SMART POWER SELECTION FOR MULTI-ELECTRODE RF ABLATION SYSTEM
20220304740 · 2022-09-29
Inventors
- Jacob I. Laughner (St. Paul, MN, US)
- Jeffry V. Marshik (New Brighton, MN, US)
- Randall Dodson (New Hope, MN, US)
- Kara Garrott (Minneapolis, MN, US)
- Dustin J. OLYNYK (Eagan, MN, US)
- Kimberly A. Miklos (Plymouth, MN, US)
- Melissa R. McMahon (Minneapolis, MN, US)
Cpc classification
A61B1/04
HUMAN NECESSITIES
A61B2018/1467
HUMAN NECESSITIES
A61B18/1492
HUMAN NECESSITIES
A61B2018/00898
HUMAN NECESSITIES
A61B2018/0016
HUMAN NECESSITIES
A61B2034/258
HUMAN NECESSITIES
A61B2018/00982
HUMAN NECESSITIES
International classification
A61B18/12
HUMAN NECESSITIES
Abstract
A computing device for generating and using a graphical user interface (GUI) is disclosed. The computing device includes one or more controllers configured to generate a graphical representation of a plurality of electrodes of an ablation catheter for displaying via the GUI; designate, via the GUI, at least some of the plurality of electrodes to be active electrodes; automatically designate the active electrodes as a source electrode or a sink electrode; assign an amount of energy to each of the designated source electrodes; and estimate an amount of energy associated with each of the designated sink electrodes based at least in part on the assigned energy of the designated source electrodes.
Claims
1. An ablation system comprising: an energy generator configured to generate ablation energy; an ablation catheter in communication with the energy generator and including a plurality of electrodes; and one or more controllers in communication with the energy generator and configured to: generate a graphical representation of the plurality of electrodes of the ablation catheter for displaying via a graphical user interface (GUI); designate, via the GUI, at least some of the plurality of electrodes to be active electrodes; designate the active electrodes as a source electrode or a sink electrode, at least two or more active electrodes of the active electrodes being designated as source electrodes and at least two or more active electrodes of the active electrodes being designated as sink electrodes; assign an amount of power to each designated source electrode of the designated source electrodes; estimate an amount of power associated with each designated sink electrode of the designated sink electrodes based at least in part on the assigned amount of power of each designated source electrode of the designated source electrodes; determine that the estimated amount of power associated with at least one of the designated sink electrodes is above a threshold; and disable an ablation-initiation button on the GUI in response to the determination.
2. The ablation system of claim 1, wherein the estimated amount of power associated with each of the designated sink electrodes is further based at least in part on and distances between the designated source electrodes and the designated sink electrodes.
3. The ablation system of claim 2, wherein the distances between the designated source electrodes and the designated sink electrodes represent edge-to-edge distances.
4. The ablation system of claim 2, wherein the distances are selected from a table of predetermined distances stored in the one or more controllers or computed by the one or more controllers.
5. The ablation system of claim 1, wherein the estimated amount of power associated with each designated sink electrode of the designated sink electrodes is based at least in part on adding each designated source electrode's contribution to power associated with each designated sink electrode of the designated sink electrodes.
6. The ablation system of claim 1, wherein the one or more controllers are configured to: modify the assigned amount of power to at least one of the designated source electrodes; and re-estimate the estimated amount of power associated with each designated sink electrode of the designated sink electrodes based at least in part on the modified assigned amount of power of the at least one of the designated source electrodes.
7. The ablation system of claim 6, wherein the one or more controllers are configured to: after re-estimating the estimated amount of power associated with each designated sink electrode of the designated sink electrodes, determine that the estimated power associated with at least one of the designated sink electrodes is below the threshold; and enable the ablation-initiation button on the GUI in response to determining that the estimated power associated with at least one of the designated sink electrodes is below the threshold.
8. The ablation system of claim 1, wherein the ablation catheter includes an expandable member carrying the plurality of electrodes.
9. The ablation system of claim 1, further comprising: a display in communication with the one or more controllers and configured to display the GUI.
10. A computing device for generating and using a graphical user interface (GUI), the computing device comprising: one or more controllers configured to: generate a graphical representation of a plurality of electrodes of an ablation catheter for displaying via the GUI; designate, via the GUI, at least some of the plurality of electrodes to be active electrodes; automatically designate the active electrodes as a source electrode or a sink electrode, at least two or more active electrodes of the active electrodes being designated as source electrodes and at least two or more active electrodes of the active electrodes being designated as sink electrodes; assign an amount of energy to each designated source electrode of the designated source electrodes; estimate an amount of energy associated with each designated sink electrode of the designated sink electrodes based at least in part on the assigned amount of energy of each designated source electrode of the designated source electrodes; determine that the estimated amount of power associated with at least one of the designated sink electrodes is above a threshold; and disable an ablation-initiation button on the GUI in response to the determination.
11. The computing device of claim 10, wherein the estimated amount of energy associated with each designated sink electrode of the designated sink electrodes is further based at least in part on distances between the designated source electrodes and the designated sink electrodes.
12. The computing device of claim 11, wherein the distances between the designated source electrodes and the designated sink electrodes represent edge-to-edge distances.
13. The computing device of claim 11, wherein the distances are selected from a table of predetermined distances stored in the one or more controllers.
14. The computing device of claim 10, wherein the estimated amount of energy associated with each designated sink electrode of the designated sink electrodes is based at least in part on adding each designated source electrode's contribution to energy associated with each designated sink electrode of the designated sink electrodes.
15. The computing device of claim 10, wherein the one or more controllers are configured to: designate an additional electrode as an active electrode or inactive electrode; and re-estimate the estimated amount of power associated with each designated sink electrode of the designated sink electrodes based at least in part on the additional electrode.
16. The computing device of claim 15, wherein the one or more controllers are configured to: after re-estimating the estimated amount of power associated with each designated sink electrode of the designated sink electrodes, determine that the estimated power associated with at least one of the designated sink electrodes is below the threshold; and enable the ablation-initiation button on the GUI in response to determining that the estimated power associated with at least one of the designated sink electrodes is below the threshold.
17. An ablation system comprising: an energy generator configured to generate ablation energy; an ablation catheter in communication with the energy generator and including a plurality of electrodes; and one or more controllers in communication with the energy generator and configured to: generate a graphical representation of the plurality of electrodes of the ablation catheter for displaying via a graphical user interface (GUI); designate, via the GUI, at least some of the plurality of electrodes to be active electrodes; designate the active electrodes as a source electrode or a sink electrode, at least two or more active electrodes of the active electrodes being designated as source electrodes and at least two or more active electrodes of the active electrodes being designated as sink electrodes; assign an amount of power to each designated source electrode of the designated source electrodes; and estimate an amount of power associated with each designated sink electrode of the designated sink electrodes based at least in part on the assigned amount of power of each designated source electrode of the designated source electrodes and distances between the designated source electrodes and the designated sink electrodes.
18. The ablation system of claim 17, wherein the distances between the designated source electrodes and the designated sink electrodes represent edge-to-edge distances.
19. The ablation system of claim 17, wherein the estimated amount of power associated with each designated sink electrode of the designated sink electrodes is based at least in part on adding each designated source electrode's contribution to power associated with each designated sink electrode of the designated sink electrodes.
20. The ablation system of claim 17, wherein the one or more controllers are configured to: modify the assigned amount of power to at least one of the designated source electrodes; and re-estimate the estimated amount of power associated with each designated sink electrode of the designated sink electrodes based at least in part on the modified assigned amount of power of the at least one of the designated source electrodes.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0040]
[0041]
[0042]
[0043]
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[0045]
[0046] While the invention is amenable to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to limit the invention to the particular embodiments described. On the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the appended claims.
DETAILED DESCRIPTION
[0047] Cardiac ablation is a procedure by which cardiac tissue is treated to inactivate the tissue. The tissue targeted for ablation may be associated with improper electrical activity, as described above. Cardiac ablation can create lesions in the tissue and prevent the tissue from improperly generating or conducting electrical signals. For example, lesions in the form of a line or a circle can block the propagation of errant electrical signals. Control of the shape, depth, uniformity, etc., of the lesion is desirable.
[0048] Certain embodiments of the present disclosure involve systems, devices, and methods that can be used in connection with cardiac ablation. In particular, the present disclosure describes graphical user interfaces that display and enable control of a graphical representation of features of the ablation catheter. The graphical user interfaces can be used for viewing, selecting, and modifying ablation parameters, among other things. For example, the graphical user interfaces can be used to view, select, and modify ablation patterns and energy associated with ablation electrodes. As such, the graphical user interfaces can be used to help control the shape, depth, and uniformity of lesions.
[0049]
[0050] The system 100 includes a radiofrequency (RF) generator 114 electrically coupled to the plurality of energy delivery elements 112 and configured to generate RF energy. The RF generator 114 includes an RF generator controller 116 configured to control the RF energy to the plurality of energy delivery elements 112. The RF generator controller 116 can be implemented using firmware, integrated circuits, and/or software modules that interact with each other or are combined together. For example, the RF generator controller 116 may include memory 118 storing computer-readable instructions/code 120 for execution by a processor 122 (e.g., microprocessor) to perform aspects of embodiments of methods discussed herein.
[0051] The system 100 can also include a computing device 124 (e.g., personal computer) with a display controller 126 configured to communicate with various components of the system 100 and generate a graphical user interface (GUI) to be displayed via a display 128 (e.g., computer monitor, television, mobile device screen). The display controller 126 can be implemented using firmware, integrated circuits, and/or software modules that interact with each other or are combined together. For example, the display controller 126 may include memory 130 storing computer-readable instructions/code 132 for execution by a processor 134 (e.g., microprocessor) to perform aspects of embodiments of methods discussed herein.
[0052] The various components of the system 100 may be communicatively coupled to each other via communication links 136. In certain embodiments, the communication links 136 may be, or include, a wired communication link (e.g., a serial communication), a wireless communication link such as, for example, a short-range radio link, such as Bluetooth, IEEE 802.11, a proprietary wireless protocol, and/or the like. The term “communication link” may refer to an ability to communicate some type of information in at least one direction between at least two components and may be a persistent communication link, an intermittent communication link, an ad-hoc communication link, and/or the like. The communication links 136 may refer to direct communications between components and/or indirect communications that travel between components via at least one other device (e.g., a repeater, router, hub).
[0053] In embodiments, the memory 118 and 130 includes computer-readable storage media in the form of volatile and/or nonvolatile memory and may be removable, non-removable, or a combination thereof. Media examples include Random Access Memory (RAM), Read Only Memory (ROM), Electronically Erasable Programmable Read Only Memory (EEPROM), flash memory, and/or any other non-transitory storage medium that can be used to store information and can be accessed by a computing device. In certain embodiments, the ablation catheter 102 includes memory that stores information unique to the ablation catheter 102 (e.g., catheter ID, manufacturer). This information can be accessed and associated with data collected as part of an ablation procedure (e.g., patient data, ablation parameters).
[0054] The computer-executable instructions 120 and 132 may include, for example, computer code, machine-useable instructions, and the like such as, for example, program components capable of being executed by the one or more processors 122 and 134. Some or all of the functionality contemplated herein may be implemented in hardware and/or firmware.
[0055] In certain embodiments, the RF generator 114 and the computing device 124 are separate components housed in a single console 138. In certain embodiments, the RF generator 114 and the computing device 124 each include a plurality of controllers that are configured to perform aspects of embodiments of methods and procedures discussed herein.
[0056]
[0057] The ablation catheter 200 includes a visualization system 206 including a camera assembly 208 and illumination sources (e.g., light-emitting diodes (LEDs)) disposed on a guide wire shaft 210. The camera assembly 208 can include a plurality of cameras disposed at an angle relative to a longitudinal axis of the ablation catheter 200. The cameras are configured to enable real-time imaging (e.g., video) of an ablation procedure from within the expandable member 202 including visualizing the expandable member 202, the energy delivery elements 204, and cardiac tissue as well as lesion formation during the ablation procedure. The illumination sources provide lighting for the cameras to visualize the ablation procedure.
[0058] As mentioned above, the computing device 124 of the system 100 includes the display controller 126 that is configured to communicate with various components of the system 100 and generate a GUI for displaying via the display 128.
[0059]
[0060] The graphical representation 306 includes a separate electrode icon 310 for each of the plurality of electrodes of the ablation catheter. In certain embodiments, each electrode icon 310 is similarly-shaped to an actual shape of a corresponding electrode on the ablation catheter. Each electrode icon 310 can include a unique numerical indicator 312. For example, in the embodiment shown in
[0061] The displayed real-time video 308 allows for visualization of an ablation procedure. The displayed real-time video 308 may include displaying video recorded by one or more cameras. For example, if an ablation catheter (e.g., the ablation catheter 200 of
[0062] The GUI 300 includes a number of icons (e.g., buttons, images, combinations thereof) that are associated with and can be used to control or monitor aspects of the ablation catheter and the GUI 300 itself.
[0063]
[0064]
[0065] The GUI 300 includes a ribbon 326 with various icons relating to the ablation catheter and/or the GUI 300 itself. The ribbon 326 includes a status icon 328 indicating the system's status and a sonic/scan icon 330, which initiates a routine for initiating an ultrasonic source and for scanning the electrodes on the ablation catheter to identify potentially faulty electrodes. For example, the ablation catheter may be placed in a bath coupled to an ultrasonic source, and once the sonic/scan icon 330 is selected, the routine can turn on the ultrasonic source for a predetermined period of time to remove air bubbles stuck to the ablation catheter before a treatment procedure. After expiration of the predetermined period of time, the routine can sequentially activate all electrodes to determine whether any electrodes or RF amplifiers are defective. If the ultrasonic source is not connected, the sonic/scan icon 330 will just initiate the scanning portion of the routine.
[0066] The ribbon 326 also includes an in vivo icon 332, which can be selected to indicate that the ablation catheter has been placed within a patient; an anatomy icon 334, which can be used to identify the pulmonary vein (e.g., right superior, right inferior, left superior, left inferior) to be treated; a power icon 336, which displays and allows a user to modify, via arrow buttons, a power level at which the selected ablation electrodes will be energized; a procedure timing icon 338, which displays and allows a user to modify, via arrow buttons, the length of time the selected ablation electrodes are to be energized; an irrigation flow rate icon 340, which can be used to control flow rates of irrigation fluid through the ablation catheter; and a fluid volume icon 342, which indicates the amount of fluid passed through the ablation catheter since the in vivo icon 332 was selected. Once various selections are made via the icons, data associated the selections can be stored in a memory (e.g., the memory 118 and 130 of
[0067] As described above, the GUI 300 allows a user to select, via the electrode icons 310, which electrodes on the ablation catheter will be active (e.g., either a source electrode or a sink electrode). The selected and highlighted electrode icons 310 indicate that, should an ablation procedure begin, only the ablation electrodes corresponding to the selected and highlighted electrode icons 310 will be active during the ablation procedure.
[0068] When the ablation activate/deactivate icon 344 indicates “Assign” and is selected, a computing device assigns or designates the selected electrode icons 310 to be a source or a sink. For example, as shown in
[0069]
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[0071] The power selector icon 352 includes icons such as a power-increase icon 354 with a “+” sign for increasing the power associated with the given ablation electrode, a power-decrease icon 356 with a “−” sign for decreasing the power associated with the given ablation electrode, a power-confirmation icon 358 with a check-mark for confirming changes in power, and a power-cancellation icon 360 with an “X” for cancelling changes in power. The amount of power for each ablation electrode can be modified in real time. As power is increased or decreased for a given ablation electrode, the electrode icons 310 can be shaded or brightened to visually indicate that such electrode icons 310 have a different power.
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[0075] The estimated energy to be received by the first sink electrode 404A, the second sink electrode 404B, and the third sink electrode 404C can be calculated based at least in part on the energy associated with each of the source electrodes and the distances between the source electrodes and the respective sink electrodes (step 508 in
[0076] As shown in Equation 1, the estimated power for each sink electrode is a summation of each source electrode's contribution to power at the sink electrode. When each of the source electrodes is assigned the same amount of power, the source electrode positioned farthest from a given sink electrode will be estimated to contribute the least to the power of the given sink electrode.
[0077] In certain embodiments, distances between source electrodes and sink electrodes are based on arc-length distances between edges (e.g., edge-to-edge distances) of the respective electrodes (e.g., energy delivery elements 204 of
[0078] In certain embodiments, the estimated power displayed in each of the power estimation icons 362 is updated as a user modifies power assigned for a given source electrode 346 or as more electrodes are designated as being inactive or active (and therefore a source electrode or a sink electrode).
[0079] In certain embodiments, the estimated power for each of the source electrodes 348 is compared to one or more thresholds. Different thresholds can be associated with different sets of sink electrodes 348 (e.g., proximal electrodes, distal electrodes). If the estimated power for a given source electrode 348 is above a predetermined threshold, the GUI 300 can indicate that the threshold is violated. For example, if one or more source electrodes 348 are estimated to receive power above the threshold, the GUI 300 can display a warning message or alarm and/or can display the power estimation icon 362 associated with the violating sink electrode 348 in a different color (e.g., red) than the power estimation icons 362 associated with the other sink electrodes 348. In
[0080] In certain embodiments, upon selecting the ablation activate/deactivate icon 344 or another icon on the GUI 300, the source electrodes 346 are automatically assigned an amount of power in accordance with certain goals. In one example, the source electrodes 346 are assigned a power such that an estimated power associated with each of the designated sink electrodes 348 is less than a predetermined threshold (e.g., 10 Watts, 11 Watts). As described above, different thresholds can be applied to different sets of sink electrodes 348 such that estimated power for each of the proximal sink electrodes are compared against a different threshold than the distal sink electrodes. In another example, the source electrodes 346 are assigned a power such that an estimated power associated with each of the designated sink electrodes 348 such that the estimated power for each of the designated sink electrodes is substantially similar (e.g., within 5%, within 10%) to the estimated power of the other sink electrodes. When the sink electrodes 348 have similar estimated powers, it is more likely that lesions created by the ablation catheter will be more uniform (e.g., lesions with same or similar depth along the lesion).
[0081] Once the user sets the desired power for each of the source electrodes 346 (e.g., assisted by viewing the estimated power amounts for the sink electrodes 348 ), the user can select the ablation activate/deactivate icon 344. Selecting the ablation activate/deactivate icon 344 initiates and/or stops energy delivery to the ablation electrodes of the ablation catheter. Once the activate/deactivate icon 344 is pressed to initiate energy delivery, a graphic in the activate/deactivate icon 344 changes (e.g., changes to a stop sign). Further, once the activate/deactivate icon 344 is selected to initiate energy delivery, a signal is transmitted to an RF generator (e.g., the RF generator 114 of
[0082] The various methods and functions described above can be carried out by components discussed above, for example, computing devices with one or more controllers implemented using firmware, integrated circuits, and/or software modules that interact with each other or are combined together. The controllers may include memory storing computer-readable instructions/code (e.g., computer program products) for execution by a processor to perform aspects discussed herein.
[0083] Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present invention. For example, while the embodiments described above refer to particular features, the scope of this invention also includes embodiments having different combinations of features and embodiments that do not include all of the described features. Accordingly, the scope of the present invention is intended to embrace all such alternatives, modifications, and variations as fall within the scope of the claims, together with all equivalents thereof.