a. Field of the Invention
This invention relates to a robotic catheter system and method for automated control of a catheter and related components, including a control system capable of being used in conjunction with a robotic catheter system to provide a certain or desired minimal tension on catheter steering wires in connection with medical applications or procedures.
b. Background Art
Electrophysiology catheters are used in a variety of diagnostic and/or therapeutic medical procedures to correct conditions such as atrial arrhythmia, including for example, ectopic atrial tachycardia, atrial fibrillation, and atrial flutter. Arrhythmia can cause a variety of serious medical conditions including irregular heart rates, loss of synchronous atrioventricular contractions, and stasis of blood flow.
Typically in a procedure, a catheter is manipulated through a patient's vasculature to, for example, a patient's heart, and carries one or more electrodes which may be used for mapping, ablation, diagnosis, and/or other treatments. After being positioned at an intended site, the catheter may be used to provide therapeutic treatment to the patient, such treatment may include radio frequency (RF) ablation, cryoablation, laser, chemicals, high-intensity focused ultrasound, or various other treatments. An ablation catheter commonly imparts ablative energy or chemicals to cardiac tissue to create a lesion in the cardiac tissue. The lesion can disrupt undesirable electrical pathways and serve to limit or prevent stray electrical signals that can lead to arrhythmias. Such treatments can require precise control of the catheter during manipulation to and at the treatment site, which can oftentimes be a function of a user's skill level.
The inventors herein have recognized a desire for a system and method for more precise and dynamic automated or semi-automated control of a catheter and its related components, for example, for diagnostic, therapeutic, mapping and ablative procedures, that help to minimize and/or eliminate procedural variability attendant to a user's skill level. The inventors herein have also recognized a need for a system and method for performing user-specified procedures at the patient site or from a remote location.
An apparatus for maintaining a robotic catheter system in a responsive state includes a catheter, a plurality of linear translatable control elements, and a controller. In an embodiment, the catheter includes a proximal portion, a distal portion, and at least two steering wires. The steering wires may be configured at one end to control the movement of at least a portion of the distal portion of the catheter and at the other end for connection to a control member. In an embodiment, each control element may be configured to engage or interface with a respective control member, and the controller may be configured to measure a force exerted on at least one control member by a respective control element and further configured to linearly translate the control element to substantially maintain a force within a predetermined range.
The drawings illustrate the design and utility of the illustrated embodiments of the invention, in which similar elements are referred to by common reference numerals, and in which:
a is a graph that generally illustrates a dynamically responsive catheter motion;
b is a graph that generally illustrates a catheter motion with transition latencies.
a is an isometric view of a device cartridge connected to a catheter body according to an embodiment;
b is an isometric view of the device cartridge shown in
c is bottom view of the lower portion shown in
a and 11b are flowcharts generally illustrating different methods in which a controller may control the linear position of a translatable drive element in response to a contact force between a control element and a control member;
a, 15b, and 15c generally illustrate, in a block form, various inputs and outputs associated with catheter models in accordance with embodiments of the invention.
Referring now to the drawings wherein like reference numerals are used to identify like or identical components in the various views,
As generally illustrated, the catheter 10 may include two steering wires 18, 20, each longitudinally situated within and along a substantial length of the catheter body. In an embodiment, the steering wires 18, 20 may be comprised of a material having a high elastic modulus—such as, for example, steel or aluminum. The catheter 10 may further include a pull ring 22, which may take the form of a rigid ring firmly connected or affixed within a portion of the distal portion 12 of the catheter 10. Each steering wire may be rigidly connected to pull ring 22, for example, via a rigid connection or coupling 24, 26. In an embodiment, such a rigid connection or coupling may comprise a weld and/or other known means for suitable attachment.
As generally depicted in the illustrated embodiment, proximal portions of the steering wires 18, 20 may be respectively connected to control members 28, 30. Control members 28, 30 may be used, for example, to interface or operatively connect control devices with steering wires 18, 20. For illustrative purposes, as generally shown in
In an embodiment, catheter 10 further includes tip 32 that may be used to perform various medical treatments or procedures. In an embodiment, catheter tip 32 may include one or more mapping electrodes that can, for example, be used to detect physical or electrical characteristics of cardiac tissue. In an embodiment, tip 32 may include one or more ablation electrodes that can, for example, be used to create lesions within cardiac tissue during an ablation procedure. In an embodiment, tip 32 may include phased ultrasound arrays that may, for example, be used to sense various properties of cardiac tissue. Moreover, the invention is not limited to a particular catheter tip and embodiments of the invention may include various combinations of one or more of the aforementioned features.
As generally shown in
As further illustrated in
To cause catheter 10 to move or retract back to an undeflected state along longitudinal axis L, a user could, for example, actively translate control member 30 in a proximal direction. Such a motion could cause the distal portion 12 to rotate and deflect toward steering wire 20, while control member 28 would be reactively translated in a distal direction. In an embodiment, due to some extent on memory effects of catheter 10, upon restoring catheter 10 to an undeflected state along longitudinal axis L, control members 28, 30 may not necessarily return to their original positions (e.g., on datum X).
It may be desirable, for example during a medical procedure, for the distal portion of a catheter to be capable of prompt dynamic, back and forth movements. To help facilitate such movement, it can be beneficial to maintain a minimal tension on all steering wires, even when such a steering wire may be reactively translating in a distal direction. Such a base or minimal tension can help ensure that no undesirable measure of slack is created in any steering wire that could potentially cause an unresponsive state (even if only momentarily) during a transition from a motion in one direction to motion in another direction.
It is noted that while
As generally illustrated in
In an embodiment, control member 50 may be similar to control members 28, 30, shown in
In an embodiment where control member 50 is required to translate distally (as generally shown by control member 30 in
In an embodiment, such as generally shown in
c generally illustrates the underside of the lower portion 86 of device cartridge 82, shown in
With reference to
In an embodiment, translatable drive element 118 may be controllably translated by a mechanical movement device 120 (e.g., a drive screw) in the X+ or X− directions. Further, a position sensor may be coupled to the translatable drive element 118 to provide the system with an indication of the location of drive element 118 along the X axis. The position sensor may operate in either absolute or relative coordinates. In an embodiment the position sensor may comprise an encoder 124. In another embodiment, the position sensor may comprise a linear encoder (not shown) coupled directly with the translatable drive element 118. In a further embodiment, the position sensor may include a potentiometer configured to provide a varying voltage output, proportional to the position of the translatable drive element 118.
In the embodiment generally illustrated in
In an embodiment, controller 126 may be configured to control the operation of motor 122 in response to a measured contact force between control element 114 and control member 110. In such a configuration, the controller 126 may help serve to ensure that a minimal tension is maintained on all steering wires, even when such a steering wire may be reactively translating in a distal direction (e.g., as previously described in connection with
a, 11b generally illustrate two methods in which a controller 126 may control the linear position of a translatable drive element 118 in response to a contact force between a control element 114 and a control member 110.
b depicts a general control algorithm where the controller 126 receives an indication of contact force (F) from the sensor 116. The controller 126 may then provide motor 122 with an appropriate drive current to cause a movement (e.g., rotation) of a mechanical movement device 120 (e.g., a drive screw) and an associated movement or translation of drive element 118. The controller 126 may then receive an indication of the position of the drive element 118 from an encoder 124 associated with the motor 122 and/or a position sensor (e.g., as generally described above) and calculate an associated drive current in a closed-loop manner.
In step 202, a first control element is translated proximally a distance ΔX1 to cause a respective control member/steering wire movement, and to further cause a deflection of the distal portion of the catheter (e.g., as generally illustrated in
In step 206, the controller controllably translates the second control element in a distal direction while maintaining a measured contact force within a pre-determined or acceptable range. As described above, if the measured force is higher than the pre-determined or acceptable range, a second control element may translate in a distal direction to alleviate some contact pressure. Likewise, if the measured force is below the pre-determined or acceptable range, the second control element may translate in a proximal direction to either re-establish contact with the control member, or to re-tension the steering wire to a minimal or desired level of tension. By way of example, without limitation, the pre-determined or acceptable range may comprise a minimal force designed to not significantly impede the distal motion of the catheter, or cause any undue axial loading on the catheter body, such as 50-100 grams of force.
As further illustrated by
In an embodiment (not shown), controller 126 may be further configured to compute the derivative of sensed force with respect to time (δF/δt) and/or position (δF/δX2). In an embodiment, the position derivative of sensed force (δF/δX2) may be used, for example, to accurately determine when initial contact has been established between a control element and the respective control member, and “zero” the sensed force at that point.
As illustrated in
Although embodiments of this invention have been described above with a certain degree of particularity, those skilled in the art could make numerous alterations to the disclosed embodiments without departing from the spirit or scope of this invention. For example, while embodiments have been described using strain gauges, it is to be understood that additional embodiment could include other types of sensors and encoders including, without limitation, absolute position encoders, relative position encoders, optical encoders, linear encoders, linear actuators, and linear variable differential transformers. All directional references (e.g., upper, lower, upward, downward, left, right, leftward, rightward, top, bottom, above, below, vertical, horizontal, clockwise, and counterclockwise) are only used for identification purposes to aid the reader's understanding of the present invention, and do not create limitations, particularly as to the position, orientation, or use of the invention. Joinder references (e.g., attached, coupled, connected, and the like) are to be construed broadly and may include intermediate members between a connection of elements and relative movement between elements. As such, joinder references do not necessarily infer that two elements are directly connected and in fixed relation to each other. It is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative only and not limiting. Changes in detail or structure may be made without departing from the spirit of the invention as defined in the appended claims.
This application claims the benefit of priority to U.S. provisional application Nos. 61/040,143, filed 27 Mar. 2008; 61/099,904, filed 24 Sep. 2008; and 61/142,008, filed 31 Dec. 2008, the entire disclosures of which are hereby incorporated by reference as though fully set forth herein.
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