CA2578963A1 - Method and system for treatment of atrial fibrillation and other cardiac arrhythmias - Google Patents
Method and system for treatment of atrial fibrillation and other cardiac arrhythmias Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/46—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with special 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/12—Devices for detecting or locating foreign bodies
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/50—Clinical applications
- A61B6/503—Clinical applications involving diagnosis of heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/54—Control of apparatus or devices for radiation diagnosis
- A61B6/541—Control of apparatus or devices for radiation diagnosis involving acquisition triggered by a physiological signal
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
- A61B2018/00392—Transmyocardial revascularisation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
-
- 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
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/02—Devices for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B6/03—Computerised tomographs
- A61B6/032—Transmission computed tomography [CT]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/50—Clinical applications
- A61B6/504—Clinical applications involving diagnosis of blood vessels, e.g. by angiography
Abstract
A method is provided for treatment of a heart arrhythmia such as atrial fibrillation that includes obtaining cardiac image data using a digital imaging system, generating a 3D model of a cardiac chamber and surrounding structures from such cardiac image data, registering the 3D model with an interventional system, visualizing this registered 3D model on the interventional system, positioning a catheter apparatus within the cardiac chamber, visualizing the catheter apparatus over the registered 3D model of the cardiac chamber upon the interventional system, navigating the catheter apparatus within the cardiac chamber utilizing this registered 3D model, and delivering biological material through the catheter apparatus to heart tissue at select locations within the cardiac chamber. Preferably, the biological material are transplanted cells or antibodies. In another aspect of the invention, a system for treatment of heart arrhythmias is provided that has a digital imaging system to obtain cardiac image data, an image generation system to generate a 3D model of a cardiac chamber and its surrounding structures from this cardiac image data, a workstation to register the 3D
model onto an interventional system so that the registered 3D model can be visualized upon the interventional system, and a catheter apparatus to deliver biological material such as transplanted cells or antibodies to heart tissue within this cardiac chamber at certain select locations, the catheter apparatus being visualized upon the interventional system over the registered 3D model.
model onto an interventional system so that the registered 3D model can be visualized upon the interventional system, and a catheter apparatus to deliver biological material such as transplanted cells or antibodies to heart tissue within this cardiac chamber at certain select locations, the catheter apparatus being visualized upon the interventional system over the registered 3D model.
Description
METHOD AND SYSTEM FOR TREATMENT OF ATRIAL FIBRILLATION AND
OTHER CARDIAC ARRHYTHMIAS
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 for delivering biological material to a chamber inside the heart.
BACKGROUND OF THE INVENTION
Atrial fibrillation is an arrhythmia of the heart in which the atria or upper chambers of the heart stop contracting as they fibrillate. Premature atrial contraction (extra beats) originating in the pulmonary veins can act as triggers and initiate paroxysms of atrial fibrillation. The inability to reproducibly induce premature beats and precisely identify the ostium or junction of the pulmonary veins with the left atrium due to the complex three-dimensional geometry of the left atrium makes prohibitive the use of ablation therapy in many patients. There is also a risk of complications such as stroke, bleeding around the heart and narrowing of the pulmonary veins during radio-frequency catheter ablation procedures.
Studies have found activity that is suggestive of the presence of conduction tissue at the left atrial-pulmonary vein junction. Thus, a new approach directed at blocking conduction at a cellular or molecular level by delivering biological material that would block conduction across cells could provide significant advantages in the treatment of this complex arrhythmia. Such delivery systems could include the transplantation of cells or the injection of antibodies.
This approach could also be beneficial to treating other arrhythmias and other conditions if precise localization and delivery of cells, antibodies and similar biological substances including genes were possible.
SUMMARY OF THE INVENTION
One aspect of this invention provides a method for treatment of a heart arrhythmia having the steps of (1) obtaining cardiac image data using a digital imaging system, preferably a computer tomography (CT) system, (2) generating a 3D model of a cardiac chamber and surrounding structures from this cardiac image data, (3) registering the 3D
model with an interventional system, (4) visualizing this registered 3D model on the interventional system, (5) positioning a catheter apparatus within the cardiac chamber, (6) visualizing the catheter apparatus over the registered 3D model of the cardiac chamber upon the interventional system, (7) navigating the catheter apparatus within the cardiac chamber utilizing this registered 3D model, and (8) delivering biological material through the catheter apparatus to heart tissue at select locations within the cardiac chamber.
In certain preferred embodiments, the biological material being delivered by the catheter apparatus are transplanted cells that can alter electrical impulses at these select locations within the heart. Highly preferred is where the transplanted cells are myoblasts.
Another desirable embodiment is where the biological material delivered to heart tissue within the cardiac chamber are antibodies such that electrical impulses at the selected locations are altered by these antibodies.
It is most desirable that the interventional system be a fluoroscopic system.
More desirable is where the heart arrhythmia is atrial fibrillation and the 3D
model is of the left atrium and pulmonary veins. Highly desirable embodiments find the catheter apparatus having a main body with a central lumen that is adapted to deliver biological material and a control mechanism coupled to the main body such that the delivery of the biological material from the main body is controlled.
In another aspect of this invention, a system is provided for treatment of a heart arrhythmia that has a digital imaging system to obtain cardiac image data, an image generation system to generate a 3D model of a cardiac chamber and its surrounding structures from this cardiac image data, a workstation to register the 3D
model onto an interventional system so that the registered 3D model can be visualized upon the interventional system, and a catheter apparatus to deliver biological material to heart tissue within this cardiac chamber at certain select locations, the catheter apparatus being visualized upon the interventional system over the registered 3D model.
Desirable cases of this system find the biological material delivered to be transplanted cells, most preferably myoblasts. Also highly desirable is where the biological material are antibodies.
OTHER CARDIAC ARRHYTHMIAS
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 for delivering biological material to a chamber inside the heart.
BACKGROUND OF THE INVENTION
Atrial fibrillation is an arrhythmia of the heart in which the atria or upper chambers of the heart stop contracting as they fibrillate. Premature atrial contraction (extra beats) originating in the pulmonary veins can act as triggers and initiate paroxysms of atrial fibrillation. The inability to reproducibly induce premature beats and precisely identify the ostium or junction of the pulmonary veins with the left atrium due to the complex three-dimensional geometry of the left atrium makes prohibitive the use of ablation therapy in many patients. There is also a risk of complications such as stroke, bleeding around the heart and narrowing of the pulmonary veins during radio-frequency catheter ablation procedures.
Studies have found activity that is suggestive of the presence of conduction tissue at the left atrial-pulmonary vein junction. Thus, a new approach directed at blocking conduction at a cellular or molecular level by delivering biological material that would block conduction across cells could provide significant advantages in the treatment of this complex arrhythmia. Such delivery systems could include the transplantation of cells or the injection of antibodies.
This approach could also be beneficial to treating other arrhythmias and other conditions if precise localization and delivery of cells, antibodies and similar biological substances including genes were possible.
SUMMARY OF THE INVENTION
One aspect of this invention provides a method for treatment of a heart arrhythmia having the steps of (1) obtaining cardiac image data using a digital imaging system, preferably a computer tomography (CT) system, (2) generating a 3D model of a cardiac chamber and surrounding structures from this cardiac image data, (3) registering the 3D
model with an interventional system, (4) visualizing this registered 3D model on the interventional system, (5) positioning a catheter apparatus within the cardiac chamber, (6) visualizing the catheter apparatus over the registered 3D model of the cardiac chamber upon the interventional system, (7) navigating the catheter apparatus within the cardiac chamber utilizing this registered 3D model, and (8) delivering biological material through the catheter apparatus to heart tissue at select locations within the cardiac chamber.
In certain preferred embodiments, the biological material being delivered by the catheter apparatus are transplanted cells that can alter electrical impulses at these select locations within the heart. Highly preferred is where the transplanted cells are myoblasts.
Another desirable embodiment is where the biological material delivered to heart tissue within the cardiac chamber are antibodies such that electrical impulses at the selected locations are altered by these antibodies.
It is most desirable that the interventional system be a fluoroscopic system.
More desirable is where the heart arrhythmia is atrial fibrillation and the 3D
model is of the left atrium and pulmonary veins. Highly desirable embodiments find the catheter apparatus having a main body with a central lumen that is adapted to deliver biological material and a control mechanism coupled to the main body such that the delivery of the biological material from the main body is controlled.
In another aspect of this invention, a system is provided for treatment of a heart arrhythmia that has a digital imaging system to obtain cardiac image data, an image generation system to generate a 3D model of a cardiac chamber and its surrounding structures from this cardiac image data, a workstation to register the 3D
model onto an interventional system so that the registered 3D model can be visualized upon the interventional system, and a catheter apparatus to deliver biological material to heart tissue within this cardiac chamber at certain select locations, the catheter apparatus being visualized upon the interventional system over the registered 3D model.
Desirable cases of this system find the biological material delivered to be transplanted cells, most preferably myoblasts. Also highly desirable is where the biological material are antibodies.
Preferred embodiments of this system are where the interventional system is a fluoroscopic system. Most preferred embodiments find the digital imaging system to be a computer tomography (CT) system. In certain preferred cases, the heart arrhythmia is atrial fibrillation and the 3D model is of the left atrium and pulmonary veins. Highly preferred is where the catheter apparatus includes a main body having a central lumen adapted to the delivery of the biological material and a control mechanism coupled to the main body to control such delivery from the apparatus.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. I is a schematic overview of a system for treatment of a heart arrhythmia in accordance with this invention with an enlarged longitudinal cross-section of a portion of the catheter.
FIG. 2A depicts 3D cardiac images of the left atrium.
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 is a flow diagram of a method for treatment of atrial fibrillation and other cardiac arrhythmias in accordance with this invention.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
FIG. 1 illustrates a schematic overview of an exemplary system for the treatment of a heart arrhythmia such as atrial fibrillation in accordance with this invention. A digital imaging system such as a CT scanning system 10 is used to acquire image data of the heart. Although the embodiments discussed hereinafter are described in the context of a CT scanning system, it will be appreciated that other imaging systems known in the art, such as MRI and ultrasound, are also contemplated.
Cardiac image data 12 is a volume of consecutive images of the heart collected by CT scanning system 10 in a continuous sequence over a short acquisition time.
The shorter scanning time through use of a faster CT scanning system and synchronization of the CT scanner with the QRS on the patient's ECG signal reduces the motion artifacts in images of a beating organ like the heart. The resulting cardiac image data 12 allows for reconstruction of images of the heart that are true geometric depictions of its structures.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. I is a schematic overview of a system for treatment of a heart arrhythmia in accordance with this invention with an enlarged longitudinal cross-section of a portion of the catheter.
FIG. 2A depicts 3D cardiac images of the left atrium.
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 is a flow diagram of a method for treatment of atrial fibrillation and other cardiac arrhythmias in accordance with this invention.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
FIG. 1 illustrates a schematic overview of an exemplary system for the treatment of a heart arrhythmia such as atrial fibrillation in accordance with this invention. A digital imaging system such as a CT scanning system 10 is used to acquire image data of the heart. Although the embodiments discussed hereinafter are described in the context of a CT scanning system, it will be appreciated that other imaging systems known in the art, such as MRI and ultrasound, are also contemplated.
Cardiac image data 12 is a volume of consecutive images of the heart collected by CT scanning system 10 in a continuous sequence over a short acquisition time.
The shorter scanning time through use of a faster CT scanning system and synchronization of the CT scanner with the QRS on the patient's ECG signal reduces the motion artifacts in images of a beating organ like the heart. The resulting cardiac image data 12 allows for reconstruction of images of the heart that are true geometric depictions of its structures.
Cardiac image data 12 is then segmented using protocols optimized for the left atrium and pulmonary arteries by image generation system 14. It will be appreciated that other chambers of the heart and their surrounding structures can be acquired in a similar manner. Image generation system 14 further processes the segmented data to create a 3D
model 16 of the left atrium and pulmonary arteries using 3D surface and/or volume rendering. Additional post-processing can be performed to create navigator (view from inside) views of these structures.
3D model 16 is then exported to workstation 18 for registration with an interventional system such as a fluoroscopic system 20. The transfer of 3D
model 16, including navigator views, can occur in several formats such as the DICOM
format and geometric wire mesh model. Information from CT scanning system 10 will thus be integrated with fluoroscopic system 20. Once 3D model 16 is registered with fluoroscopic system 20, 3D model 16 and any navigator views can be seen on the fluoroscopic system 20.
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 this 3D image to create a roadmap for use during the ablation procedure.
Using a transeptal catheterization, which is a standard technique for gaining access to the left atrium, a catheter apparatus 22, having a flexible catheter 24 with a central lumen 26, is introduced into the left atrium. Catheter 24 is visualized on the fluoroscopic system 20 over the registered 3D model 16. Catheter 24 can then be navigated in real-time over 3D
model 16 to the appropriate site within the left atrium. FIG. 2B illustrates localization of a standard mapping and ablation catheter over an endocardial view of the left atrium registered upon an interventional system.
Catheter apparatus 22 is provided with a control mechanism 28 for opening and closing the distal end of lumen 26. Upon filling lumen 26 with biological material 30, catheter apparatus 22 can be used as a delivery device for the release of biological material 30 at specifically selected locations within the heart. After catheter 24 has been guided to a site identified as a strategic area whose electrical conductivity needs to be altered or blocked, control mechanism 28 is actuated to deliver biological material 30 such as transplanted cells at that site. Such transplanted cells could be myoblastic or smooth muscle cells. Antibodies can also be injected in this manner to alter or block abnormal electrical activity at the cellular level, especially in responding to antigens that may be responsible for the triggering of impulses that initiate atrial fibrillation.
There is shown in FIG. 3 an overview of a method for ablation of atrial fibrillation and other cardiac arrhythmias in accordance with this invention. As seen in step 110, a 3D
image of the heart is acquired. 3D images of the heart can be created using CT
scan or MRI. At step 120, a 3D model of the chamber of interest such as the left atrium is created through segmentation of the image data using protocols optimized for the appropriate structures. Once this 3D model has been obtained, it can be stored as an electronic data file using various means of storage. The stored model can then later be transferred to a computer workstation linked to an interventional system.
As illustrated in step 130, after it has been transferred to the workstation, the 3D
model is registered with the interventional system. The registration process allows medical personnel to correlate this 3D model of the cardiac chamber with the interventional system that is being used with a particular patient so that it can be visualized during the interventional procedure.
The following step 140 involves visualization of a catheter that has been positioned within the left atrium over the registered 3D model. This permits the catheter to be navigated inside the chamber in real-time over this registered image to the locations selected for the treatment to be performed.
model 16 of the left atrium and pulmonary arteries using 3D surface and/or volume rendering. Additional post-processing can be performed to create navigator (view from inside) views of these structures.
3D model 16 is then exported to workstation 18 for registration with an interventional system such as a fluoroscopic system 20. The transfer of 3D
model 16, including navigator views, can occur in several formats such as the DICOM
format and geometric wire mesh model. Information from CT scanning system 10 will thus be integrated with fluoroscopic system 20. Once 3D model 16 is registered with fluoroscopic system 20, 3D model 16 and any navigator views can be seen on the fluoroscopic system 20.
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 this 3D image to create a roadmap for use during the ablation procedure.
Using a transeptal catheterization, which is a standard technique for gaining access to the left atrium, a catheter apparatus 22, having a flexible catheter 24 with a central lumen 26, is introduced into the left atrium. Catheter 24 is visualized on the fluoroscopic system 20 over the registered 3D model 16. Catheter 24 can then be navigated in real-time over 3D
model 16 to the appropriate site within the left atrium. FIG. 2B illustrates localization of a standard mapping and ablation catheter over an endocardial view of the left atrium registered upon an interventional system.
Catheter apparatus 22 is provided with a control mechanism 28 for opening and closing the distal end of lumen 26. Upon filling lumen 26 with biological material 30, catheter apparatus 22 can be used as a delivery device for the release of biological material 30 at specifically selected locations within the heart. After catheter 24 has been guided to a site identified as a strategic area whose electrical conductivity needs to be altered or blocked, control mechanism 28 is actuated to deliver biological material 30 such as transplanted cells at that site. Such transplanted cells could be myoblastic or smooth muscle cells. Antibodies can also be injected in this manner to alter or block abnormal electrical activity at the cellular level, especially in responding to antigens that may be responsible for the triggering of impulses that initiate atrial fibrillation.
There is shown in FIG. 3 an overview of a method for ablation of atrial fibrillation and other cardiac arrhythmias in accordance with this invention. As seen in step 110, a 3D
image of the heart is acquired. 3D images of the heart can be created using CT
scan or MRI. At step 120, a 3D model of the chamber of interest such as the left atrium is created through segmentation of the image data using protocols optimized for the appropriate structures. Once this 3D model has been obtained, it can be stored as an electronic data file using various means of storage. The stored model can then later be transferred to a computer workstation linked to an interventional system.
As illustrated in step 130, after it has been transferred to the workstation, the 3D
model is registered with the interventional system. The registration process allows medical personnel to correlate this 3D model of the cardiac chamber with the interventional system that is being used with a particular patient so that it can be visualized during the interventional procedure.
The following step 140 involves visualization of a catheter that has been positioned within the left atrium over the registered 3D model. This permits the catheter to be navigated inside the chamber in real-time over this registered image to the locations selected for the treatment to be performed.
In step 150, transplanted cells such as myoblasts are released from a central lumen of the catheter at the selected site to alter or block electrical activity across that location.
Alternatively, at step 160, antibodies or genes can be inserted at the site in treatment of the arrhythmia after being transported to the left atrium within the catheter's lumen.
It will be appreciated to one skilled in the art that other arrhythmias such as ventricular tachycardia can be targeted for treatment in this manner. Furthermore, automatic techniques may be used to perform any of the above steps.
Various alternatives and embodiments are contemplated as being within the scope of the following claims particularly pointing out and distinctly claiming the subject matter regarded as the invention.
Alternatively, at step 160, antibodies or genes can be inserted at the site in treatment of the arrhythmia after being transported to the left atrium within the catheter's lumen.
It will be appreciated to one skilled in the art that other arrhythmias such as ventricular tachycardia can be targeted for treatment in this manner. Furthermore, automatic techniques may be used to perform any of the above steps.
Various alternatives and embodiments are contemplated as being within the scope of the following claims particularly pointing out and distinctly claiming the subject matter regarded as the invention.
Claims (16)
1. A method for treatment of a heart arrhythmia comprising:
- obtaining cardiac image data from a digital imaging system;
- generating a 3D model of a cardiac chamber and surrounding structures from the cardiac image data;
- registering the 3D model with an interventional system;
- visualizing the registered 3D model upon the interventional system;
- positioning a catheter apparatus within the cardiac chamber;
- visualizing the catheter apparatus over the registered 3D model upon the interventional system;
- navigating the catheter apparatus within the cardiac chamber utilizing the registered 3D
model; and - delivering biological material through the catheter apparatus to heart tissue at select locations.
- obtaining cardiac image data from a digital imaging system;
- generating a 3D model of a cardiac chamber and surrounding structures from the cardiac image data;
- registering the 3D model with an interventional system;
- visualizing the registered 3D model upon the interventional system;
- positioning a catheter apparatus within the cardiac chamber;
- visualizing the catheter apparatus over the registered 3D model upon the interventional system;
- navigating the catheter apparatus within the cardiac chamber utilizing the registered 3D
model; and - delivering biological material through the catheter apparatus to heart tissue at select locations.
2. The method of claim 1 wherein the biological material are transplanted cells, whereby the transplanted cells alter electrical impulses at the select locations.
3. The method of claim 2 wherein the transplanted cells are myoblasts.
4. The method of claim 1 wherein the biological material are antibodies, whereby the antibodies alter electrical impulses at the select locations.
5. The method of claim 1 wherein the interventional system is a fluoroscopic system.
6. The method of claim 1 wherein the digital imaging system is a computer tomography (CT) system.
7. The method of claim 1 wherein the heart arrhythmia is atrial fibrillation and wherein the 3D model is of the left atrium and pulmonary veins.
8 8. The method of claim 1 wherein the catheter apparatus comprises:
- a main body having a central lumen adapted to the delivery of biological material; and - a control mechanism coupled to the main body wherein delivery of the biological material from the main body is controlled.
- a main body having a central lumen adapted to the delivery of biological material; and - a control mechanism coupled to the main body wherein delivery of the biological material from the main body is controlled.
9. A system for treatment of a heart arrhythmia comprising:
- a digital imaging system for obtaining cardiac image data;
- an image generation system for generating a 3D model of a cardiac chamber and surrounding structures from the cardiac image data;
- a workstation for registering the 3D model with an interventional system to visualize the registered 3D model upon the interventional system; and - a catheter apparatus for delivering biological material to heart tissue within the cardiac chamber at select locations, whereby the catheter apparatus is visualized over the registered 3D model upon the interventional system.
- a digital imaging system for obtaining cardiac image data;
- an image generation system for generating a 3D model of a cardiac chamber and surrounding structures from the cardiac image data;
- a workstation for registering the 3D model with an interventional system to visualize the registered 3D model upon the interventional system; and - a catheter apparatus for delivering biological material to heart tissue within the cardiac chamber at select locations, whereby the catheter apparatus is visualized over the registered 3D model upon the interventional system.
10. The system of claim 9 wherein the biological material are transplanted cells, whereby the transplanted cells alter electrical impulses at the select locations.
11. The system of claim 10 wherein the transplanted cells are myoblasts.
12. The system of claim 9 wherein the biological material are antibodies, whereby the antibodies alter electrical impulses at the select locations.
13. The system of claim 9 wherein the interventional system is a fluoroscopic system.
14. The system of claim 9 wherein the digital imaging system is a computer tomography (CT) system.
15. The system of claim 9 wherein the heart arrhythmia is atrial fibrillation and wherein the 3D model is of the left atrium and pulmonary veins.
16. The system of claim 9 wherein the catheter apparatus comprises:
- a main body having a central lumen adapted to the delivery of biological material; and - a control mechanism coupled to the main body wherein delivery of the biological material from the main body is controlled.
- a main body having a central lumen adapted to the delivery of biological material; and - a control mechanism coupled to the main body wherein delivery of the biological material from the main body is controlled.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/932,487 | 2004-09-02 | ||
US10/932,487 US20050054918A1 (en) | 2003-09-04 | 2004-09-02 | Method and system for treatment of atrial fibrillation and other cardiac arrhythmias |
PCT/US2005/030991 WO2006028855A1 (en) | 2004-09-02 | 2005-08-31 | Method and system for treatment of atrial fibrillation and other cardiac arrhythmias |
Publications (1)
Publication Number | Publication Date |
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CA2578963A1 true CA2578963A1 (en) | 2006-03-16 |
Family
ID=35447420
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002578963A Abandoned CA2578963A1 (en) | 2004-09-02 | 2005-08-31 | Method and system for treatment of atrial fibrillation and other cardiac arrhythmias |
Country Status (6)
Country | Link |
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US (1) | US20050054918A1 (en) |
EP (1) | EP1807006A1 (en) |
JP (1) | JP2008511413A (en) |
CN (1) | CN101035467A (en) |
CA (1) | CA2578963A1 (en) |
WO (1) | WO2006028855A1 (en) |
Families Citing this family (45)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20050137661A1 (en) * | 2003-12-19 | 2005-06-23 | Sra Jasbir S. | Method and system of treatment of cardiac arrhythmias using 4D imaging |
US20050143777A1 (en) * | 2003-12-19 | 2005-06-30 | Sra Jasbir S. | Method and system of treatment of heart failure using 4D imaging |
US7515954B2 (en) * | 2006-06-13 | 2009-04-07 | Rhythmia Medical, Inc. | Non-contact cardiac mapping, including moving catheter and multi-beat integration |
US7505810B2 (en) * | 2006-06-13 | 2009-03-17 | Rhythmia Medical, Inc. | Non-contact cardiac mapping, including preprocessing |
US7729752B2 (en) * | 2006-06-13 | 2010-06-01 | Rhythmia Medical, Inc. | Non-contact cardiac mapping, including resolution map |
US20080190438A1 (en) * | 2007-02-08 | 2008-08-14 | Doron Harlev | Impedance registration and catheter tracking |
US8715195B2 (en) * | 2007-04-11 | 2014-05-06 | Elcam Medical Agricultural Cooperative | System and method for accurate placement of a catheter tip in a patient |
US8285021B2 (en) * | 2007-05-07 | 2012-10-09 | Siemens Aktiengesellschaft | Three-dimensional (3D) reconstruction of the left atrium and pulmonary veins |
US8103327B2 (en) | 2007-12-28 | 2012-01-24 | Rhythmia Medical, Inc. | Cardiac mapping catheter |
US8538509B2 (en) | 2008-04-02 | 2013-09-17 | Rhythmia Medical, Inc. | Intracardiac tracking system |
CN104545894A (en) * | 2008-10-09 | 2015-04-29 | 加利福尼亚大学董事会 | Device and process for automatically positioning biological rhythm disorder source |
US8137343B2 (en) | 2008-10-27 | 2012-03-20 | Rhythmia Medical, Inc. | Tracking system using field mapping |
US9398862B2 (en) | 2009-04-23 | 2016-07-26 | Rhythmia Medical, Inc. | Multi-electrode mapping system |
US8571647B2 (en) * | 2009-05-08 | 2013-10-29 | Rhythmia Medical, Inc. | Impedance based anatomy generation |
US8103338B2 (en) * | 2009-05-08 | 2012-01-24 | Rhythmia Medical, Inc. | Impedance based anatomy generation |
US8694074B2 (en) | 2010-05-11 | 2014-04-08 | Rhythmia Medical, Inc. | Electrode displacement determination |
US9002442B2 (en) | 2011-01-13 | 2015-04-07 | Rhythmia Medical, Inc. | Beat alignment and selection for cardiac mapping |
US8428700B2 (en) | 2011-01-13 | 2013-04-23 | Rhythmia Medical, Inc. | Electroanatomical mapping |
JP5784351B2 (en) * | 2011-04-22 | 2015-09-24 | 株式会社東芝 | X-ray diagnostic apparatus and image processing apparatus |
KR20140070502A (en) * | 2011-05-02 | 2014-06-10 | 더 리젠츠 오브 더 유니버시티 오브 캘리포니아 | System and method for targeting heart rhythm disorders using shaped ablation |
WO2013082581A1 (en) * | 2011-12-01 | 2013-06-06 | Neochord, Inc. | Surgical navigation for repair of heart valve leaflets |
DE102011121445A1 (en) | 2011-12-16 | 2013-06-20 | Hans-Dieter Cornelius | Manufacture of shot-resistant armor for military vehicles, involves forming base consisting of packing of ceramic balls, in which remaining open pores are filled with metal carbide or synthetic resin, and cover plate |
WO2014182680A1 (en) | 2013-05-06 | 2014-11-13 | Boston Scientific Scimed Inc. | Persistent display of nearest beat characteristics during real-time or play-back electrophysiology data visualization |
CN105228510B (en) | 2013-05-14 | 2018-12-14 | 波士顿科学医学有限公司 | The expression and identification of the activity pattern of vector field are used during electrophysiology mapping |
US9687166B2 (en) | 2013-10-14 | 2017-06-27 | Boston Scientific Scimed, Inc. | High resolution cardiac mapping electrode array catheter |
JP2017522923A (en) | 2014-06-03 | 2017-08-17 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Electrode assembly with atraumatic distal tip |
WO2015187430A2 (en) | 2014-06-04 | 2015-12-10 | Boston Scientific Scimed, Inc. | Electrode assembly |
US9589379B2 (en) * | 2014-06-24 | 2017-03-07 | Siemens Healthcare Gmbh | System and method for visualization of cardiac changes under various pacing conditions |
US10925511B2 (en) | 2014-07-24 | 2021-02-23 | Cardiosolv Ablation Technologies, Inc. | System and method for cardiac ablation |
CN107635463B (en) | 2015-05-12 | 2021-12-28 | 纳维斯国际有限公司 | Contact quality assessment by dielectric property analysis |
US10278616B2 (en) | 2015-05-12 | 2019-05-07 | Navix International Limited | Systems and methods for tracking an intrabody catheter |
US10828106B2 (en) | 2015-05-12 | 2020-11-10 | Navix International Limited | Fiducial marking for image-electromagnetic field registration |
RU2017140235A (en) | 2015-05-12 | 2019-06-13 | Навикс Интернэшнл Лимитед | Assessment of lesions by analyzing dielectric properties |
WO2017031197A1 (en) | 2015-08-20 | 2017-02-23 | Boston Scientific Scimed Inc. | Flexible electrode for cardiac sensing and method for making |
WO2017053927A1 (en) | 2015-09-26 | 2017-03-30 | Boston Scientific Scimed Inc. | Systems and methods for anatomical shell editing |
WO2017053921A1 (en) | 2015-09-26 | 2017-03-30 | Boston Scientific Scimed Inc. | Intracardiac egm signals for beat matching and acceptance |
US10405766B2 (en) | 2015-09-26 | 2019-09-10 | Boston Scientific Scimed, Inc. | Method of exploring or mapping internal cardiac structures |
EP3352648B1 (en) | 2015-09-26 | 2022-10-26 | Boston Scientific Scimed Inc. | Multiple rhythm template monitoring |
US10078713B2 (en) * | 2015-12-24 | 2018-09-18 | Biosense Webster (Israel) Ltd. | Global mapping catheter contact optimization |
US11350996B2 (en) | 2016-07-14 | 2022-06-07 | Navix International Limited | Characteristic track catheter navigation |
CN110177500B (en) | 2016-11-16 | 2022-03-04 | 纳维斯国际有限公司 | Dynamic visual rendering of tissue models |
WO2018092063A1 (en) | 2016-11-16 | 2018-05-24 | Navix International Limited | Real-time display of treatment-related tissue changes using virtual material |
WO2018092062A1 (en) | 2016-11-16 | 2018-05-24 | Navix International Limited | Real-time display of tissue deformation by interactions with an intra-body probe |
US11331029B2 (en) | 2016-11-16 | 2022-05-17 | Navix International Limited | Esophagus position detection by electrical mapping |
EP3541313B1 (en) | 2016-11-16 | 2023-05-10 | Navix International Limited | Estimators for ablation effectiveness |
Family Cites Families (50)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3954098A (en) * | 1975-01-31 | 1976-05-04 | Dick Donald E | Synchronized multiple image tomographic cardiography |
US4574807A (en) * | 1984-03-02 | 1986-03-11 | Carl Hewson | Method and apparatus for pacing the heart employing external and internal electrodes |
US5167228A (en) * | 1987-06-26 | 1992-12-01 | Brigham And Women's Hospital | Assessment and modification of endogenous circadian phase and amplitude |
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 |
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 |
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 |
US6522905B2 (en) * | 1993-03-11 | 2003-02-18 | Jawahar M. Desai | Apparatus and method for cardiac ablation |
US5839440A (en) * | 1994-06-17 | 1998-11-24 | Siemens Corporate Research, Inc. | Three-dimensional image registration method for spiral CT angiography |
US6314310B1 (en) * | 1997-02-14 | 2001-11-06 | Biosense, Inc. | X-ray guided surgical location system with extended mapping volume |
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 |
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 |
US6950689B1 (en) * | 1998-08-03 | 2005-09-27 | Boston Scientific Scimed, Inc. | Dynamically alterable three-dimensional graphical model of a body region |
US6154516A (en) * | 1998-09-04 | 2000-11-28 | Picker International, Inc. | Cardiac CT system |
EP1115328A4 (en) * | 1998-09-24 | 2004-11-10 | Super Dimension Ltd | System and method for determining the location of a catheter during an intra-body medical procedure |
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 |
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 |
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 |
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 |
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 |
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 |
US6714806B2 (en) * | 2000-09-20 | 2004-03-30 | Medtronic, Inc. | System and method for determining tissue contact of an implantable medical device within a body |
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 |
KR20020087946A (en) * | 2001-01-30 | 2002-11-23 | 코닌클리케 필립스 일렉트로닉스 엔.브이. | Image processing method for displaying an image sequence of a deformable 3-D object with indications of the object wall motion |
US7010350B2 (en) * | 2001-03-21 | 2006-03-07 | Kralik Michael R | Temporary biventricular pacing of heart after heart surgery |
US6743225B2 (en) * | 2001-03-27 | 2004-06-01 | Uab Research Foundation | Electrophysiologic measure of endpoints for ablation lesions created in fibrillating substrates |
US20030018251A1 (en) * | 2001-04-06 | 2003-01-23 | Stephen Solomon | Cardiological mapping and navigation system |
US6796963B2 (en) * | 2001-07-10 | 2004-09-28 | Myocardial Therapeutics, Inc. | Flexible tissue injection catheters with controlled depth penetration |
US20030023266A1 (en) * | 2001-07-19 | 2003-01-30 | Borillo Thomas E. | Individually customized atrial appendage implant device |
US7286866B2 (en) * | 2001-11-05 | 2007-10-23 | Ge Medical Systems Global Technology Company, Llc | Method, system and computer product for cardiac interventional procedure planning |
US7346381B2 (en) * | 2002-11-01 | 2008-03-18 | Ge Medical Systems Global Technology Company Llc | Method and apparatus for medical intervention procedure planning |
WO2003084386A2 (en) * | 2002-04-03 | 2003-10-16 | See Jackie R | Methods for ultrasonic imaging and treating diseased tissues |
US20040106896A1 (en) * | 2002-11-29 | 2004-06-03 | The Regents Of The University Of California | System and method for forming a non-ablative cardiac conduction block |
AU2003239418B2 (en) * | 2002-05-08 | 2008-01-31 | The Regents Of The University Of California | System and method for forming a non-ablative cardiac conduction block |
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 |
AU2003248750A1 (en) * | 2002-06-27 | 2004-01-19 | J. Luis Guerrero | Ventricular remodeling for artioventricular valve regurgitation |
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CN101035467A (en) | 2007-09-12 |
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