MRI) and x-ray systems. CT imaging is a fast and accurate way to delineate the anatomy of any organ. The ability to collect volumes of data at short acquisition times allows for 3-D reconstruction of images resulting in true depictions and more understandable anatomic images.
The role of CT in the management of cardiac rhythm problems has been, however, insignificant for several reasons which include motion artifacts in a beating structure such as the heart, and the inability to delineate the origin and propagation of electrical impulses. Use of cardiac gating allows acquisition of consecutive axial images from the same phase of a cardiac cycle. This will allow elimination of motion artifacts. Surface rendering techniques make it possible to view both endocardial (inside) and epicardial (outside) views of any chamber. Although the 3D images of the different cardiac chambers could be created by the modalities mentioned before these images even if they can be registered on an interventional system are still and do not replicate the motion of the heart real-time. It is thus not possible to assess the different aspects of the motion of the heart such as systole (contraction) or diastole (relaxation). This is critical if the mapping and ablation catheters need to be navigated to the appropriate sites for successful results during the intervention procedure an to avoid complications such as perforation of the heart during the procedure as the exact orientation and location of the catheter is not possible in a still image.
The drawbacks discussed above and deficiencies of the prior art are overcome with a method and system of 4D imaging where the reconstructed 3D images are seen in real- time over different phases of the cardiac cycle.
SUMMARY OF THE INVENTION
One aspect of this invention provides a method for treatment of a heart arrhythmia, preferably atrial fibrillation, in a patient using 4D imaging. The method has the steps of (1) obtaining cardiac digital data from a medical imaging system utilizing an electrocardiogram (ECG) gated protocol; (2) generating a series of three-dimensional (3D) images of a cardiac chamber and its surrounding structures from this cardiac digital data, the data being gated at select ECG trigger points having correspondence with different phases of the cardiac cycle; (3) registering these 3D images with an interventional system; (4) acquiring ECG signals from the patient in real-time; (5) transmitting these ECG signals to the interventional system; (6) synchronizing the registered 3D images with certain corresponding trigger points on the transmitted ECG signals such that a 4D image covering the different phases of the cardiac cycle is generated; (7) visualizing this 4D image upon the interventional system in real-time; (8) visualizing a catheter over the 4D image also upon the interventional system; (9) navigating the catheter within the cardiac chamber utilizing the 4D image; and then (10) using the catheter to treat the cardiac chamber, preferably with ablation.
In a desirable embodiment, the medical imaging system is a computer tomography (CT) system. Also preferred is where the imaging system is a magnetic resonance imaging (MRI) system or one utilizing ultrasound. Most desirable is where the method also includes the step of visualizing the 4D image over a computer workstation of the interventional system.
One very preferred embodiment finds the 3D images are of the left atrium and pulmonary veins. More preferred is where the catheter is one adapted for mapping and ablation. Most preferred is where the step of generating 3D images from the cardiac digital data uses a protocol optimized for 3D imaging of the left atrium and pulmonary veins.
Certain exemplary embodiments are where the interventional system is a fluoroscopic system. Also highly desired are embodiments having the additional step of continuously updating and adjusting the synchronization of the registered 3D images with the trigger points on the transmitted ECG signals during an interventional procedure.
Another aspect of this invention finds a system for providing treatment of a heart arrhythmia in a patient. This system has a medical imaging system for obtaining cardiac digital data utilizing an electrocardiogram (ECG) gated protocol; an image generation system for generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points that correspond to different phases of the cardiac cycle; an ECG monitor for acquiring ECG signals from the patient in real-time and for transmitting these ECG signals to an interventional system; a workstation for registering the 3D images with an interventional system and for then synchronizing these registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image that is visualized upon the interventional system in real-time; and a catheter apparatus for treating heart tissue within the cardiac chamber at select locations, the catheter apparatus having a catheter visualized upon the interventional system over the 4D image. A preferred embodiment is where the medical imaging system is a computer tomography (CT) system. Also preferred is where the 3D images are of the left atrium and pulmonary veins. Most preferred is when the catheter is adapted for mapping and ablation. Highly preferred cases find that the image generation system generates 3D images from the cardiac digital data utilizing a protocol optimized for 3D imaging of the left atrium and pulmonary veins. In certain desirable embodiments, the interventional system is a fluoroscopic system. Most desirable is where the workstation continuously updates and adjusts the synchronization of the registered 3D images with the trigger points on the transmitted ECG signals during an interventional procedure.
In another aspect of this invention, a method is provided for planning treatment of a patient's heart arrhythmia. This method includes the steps of (1) obtaining cardiac digital data from a medical imaging system utilizing an electrocardiogram (ECG) gated protocol; (2) generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle; (3) registering the 3D images with an interventional system; (4) acquiring ECG signals from the patient in real-time; (5) transmitting the ECG signals to the interventional system; (6) synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image; and (7) visualizing the 4D image upon the interventional system in real-time.
Yet another aspect of this invention finds a system for planning treatment of a heart arrhythmia. The system comprises a medical imaging system for obtaining cardiac digital data utilizing an electrocardiogram (ECG) gated protocol; an image generation system for generating a series of three-dimensional (3D) images of a cardiac chamber and its surrounding structures from the cardiac digital data at select ECG trigger points corresponding to different phases of the cardiac cycle; an ECG monitor for acquiring ECG signals from the patient in real-time and for transmitting the ECG signals to an interventional system; and a workstation for registering the 3D images with an interventional system and for synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image that is visualized upon the interventional system in real-time. BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a schematic overview of a system for treatment of a heart arrhythmia in accordance with this invention.
FIG. 2A depicts 3D cardiac images of the left atrium. FIG. 2B illustrates localization of a standard mapping and ablation catheter in realtime over an endocardial view of the left atrium registered upon an interventional system.
FIG. 3 is a flow diagram of a method for treatment of atrial fibrillation and other cardiac arrhythmias in accordance with this invention.
FIG. 4 is an example of 3D images of the left ventricle that are depicted as being synchronized to the systole (contraction) and diastole (relaxation) phases of the cardiac cycle.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
The drawings illustrate embodiments of a system and method for treating heart arrhythmia in a patient using 4D imaging in accordance with this invention. The embodiments shown enable an electrophysiologist, cardiologist and/or surgeon to plan in advance and to later perform an interventional procedure such as atrial fibrillation ablation in a manner that makes the procedure simpler and more efficacious while decreasing the risk of complications. Using imaging systems known in the art, 3D images are obtained of a cardiac chamber such as the left atrium and its adjacent pulmonary veins. These images include detailed 3D models and endocardial views (i.e., navigator or views from the inside) of the chamber. These images are then registered and synchronized with real-time cardiac motion on an interventional system such as a fluoroscopic system to generate a 4D image. In this manner, detailed 3D images acquired at different phases of the cardiac cycle prior to an interventional procedure constitute displacement profiles of the cardiac chamber that can be visualized sequentially in real-time during the procedure.
In addition, a mapping/ablation catheter may be seen over these images so that the practitioner can navigate the catheter to strategic locations within the left atrium such as the left atrial-pulmonary vein junctions in a manner where the orientation and location of the catheter is better understood to avoid complications such as perforation of the heart during the procedure.
Although the embodiments illustrated are described in the context of a CT imaging system, it will be appreciated that other imaging systems known in the art, such as MRI and ultrasound, are also contemplated with regard to obtaining cardiac digital data for generating 3D images of the heart. Similarly, although the interventional system is described in the context of fluoroscopy and an associated computer work station, other interventional systems are also contemplated. In addition to viewing the left atrium, the anatomy of other cardiac chambers can also be imaged, registered and visualized. There is shown in Fig. 1 an schematic overview of an exemplary system 10 for treatment of a heart arrhythmia in a patient in accordance with this invention. System 10 includes CT imaging system 12 having a scanner 14 and a first ECG monitor 16 that outputs ECG trigger points corresponding with different phases of the cardiac cycle to scanner 14 through a scanner interface board 18 utilizing a ECG gated protocol. A suitable example of scanner interface board 18 is a Gantry interface board. Scanner 14 therefore utilizes ECG-gated acquisition to image the heart at different phases of the cardiac cycle such as when the heart is free of motion and its diastolic phase, as well as in multiple phases of systole and early diastole.
Scanner 14 outputs cardiac digital data 20, including ECG signal time-stamps associated with such data generated by the gating protocol, to image generation system 22.
Image generation is performed using one or more optimized 3D protocols for automated image segmentation of the cardiac digital data for the left atrium and such surrounding structures as the pulmonary veins. A series of gated 3D images 24 corresponding to the selected ECG trigger points are thus generated having quantitative features of the left atrium such as its contour, orientation and thickness as well as providing endocardial or
"immersible" views of the ostial areas between the left atrium and the pulmonary veins. 3D images 24 may be in any one of several formats, including but not limited to: a wire mess geometric model, a set of surface contours, a segmented volume of binary images, and a DICOM (Digital Imaging and Communications in Medicine) object using the radiation therapy DICOM object standard. 3D images 24 are exported from image generation system 22 and registered with workstation 26 of fluoroscopic system 28. ECG signals 30 are generated by second ECG monitor 32 and transmitted by ECG monitor 32 to workstation 26. ECG signals 30 contain data referable to an ECG being performed on the patient in real-time using ECG monitor 32 during the interventional procedure.
Workstation 26 includes patient interface unit 34 that places ECG signals 30 in communication with 3D images 24. Interface unit 34 is a processing unit that analyzes
ECG signals 30 and synchronizes 3D images 24 with the real-time cardiac cycle of the patient by recognizing the ECG signal time-stamps on the images and matching them with the corresponding points on the real-time ECG. A zero time differential between these two values is calculated by workstation 26 to enhance synchronization. In this manner, 4D imaging 40 of the left atrium is visualized on the interventional system at a display console 35.
A detailed 3D model of the left atrium and the pulmonary veins, including endocardial or inside views, is seen in FIG. 2A. The distance and orientation of the pulmonary veins and other strategic areas can be calculated in advance from such images. 3D images of this type are used to generate 4D imaging in accordance with this invention, thereby creating a roadmap for use during an ablation procedure.
During the interventional procedure, a catheter apparatus 36 having a mapping/ablation catheter 38 is delivered to the left atrium typically using a transeptal catheterization. Catheter 38 is continuously localized on fluoroscopic system 28 whereby catheter 38 is visualized over 4D image 40. Having catheter 38 seen over 4D image 40 in real-time enables the practitioner to safely and accurately navigate catheter 38 in real-time to the appropriate sites within the left atrium and its surrounding structures where radio- frequency energy can be delivered to ablate heart tissue in treatment of atrial fibrillation.
FIG. 2B illustrates localization of a standard mapping and ablation catheter over an endocardial view of the left atrium registered upon an interventional system.
FIG. 3 illustrates a schematic overview of the method for treating a heart arrhythmia using 4D imaging in accordance with this invention. As shown in step 100, the CT scanning system is used to obtain cardiac digital data. The CT imaging system is automated to acquire a continuous sequence of data of the patient's heart. A shorter scanning time using a faster scanner and synchronization of the CT scanning with a gated ECG signal of the patient at select trigger points reduces the motion artifacts in a beating organ like the heart and provides displacement profiles of the heart at different phases of the cardiac cycle. The ability to collect a volume of data in a short acquisition time allows reconstruction of cardiac images in more accurate geometric depictions, thereby making them easier to understand.
In step 120, the data-set acquired by the CT imaging system is segmented and a series of 3D images of the left atrium and surrounding pulmonary veins is generated using protocols optimized for those structures. The 3D images identify and visualize the desired views of the left atrium at select points within the cardiac cycle.
As shown in step 140, the 3D images are then exported and registered with an interventional system such as one using fluoroscopy. The transfer of 3D images, including 3D model and navigator views, can occur in several formats such as DICOM format or object and geometric wire mesh model. The registration method transfonns the coordinates in the CT images into the coordinates in the fluoroscopic system. Information acquired by the CT scanning system will in this manner be integrated in real-time with imaging of the left atrium by the fluoroscopic system. Once these coordinates are locked in between the 3D images and the fluoroscopic views, the 3D models and navigator views can be seen from different perspectives on the fluoroscopic system. At step 160, ECG signals are acquired from the patient at the time of the interventional procedure. These signals are transmitted to the interventional system and brought into communication with the 3D images through a patient interface unit. In step 180, the interface unit analyzes the ECG signals received and synchronizes these signals with the gated 3D images to generate a 4D image. Several trigger points are recognized on both the real-time ECG and the ECG time-stamped 3D images and a zero time differential between these values is calculated.
As seen at step 200, this 4D image comprising multiple views of the left atrium can then be viewed sequentially in synchronization with the various phases of the cardiac cycle in real-time on the interventional system. Preferably, the synchronization of the 3D images with the real-time ECG signals is continuously updated and adjusted during the interventional procedure. In addition, as shown at step 220, the invention further involves the location of a mapping/ablation catheter over the fluoroscopic system and, in particular, over the registered 4D image of the left atrium and surrounding structures. The catheter is then navigated to the appropriate site within the left atrium in a less risky and efficient manner to perform the necessary ablation procedure in treatment of the patient's arrhythmia.
FIG. 4 is an example of 3D images depicting relaxation (diastole) and contraction (systole) of the left ventricle. The different displacement profiles are shown synchronized to a ECG signal where different trigger points are shown as small lines transecting the different phases of the cardiac cycle as shown by the horizontal line. Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims.

Claims

1. A method for treating of a heart arrhythmia in a patient using 4D imaging comprising: • obtaining cardiac digital data from a medical imaging system utilizing an electrocardiogram (ECG) gated protocol;
• generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle; • registering the 3D images with an interventional system;
• acquiring ECG signals from the patient in real-time;
• transmitting the ECG signals to the interventional system;
■ synchronizing the registered 3D images with trigger points on the transmitted
ECG signals to generate a 4D image; • visualizing the 4D image upon the interventional system in real-time;
• visualizing a catheter over the 4D image upon the interventional system;
• navigating the catheter within the cardiac chamber utilizing the 4D image; and
• using the catheter to treat the cardiac chamber.
2. The method of claim 1 wherein the medical imaging system is a computer tomography (CT) system.
3. The method of claim 1 further comprising the step of visualizing the 4D image over a computer workstation of the interventional system.
4. The method of claim 1 wherein the 3D images are of the left atrium and pulmonary veins.
5. The method of claim 4 wherein the catheter is adapted for mapping and ablation.
6. The method of claim 5 wherein generating 3D images from the cardiac digital data comprises using a protocol optimized for 3D imaging of the left atrium and pulmonary veins.
7. The method of claim 1 wherein the interventional system is a fluoroscopic system.
8. The method of claim 1 further comprising the step of continuously updating and adjusting the synchronization of the registered 3D images with the trigger points on the transmitted ECG signals during an interventional procedure.
9. A system for treating of a heart arrhythmia in a patient using 4D imaging comprising:
• a medical imaging system for obtaining cardiac digital data utilizing an electrocardiogram (ECG) gated protocol;
• an image generation system for generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle; • an ECG monitor for acquiring ECG signals from the patient in real-time and for transmitting the ECG signals to an interventional system;
• a workstation for registering the 3D images with the interventional system and for synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image that is visualized upon the interventional system in real-time; and
• a catheter apparatus for treating heart tissue within the cardiac chamber at select locations, the catheter apparatus having a catheter visualized over the 4D image upon the interventional system.
10. The system of claim 9 wherein the medical imaging system is a computer tomography (CT) system.
11. The system of claim 9 wherein the 3D images are of the left atrium and pulmonary veins.
12. The system of claim 11 wherein the catheter is adapted for mapping and ablation.
13. The system of claim 12 wherein the image generation system generates 3D images from the cardiac digital data utilizing a protocol optimized for 3D imaging of the left atrium and pulmonary veins.
14. The system of claim 9 wherein the interventional system is a fluoroscopic system.
15. The system of claim 9 wherein the workstation continuously updates and adjusts the synchronization of the registered 3D images with the trigger points on the transmitted ECG signals during an interventional procedure.
16. A method for planning treatment of a heart arrhythmia in a patient using 4D imaging comprising:
• obtaining cardiac digital data from a medical imaging system utilizing an electrocardiogram (ECG) gated protocol;
■ generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle;
• registering the 3D images with an interventional system;
• acquiring ECG signals from the patient in real-time;
■ transmitting the ECG signals to the interventional system;
• synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image; and
• visualizing the 4D image upon the interventional system in real-time.
17. The method of claim 16 wherein the medical imaging system is a computer tomography (CT) system.
18. The method of claim 17 wherein generating 3D images from the cardiac digital data comprises using a protocol optimized for 3D imaging of the left atrium and pulmonary veins.
19. The method of claim 18 wherein the interventional system is a fluoroscopic system.
20. A system for planning treatment of a heart arrhythmia in a patient using 4D imaging comprising: a medical imaging system for obtaining cardiac digital data utilizing an electrocardiogram (ECG) gated protocol; an image generation system for generating a series of three-dimensional (3D) images of a cardiac chamber and surrounding structures from the cardiac digital data at select ECG trigger points corresponding with different phases of the cardiac cycle; ■ an ECG monitor for acquiring ECG signals from the patient in real-time and for transmitting the ECG signals to an interventional system; and a workstation for registering the 3D images with an interventional system and for synchronizing the registered 3D images with trigger points on the transmitted ECG signals to generate a 4D image that is visualized upon the interventional system in real-time.
PCT/US2005/045762 2004-12-17 2005-12-16 Method and system of treatment of cardiac arrhythmias using 4d imaging WO2006066124A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP05854468A EP1830732A1 (en) 2004-12-17 2005-12-16 System of treatment of cardiac arrhythmias using 4d imaging
JP2007546966A JP2008523921A (en) 2004-12-17 2005-12-16 Method and system for treating cardiac arrhythmias using 4D imaging
CA002591594A CA2591594A1 (en) 2004-12-17 2005-12-16 Method and system of treatment of cardiac arrhythmias using 4d imaging

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US11/016,232 2004-12-17
US11/016,232 US20050137661A1 (en) 2003-12-19 2004-12-17 Method and system of treatment of cardiac arrhythmias using 4D imaging

Publications (1)

Publication Number Publication Date
WO2006066124A1 true WO2006066124A1 (en) 2006-06-22

Family

ID=36124013

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2005/045762 WO2006066124A1 (en) 2004-12-17 2005-12-16 Method and system of treatment of cardiac arrhythmias using 4d imaging

Country Status (5)

Country Link
US (1) US20050137661A1 (en)
EP (1) EP1830732A1 (en)
JP (1) JP2008523921A (en)
CA (1) CA2591594A1 (en)
WO (1) WO2006066124A1 (en)

Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010046838A1 (en) 2008-10-23 2010-04-29 Koninklijke Philips Electronics N.V. Cardiac- and/or respiratory-gated image acquisition system and method for virtual anatomy enriched real-time 2d imaging in interventional radiofrequency ablation or pacemaker placement procedures
WO2010058398A2 (en) 2007-03-08 2010-05-27 Sync-Rx, Ltd. Image processing and tool actuation for medical procedures
US8855744B2 (en) 2008-11-18 2014-10-07 Sync-Rx, Ltd. Displaying a device within an endoluminal image stack
US9095313B2 (en) 2008-11-18 2015-08-04 Sync-Rx, Ltd. Accounting for non-uniform longitudinal motion during movement of an endoluminal imaging probe
US9101286B2 (en) 2008-11-18 2015-08-11 Sync-Rx, Ltd. Apparatus and methods for determining a dimension of a portion of a stack of endoluminal data points
US9144394B2 (en) 2008-11-18 2015-09-29 Sync-Rx, Ltd. Apparatus and methods for determining a plurality of local calibration factors for an image
US9305334B2 (en) 2007-03-08 2016-04-05 Sync-Rx, Ltd. Luminal background cleaning
US9375164B2 (en) 2007-03-08 2016-06-28 Sync-Rx, Ltd. Co-use of endoluminal data and extraluminal imaging
US9629571B2 (en) 2007-03-08 2017-04-25 Sync-Rx, Ltd. Co-use of endoluminal data and extraluminal imaging
US9855384B2 (en) 2007-03-08 2018-01-02 Sync-Rx, Ltd. Automatic enhancement of an image stream of a moving organ and displaying as a movie
US9888969B2 (en) 2007-03-08 2018-02-13 Sync-Rx Ltd. Automatic quantitative vessel analysis
US9974509B2 (en) 2008-11-18 2018-05-22 Sync-Rx Ltd. Image super enhancement
RU2694330C1 (en) * 2018-06-09 2019-07-11 Общество с ограниченной ответственностью "Системы компьютерного моделирования" (ООО "Системы КМ") Method for visualizing a patient's chest surface and determining the coordinates of electrodes in non-invasive electrophysiological cardiac mapping
US10362962B2 (en) 2008-11-18 2019-07-30 Synx-Rx, Ltd. Accounting for skipped imaging locations during movement of an endoluminal imaging probe
US10716528B2 (en) 2007-03-08 2020-07-21 Sync-Rx, Ltd. Automatic display of previously-acquired endoluminal images
US10748289B2 (en) 2012-06-26 2020-08-18 Sync-Rx, Ltd Coregistration of endoluminal data points with values of a luminal-flow-related index
RU2733470C1 (en) * 2019-11-11 2020-10-01 Общество с ограниченной ответственностью "Системы компьютерного моделирования" (ООО "Системы КМ") Method for forming three-dimensional model of patient's chest surface of 360 degrees with system of ecg electrodes applied along whole circumference of patient's chest in non-invasive electrophysiological cardiac mapping
US11064964B2 (en) 2007-03-08 2021-07-20 Sync-Rx, Ltd Determining a characteristic of a lumen by measuring velocity of a contrast agent
US11064903B2 (en) 2008-11-18 2021-07-20 Sync-Rx, Ltd Apparatus and methods for mapping a sequence of images to a roadmap image
US11197651B2 (en) 2007-03-08 2021-12-14 Sync-Rx, Ltd. Identification and presentation of device-to-vessel relative motion

Families Citing this family (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7778686B2 (en) * 2002-06-04 2010-08-17 General Electric Company Method and apparatus for medical intervention procedure planning and location and navigation of an intervention tool
US20050143777A1 (en) * 2003-12-19 2005-06-30 Sra Jasbir S. Method and system of treatment of heart failure using 4D imaging
EP1838378B1 (en) * 2005-01-18 2017-03-22 Philips Electronics LTD Apparatus for guiding an instrument to a target in the lung
DE102005029476A1 (en) * 2005-06-24 2007-02-08 Siemens Ag Device for carrying out intravascular examinations
US8583220B2 (en) * 2005-08-02 2013-11-12 Biosense Webster, Inc. Standardization of catheter-based treatment for atrial fibrillation
US20070066880A1 (en) * 2005-09-09 2007-03-22 Warren Lee Image-based probe guidance system
US20070066881A1 (en) 2005-09-13 2007-03-22 Edwards Jerome R Apparatus and method for image guided accuracy verification
US20070073151A1 (en) * 2005-09-13 2007-03-29 General Electric Company Automated imaging and therapy system
EP3492008B1 (en) 2005-09-13 2021-06-02 Veran Medical Technologies, Inc. Apparatus and method for image guided accuracy verification
US7981038B2 (en) * 2005-10-11 2011-07-19 Carnegie Mellon University Sensor guided catheter navigation system
US20070167806A1 (en) * 2005-11-28 2007-07-19 Koninklijke Philips Electronics N.V. Multi-modality imaging and treatment
DE102006013475A1 (en) * 2006-03-23 2007-09-27 Siemens Ag Image recording device synchronisation device for use during operational interferences in patient, has recording units for recording periodically recurring, current information of area of patient
US8233962B2 (en) * 2006-05-16 2012-07-31 Siemens Medical Solutions Usa, Inc. Rotational stereo roadmapping
US7467007B2 (en) * 2006-05-16 2008-12-16 Siemens Medical Solutions Usa, Inc. Respiratory gated image fusion of computed tomography 3D images and live fluoroscopy images
US20080154131A1 (en) * 2006-12-20 2008-06-26 General Electric Company Methods for enhancement of visibility of ablation regions
DE102007004105A1 (en) * 2007-01-26 2008-04-24 Siemens Ag Patient heart's anatomical structure visualizing method for X-ray C-arm system, involves assigning electrocardiogram phase, assigned to current two dimensional image, to two dimensional image generated from three dimensional image data set
US9173638B2 (en) 2007-06-04 2015-11-03 Biosense Webster, Inc. Cardiac mechanical assessment using ultrasound
US8396533B2 (en) * 2007-08-21 2013-03-12 Siemens Aktiengesellschaft Method and system for catheter detection and tracking in a fluoroscopic image sequence
EP2303385B1 (en) 2008-06-19 2013-12-11 Sync-RX, Ltd. Stepwise advancement of a medical tool
US8409098B2 (en) * 2009-10-14 2013-04-02 St. Jude Medical, Atrial Fibrillation Division, Inc. Method and apparatus for collection of cardiac geometry based on optical or magnetic tracking
CN103202727B (en) * 2012-01-12 2015-11-25 通用电气公司 Non-invasive arrhythmia treatment system
WO2013126659A1 (en) 2012-02-22 2013-08-29 Veran Medical Technologies, Inc. Systems, methods, and devices for four dimensional soft tissue navigation
US20150305612A1 (en) 2014-04-23 2015-10-29 Mark Hunter Apparatuses and methods for registering a real-time image feed from an imaging device to a steerable catheter
US20150305650A1 (en) 2014-04-23 2015-10-29 Mark Hunter Apparatuses and methods for endobronchial navigation to and confirmation of the location of a target tissue and percutaneous interception of the target tissue
US20160354049A1 (en) * 2015-06-04 2016-12-08 Biosense Webster (Israel) Ltd. Registration of coronary sinus catheter image
CN112584738B (en) * 2018-08-30 2024-04-23 奥林巴斯株式会社 Recording device, image observation device, observation system, control method for observation system, and storage medium
CN112914717B (en) * 2021-03-15 2023-07-25 绍兴梅奥心磁医疗科技有限公司 High-voltage high-frequency pulse electric field ablation instrument based on double-gating technology

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6556695B1 (en) * 1999-02-05 2003-04-29 Mayo Foundation For Medical Education And Research Method for producing high resolution real-time images, of structure and function during medical procedures
WO2003045247A1 (en) * 2001-11-30 2003-06-05 Hitachi Medical Corporation Cardiac tomography and tomogram using x-ray ct apparatus
US20030187358A1 (en) * 2001-11-05 2003-10-02 Okerlund Darin R. Method, system and computer product for cardiac interventional procedure planning
US20040225328A1 (en) * 2003-05-09 2004-11-11 Ge Medical Systems Global Technology Company Llc Cardiac ct system and method for planning and treatment of biventricular pacing using epicardial lead

Family Cites Families (86)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US530212A (en) * 1894-12-04 Method of and apparatus for making milling-cutters
US3954098A (en) * 1975-01-31 1976-05-04 Dick Donald E Synchronized multiple image tomographic cardiography
US4547892A (en) * 1977-04-01 1985-10-15 Technicare Corporation Cardiac imaging with CT scanner
US4574807A (en) * 1984-03-02 1986-03-11 Carl Hewson Method and apparatus for pacing the heart employing external and internal electrodes
US4660571A (en) * 1985-07-18 1987-04-28 Cordis Corporation Percutaneous lead having radially adjustable electrode
US4940064A (en) * 1986-11-14 1990-07-10 Desai Jawahar M Catheter for mapping and ablation and method therefor
US4807621A (en) * 1987-06-03 1989-02-28 Siemens Aktiengesellschaft Multi-element flat electrode especially useful for HF-surgery
US5891088A (en) * 1990-02-02 1999-04-06 Ep Technologies, Inc. Catheter steering assembly providing asymmetric left and right curve configurations
US5431688A (en) * 1990-06-12 1995-07-11 Zmd Corporation Method and apparatus for transcutaneous electrical cardiac pacing
US5823958A (en) * 1990-11-26 1998-10-20 Truppe; Michael System and method for displaying a structural data image in real-time correlation with moveable body
US5348020A (en) * 1990-12-14 1994-09-20 Hutson William H Method and system for near real-time analysis and display of electrocardiographic signals
US5245282A (en) * 1991-06-28 1993-09-14 University Of Virginia Alumni Patents Foundation Three-dimensional magnetic resonance imaging
DE4127529C2 (en) * 1991-08-20 1995-06-08 Siemens Ag A method of operating a magnetic resonance imaging apparatus having a resonant circuit for generating gradient fields
US5274551A (en) * 1991-11-29 1993-12-28 General Electric Company Method and apparatus for real-time navigation assist in interventional radiological procedures
US5327905A (en) * 1992-02-14 1994-07-12 Boaz Avitall Biplanar deflectable catheter for arrhythmogenic tissue ablation
US5555883A (en) * 1992-02-24 1996-09-17 Avitall; Boaz Loop electrode array mapping and ablation catheter for cardiac chambers
US5255679A (en) * 1992-06-02 1993-10-26 Cardiac Pathways Corporation Endocardial catheter for mapping and/or ablation with an expandable basket structure having means for providing selective reinforcement and pressure sensing mechanism for use therewith, and method
US5341807A (en) * 1992-06-30 1994-08-30 American Cardiac Ablation Co., Inc. Ablation catheter positioning system
US6086581A (en) * 1992-09-29 2000-07-11 Ep Technologies, Inc. Large surface cardiac ablation catheter that assumes a low profile during introduction into the heart
US5568384A (en) * 1992-10-13 1996-10-22 Mayo Foundation For Medical Education And Research Biomedical imaging and analysis
US5353795A (en) * 1992-12-10 1994-10-11 General Electric Company Tracking system to monitor the position of a device using multiplexed magnetic resonance detection
US5611777A (en) * 1993-05-14 1997-03-18 C.R. Bard, Inc. Steerable electrode catheter
US5571088A (en) * 1993-07-01 1996-11-05 Boston Scientific Corporation Ablation catheters
US5391199A (en) * 1993-07-20 1995-02-21 Biosense, Inc. Apparatus and method for treating cardiac arrhythmias
US5575766A (en) * 1993-11-03 1996-11-19 Daig Corporation Process for the nonsurgical mapping and treatment of atrial arrhythmia using catheters guided by shaped guiding introducers
US5839440A (en) * 1994-06-17 1998-11-24 Siemens Corporate Research, Inc. Three-dimensional image registration method for spiral CT angiography
IT1275924B1 (en) * 1995-03-16 1997-10-24 Gse Giunio Santi Engineering S FLEXIBLE HULL LIFE-HYBRIC CHAMBER
US5676662A (en) * 1995-03-17 1997-10-14 Daig Corporation Ablation catheter
US5702438A (en) * 1995-06-08 1997-12-30 Avitall; Boaz Expandable recording and ablation catheter system
US5807249A (en) * 1996-02-16 1998-09-15 Medtronic, Inc. Reduced stiffness, bidirectionally deflecting catheter assembly
US5720775A (en) * 1996-07-31 1998-02-24 Cordis Corporation Percutaneous atrial line ablation catheter
US5779669A (en) * 1996-10-28 1998-07-14 C. R. Bard, Inc. Steerable catheter with fixed curve
US6314310B1 (en) * 1997-02-14 2001-11-06 Biosense, Inc. X-ray guided surgical location system with extended mapping volume
US6012457A (en) * 1997-07-08 2000-01-11 The Regents Of The University Of California Device and method for forming a circumferential conduction block in a pulmonary vein
US5938660A (en) * 1997-06-27 1999-08-17 Daig Corporation Process and device for the treatment of atrial arrhythmia
US6117101A (en) * 1997-07-08 2000-09-12 The Regents Of The University Of California Circumferential ablation device assembly
US6246784B1 (en) * 1997-08-19 2001-06-12 The United States Of America As Represented By The Department Of Health And Human Services Method for segmenting medical images and detecting surface anomalies in anatomical structures
DE19740214A1 (en) * 1997-09-12 1999-04-01 Siemens Ag Computer tomography device with spiral scanning e.g. for examination of heart
US5951475A (en) * 1997-09-25 1999-09-14 International Business Machines Corporation Methods and apparatus for registering CT-scan data to multiple fluoroscopic images
JPH11239165A (en) * 1998-02-20 1999-08-31 Fuji Photo Film Co Ltd Medical network system
AU745659B2 (en) * 1998-03-02 2002-03-28 Atrionix, Inc. Tissue ablation system and method for forming long linear lesion
US6106460A (en) * 1998-03-26 2000-08-22 Scimed Life Systems, Inc. Interface for controlling the display of images of diagnostic or therapeutic instruments in interior body regions and related data
US6493575B1 (en) * 1998-06-04 2002-12-10 Randy J. Kesten Fluoroscopic tracking enhanced intraventricular catheter system
US6223304B1 (en) * 1998-06-18 2001-04-24 Telefonaktiebolaget Lm Ericsson (Publ) Synchronization of processors in a fault tolerant multi-processor system
US6081577A (en) * 1998-07-24 2000-06-27 Wake Forest University Method and system for creating task-dependent three-dimensional images
US6226542B1 (en) * 1998-07-24 2001-05-01 Biosense, Inc. Three-dimensional reconstruction of intrabody organs
US6154516A (en) * 1998-09-04 2000-11-28 Picker International, Inc. Cardiac CT system
US6468265B1 (en) * 1998-11-20 2002-10-22 Intuitive Surgical, Inc. Performing cardiac surgery without cardioplegia
US6353445B1 (en) * 1998-11-25 2002-03-05 Ge Medical Systems Global Technology Company, Llc Medical imaging system with integrated service interface
US6421412B1 (en) * 1998-12-31 2002-07-16 General Electric Company Dual cardiac CT scanner
US6325797B1 (en) * 1999-04-05 2001-12-04 Medtronic, Inc. Ablation catheter and method for isolating a pulmonary vein
US6285907B1 (en) * 1999-05-21 2001-09-04 Cardiac Pacemakers, Inc. System providing ventricular pacing and biventricular coordination
US6616655B1 (en) * 1999-06-03 2003-09-09 C. R. Bard, Inc. Method and apparatus for performing cardiac ablations
US6629987B1 (en) * 1999-07-30 2003-10-07 C. R. Bard, Inc. Catheter positioning systems
US6632223B1 (en) * 2000-03-30 2003-10-14 The General Hospital Corporation Pulmonary vein ablation stent and method
US6368285B1 (en) * 1999-09-21 2002-04-09 Biosense, Inc. Method and apparatus for mapping a chamber of a heart
FR2799031B1 (en) * 1999-09-24 2002-01-04 Ge Medical Syst Sa METHOD FOR RECONSTRUCTING A SECTION, FOR EXAMPLE CROSS-SECTION, OF AN ELEMENT OF INTEREST CONTAINED IN AN OBJECT, IN PARTICULAR A VESSEL OF THE HUMAN HEART
US6252924B1 (en) * 1999-09-30 2001-06-26 General Electric Company Method and apparatus for motion-free cardiac CT imaging
DE19946948A1 (en) * 1999-09-30 2001-04-05 Philips Corp Intellectual Pty Method and arrangement for determining the position of a medical instrument
US6256368B1 (en) * 1999-10-15 2001-07-03 General Electric Company Methods and apparatus for scout-based cardiac calcification scoring
US6235038B1 (en) * 1999-10-28 2001-05-22 Medtronic Surgical Navigation Technologies System for translation of electromagnetic and optical localization systems
US6379302B1 (en) * 1999-10-28 2002-04-30 Surgical Navigation Technologies Inc. Navigation information overlay onto ultrasound imagery
US6381485B1 (en) * 1999-10-28 2002-04-30 Surgical Navigation Technologies, Inc. Registration of human anatomy integrated for electromagnetic localization
US6249693B1 (en) * 1999-11-01 2001-06-19 General Electric Company Method and apparatus for cardiac analysis using four-dimensional connectivity and image dilation
US6584343B1 (en) * 2000-03-15 2003-06-24 Resolution Medical, Inc. Multi-electrode panel system for sensing electrical activity of the heart
US6484049B1 (en) * 2000-04-28 2002-11-19 Ge Medical Systems Global Technology Company, Llc Fluoroscopic tracking and visualization system
US6389104B1 (en) * 2000-06-30 2002-05-14 Siemens Corporate Research, Inc. Fluoroscopy based 3-D neural navigation based on 3-D angiography reconstruction data
US6546270B1 (en) * 2000-07-07 2003-04-08 Biosense, Inc. Multi-electrode catheter, system and method
US6650927B1 (en) * 2000-08-18 2003-11-18 Biosense, Inc. Rendering of diagnostic imaging data on a three-dimensional map
DE10051244A1 (en) * 2000-10-17 2002-05-16 Philips Corp Intellectual Pty X-ray free intravascular localization and imaging procedure
US6348793B1 (en) * 2000-11-06 2002-02-19 Ge Medical Systems Global Technology, Company, Llc System architecture for medical imaging systems
US6490479B2 (en) * 2000-12-28 2002-12-03 Ge Medical Systems Information Technologies, Inc. Atrial fibrillation detection method and apparatus
WO2002082375A2 (en) * 2001-04-06 2002-10-17 Stephen Solomon Cardiological mapping and navigation system
US6610058B2 (en) * 2001-05-02 2003-08-26 Cardiac Pacemakers, Inc. Dual-profile steerable catheter
US7607440B2 (en) * 2001-06-07 2009-10-27 Intuitive Surgical, Inc. Methods and apparatus for surgical planning
US6782284B1 (en) * 2001-11-21 2004-08-24 Koninklijke Philips Electronics, N.V. Method and apparatus for semi-automatic aneurysm measurement and stent planning using volume image data
US7311705B2 (en) * 2002-02-05 2007-12-25 Medtronic, Inc. Catheter apparatus for treatment of heart arrhythmia
DE10210646A1 (en) * 2002-03-11 2003-10-09 Siemens Ag Method for displaying a medical instrument brought into an examination area of a patient
US7346381B2 (en) * 2002-11-01 2008-03-18 Ge Medical Systems Global Technology Company Llc Method and apparatus for medical intervention procedure planning
US6892090B2 (en) * 2002-08-19 2005-05-10 Surgical Navigation Technologies, Inc. Method and apparatus for virtual endoscopy
US6628743B1 (en) * 2002-11-26 2003-09-30 Ge Medical Systems Global Technology Company, Llc Method and apparatus for acquiring and analyzing cardiac data from a patient
US6991605B2 (en) * 2002-12-18 2006-01-31 Siemens Medical Solutions Usa, Inc. Three-dimensional pictograms for use with medical images
EP1636757A2 (en) * 2003-06-25 2006-03-22 Siemens Medical Solutions USA, Inc. Systems and methods for providing automated regional myocardial assessment for cardiac imaging
US7813785B2 (en) * 2003-07-01 2010-10-12 General Electric Company Cardiac imaging system and method for planning minimally invasive direct coronary artery bypass surgery
US20050054918A1 (en) * 2003-09-04 2005-03-10 Sra Jasbir S. Method and system for treatment of atrial fibrillation and other cardiac arrhythmias
US7308297B2 (en) * 2003-11-05 2007-12-11 Ge Medical Systems Global Technology Company, Llc Cardiac imaging system and method for quantification of desynchrony of ventricles for biventricular pacing

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6556695B1 (en) * 1999-02-05 2003-04-29 Mayo Foundation For Medical Education And Research Method for producing high resolution real-time images, of structure and function during medical procedures
US20030187358A1 (en) * 2001-11-05 2003-10-02 Okerlund Darin R. Method, system and computer product for cardiac interventional procedure planning
WO2003045247A1 (en) * 2001-11-30 2003-06-05 Hitachi Medical Corporation Cardiac tomography and tomogram using x-ray ct apparatus
US20050069081A1 (en) * 2001-11-30 2005-03-31 Hiroto Kokubun Cardiac tomography and tomogram using x-ray ct apparatus
US20040225328A1 (en) * 2003-05-09 2004-11-11 Ge Medical Systems Global Technology Company Llc Cardiac ct system and method for planning and treatment of biventricular pacing using epicardial lead

Cited By (36)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9308052B2 (en) 2007-03-08 2016-04-12 Sync-Rx, Ltd. Pre-deployment positioning of an implantable device within a moving organ
US10307061B2 (en) 2007-03-08 2019-06-04 Sync-Rx, Ltd. Automatic tracking of a tool upon a vascular roadmap
US8693756B2 (en) 2007-03-08 2014-04-08 Sync-Rx, Ltd. Automatic reduction of interfering elements from an image stream of a moving organ
US12053317B2 (en) 2007-03-08 2024-08-06 Sync-Rx Ltd. Determining a characteristic of a lumen by measuring velocity of a contrast agent
US9008367B2 (en) 2007-03-08 2015-04-14 Sync-Rx, Ltd. Apparatus and methods for reducing visibility of a periphery of an image stream
US9008754B2 (en) 2007-03-08 2015-04-14 Sync-Rx, Ltd. Automatic correction and utilization of a vascular roadmap comprising a tool
US9014453B2 (en) 2007-03-08 2015-04-21 Sync-Rx, Ltd. Automatic angiogram detection
US9216065B2 (en) 2007-03-08 2015-12-22 Sync-Rx, Ltd. Forming and displaying a composite image
US11197651B2 (en) 2007-03-08 2021-12-14 Sync-Rx, Ltd. Identification and presentation of device-to-vessel relative motion
US11064964B2 (en) 2007-03-08 2021-07-20 Sync-Rx, Ltd Determining a characteristic of a lumen by measuring velocity of a contrast agent
US10716528B2 (en) 2007-03-08 2020-07-21 Sync-Rx, Ltd. Automatic display of previously-acquired endoluminal images
WO2010058398A2 (en) 2007-03-08 2010-05-27 Sync-Rx, Ltd. Image processing and tool actuation for medical procedures
US9629571B2 (en) 2007-03-08 2017-04-25 Sync-Rx, Ltd. Co-use of endoluminal data and extraluminal imaging
US9375164B2 (en) 2007-03-08 2016-06-28 Sync-Rx, Ltd. Co-use of endoluminal data and extraluminal imaging
US10499814B2 (en) 2007-03-08 2019-12-10 Sync-Rx, Ltd. Automatic generation and utilization of a vascular roadmap
US9717415B2 (en) 2007-03-08 2017-08-01 Sync-Rx, Ltd. Automatic quantitative vessel analysis at the location of an automatically-detected tool
US9855384B2 (en) 2007-03-08 2018-01-02 Sync-Rx, Ltd. Automatic enhancement of an image stream of a moving organ and displaying as a movie
US9888969B2 (en) 2007-03-08 2018-02-13 Sync-Rx Ltd. Automatic quantitative vessel analysis
US9968256B2 (en) 2007-03-08 2018-05-15 Sync-Rx Ltd. Automatic identification of a tool
US11179038B2 (en) 2007-03-08 2021-11-23 Sync-Rx, Ltd Automatic stabilization of a frames of image stream of a moving organ having intracardiac or intravascular tool in the organ that is displayed in movie format
US10226178B2 (en) 2007-03-08 2019-03-12 Sync-Rx Ltd. Automatic reduction of visibility of portions of an image
US9305334B2 (en) 2007-03-08 2016-04-05 Sync-Rx, Ltd. Luminal background cleaning
WO2010046838A1 (en) 2008-10-23 2010-04-29 Koninklijke Philips Electronics N.V. Cardiac- and/or respiratory-gated image acquisition system and method for virtual anatomy enriched real-time 2d imaging in interventional radiofrequency ablation or pacemaker placement procedures
US11627904B2 (en) 2008-10-23 2023-04-18 Koninklijke Philips N.V. Cardiac and or respiratory gated image acquisition system and method for virtual anatomy enriched real time 2D imaging in interventional radiofrequency ablation or pace maker replacement procecure
US9144394B2 (en) 2008-11-18 2015-09-29 Sync-Rx, Ltd. Apparatus and methods for determining a plurality of local calibration factors for an image
US10362962B2 (en) 2008-11-18 2019-07-30 Synx-Rx, Ltd. Accounting for skipped imaging locations during movement of an endoluminal imaging probe
US11064903B2 (en) 2008-11-18 2021-07-20 Sync-Rx, Ltd Apparatus and methods for mapping a sequence of images to a roadmap image
US9974509B2 (en) 2008-11-18 2018-05-22 Sync-Rx Ltd. Image super enhancement
US9101286B2 (en) 2008-11-18 2015-08-11 Sync-Rx, Ltd. Apparatus and methods for determining a dimension of a portion of a stack of endoluminal data points
US9095313B2 (en) 2008-11-18 2015-08-04 Sync-Rx, Ltd. Accounting for non-uniform longitudinal motion during movement of an endoluminal imaging probe
US11883149B2 (en) 2008-11-18 2024-01-30 Sync-Rx Ltd. Apparatus and methods for mapping a sequence of images to a roadmap image
US8855744B2 (en) 2008-11-18 2014-10-07 Sync-Rx, Ltd. Displaying a device within an endoluminal image stack
US10748289B2 (en) 2012-06-26 2020-08-18 Sync-Rx, Ltd Coregistration of endoluminal data points with values of a luminal-flow-related index
US10984531B2 (en) 2012-06-26 2021-04-20 Sync-Rx, Ltd. Determining a luminal-flow-related index using blood velocity determination
RU2694330C1 (en) * 2018-06-09 2019-07-11 Общество с ограниченной ответственностью "Системы компьютерного моделирования" (ООО "Системы КМ") Method for visualizing a patient's chest surface and determining the coordinates of electrodes in non-invasive electrophysiological cardiac mapping
RU2733470C1 (en) * 2019-11-11 2020-10-01 Общество с ограниченной ответственностью "Системы компьютерного моделирования" (ООО "Системы КМ") Method for forming three-dimensional model of patient's chest surface of 360 degrees with system of ecg electrodes applied along whole circumference of patient's chest in non-invasive electrophysiological cardiac mapping

Also Published As

Publication number Publication date
US20050137661A1 (en) 2005-06-23
CA2591594A1 (en) 2006-06-22
JP2008523921A (en) 2008-07-10
EP1830732A1 (en) 2007-09-12

Similar Documents

Publication Publication Date Title
US20050137661A1 (en) Method and system of treatment of cardiac arrhythmias using 4D imaging
EP3382714B1 (en) Method to project a two dimensional image/photo onto a 3d reconstruction, such as an epicardial view of heart
US12064251B2 (en) Systems and methods for noninvasive spectral-spatiotemporal imaging of cardiac electrical activity
US7327872B2 (en) Method and system for registering 3D models of anatomical regions with projection images of the same
US20050143777A1 (en) Method and system of treatment of heart failure using 4D imaging
US8515527B2 (en) Method and apparatus for registering 3D models of anatomical regions of a heart and a tracking system with projection images of an interventional fluoroscopic system
US7499743B2 (en) Method and system for registration of 3D images within an interventional system
US7343196B2 (en) Cardiac CT system and method for planning and treatment of biventricular pacing using epicardial lead
US7565190B2 (en) Cardiac CT system and method for planning atrial fibrillation intervention
US9101285B2 (en) Reference structure for a tracking system
JP5122743B2 (en) System for aligning 3D images within an interventional system
JP2004329939A (en) System and method of cardiac ct for planning left atrial appendage isolation
US9622821B2 (en) System and method for structure-function fusion for surgical interventions
Markides et al. New mapping technologies: an overview with a clinical perspective
Tilg et al. Imaging of electrical function within the human atrium and ventricle from paced ecg mapping data
Tilg et al. Noninvasive functional cardiac electrical source imaging: combining MRI and ECG mapping for imaging electrical function

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BW BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE EG ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KM KN KP KR KZ LC LK LR LS LT LU LV LY MA MD MG MK MN MW MX MZ NA NG NI NO NZ OM PG PH PL PT RO RU SC SD SE SG SK SL SM SY TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): BW GH GM KE LS MW MZ NA SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LT LU LV MC NL PL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
WWE Wipo information: entry into national phase

Ref document number: 2591594

Country of ref document: CA

Ref document number: 2007546966

Country of ref document: JP

NENP Non-entry into the national phase

Ref country code: DE

WWE Wipo information: entry into national phase

Ref document number: 2005854468

Country of ref document: EP

WWP Wipo information: published in national office

Ref document number: 2005854468

Country of ref document: EP