WO2004026134B1 - Method and apparatus for locating the fossa ovalis and performing transseptal puncture - Google Patents

Method and apparatus for locating the fossa ovalis and performing transseptal puncture

Info

Publication number
WO2004026134B1
WO2004026134B1 PCT/US2003/026776 US0326776W WO2004026134B1 WO 2004026134 B1 WO2004026134 B1 WO 2004026134B1 US 0326776 W US0326776 W US 0326776W WO 2004026134 B1 WO2004026134 B1 WO 2004026134B1
Authority
WO
WIPO (PCT)
Prior art keywords
fossa ovalis
signal
locating
electrodes
electrograms
Prior art date
Application number
PCT/US2003/026776
Other languages
French (fr)
Other versions
WO2004026134A1 (en
Inventor
Subramaniam C Krishnan
Original Assignee
Subramaniam C Krishnan
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Subramaniam C Krishnan filed Critical Subramaniam C Krishnan
Priority to JP2004537695A priority Critical patent/JP4511935B2/en
Priority to EP03797867A priority patent/EP1542587B1/en
Priority to DE60336914T priority patent/DE60336914D1/en
Priority to AU2003262896A priority patent/AU2003262896B2/en
Priority to AT03797867T priority patent/ATE506891T1/en
Publication of WO2004026134A1 publication Critical patent/WO2004026134A1/en
Publication of WO2004026134B1 publication Critical patent/WO2004026134B1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3478—Endoscopic needles, e.g. for infusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
    • A61B5/0036—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room including treatment, e.g., using an implantable medical device, ablating, ventilating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
    • A61B5/068—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe using impedance sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/333—Recording apparatus specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
    • A61B2017/00044—Sensing electrocardiography, i.e. ECG
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M2025/0166—Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided

Abstract

A method and apparatus for identifying the fossa ovalis. The transseptal apparatus (50) includes a hollow sheath (51) and an internal catheter (52). The distal end (70) of the catheter (52) includes first and second electrodes (65, 66) that communicate with cables (53, 54) which may be attached to a device for generating electrograms. The electrograms are acquired while moving the electrodes to a plurality of positions against the interatrial septum. The fossa ovalis is identified on the basis of at least one of unipolar voltage reduction, signal fractionation, broadened signal, reduced signal slew rate, reduced local myocardial impedance, increased phase angle, and increased pacing threshold.

Claims

AMENDED CLAIMS
[received by the International Bureau on 30 March 2004 (30.03.04); original claims 1-11 replaced by new claims 1-20 (5 pages)]
+ STATEMENT
PCT/US2003/026776 2002-08-24 2003-08-25 Method and apparatus for locating the fossa ovalis and performing transseptal puncture WO2004026134A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
JP2004537695A JP4511935B2 (en) 2002-08-24 2003-08-25 Transseptal puncture device
EP03797867A EP1542587B1 (en) 2002-08-24 2003-08-25 Method and apparatus for locating the fossa ovalis and performing transseptal puncture
DE60336914T DE60336914D1 (en) 2002-08-24 2003-08-25 METHOD AND DEVICE FOR LOCATING THE FOSSA OVALIS AND PERFORMING A TRANSSEPTAL PUNCTURE
AU2003262896A AU2003262896B2 (en) 2002-08-24 2003-08-25 Method and apparatus for locating the fossa ovalis and performing transseptal puncture
AT03797867T ATE506891T1 (en) 2002-08-24 2003-08-25 METHOD AND DEVICE FOR LOCALIZING THE FOSSA OVALIS AND PERFORMING A TRANSSEPTAL PUNCTURE

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US40584902P 2002-08-24 2002-08-24
US60/405,849 2002-08-24

Publications (2)

Publication Number Publication Date
WO2004026134A1 WO2004026134A1 (en) 2004-04-01
WO2004026134B1 true WO2004026134B1 (en) 2004-05-13

Family

ID=32030628

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2003/026776 WO2004026134A1 (en) 2002-08-24 2003-08-25 Method and apparatus for locating the fossa ovalis and performing transseptal puncture

Country Status (7)

Country Link
US (5) US20040133113A1 (en)
EP (1) EP1542587B1 (en)
JP (1) JP4511935B2 (en)
AT (1) ATE506891T1 (en)
AU (1) AU2003262896B2 (en)
DE (1) DE60336914D1 (en)
WO (1) WO2004026134A1 (en)

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