DUAL-FUNCTION SENSORS FOR A BASKET CATHETER

Abstract

Described embodiments include a catheter, which includes a plurality of splines at a distal end of the catheter, and a plurality of helical conducting elements disposed on the splines. Other embodiments are also described.

Claims

1. A catheter, comprising: a plurality of splines at a distal end of the catheter; and a plurality of helical conducting elements disposed on the splines.

2. The catheter according to claim 1, wherein the plurality of splines are arranged to define a basket.

3. The catheter according to claim 1, wherein the helical conducting elements are printed onto the splines.

4. The catheter according to claim 3, wherein each of the helical conducting elements comprises electrically-conductive paint that is helically painted onto the splines.

5. The catheter according to claim 1, further comprising an electrically-insulative layer covering at least a majority of each of the helical conducting elements.

6. The catheter according to claim 5, wherein the electrically-insulative layer does not cover a portion of exactly one respective turn of each of the helical conducting elements.

7. Apparatus, comprising: circuitry, configured: to generate a first output, based on an intracardiac electrocardiogram (ECG) voltage received from a helical conducting element, and to generate a second output, based on a voltage difference that was induced across the conducting element by a magnetic field; and a processor, configured to build an electroanatomical map, based on the first output and the second output.

8. The apparatus according to claim 7, wherein the circuitry is further configured: to cause a proximity-indicating voltage to be received from the conducting element, by passing a current between the conducting element and a reference electrode, and to generate a third output, based on the proximity-indicating voltage, and wherein the processor is configured to build the electroanatomical map based on the third output.

9. The apparatus according to claim 8, wherein the processor is configured to derive, from the third output, a proximity of the conducting element to tissue.

10. The apparatus according to claim 8, wherein the circuitry comprises: a first differential amplifier, configured: to generate the first output by amplifying a difference between the ECG voltage and a reference voltage, and to generate the third output by amplifying a difference between the proximity-indicating voltage and the reference voltage; and a second differential amplifier, configured to generate the second output by amplifying the induced voltage difference.

11. The apparatus according to claim 7, wherein the circuitry comprises exactly two connections to the conducting element.

12. The apparatus according to claim 7, wherein the processor is configured: to derive electrical-activity information from the first output, to derive anatomical information from the second output, and to build the electroanatomical map by combining the electrical-activity information with the anatomical information.

13. A method, comprising: receiving an intracardiac electrocardiogram (ECG) voltage from a conducting element; receiving a voltage difference induced across the conducting element by a magnetic field; and building an electroanatomical map, using the ECG voltage and the voltage difference.

14. The method according to claim 13, wherein receiving the voltage difference comprises receiving the voltage difference while receiving the ECG voltage.

15. The method according to claim 13, wherein building the electroanatomical map comprises: generating a first output, based on the ECG voltage, generating a second output, based on the voltage difference, and building the electroanatomical map, based on the first output and the second output.

16. The method according to claim 15, wherein building the electroanatomical map comprises: deriving electrical-activity information from the first output, deriving anatomical information from the second output, and building the electroanatomical map by combining the electrical-activity information with the anatomical information.

17. The method according to claim 15, wherein generating the first output comprises generating the first output by amplifying a difference between the ECG voltage and a reference voltage, and wherein generating the second output comprises generating the second output by amplifying the induced voltage difference.

18. The method according to claim 13, further comprising causing a proximity-indicating voltage to be received from the conducting element by passing a current between the conducting element and a reference electrode, wherein building the electroanatomical map comprises using the proximity-indicating voltage.

19. The method according to claim 18, wherein using the proximity-indicating voltage comprises using the proximity-indicating voltage by deriving, from the proximity-indicating voltage, a proximity of the conducting element to tissue.

20. The method according to claim 13, wherein the conducting elements are disposed on a plurality of splines at a distal end of a catheter.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0035] FIG. 1 is a schematic illustration of a basket catheter, in accordance with some embodiments of the present invention; and

[0036] FIGS. 2-3 are schematic illustrations of circuitry for processing signals received from conducting elements, in accordance with some embodiments of the present invention.

DETAILED DESCRIPTION OF EMBODIMENTS

Overview

[0037] Embodiments described herein include a basket catheter that may be used, for example, to build an electroanatomical map. The basket catheter comprises a plurality of splines at its distal end, and further comprises a plurality of helical conducting elements, which are disposed on the splines. During the electroanatomical mapping procedure, the helical conducting elements function as inductors, in that a generated magnetic field induces respective voltage differences across the conducting elements. Based on the induced voltage differences, the respective locations and orientations of the conducting elements—and hence, the location and orientation of the basket catheter—may be precisely determined.

[0038] Typically, embodiments described herein are rendered even more advantageous, in that the helical conducting elements may additionally function as electrodes for acquiring ECG signals, such that it may not be necessary to equip the basket catheter with separate ECG-acquiring electrodes. For example, an electrically-insulative layer may cover the majority of each of the helical conducting elements, but leave a small portion of each of the helical conducting elements exposed. This exposed portion, when brought into contact with the intracardiac tissue, acquires ECG signals from the tissue.

[0039] The helical conducting elements described herein may thus function in two capacities—e.g., simultaneously—during a single procedure. First, they may function as ECG electrodes, by sensing the intracardiac ECG signals. Second, they may function as magnetic-field sensors, by generating location signals (in the form of the above-described induced voltages) in response to the generated magnetic field. The conducting elements may thus be described as ECG electrodes that additionally function as magnetic-field sensors, or as magnetic-field sensors that additionally function as ECG electrodes. (Notwithstanding the above, in some embodiments, the conducting elements are used only as magnetic-field sensors, and separate electrodes coupled to the splines are used to acquire the ECG signals.)

[0040] Embodiments described herein further include circuitry for processing signals received from the helical conducting elements. In particular, the circuitry described herein generates, based on the received signals, a plurality of outputs, which are used by a processor to construct an electroanatomical map. These outputs include a plurality of first outputs, which indicate the electrical activity of the tissue, a plurality of second outputs, which indicate the respective induced voltage differences across the conducting elements, and a plurality of third outputs, which indicate the proximity to the tissue of each of the conducting elements.

Apparatus Description

[0041] Reference is initially made to FIG. 1, which is a schematic illustration of a basket catheter 22, in accordance with some embodiments of the present invention. FIG. 1 depicts a physician 34 using basket catheter 22 to perform an electroanatomical mapping of a heart 25 of a subject 26. During the mapping procedure, the distal end of the catheter, which comprises a basket 20 of splines 28, is inserted into heart 25. The splines are then brought into contact with the intracardiac tissue, and conducting elements 24 on the splines acquire intracardiac ECG signals. A console 36, which is connected to the basket catheter and comprises a computer processor 32, receives these ECG signals.

[0042] While the intracardiac ECG signals are being acquired, a magnetic field is generated by a plurality of magnetic-field generators 30 located underneath subject 26 or otherwise in the vicinity of the subject. (As shown in FIG. 1, a signal generator (“SIG GEN”) 40 in console 36 may cause generators 30 to generate the magnetic field by supplying an alternating current to the generators.) The magnetic field induces voltage differences across conducting elements 24. The induced voltage differences are received by the console, and, based on the induced voltages, processor 32 ascertains the position of each of the conducting elements. Processor 32 then constructs an electroanatomical map of the heart, based on the ECG signals (which indicate the electrical activity of the intracardiac tissue) and the voltages received from the helical conducting elements (which indicate the respective locations of the sources of the ECG signals). Such a map may be displayed on a monitor for viewing by physician 34, and/or stored for later analysis.

[0043] Splines 28 may be arranged to define any suitably-shaped basket, such as the spheroidal basket shown in FIG. 1. FIG. 1 shows an embodiment in which a plurality of helical conducting elements 24 are disposed on the surface of each of the splines. The top-left portion of the figure shows an enlarged view of a single such helical conducting element. In this enlarged view, the solid portion of the conducting element corresponds to the portion of the conducting element that is on the near side of the spline, facing the viewer. The dotted portion corresponds to the portion of the conducting element that is on the far side of the spline, facing away from the viewer. Each of the two terminals of each of the conducting elements is typically connected to the console via a wire 42 which passes through the interior of the spline.

[0044] In some embodiments, the conducting elements are printed onto the splines. For example, each of the conducting elements may comprise electrically-conductive paint that is helically painted onto the splines. In other embodiments, the conducting elements comprise wires that are wound (i.e., coiled) around, and glued or otherwise attached to, the splines. In any case, for embodiments in which the helical conducting elements are on the surface of the splines, an electrically-insulative layer 44 typically covers at least a majority of each of the helical conducting elements. Electrically-insulative layer 44 prevents the turns of any given conducting element from being shorted with each other.

[0045] Typically, the electrically-insulative layer does not cover a portion of exactly one respective turn of each of the helical conducting elements. Thus, the electrically-insulative layer prevents shorting of the turns (in that no more than one turn of each conducting element is exposed), but also allows the conducting elements to acquire ECG signals. For example, the enlarged portion of FIG. 1 shows an embodiment in which the electrically-insulative layer exposes a portion 46 of the conducting element. Exposed portion 46 may be brought into contact with tissue, in order to acquire an ECG signal.

[0046] As noted above, the exposed portion of the conducting element is confined to one turn of the conducting element. This means that the distance between the distalmost exposed portion of the conducting element and the proximalmost exposed portion of the conducting element is less than the distance D that separates between successive turns of the conducting element.

[0047] In some embodiments, the electrically-insulative layer is contiguous across a plurality of conducting elements. In other embodiments, as depicted in FIG. 1, the electrically-insulative layer is discontiguous, such that no portion of the electrically-insulative layer covers more than one of the conducting elements. Similarly, for any given conducting element, the cover provided by the electrically-insulative layer may be contiguous or discontiguous. As an example of the latter, in FIG. 1, the conducting element is covered by two separate, disjoint portions of the electrically-insulative layer, these portion being on respective opposite sides of exposed portion 46 of the conducting element.

[0048] In some embodiments, alternatively to being disposed on the splines as in FIG. 1, the conducting elements are contained within the splines. In such embodiments, the splines, being made of an electrically-insulative material (such as plastic), provide the “cover” that prevents the conducting elements from being shorted. For embodiments in which the conducting elements are additionally used to acquire ECG signals, the splines are shaped to define a plurality of openings that expose a portion of exactly one respective turn of each of the helical conducting elements. In other words, such embodiments are analogous to the embodiments described above, with the surface of the spline functioning analogously to electrically-insulative layer 44 in preventing shorting of the conducting elements, but also, optionally, providing for ECG-signal acquisition.

[0049] Reference is now made to FIG. 2, which is a schematic illustration of circuitry 48 for processing signals received from conducting elements 24, in accordance with some embodiments of the present invention. Circuitry 48 is typically located within console 36, between the catheter-console interface and the processor. As shown in FIG. 2, circuitry 48 is connected to each helical conducting element 24, typically via exactly two connections (or “leads”) connected to the conducting element: a first connection 50a to one terminal of the conducting element, and a second connection 50b to the other terminal of the conducting element. As further described below, circuitry 48 generates outputs based on signals received, via connections 50a and 50b, from each helical conducting element. Based on these outputs, processor 32 constructs an electroanatomical map of the subject's heart.

[0050] Typically, circuitry 48 comprises a first differential amplifier 52a and a second differential amplifier 52b. Connections 50a and 50b are connected to second differential amplifier 52b, while one of the connections—e.g., first connection 50a—is also connected to first differential amplifier 52a. Connections 50a and 50b thus carry inputs to the differential amplifiers, as further described below.

[0051] As described above, the exposed portion of each conducting element 24 is brought into contact with intracardiac tissue 56, such that an ECG voltage (referred to above as an “ECG signal”) is transferred to the conducting element from the tissue. (The ECG voltage is generally constant across the conducting element, i.e., the ECG voltage at the terminal of the conducting element is not significantly different from the ECG voltage at the exposed portion of the conducting element.) First connection 50a carries the ECG voltage to first differential amplifier 52a, which generates a first output 54a based on the ECG voltage, by amplifying a difference between the received ECG voltage and a reference voltage. The processor derives electrical-activity information from first output 54a, and uses this information to build the electroanatomical map. Typically, the reference voltage is the voltage at a reference electrode 58 disposed on the basket catheter, e.g., on a central spline of the catheter shaft (not shown in FIG. 1). (In FIG. 2, reference electrode 58 is connected to ground, such that the reference voltage is ground.)

[0052] Connection 50a also carries, to second differential amplifier 52b, the voltage induced by the magnetic field at one terminal of the conducting element, while connection 50b carries the voltage induced at the other terminal. In other words, connections 50a and 50b collectively carry, to the second differential amplifier, the voltage difference that is induced across the conducting element. Based on this voltage difference, second differential amplifier 52b generates a second output 54b, by amplifying the voltage difference. Second output 54b includes anatomical information, in that the second output indicates the position of the conducting element, and hence, the location of the source of the ECG signal. The processor derives this anatomical information from the second output, and then, in building the electroanatomical map, combines this anatomical information with the electrical-activity information derived from the first output.

[0053] Typically, circuitry 48 further comprises a current source, or, as in FIG. 2, a voltage source 60 in series with a resistor 62, which together function as a current source. The current source passes a current “I” over connection 50a and between the conducting element and reference electrode 58 (or a different reference electrode that is not used for the ECG reference voltage). During the passing of the current, the voltage on the conducting element indicates the impedance that is seen by the conducting element; the higher the voltage, the higher the impedance. The impedance, in turn, indicates the proximity of the conducting element to the tissue; the higher the impedance, the greater the proximity. Thus, the voltage on the conducting element indicates the proximity of the conducting element to the tissue. The first differential amplifier generates a third output 54c based on this proximity-indicating voltage, by amplifying the difference between the proximity-indicating voltage and the reference voltage. The processor then uses the third output to build the electroanatomical map. In particular, the processor first derives, from the third output, the proximity of the conducting element to the tissue. The processor then decides whether to accept the first (electrical-activity-related) output, based on the proximity. For example, the processor may compare the proximity to a threshold, and accept the first output only if the proximity is greater than the threshold (i.e., the distance between the conducting element and the tissue is sufficiently small).

[0054] It is noted that the ECG voltage, the induced voltage, and the proximity-indicating voltage are of sufficiently different frequencies, such that the three voltages may be simultaneously carried on connection 50a (and hence, simultaneously received by the circuitry). Thus, first output 54a, second output 54b, and third output 54c may be generated at the same time. In some embodiments, an adder 61 adds the first output, the second output, and the third output, yielding a combined output 64 having a plurality of components at various frequencies. Combined output 64 is then passed to an analog-to-digital converter (ADC) 66, which converts the combined output to a digital signal that is passed to the processor.

[0055] Although, for simplicity, only a single helical conducting element 24 is shown in FIG. 2, basket catheter 22 typically comprises a large number of helical conducting elements. On this note, reference is now made to FIG. 3, which is a schematic illustration of circuitry 48, in accordance with some embodiments of the present invention.

[0056] FIG. 3 shows a way in which the configuration of circuitry 48 shown in FIG. 2 may be extended to handle a large number of inputs from a large number of helical conducting elements. In particular, in FIG. 3, a block 68 of circuitry that is shown in FIG. 2 is replicated for each of the conducting elements. Thus, in FIG. 3, a conducting element 24a connects to a block 68a of circuitry, a conducting element 24b connects to a block 68b, and a conducting element 24c connects to a block 68c. Similarly, resistor 62 is replicated for each of the conducting elements, such that voltage source 60 may be connected to block 68a via a resistor 62a, to block 68b via a resistor 62b, or to block 68c via a resistor 62c. (Typically, switches 70 ensure that the voltage source is connected to no more than one block at a time.) Thus, for example, to pass a current between conducting element 24a and the reference electrode, the voltage source is connected to block 68a.

[0057] As indicated by the three-dot sequences in the figure, the configuration shown in FIG. 3 may be extended to handle any number of conducting elements.

[0058] It is emphasized that the principles described herein may be applied in many ways. For example, the scope of the present disclosure includes using each of one or more coils, and/or other conducting elements, for both (i) magnetic tracking, and (ii) exchanging signals with tissue, in any relevant application. (Circuitry described with reference to FIGS. 2-3 may be modified as appropriate to suit the application.) Exchanging signals with tissue includes, for example, acquiring ECG signals as described above, and/or passing ablating signals into tissue. (In the latter case, the same leads that carry the induced voltage from the conducting element may be used to deliver the ablating signal to the conducting element.) Moreover, the dual-function sensors described herein may be disposed on any suitable apparatus, including, for example, a lasso catheter, balloon catheter, or other type of catheter.

[0059] It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of embodiments of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art, which would occur to persons skilled in the art upon reading the foregoing description. Documents incorporated by reference in the present patent application are to be considered an integral part of the application except that to the extent any terms are defined in these incorporated documents in a manner that conflicts with the definitions made explicitly or implicitly in the present specification, only the definitions in the present specification should be considered.