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Apparatus for treating cardiac arrhythmias    
United States Patent5480422   
Link to this pagehttp://www.wikipatents.com/5480422.html
Inventor(s)Ben-Haim; Shlomo (Haifa, IL)
AbstractThis invention concerns an apparatus and method for the treatment of cardiac arrhythmias. More particularly, this invention is directed to a method for ablating a portion of an organ or bodily structure of a patient, which comprises obtaining a perspective image of the organ or structure to be mapped; advancing one or more catheters having distal tips to sites adjacent to or within the organ or structure, at least one of the catheters having ablation ability; sensing the location of each catheter's distal tip using a non-ionizing field; at the distal tip of one or more catheters, sensing local information of the organ or structure; processing the sensed information to create one or more data points; superimposing the one or more data points on the perspective image of the organ or structure; and ablating a portion of the organ or structure.
   














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Drawing from US Patent 5480422
Apparatus for treating cardiac arrhythmias - US Patent 5480422 Drawing
Apparatus for treating cardiac arrhythmias
Inventor     Ben-Haim; Shlomo (Haifa, IL)
Owner/Assignee     Biosense, Inc. (Orangeburg, NY)
Patent assignment
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Publication Date     January 2, 1996
Application Number     08/311,594
PAIR File History     Application Data   Transaction History
Image File Wrapper   Patent Term   Fees
Litigation
Filing Date     September 23, 1994
US Classification     607/122 600/439
Int'l Classification     A61N 001/18
Examiner     Manuel; George
Assistant Examiner    
Attorney/Law Firm     Cowan, Liebowitz & Latman
Address
Parent Case     This application is a continuation of U.S. patent application Ser. No. 08/094,539, filed Jul. 20, 1993, now U.S. Pat. No. 5,391,199.
Priority Data    
USPTO Field of Search     128/642 128/660.03 128/702 128/710 607/2 607/115 607/116 607/119 607/122
Patent Tags     treating cardiac arrhythmias
   
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Nardella
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I claim:

1. An apparatus for treating cardiac arrhythmias, which comprises:

(a) means for positioning the distal tip of each of one or more catheters at a site adjacent to or within a patient's heart;

(b) means for sensing location information at the site;

(c) means for sensing local information concerning the heart's electrical activity at the site;

(d) means for processing sensed information from means (b) and (c) to create one or more data points;

(e) means for repeating the functions of means (a), (b), (c) and (d) one or more times to create sufficient data points for a map of the heart's electrical pathways; and

(f) means for ablating a portion of the heart, whose electrical pathways cause said arrhythmias.

2. The apparatus of 1 which additionally comprises means for transmitting said data points or said map to receiving means.

3. The apparatus of claim 2 which further comprises means for projecting said data points or said map received by receiving means onto an image receiving means.

4. The apparatus of claim 3 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map on said image receiving means.

5. An apparatus for treating cardiac arrhythmias, which comprises:

(a) means for obtaining a perspective image of a patient's heart;

(b) means for positioning the distal tip of each of one or more catheters at a site adjacent to or within the heart;

(c) means for sensing location information at the site;

(d) means for sensing local information concerning the heart's electrical activity at the site;

(e) means for processing sensed information from means (c) and (d) to create one or more data points;

(f) means for repeating the functions of means (b), (c), (d) and (e) one or more times to create sufficient data points for a map of the heart's electrical pathways;

(g) means for superimposing said data points from means (e) or map from means (f) on the perspective image of the heart; and

(h) means for ablating a portion of the heart, whose

electrical pathways cause said arrhythmias.

6. The apparatus of claim 5 which additionally comprises means for transmitting said data points or map and said perspective image to receiving means.

7. The apparatus of claim 6 which further comprises means for superimposing the location of a mapping/ablation catheter distal tip on the perspective image of the organ or bodily structure.

8. The apparatus of claim 6 which additionally comprises means for projecting said data points or said map and said perspective image received by receiving means onto an image receiving means.

9. The apparatus of claim 8 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map and said perspective image on the said image receiving means.

10. An apparatus for treating cardiac arrhythmias, which comprises:

(a) means for positioning the distal tip of each of one or more reference catheters at a site adjacent to or within a patient's heart;

(b) means for positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within the heart;

(c) means for sensing location information at each site;

(d) means for sensing local information concerning the heart's electrical activity at a site with each mapping/ablation catheter distal tip;

(e) means for processing sensed information from means (c) and (d) to create one or more data points;

(f) means for repeating the functions of means (b), (c), (d), and (e) one or more times to create sufficient data points for a map of the heart's electrical pathways; and

(g) means for ablating a portion of the heart, whose electrical pathways cause said arrhythmias.

11. The apparatus of claim 10 which additionally comprises means for transmitting said data points or said map to receiving means.

12. The apparatus of claim 11 which further comprises means for projecting said data points or said map received by receiving means onto an image receiving means.

13. The apparatus of claim 12 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map on said image receiving means.

14. An apparatus for treating cardiac arrhythmias, which comprises:

(a) means for positioning the distal tip of each of one or more reference catheters at a site adjacent to or within a patient's heart;

(b) means for positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within the heart;

(c) means for sensing location information at each site;

(d) means for determining relative location of the mapping/ablation catheter distal tip relative to reference catheter distal tips;

(e) means for sensing local information concerning the heart's electrical activity at a site with each mapping/ablation catheter distal tip;

(f) means for processing sensed information from means (d) and (e) to create one or more data points;

(g) means for repeating the functions of means (b), (c), (d) and (e) one or more times to create sufficient data points for a map of the heart's electrical pathways; and

(h) means for ablating a portion of the heart, whose electrical pathways cause said arrhythmias.

15. The apparatus of claim 14 which additionally comprises means for transmitting said data points or said map to receiving means.

16. The apparatus of claim 15 which further comprises means for projecting said data points or said map received by receiving means onto an image receiving means.

17. The apparatus of claim 16 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map on said image receiving means.

18. An apparatus for treating cardiac arrhythmias, which comprises:

(a) means for obtaining a perspective image of a patient's heart;

(b) means for positioning the distal tip of each of one or more reference catheters at a site adjacent to or within the heart;

(c) means for positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within the heart;

(d) means for sensing location information at each site;

(e) means for sensing local information concerning the heart's electrical activity at a site with each mapping/ablation catheter distal tip;

(f) means for processing sensed information from means (d) and (e) to create one or more data points;

(g) means for repeating the functions of means (b) , (c), (d), (e) and (f) one or more times to create sufficient data points for a map of the heart's electrical pathways;

(h) means for superimposing said data points from means (f) and (g) on the perspective image of the heart; and

(i) means for ablating a portion of the heart, whose electrical pathways cause said arrhythmias.

19. The apparatus of claim 18 which additionally comprises means for transmitting said data points or map and said perspective image to receiving means.

20. The apparatus of claim 19 which further comprises means for superimposing the location of a mapping/ablation catheter distal tip on the perspective image of the organ or bodily structure.

21. The apparatus of claim 19 which further comprises means for projecting said data points or map and said perspective image received by receiving means onto an image receiving means.

22. The apparatus of claim 21 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map on said image receiving means.

23. An apparatus for treating cardiac arrhythmias, which comprises:

(a) means for obtaining a perspective image of the heart;

(b) means for positioning the distal tip of each of one or more reference catheters at a site adjacent to or within the heart;

(c) means for positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within the heart;

(d) means for sensing location information at each site;

(e) means for determining relative location of each mapping/ablation catheter distal tip relative to reference catheter distal tips;

(f) means for sensing local information concerning the heart's electrical activity at a site with each mapping/ablation catheter distal tip;

(g) means for processing sensed information from means (e) and (f) to create one or more data points;

(h) means for repeating the functions of means (b), (c), (d), (e), (f), and (g) one or more times to create sufficient data points for a map of the heart's electrical pathways;

(i) means for superimposing said data points from means (g) and (h) on the perspective image of the heart; and

(j) means for ablating a portion of the heart, whose electrical pathways cause said arrhythmias.

24. The apparatus of claim 23 which additionally comprises means for transmitting said data points or map and said perspective image to receiving means.

25. The apparatus of claim 24 which further comprises means for superimposing the location of a mapping/ablation catheter distal tip on the perspective image of the organ or bodily structure.

26. The apparatus of claim 24 which further comprises means for projecting said data points or map and said perspective image received by receiving means onto an image receiving means.

27. The apparatus of claim 26 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map on said image receiving means.

28. The apparatus of claim 1, 5, 10, 14, 18, or 23, wherein sensing location information is achieved using a non-ionizing field.
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FIELD OF THE INVENTION

This invention is directed to an apparatus and method for treating a cardiac arrhythmia such as ventricular tachycardia. More particularly, this invention is directed to an improved apparatus and method whereby there is faster identification of an active site to be ablated.

BACKGROUND OF THE INVENTION

Cardiac arrhythmias are the leading cause of death in the United States. The most common cardiac arrhythmia is ventricular tachycardia (VT), i.e., very rapid and ineffectual contractions of the heart muscle. VT is the cause death of approximately 300,000 people annually.

In the United States, from 34,000 to 94,000 new patients are diagnosed annually with VT. Patients are diagnosed with VT after either (1) surviving a successful resuscitation after an aborted sudden death (currently 25-33% of sudden death cases) or (2) syncope, i.e., temporary loss of consciousness caused by insufficient cerebral circulation. The number of VT patients is expected to increase in the future, estimated to range between 61,000 and 121,000 patients annually in five years, as a result of early detection of patients at risk for sudden death by newly developed cardiac tests, advances in cardiopulmonary resuscitation, better medical management of acute myocardial infarction patients, and the demographic shift to a more aged population.

Without proper treatment most patients diagnosed with VT do not survive more than two years. The most frequent current medical treatment consists of certain antiarrhythmic drugs or implantation of an automatic implantable cardiac defibrillator (AICD). Drug treatment is associated with an average life span of 3.2 years, a 30% chance of debilitating side effects, and an average cost of approximately $88,000 per patient. In contrast, AICD implantation is associated with a life expectancy of 5.1 years, a 4% chance of fatal complications, and a cost of approximately $121,000 per patient.

In a majority of patients VT originates from a 1 to 2 mm lesion that is located close to the inner surface of the heart chamber. A treatment of VT in use since 1981 comprises a method whereby electrical pathways of the heart are mapped to locate the lesion, i.e., the "active site," and then the active site is physically ablated. In most instances the mapping and ablation are performed while the patient's chest and heart are open. Also, the mapping procedure has been carried out by sequentially moving a hand-held electrical recording probe or catheter over the heart and recording the times of arrival of electrical pulses to specific locations. These processes are long and tedious.

Attempts to destroy, i.e., ablate, the critical lesion are now quite successful, but are currently limited to a small number of patients who can survive a prolonged procedure during which they have to remain in VT for almost intolerable periods of time. The time-consuming part of the treatment is the localization, i.e., identifying the site, of the target lesion to be ablated. Another limitation preventing the widespread use of catheter ablation for VT is poor resolution of target localization, which in turn compels the physician to ablate a large area of the patient's heart. The reduction in heart function following such ablation becomes detrimental to most patients with pre-existing cardiac damage. However, once the target is correctly identified, ablation is successful in almost all patients.

An improved procedure for treatment of VT must include a faster, more efficient and accurate technique for identifying, or "mapping", the electrical activation sequence of the heart to locate the active site.

In electrophysiologic examinations, and in particular in those using invasive techniques, so-called electrical activation mapping is frequently