The present disclosure relates generally to various force sensing catheter features.
In ablation therapy, it may be useful to assess the contact between the ablation element and the tissue targeted for ablation. In interventional cardiac electrophysiology (EP) procedures, for example, the contact can be used to assess the effectiveness of the ablation therapy being delivered. Other catheter-based therapies and diagnostics can be aided by knowing whether a part of the catheter contacts targeted tissue, and to what degree the part of the catheter presses on the targeted tissue. The tissue exerts a force back on the catheter, which can be measured to assess the contact and the degree to which the catheter presses on the targeted tissue.
The present disclosure concerns, amongst other things, systems for measuring a force with a catheter.
The present disclosure relates to devices, systems, and methods for measuring a contact force experienced by a catheter.
Example 1 is a catheter adapted to measure a contact force. The catheter includes a proximal segment, a distal segment, and a spring segment. The spring segment extends from the proximal segment to the distal segment. The spring segment is configured to permit relative movement between the distal segment and the proximal segment in response to an application of the force on the distal segment. The spring segment includes a slotted tube having a longitudinal axis and a plurality of sensing elements. The sensing elements are disposed on surfaces of the slotted tube. The sensing elements are configured to output a plurality of signals indicative of the relative movement between the proximal segment and the distal segment.
In Example 2, the catheter of Example 1, wherein the slotted tube includes a first plurality of slots and a second plurality of slots. Slots of the first plurality of slots extend through a wall of the slotted tube and are formed in a first plane. The first plane perpendicular to the longitudinal axis of the slotted tube. Slots of the second plurality of slots extend through the wall of the slotted tube and are formed in a second plane. The second plane is parallel to and axially spaced apart from the first plane. Ends of the first plurality of slots are offset in a circumferential direction from ends of the second plurality of slots. The slotted tube is configured to flex and resiliently change an axial width of at least one of the first plurality of slots and the second plurality of slots in response to the application of the force on the distal segment.
In Example 3, the catheter of Example 2, wherein the sensing elements are disposed on axially-facing surfaces within the first plurality of slots and the second plurality of slots.
In Example 4, the catheter of Example 3, wherein the plurality of sensing elements includes a plurality of inductive sensors configured to signal a change in inductance caused by changes in an axial width of the at least one of the first plurality of slots and the second plurality of slots, the changes in axial width indicative of the relative movement between the proximal segment and the distal segment.
In Example 5, the catheter of Example 4, wherein the spring segment further includes a plurality of masses of high magnetic permeability material disposed within the at least one of the first plurality of slots and the second plurality of slots on axially-facing surfaces opposite from the inductive sensors.
In Example 6, the catheter of any of Examples 2-5, wherein at least one of the plurality of sensing elements is disposed on an axially-facing surface within each slot of the first plurality of slots and the second plurality of slots, the at least one of the plurality of sensing elements disposed at a location midway between the ends of each slot.
In Example 7, the catheter of any of Examples 2-6, wherein the first plurality of slots consists of two substantially identical slots, the second plurality of slots consists of two substantially identical slots, and the ends of the first plurality of slots are offset in the circumferential direction from the ends of the second plurality of slots by about 90 degrees.
In Example 8, the catheter of any of Examples 2-6, wherein the first plurality of slots consists of three substantially identical slots, the second plurality of slots consists of three substantially identical slots, and the ends of the first plurality of slots are offset in the circumferential direction from the ends of the second plurality of slots by about 60 degrees.
In Example 9, the catheter of Example 2, wherein the plurality of sensing elements is disposed on at least one of a radially-facing surface of the slotted tube and a circumferentially-facing surface of the slotted tube. The radially facing surface of the slotted tube is adjacent to the first plurality of slots and the second plurality of slots. The circumferentially-facing surface of the slotted tube is within at least one of the first plurality of slots and the second plurality of slots. The plurality of sensing elements is configured to measure changes in strain indicative of the relative movement between the proximal segment and the distal segment.
In Example 10, the catheter of Example 9, wherein the plurality of sensing elements includes a plurality of strain sensors.
In Example 11, the catheter of any of Examples 1-10, wherein the proximal segment includes a proximal hub and the distal segment includes a distal hub, wherein a proximal end of the slotted tube is attached to the proximal hub and a distal end of the slotted tube is attached to the distal hub.
In Example 12, the catheter of Example 11, wherein when the distal segment is in the base orientation with respect to the proximal segment, the proximal and distal hubs are coaxially aligned with the longitudinal axis; and when the distal segment is moved out of the base orientation with respect to the proximal segment, the distal hub is no longer coaxially aligned with the longitudinal axis.
In Example 13, the catheter of either of Examples 11 or 12, further including a polymer tube having a lumen and a circumferential surface that defines an exterior of the catheter, wherein each of the proximal hub, the distal hub, and the slotted tube are at least partially located within the lumen.
In Example 14, the catheter of any of Examples 1-13, wherein the distal segment includes an ablation element configured to deliver ablation therapy.
Example 15 is a system adapted to measure a catheter contact force. The system includes a catheter according to any of Examples 1-14 and control circuitry configured to receive the plurality of signals and calculate a magnitude and a direction of the force based on the plurality of signals.
Example 16 is a catheter adapted to measure a contact force. The catheter includes a proximal segment, a distal segment, and a spring segment. The spring segment extends from the proximal segment to the distal segment. The spring segment is configured to permit relative movement between the distal segment and the proximal segment in response to an application of the force on the distal segment. The spring segment includes a slotted tube and a plurality of sensing elements. The slotted tube has a longitudinal axis and is configured to mechanically support the distal segment in a base orientation with respect to the proximal segment, flex when the distal segment moves relative to the proximal segment in response to the application of the force, and resiliently return the distal segment to the base orientation with respect to the proximal segment once the force has been removed. The sensing elements are disposed on surfaces of the slotted tube and configured to output a plurality of signals indicative of the relative movement between the proximal segment and the distal segment.
In Example 17, the catheter of Example 16, wherein the slotted tube includes a first plurality of slots and a second plurality of slots. Slots of the first plurality of slots extend through a wall of the slotted tube and are formed in a first plane. The first plane perpendicular to the longitudinal axis of the slotted tube. Slots of the second plurality of slots extend through the wall of the slotted tube and are formed in a second plane. The second plane is parallel to and axially spaced apart from the first plane. Ends of the first plurality of slots are offset in a circumferential direction from ends of the second plurality of slots. The slotted tube is configured to change an axial width of at least one of the first plurality of slots and the second plurality of slots in response to the application of the force on the distal segment.
In Example 18, the catheter of Example 17, wherein the sensing elements are disposed on axially-facing surfaces within the first plurality of slots and the second plurality of slots.
In Example 19, the catheter of Example 18, wherein the plurality of sensing elements includes a plurality of inductive sensors configured to signal a change in inductance caused by changes in an axial width of the at least one of the first plurality of slots and the second plurality of slots, the changes in axial width indicative of the relative movement between the proximal segment and the distal segment.
In Example 20, the catheter of Example 19, wherein the spring segment further includes a plurality of masses of high magnetic permeability material disposed within the at least one of the first plurality of slots and the second plurality of slots on axially-facing surfaces opposite from the inductive sensors.
In Example 21, the catheter of Example 17, wherein the plurality of sensing elements is disposed on at least one of a radially-facing surface of the slotted tube and a circumferentially-facing surface of the slotted tube. The radially facing surface of the slotted tube is adjacent to the first plurality of slots and the second plurality of slots. The circumferentially-facing surface of the slotted tube is within at least one of the first plurality of slots and the second plurality of slots. The plurality of sensing elements is configured to measure changes in strain indicative of the relative movement between the proximal segment and the distal segment.
In Example 22, the catheter of Example 21, wherein the plurality of sensing elements includes a plurality of strain sensors.
In Example 23, the catheter of Example 17, wherein at least one of the plurality of sensing elements is disposed on an axially-facing surface within each slot of the first plurality of slots and the second plurality of slots, the at least one of the plurality of sensing elements disposed at a location midway between the ends of each slot.
In Example 24, the catheter of any of Examples 17-23, wherein the first plurality of slots consists of two substantially identical slots, the second plurality of slots consists of two substantially identical slots, and the ends of the first plurality of slots are offset in the circumferential direction from the ends of the second plurality of slots by about 90 degrees.
In Example 25, the catheter of any of Examples 17-23, wherein the first plurality of slots consists of three substantially identical slots, the second plurality of slots consists of three substantially identical slots, and the ends of the first plurality of slots are offset in the circumferential direction from the ends of the second plurality of slots by about 60 degrees.
In Example 26, the catheter of any of Examples 16-25, wherein the proximal segment includes a proximal hub and the distal segment includes a distal hub, wherein a proximal end of the slotted tube is attached to the proximal hub and a distal end of the slotted tube is attached to the distal hub.
In Example 27, the catheter of Example 26, wherein when the distal segment is in the base orientation with respect to the proximal segment, the proximal and distal hubs are coaxially aligned with the longitudinal axis; and when the distal segment is moved out of the base orientation with respect to the proximal segment, the distal hub is no longer coaxially aligned with the longitudinal axis.
In Example 28, the catheter of either of Examples 26 or 27, further including a polymer tube having a lumen and a circumferential surface that defines an exterior of the catheter, wherein each of the proximal hub, the distal hub, and the slotted tube are at least partially located within the lumen.
In Example 29, the catheter of any of Examples 16-28, wherein the distal segment includes an ablation element configured to deliver ablation therapy.
Example 30 is a catheter adapted to measure a contact force. The catheter includes a proximal segment, a distal segment, and a spring segment. The spring segment extends from the proximal segment to the distal segment. The spring segment is configured to permit relative movement between the distal segment and the proximal segment in response to an application of the force on the distal segment. The spring segment includes a slotted tube and a plurality of sensing elements. The slotted tube has a longitudinal axis and includes a first plurality of slots and a second plurality of slots. Slots of the first plurality of slots extend through a wall of the slotted tube and are formed in a first plane. The first plane is perpendicular to the longitudinal axis. Slots of the second plurality of slots extend through the wall of the slotted tube and are formed in a second plane. The second plane is parallel to and axially spaced apart from the first plane. Ends of the first plurality of slots are offset in a circumferential direction from ends of the second plurality of slots. The slotted tube is configured to flex and resiliently change an axial width of at least one of the first plurality of slots and the second plurality of slots in response to the application of the force on the distal segment. The sensing elements are disposed on surfaces of the slotted tube and configured to output a plurality of signals indicative of the relative movement between the proximal segment and the distal segment.
In Example 31, the catheter of Example 30, wherein at least one of the plurality of sensing elements is disposed on an axially-facing surface within each slot of the first plurality of slots and the second plurality of slots, the at least one of the plurality of sensing elements disposed at a location midway between the ends of each slot.
In Example 32, the catheter of Example 31, wherein the plurality of sensing elements include a plurality of inductive sensors configured to signal a change in inductance caused by changes in an axial width of the at least one of the first plurality of slots and the second plurality of slots, the changes in axial width indicative of the relative movement between the proximal segment and the distal segment.
In Example 33, the catheter of Example 32, wherein the spring segment further includes a plurality of masses of high magnetic permeability material disposed within the at least one of the first plurality of slots and the second plurality of slots on axially-facing surfaces opposite from the inductive sensors.
In Example 34, the catheter of Example 30, wherein the plurality of sensing elements is disposed on at least one of a radially-facing surface of the slotted tube and a circumferentially-facing surface of the slotted tube. The radially facing surface of the slotted tube is adjacent to the first plurality of slots and the second plurality of slots. The circumferentially-facing surface of the slotted tube is within at least one of the first plurality of slots and the second plurality of slots. The plurality of sensing elements is configured to measure changes in strain indicative of the relative movement between the proximal segment and the distal segment.
Example 35 is a system adapted to measure a catheter contact force. The system includes a catheter and control circuitry. The catheter includes a proximal segment, a distal segment, and a spring segment. The spring segment extends from the proximal segment to the distal segment. The spring segment is configured to permit relative movement between the distal segment and the proximal segment in response to an application of the force on the distal segment. The spring segment includes a slotted tube having a longitudinal axis and a plurality of sensing elements disposed on surfaces of the slotted tube. The slotted tube is configured to mechanically support the distal segment in a base orientation with respect to the proximal segment, flex when the distal segment moves relative to the proximal segment in response to the application of the force, and resiliently return the distal segment to the base orientation with respect to the proximal segment once the force has been removed. The sensing elements are disposed on surfaces of the slotted tube and configured to output a plurality of signals indicative of the relative movement between the proximal segment and the distal segment. The control circuitry is configured to receive the plurality of signals and calculate a magnitude and a direction of the force based on the plurality of signals.
While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
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.
Various cardiac abnormalities can be attributed to improper electrical activity of cardiac tissue. Such improper electrical activity can include, but is not limited to, generation of electrical signals, conduction of electrical signals, and/or mechanical contraction of the tissue in a manner that does not support efficient and/or effective cardiac function. For example, an area of cardiac tissue may become electrically active prematurely or otherwise out of synchrony during the cardiac cycle, thereby causing the cardiac cells of the area and/or adjacent areas to contract out of rhythm. The result is an abnormal cardiac contraction that is not timed for optimal cardiac output. In some cases, an area of cardiac tissue may provide a faulty electrical pathway (e.g., a short circuit) that causes an arrhythmia, such as atrial fibrillation or supraventricular tachycardia. In some cases, inactivate tissue (e.g., scar tissue) may be preferable to malfunctioning cardiac tissue.
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 lesion the tissue and prevent the tissue from improperly generating or conducting electrical signals. For example, a line, a circle, or other formation of lesioned cardiac tissue can block the propagation of errant electrical signals. In some cases, cardiac ablation is intended to cause the death of cardiac tissue and to have scar tissue reform over the lesion, where the scar tissue is not associated with the improper electrical activity. Lesioning therapies include electrical ablation, radiofrequency ablation, cyroablation, microwave ablation, laser ablation, and surgical ablation, among others. While cardiac ablation therapy is referenced herein as an exemplar, various embodiments of the present disclosure can be directed to ablation of other types of tissue and/or to non-ablation diagnostic and/or catheters that deliver other therapies.
Ideally, an ablation therapy can be delivered in a minimally invasive manner, such as with a catheter introduced to the heart through a vessel, rather than surgically opening the heart for direct access (e.g., as in a maze surgical procedure). For example, a single catheter can be used to perform an electrophysiology study of the inner surfaces of a heart to identify electrical activation patterns. From these patterns, a clinician can identify areas of inappropriate electrical activity and ablate cardiac tissue in a manner to kill or isolate the tissue associated with the inappropriate electrical activation. However, the lack of direct access in a catheter-based procedure may require that the clinician only interact with the cardiac tissue through a single catheter and keep track of all of the information that the catheter collects or is otherwise associated with the procedure. In particular, it can be challenging to determine the location of the therapy element (e.g., the proximity to tissue), the quality of a lesion, and whether the tissue is fully lesioned, under-lesioned (e.g., still capable of generating and/or conducting unwanted electrical signals), or over-lesioned (e.g., burning through or otherwise weakening the cardiac wall). The quality of the lesion can depend on the degree of contact between the ablation element and the targeted tissue. For example, an ablation element that is barely contacting tissue may not be adequately positioned to deliver effective ablation therapy. Conversely, an ablation element that is pressed too hard into tissue may deliver too much ablation energy or cause a perforation.
The present disclosure concerns, among other things, methods, devices, and systems for assessing a degree of contact between a part of a catheter (e.g., an ablation element) and tissue. Knowing the degree of contact, such as the magnitude and the direction of a force generated by contact between the catheter and the tissue, can be useful in determining the degree of lesioning of the targeted tissue. Information regarding the degree of lesioning of cardiac tissue can be used to determine whether the tissue should be further lesioned or whether the tissue was successfully ablated, among other things. Additionally or alternatively, an indicator of contact can be useful when navigating the catheter because a user may not feel a force being exerted on the catheter from tissue as the catheter is advanced within a patient, thereby causing vascular or cardiac tissue damage or perforation.
As shown in
The distal segment 113, or any other segment, can be in the form of an electrode configured for sensing electrical activity, such as electrical cardiac signals. In other embodiments, such an electrode can additionally or alternatively be used to deliver ablative energy to tissue.
The catheter 110 includes force sensing capabilities. For example, as shown in
The control unit 120 of the system 100 includes a display 121 (e.g., a liquid crystal display or a cathode ray tube) for displaying information. The control unit 120 further includes a user input 122 which can include one or more buttons, toggles, a track ball, a mouse, touchpad, or the like for receiving user input. The user input 122 can additionally or alternatively be located on the handle 114. The control unit 120 can contain control circuitry for performing the functions referenced herein. Some or all of the control circuitry can alternatively be located within the handle 114.
The control unit 120 can include a catheter interface 123. The catheter interface 123 can include a plug which receives a cord from the handle 114. The catheter 110 can include multiple conductors (not illustrated but known in the art) to convey electrical signals between the distal end 116 and the proximal end 115 and further to the catheter interface 123. It is through the catheter interface 123 that the control unit 120 (and/or the handle 114 if control circuitry is included in the handle 114) can send electrical signals to any element within the catheter 110 and/or receive an electrical signal from any element within the catheter 110. The catheter interface 123 can conduct signals to any of the components of the control unit 120.
The control unit 120 can include an ultrasound subsystem 124 which includes components for operating the ultrasound functions of the system 100. While the illustrated example of control circuitry shown in
The control unit 120 can include an ablation subsystem 125. The ablation subsystem 125 can include components for operating the ablation functions of the system 100. While the illustrated example of control circuitry shown in
The control unit 120 can include a force sensing subsystem 126. The force sensing subsystem 126 can include components for measuring a force experienced by the catheter 110. Such components can include signal processors, analog-to-digital converters, operational amplifiers, comparators, and/or any other circuitry for conditioning and measuring one or more signals. The force sensing subsystem 126 can send signals to elements within the catheter 110 via the catheter interface 123 and/or receive signals from elements within the catheter 110 via the catheter interface 123.
Each of the ultrasound subsystem 124, the ablation subsystem 125, and the force sensing subsystem 126 can send signals to, and receive signals from, the processor 127. The processor 127 can be any type of processor for executing computer functions. For example, the processor 127 can execute program instructions stored within the memory 128 to carry out any function referenced herein, such as determine the magnitude and direction of a force experienced by the catheter 110.
The control unit 120 further includes an input/output subsystem 129 which can support user input and output functionality. For example, the input/output subsystem 129 may support the display 121 to display any information referenced herein, such as a graphic representation of tissue, the catheter 110, and a magnitude and direction of the force experienced by the catheter 110, amongst other options. Input/output subsystem 129 can log key and/or other input entries via the user input 122 and route the entries to other circuitry.
A single processor 127, or multiple processors, can perform the functions of one or more subsystems, and as such the subsystems may share control circuitry. Although different subsystems are presented herein, circuitry may be divided between a greater or lesser numbers of subsystems, which may be housed separately or together. In various embodiments, circuitry is not distributed between subsystems, but rather is provided as a unified computing system. Whether distributed or unified, the components can be electrically connected to coordinate and share resources to carry out functions.
As shown, the proximal segment 111 can be proximal and adjacent to the spring segment 112. The length of the proximal segment 111 can vary between different embodiments, and can be five millimeters to five centimeters, although different lengths are also possible. The length of the spring segment 112 can also vary between different embodiments and is dependent on the length of underlying features as will be further discussed herein. The spring segment 112 is adjacent to the distal segment 113. As shown in
In the base orientation, the proximal hub 134, the distal hub 136, and the slotted tube 138 can be coaxially aligned with respect to the longitudinal axis 109, as shown in
A tether 148 can attach to a proximal end of the proximal hub 134. Considering
As shown in
The slotted tube 138 may include a first plurality of slots 150 and a second plurality of slots 152. The first plurality of slots 150 are formed in a first plane 154, which is perpendicular to the longitudinal axis 109. The second plurality of slots 152 are formed in a second plane 156. The second plane 156 is parallel to the first plane 154 and is axially spaced apart from the first plane 154. The first plurality of slots 150 and the second plurality of slots 152 may be formed by, for example, laser cutting, mechanical sawing, or precision electrochemical machining (PEM).
In the embodiment of
In some embodiments, as shown in
In some embodiments, the plurality of sensing elements 140 may be strain sensors configured to measure changes in strain indicative of relative movement between the proximal segment 111 and the distal segment 113, as described below. In some embodiments, the strain sensors are disposed on axially-facing surfaces 168 within the first plurality of slots 150 and the second plurality of slots 152 at locations midway between the ends 164 and the ends 166, as shown in
In
In some embodiments in which the sensing elements 140a-140d are inductive sensors, the slotted tube 138 may be formed of a material having a magnetic permeability greater than air. In such embodiments, the decrease in axial width proximate to the sensing element 140a moves the sensing element 140a closer to a portion of the slotted tube 138 opposite the sensing element 140a, thus increasing the magnetic permeability proximate to the sensing element 140a and increasing the inductance associated with sensing element 140a. Conversely, the increase in axial width proximate to the sensing element 140b moves the sensing element 140b farther from a portion of the slotted tube 138 opposite the sensing element 140b, thus decreasing the magnetic permeability proximate to the sensing element 140b and decreasing the inductance associate with sensing element 140b. No change in inductance is associated with the sensing elements 140c and 140d because there is no change in axial width of the second plurality of slots 152. In other embodiments in which the sensing elements 140a-140d are strain sensors, the strain of the slotted tube 138 adjacent to the first plurality of slots 150 is measured directly by the strain sensors.
In embodiments in which the sensing elements 140a-140d are inductive sensors, the decrease in axial width proximate to the sensing element 140d moves the sensing element 140d closer to a portion of the slotted tube 138 opposite the sensing element 140d, thus increasing the magnetic permeability proximate to the sensing element 140d and increasing the inductance associated with sensing element 140d. Conversely, the increase in axial width proximate to the sensing element 140c moves the sensing element 140c farther from a portion of the slotted tube 138 opposite the sensing element 140c, thus decreasing the magnetic permeability proximate to the sensing element 140c and decreasing the inductance associate with sensing element 140c. No change in inductance is associated with the sensing elements 140a and 140b because there is no change in axial width of the first plurality of slots 150. In other embodiments in which the sensing elements 140a-140d are strain sensors, the strain of the slotted tube 138 adjacent to the second plurality of slots 152 is measured directly by the strain sensors.
As noted above, the slotted tube 138 is formed of a resilient material. Thus, the amount of strain and the degree to which the axial widths of the slots change is a function of the magnitude of the force applied to the distal end 113. In this way, a force applied to the distal end 113 may be resolved into orthogonal components to measure both a magnitude and a direction of the force applied.
The embodiments have been describe above with the slotted tube 138 having two rows of axially-spaces slots, the first plurality of slots 150 and the second plurality of slots 152. However, it is understood that embodiments include slotted tubes having more than two rows of axially-spaced slots. In some embodiments including more than two rows of axially-spaced slots, each row of slots has associated sensing elements 140. Additional rows of slots and associated sensing elements 140 may be added to provide additional signals indicative of the relative movement between the proximal segment 111 and the distal segment 113 and tailor the permitted relative movement between the proximal segment 111 and the distal segment 113. In other embodiments including more than two rows of axially-spaced slots, not all of the rows of slots need to have associated sensing elements 140.
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.
This application claims priority to Provisional Application No. 62/258,453, filed Nov. 21, 2015, which is herein incorporated by reference in its entirety.
Number | Date | Country | |
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62258453 | Nov 2015 | US |