Surgery – Diagnostic testing – Detecting nuclear – electromagnetic – or ultrasonic radiation
Reexamination Certificate
1999-07-22
2001-10-09
Lateef, Marvin M. (Department: 3737)
Surgery
Diagnostic testing
Detecting nuclear, electromagnetic, or ultrasonic radiation
C600S416000, C600S509000, C600S515000, C600S518000, C600S523000, C345S419000, C345S423000, 36, C382S128000
Reexamination Certificate
active
06301496
ABSTRACT:
FIELD AND BACKGROUND OF THE INVENTION
The present invention relates generally to systems and methods for mapping, and specifically to methods of mapping of intrabody organs.
Cardiac mapping is used to locate aberrant electrical pathways and currents within the heart, as well as mechanical and other aspects of cardiac activity. Various methods and devices have been described for mapping the heart. Such methods and device are described, for example, in U.S. Pat. Nos. 5,471,982, 5,391,199 and 5,718,241 and in PCT patent publications WO94/06349, WO96/05768 and WO97/24981. U.S. Pat. No. 5,391,199, for example, describes a catheter including both electrodes for sensing cardiac electrical activity and miniature coils for determining the position of the catheter relative to an externally-applied magnetic field. Using this catheter a cardiologist may collect a set of sampled points within a short period of time, by determining the electrical activity at a plurality of locations and determining the spatial coordinates of the locations.
In order to allow the surgeon to appreciate the determined data, a map, preferably a three dimensional (3D) map, including the sampled points is produced. U.S. Pat. No. 5,391,199 suggests superimposing the map on an image of the heart. The positions of the locations are determined with respect to a frame of reference of the image. However, it is not always desirable to acquire an image, nor is it generally possible to acquire an image in which the positions of the locations can be found with sufficient accuracy.
Various methods are known in the art for reconstructing a 3D map of a cavity or volume using the known position coordinates of a plurality of locations on the surface of the cavity or volume. Some methods include triangulation, in which the map is formed of a plurality of triangles which connect the sampled points. In some cases a convex hull or an alpha-hull of the points is constructed to form the mesh, and thereafter the constructed mesh is shrunk down to fit on the sampled points within the hull. Triangulation methods do not provide a smooth surface and therefore require additional stages of smoothing.
Another method which has been suggested is forming a bounding ellipsoid which encloses the sampled points. The sampled points are projected onto the ellipsoid, and the projected points are connected by a triangulation method. The triangles are thereafter moved with the sampled points back to their original locations, forming a crude piecewise linear approximation of the sampled surface. However, this method may reconstruct only surfaces which have a star shape, i.e., a straight line connecting a center of the reconstructed mesh to any point on the surface does not intersect the surface. In most cases heart chambers do not have a star shape.
In addition, reconstruction methods known in the art require a relatively large number of sampled locations to achieve a suitable reconstructed map. These methods were developed, for example, to work with CT and MRI imaging systems which provide large numbers of points, and therefore generally work properly only on large numbers of points. In contrast, determining the data at the locations using an invasive catheter is a time-consuming process which should be kept as short as possible, especially when dealing with a human heart. Therefore, reconstruction methods which require a large number of determined locations are not suitable.
One important example of cardiac mapping is the determination of the speed and direction of propagation of electrical signals through the tissue of the heart. Abnormal propagation velocity, or vortical signal flow, may be diagnostic of locally diseased heart tissue that should be treated, for example by ablation. Typically, the velocity of propagation of cardiac signals is measured by sensing the wavefronts at a plurality of electrodes in contact with the inner surface of a chamber of the heart. A representative example of the prior art in this field is Kadish, et al., “Vector Mapping of Myocardial Activation”, Circulation, Vol. 74, No. 3, Pages 603-615 (September 1986), in which vectors based on activation maps are drawn perpendicular to the isochrome tangent. Kadish et al. describes the measurement of the timing of local depolarization events, using an array of electrodes, for the purpose of deriving propagation velocities. This propagation velocity deriving technique is also described in Gerstenfeld et al., “Evidence for Transient Linking of Atrial Excitation During Atrial Fibrillation in Humans”, Circulation, Vol. 86, No. 2, Pages 375-382 (August 1992) and Gerstenfeld et al., “Detection of Changes in Atrial Endocardial Activation with Use of an Orthogonal Catheter”, J. Am. Coll. Cardiol. 1991; 18:1034-42 as well as U.S. Pat. No. 5,487,391 (Panescu).
SUMMARY OF THE INVENTION
It is an object of the present invention to provide an improved method for mapping a 3D volume or cavity, based on the positions of points on a surface of the volume or cavity.
It is an object of some aspects of the present invention to provide methods and apparatus for generating a map of a volume in the human body from a plurality of sampled points, regardless of the shape of the volume.
It is another object of some aspects of the present invention to provide a simple, rapid method for reconstructing a 3D map of a volume in the human body from a plurality of sampled points, preferably using fewer sampled points than is feasible using methods known the art.
It is another object of preferred embodiments of the present invention to provide a method for reconstructing a 3D map of a volume in the human body from a plurality of sampled points, without assuming any topological relationship between the points.
It is another object of some aspects of the present invention to provide a simple method for reconstructing a 3D map of a volume in movement.
It is another object of some aspects of the present invention to provide a simple method for reconstructing a 3D map of a volume in the human body from a plurality of sampled points independent of the sampling order.
It is another object of some aspects of the present invention to provide a quick method for reconstructing a 3D map of a volume in the human body from a plurality of sampled points, such that the method may be used in interactive procedures.
It is another object of some aspects of the present invention to provide a method for reconstructing a smooth 3D map of a volume in the human body from a plurality of sampled points.
In preferred embodiments of the present invention, a processor reconstructs a 3D map of a volume or cavity in a patient's body (hereinafter referred to as the volume), from a plurality of sampled points on the volume whose position coordinates have been determined. In contrast to prior art reconstruction methods in which a large number of sampled points are used, the preferred embodiments of the present invention are directed to reconstruction of a surface based on a limited number of sampled points. The number of sampled points is generally less than 200 points and may be less than 50 points. Preferably, ten to twenty sampled points are sufficient in order to perform a preliminary reconstruction of the surface to a satisfactory quality.
An initial, generally arbitrary, closed 3D curved surface (also referred to herein for brevity as a curve) is defined in a reconstruction space in the volume of the sampled points. The closed curve is roughly adjusted to a shape which resembles a reconstruction of the sampled points. Thereafter, a flexible matching stage is preferably repeatedly performed once or more to bring the closed curve to accurately resemble the shape of the actual volume being reconstructed. Preferably, the 3D surface is rendered to a video display or other screen for viewing by a physician or other user of the map.
In preferred embodiments of the present invention, the initial closed curved surface encompasses substantially all the sampled points or is interior to substantially all the sampled points. However, it is noted t
Biosense Inc.
Capezzuto Louis J.
Herman Frederick L.
Lateef Marvin M.
Lin Joeyuh
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