US20100030061A1 - Navigation system for cardiac therapies using gating - Google Patents
Navigation system for cardiac therapies using gating Download PDFInfo
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- US20100030061A1 US20100030061A1 US12/183,688 US18368808A US2010030061A1 US 20100030061 A1 US20100030061 A1 US 20100030061A1 US 18368808 A US18368808 A US 18368808A US 2010030061 A1 US2010030061 A1 US 2010030061A1
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Abstract
An image guided navigation system for navigating a region of a patient which is gated using ECG signals to confirm diastole. The navigation system includes an imaging device, a tracking device, a controller, and a display. The imaging device generates images of the region of a patient. The tracking device tracks the location of the instrument in a region of the patient. The controller superimposes an icon representative of the instrument onto the images generated from the imaging device based upon the location of the instrument. The display displays the image with the superimposed instrument. The images and a registration process may be synchronized to a physiological event.
Description
- The present invention relates generally to image guided surgery, and more specifically, to systems and methods for using one or more medical images to assist in navigating an instrument through internal body structures, in particular for navigating a catheter in a moving body structure, such as the heart, during a surgical procedure.
- Image guided medical and surgical procedures utilize patient images obtained prior to or during a medical procedure to guide a physician performing the procedure. Recent advances in imaging technology, especially in imaging technologies that produce two, three, and four dimensional images, such as computed tomography (CT), magnetic resonance imaging (MRI), isocentric C-arm fluoroscopic imaging, positron emission tomography (PET), and ultrasound imaging (US), has increased the interest in image guided medical procedures.
- At present, cardiac catheterization procedures are typically performed with the aid of fluoroscopic images. Two-dimensional fluoroscopic images taken intra-procedurally allow a physician to visualize the location of a catheter being advanced through cardiovascular structures. However, use of such fluoroscopic imaging throughout a procedure exposes both the patient and the operating room staff to radiation, and exposes the patient to contrast agents. Therefore, the number of fluoroscopic images taken during a procedure is preferably limited to reduce the radiation exposure to the patient and staff.
- An image guided surgical navigation system that enables the physician to see the location of an instrument relative to a patient's anatomy, without the need to acquire real-time fluoroscopic images throughout the surgical procedure is generally disclosed in U.S. Pat. No. 6,470,207, entitled “Navigational Guidance Via Computer-Assisted Fluoroscopic Imaging,” issued Oct. 22, 2002, which is incorporated herein by reference in its entirety. In this system, representations of surgical instruments are overlaid on pre-acquired fluoroscopic images of a patient based on the position of the instruments determined by a tracking sensor.
- Other types of procedures include the use of electro-physiologic mapping catheters to map the heart based on measured electrical potentials. Such mapping catheters are useful in identifying an area of tissue that is either conducting normally or abnormally, however, some mapping catheters may not aid in actually guiding a medical device to a targeted tissue area for medical treatment.
- Other procedures that could benefit from a navigation system include cardiac lead placement. Cardiac lead placement is important in achieving proper stimulation or accurate sensing at a desired cardiac location. Endocardial is one type of lead placement procedure that is an internal procedure where coronary vein leads are generally implanted with the use of a guide catheter and/or a guide wire or stylet to achieve proper placement of the lead. Epicardial is another type of procedure that is an external procedure for cardiac lead placement that may also benefit from this navigation system. A coronary vein lead may be placed using a multi-step procedure wherein a guide catheter is advanced into the coronary sinus ostium and a guide wire is advanced further through the coronary sinus and great cardiac vein to a desired cardiac vein branch. Because the tip of a guide wire is generally flexible and may be preshaped in a bend or curve, the tip of the guide wire can be steered into a desired venous branch. The guide wire tip is directed with a steerable guide catheter, and with the appropriate pressure, it is manipulated into the desired vein branch.
- A cardiac lead may therefore be advanced to a desired implant location using a guide wire extending entirely through the lead and out its distal end. Cardiac leads generally need to be highly flexible in order to withstand flexing motion caused by the beating heart without fracturing. A guide wire provides a flexible lead with the stiffness needed to advance it through a venous pathway. Leads placed with the use of a guide wire are sometimes referred to as “over-the-wire” leads. Once the lead is placed in a desired location, the guide wire and guide catheter may be removed. A guide wire placed implantable lead is disclosed in U.S. Pat. No. 6,192,280, entitled “Guide wire Placed Implantable Lead With Tip Seal,” issued Feb. 20, 2001. A coronary vein lead having a flexible tip and which may be adapted for receiving a stylet or guide wire is disclosed in U.S. Pat. No. 5,935,160, entitled “Left Ventricular Access Lead for Heart Failure Pacing”, issued Aug. 10, 1999, each of which are hereby incorporated by reference.
- Also, pacing lead procedures currently performed today for use in heart failure treatment are not optimized. In this regard, the lead placement is not optimized due to the lack of having real-time anatomic information, navigation and localization information, hemo-dynamic data, and electro-physiological data. Currently, pacing leads are simply “stuffed” into the heart without any optimization being performed due to lack of information that can be used for this optimization.
- Advancement of a guide catheter or an over-the-wire lead through a vessel pathway and through cardiac structures requires considerable skill and can be a time-consuming task. This type of procedure also exposes the patient to an undesirable amount of radiation exposure and contrast agent. Therefore, it is desirable to provide an image guided navigation system that allows the location of a guide catheter being advanced within the cardiovascular structures for lead placement to be followed in either two, three, or four dimensional space in real time. It is also desirable to provide an image guided navigation system that assists in navigating an instrument, such as a catheter, through a moving body structure or any type of soft tissue.
- With regard to navigating an instrument through a moving body structure, difficulties arise in attempting to track such an instrument using known tracking technology as the instrument passes adjacent or through a moving body structure, since the virtual representation of the instrument may be offset from the corresponding anatomy when superimposed onto image data. Accordingly, it is also desirable to acquire image data and track the instrument in a synchronized manner with the pre-acquired image using gating or synchronization techniques, such as ECG gating or respiratory gating.
- Other difficulties with cardiac procedures include annual check-ups to measure early indications for organ rejection in heart transplant patients. These indicators include white blood cells, chemical change, blood oxygen levels, etc. During the procedure, an endovascular biopsy catheter is inserted into the heart and multiple biopsies are performed in the septum wall of the heart. Again, during this procedure, radiation and contrast agent is utilized to visualize the biopsy catheter, thereby exposing both a patient and the doctor to potential excess radiation and contrast agents during the procedure. As such, it would also be desirable to provide an image guided navigation system that assists in performing this type of procedure in order to reduce radiation and contrast agent exposure.
- A navigation system is provided including a catheter carrying single or multiple localization sensors, a sensor interface, a user interface, a controller, and a visual display. Aspects of the present invention allow for the location of a catheter advanced within an internal space within the human body, for example within the cardiovascular structures, to be identified in two, three or four dimensions in real time. Further aspects of the present invention allow for accurate mapping of a tissue or organ, such as the heart or other soft tissue, and/or precise identification of a desired location for delivering a medical lead, or other medical device or therapy, while reducing the exposure to fluoroscopy normally required during conventional catheterization procedures. These types of therapies include, but are not limited to, drug delivery therapy, cell delivery therapy, ablation, stenting, or sensing of various physiological parameters with the appropriate type of sensor. In cardiac applications, methods included in the present invention compensate for the effects of respiration and the beating heart that can normally complicate mapping or diagnostic data. Aspects of the present invention may be tailored to improve the outcomes of numerous cardiac therapies as well as non-cardiac therapies, such as neurological, oncological, or other medical therapies, including lung, liver, prostate and other soft tissue therapies, requiring the use of a catheter or other instrument at a precise location.
- The steerable catheter provided by the present invention features at least one or more location sensors located near the distal end of an elongated catheter body. The location sensors may be spaced axially from each other and may be electromagnetic detectors. An electromagnetic source is positioned externally to the patient for inducing a magnetic field, which causes voltage to be developed on the location sensors. The location sensors may each be electrically coupled to twisted pair conductors, which extend through the catheter body to the proximal catheter end. Twisted pair conductors provide electromagnetic shielding of the conductors, which prevents voltage induction along the conductors when exposed to the magnetic flux produced by the electromagnetic source. Alternatively, the sensors and the source may be reversed where the catheter emits a magnetic field that is sensed by external sensors.
- By sensing and processing the voltage signals from each location sensor, the location of the catheter tip with respect to the external sources and the location of each sensor with respect to one another may be determined. The present invention allows a two, three, or four-dimensional reconstruction of several centimeters of the distal portion of the catheter body in real time. Visualization of the shape and position of a distal portion of the catheter makes the advancement of the catheter to a desired position more intuitive to the user. The system may also provide a curve fitting algorithm that is selectable based upon the type of catheter used, and based upon the flexibility of the catheter, based upon a path finding algorithm, and based upon image data. This enables estimated curved trajectories of the catheter to be displayed to assist the user.
- The location sensor conductors, as well as conductors coupled to other physiological sensors present, are coupled to a sensor interface for filtering, amplifying, and digitizing the sensed signals. The digitized signals are provided via a data bus to a control system, embodied as a computer. Programs executed by the control system process the sensor data for determining the location of the location sensors relative to a reference source. A determined location is superimposed on a two, three, or four-dimensional image that is displayed on a monitor. A user-interface, such as a keyboard, mouse or pointer, is provided for entering operational commands or parameters.
- In one embodiment, an image guided navigation system for guiding an instrument through a region of the patient includes an anatomic gating device, an imaging device, a tracking device, a controller, and a display. The anatomic gating device senses a first and second physiological event. The imaging device captures image data in response to the first and second physiological event. The tracking device tracks the position of the instrument in the region of the patient. The controller is in communication with the anatomic gating device, the imaging device and the tracking device, and registers the image data with the region of a patient in response to the first and second physiological event. The controller also superimposes an icon representing the instrument onto the image data, based on the tracked position. The display shows the image data of the region of the patient with the superimposed icon of the instrument.
- Further areas of applicability of the present invention will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples, while indicating the preferred embodiments of the invention, are intended for purposes of illustration only and are not intended to limit the scope of the invention.
- The present invention will become more fully understood from the detailed description and the accompanying drawings, wherein:
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FIG. 1 is a diagram of a catheter navigation system according to the teachings of the present invention; -
FIGS. 2 a and 2 b are diagrams representing undistorted and distorted views from a fluoroscopic C-arm imaging device; -
FIG. 3 is a logic block diagram illustrating a method for navigating a catheter during cardiac therapy; -
FIG. 4 is a logic block diagram illustrating the R-wave detector associated with the method for navigating a catheter during cardiac therapy as shown inFIG. 3 ; -
FIG. 5 is a logic block diagram illustrating the diastole detector associated with the method for navigating a catheter during cardiac therapy as shown inFIG. 3 ; and -
FIG. 6 is a logic block diagram illustrating the gating phase of the diastole detector illustrated inFIG. 5 . - The following description of the preferred embodiment(s) is merely exemplary in nature and is in no way intended to limit the invention, its application, or uses. As indicated above, the present invention is directed at providing improved, non-line-of-site, image-guided navigation of an instrument, such as a catheter, balloon catheter, implant, lead, stent, needle, guide wire, insert, and/or capsule, that may be used for physiological monitoring, delivering a medical therapy, or guiding the delivery of a medical device in an internal body space, such as the heart or any other region of the body.
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FIG. 1 is a diagram illustrating an overview of an image-guidedcatheter navigation system 10 for use in non-line-of-site navigating of a catheter during cardiac therapy or any other soft tissue therapy. It should further be noted that thenavigation system 10 may be used to navigate any other type of instrument or delivery system, including guide wires, needles, drug delivery systems, cell delivery systems, gene delivery systems, and biopsy systems. Moreover, these instruments may be used for cardiac therapy or any other therapy in the body or be used to navigate or map any other regions of the body, such as moving body structures. However, each region of the body poses unique requirements to navigate, as disclosed herein. For example, thenavigation system 10 addresses multiple cardiac, neurological, organ and other soft tissue therapies, including drug delivery, cell transplantation, gene delivery, electro-physiology ablations, revascularization, biopsy guidance, mitral valve repair, aortic valve repair, leadless pacemaker placement, leadless pressure sensor placement, and virtual echography imaging. - The
navigation system 10 may include animaging device 12 that is used to acquire pre-operative or real-time images of apatient 14. Theimaging device 12 is a fluoroscopic x-ray imaging device that may include a C-arm 16 having anx-ray source 18, anx-ray receiving section 20, an optional calibration and trackingtarget 22, andoptional radiation sensors 24. The calibration and trackingtarget 22 includes calibration markers 26 (seeFIGS. 2 a-2 b), further discussed herein. A C-arm controller 28 captures the x-ray images received at the receivingsection 20 and stores the images for later use. The C-arm controller 28 may also control the rotation of the C-arm 16. For example, the C-arm 16 may move in the direction ofarrow 30 or rotates about the long axis of the patient, allowing anterior or lateral views of the patient 14 to be imaged. Each of these movements involve rotation about amechanical axis 32 of the C-arm 16. In this example, the long axis of thepatient 14 is substantially in line with themechanical axis 32 of the C-arm 16. This enables the C-arm 16 to be rotated relative to thepatient 14, allowing images of the patient 14 to be taken from multiple directions or about multiple planes. An example of a fluoroscopic C-armx-ray imaging device 12 is the “Series 9600 Mobile Digital Imaging System,” from OEC Medical Systems, Inc., of Salt Lake City, Utah. Other exemplary fluoroscopes include bi-plane fluoroscopic systems, ceiling fluoroscopic systems, cath-lab fluoroscopic systems, fixed C-arm fluoroscopic systems, isocentric C-arm fluoroscopic systems, 3D fluoroscopic systems, etc. - In operation, the
imaging device 12 generates x-rays from thex-ray source 18 that propagate through thepatient 14 and calibration and/or trackingtarget 22, into thex-ray receiving section 20. The receivingsection 20 generates an image representing the intensities of the received x-rays. Typically, the receivingsection 20 includes an image intensifier that first converts the x-rays to visible light and a charge coupled device (CCD) video camera that converts the visible light into digital images. Receivingsection 20 may also be a digital device that converts x-rays directly to digital images, thus potentially avoiding distortion introduced by first converting to visible light. With this type of digital C-arm, which is generally a flat panel device, the optional calibration and/or trackingtarget 22 and the calibration process discussed below may be eliminated. Also, the calibration process may be eliminated or not used at all for cardiac therapies. Alternatively, theimaging device 12 may only take a single image with the calibration and trackingtarget 22 in place. Thereafter, the calibration and trackingtarget 22 may be removed from the line-of-sight of theimaging device 12. - Two-dimensional fluoroscopic images taken by the
imaging device 12 are captured and stored in the C-arm controller 28. Multiple two-dimensional images taken by theimaging device 12 may also be captured and assembled to provide a larger view or image of a whole region of a patient, as opposed to being directed to only a portion of a region of the patient. For example, multiple image data of a patient's leg may be appended together to provide a full view or complete set of image data of the leg that can be later used to follow a contrast agent, such as Bolus tracking. These images are then forwarded from the C-arm controller 28 to a controller orwork station 34 having adisplay 36 and auser interface 38. Thework station 34 provides facilities for exhibiting on thedisplay 36, and saving, digitally manipulating, or printing a hard copy of the received images. Theuser interface 38, which may be a keyboard, mouse, touch pen, touch screen or other suitable device, allows a physician or user to provide inputs to control theimaging device 12 via the C-arm controller 28, or adjust the display settings of thedisplay 36. Thework station 34 may also direct the C-arm controller 28 to adjust therotational axis 32 of the C-arm 16 to obtain various two-dimensional images along different planes in order to generate representative two-dimensional and three-dimensional images. When thex-ray source 18 generates the x-rays that propagate to thex-ray receiving section 20, theradiation sensors 24 sense the presence of radiation, which is forwarded to the C-arm controller 28 to identify whether or not theimaging device 12 is actively imaging. This information is also transmitted to acoil array controller 48, further discussed herein. Alternatively, a person or physician may manually indicate when theimaging device 12 is actively imaging or this function can be built into thex-ray source 18,x-ray receiving section 20, or thecontrol computer 28. - Fluoroscopic C-
arm imaging devices 12 that do not include adigital receiving section 20 generally require the optional calibration and/or trackingtarget 22. This is because the raw images generated by the receivingsection 20 tend to suffer from undesirable distortion caused by a number of factors, including inherent image distortion in the image intensifier and external electromagnetic fields. An empty undistorted or ideal image and an empty distorted image are shown inFIGS. 2 a and 2 b, respectively. The checkerboard shape, shown inFIG. 2 a, represents theideal image 40 of the checkerboard-arrangedcalibration markers 26. The image taken by the receivingsection 20, however, can suffer from distortion, as illustrated by the distortedcalibration marker image 42, shown inFIG. 2 b. - Intrinsic calibration, which is the process of correcting image distortion in a received image and establishing the projective transformation for that image, involves placing the
calibration markers 26 in the path of the x-ray, where thecalibration markers 26 are opaque or semi-opaque to the x-rays. Thecalibration markers 26 are rigidly arranged in pre-determined patterns in one or more planes in the path of the x-rays and are visible in the recorded images. Because the true relative position of thecalibration markers 26 in the recorded images are known, the C-arm controller 28 or the work station orcomputer 34 is able to calculate an amount of distortion at each pixel in the image (where a pixel is a single point in the image). Accordingly, the computer orwork station 34 can digitally compensate for the distortion in the image and generate a distortion-free or at least a distortion-improved image 40 (seeFIG. 2 a). A more detailed explanation of exemplary methods for performing intrinsic calibration is described in the references: B. Schuele, et al., “Correction of Image Intensifier Distortion for Three-Dimensional Reconstruction,” presented at SPIE Medical Imaging, San Diego, Calif., 1995; G. Champleboux, et al., “Accurate Calibration of Cameras and Range Imaging Sensors: the NPBS Method,” Proceedings of the IEEE International Conference on Robotics and Automation, Nice, France, May, 1992; and U.S. Pat. No. 6,118,845, entitled “System And Methods For The Reduction And Elimination Of Image Artifacts In The Calibration Of X-Ray Imagers,” issued Sep. 12, 2000, the contents of which are each hereby incorporated by reference. - While the
fluoroscopic imaging device 12 is shown inFIG. 1 , any other alternative 2D, 3D or 4D imaging modality may also be used. For example, any 2D, 3D or 4D imaging device, such as isocentric fluoroscopy, bi-plane fluoroscopy, ultrasound, computed tomography (CT), multi-slice computed tomography (MSCT), magnetic resonance imaging (MRI), high frequency ultrasound (HIFU), positron emission tomography (PET), positron emission tomography-computed tomography (PET/CT), high definition computed tomography (HDCT), dual source computed tomography, optical coherence tomography (OCT), intra-vascular ultrasound (IVUS), ultrasound, intra-operative CT or MRI, may also be used to acquire 2D, 3D or 4D pre-operative or real-time images or image data of thepatient 14. The images may also be obtained and displayed in two, three or four dimensions. In more advanced forms, four-dimensional surface rendering of the heart or other regions of the body may also be achieved by incorporating heart data or other soft tissue data from an atlas map or from pre-operative image data captured by MRI, CT, or echocardiography modalities. A more detailed discussion on optical coherence tomography (OCT), is set forth in U.S. Pat. No. 5,740,808, issued Apr. 21, 1998, entitled “Systems And Methods For Guilding Diagnostic Or Therapeutic Devices In Interior Tissue Regions” which is hereby incorporated by reference. - Image datasets from hybrid modalities, such as positron emission tomography (PET) combined with CT, or single photon emission computer tomography (SPECT) combined with CT, could also provide functional image data superimposed onto anatomical data to be used to confidently reach target sights within the heart or other areas of interest. It should further be noted that the
fluoroscopic imaging device 12, as shown inFIG. 1 , provides a virtual bi-plane image using a single-head C-arm fluoroscope 12 by simply rotating the C-arm 16 about at least two planes, which could be orthogonal planes to generate two-dimensional images that can be converted to three-dimensional volumetric images. By acquiring images in more than one plane, an icon representing the location of a catheter or other instrument, introduced and advanced in thepatient 14, may be superimposed in more than one view ondisplay 36 allowing simulated bi-plane or even multi-plane views, including two and three-dimensional views. - These types of imaging modalities may provide certain distinct benefits and disadvantages for their use. For example, magnetic resonance imaging (MRI) is generally performed pre-operatively using a non-ionizing field. This type of imaging provides very good tissue visualization in three-dimensional form and also provides anatomical and functional information from the imaging. MRI imaging data is generally registers and compensates for motion correction using dynamic reference frames that are discussed herein.
- Positron emission tomography (PET) imaging is generally a pre-operative imaging procedure that exposes the patient to some level of radiation to provide a 3D image. PET imaging provides functional information and also generally requires registration and motion correction using dynamic reference frames.
- Computed tomography (CT) imaging is also generally a pre-operative technique that exposes the patient to a limited level of radiation. CT imaging, however, is a very rapid imaging procedure. A multi-slice CT system provides 3D images having good resolution and anatomical information. Again, CT imaging is generally registered and needs to account for motion correction via dynamic reference frames.
- Fluoroscopy imaging is generally an intra-operative imaging procedure that exposes the patient to certain amounts of radiation to provide either two-dimensional or rotational three-dimensional images. Fluoroscopic images generally provide good resolution and anatomical information. Fluoroscopic images can be either manually or automatically registered and also need to account for motion correction using dynamic reference frames.
- Ultrasound imaging is also generally an intra-operative procedure using a non-ionizing field to provide either 2D, 3D, or 4D imaging, including anatomical and blood flow information. Ultrasound imaging provides automatic registration and does not need to account for any motion correction.
- The
navigation system 10 further includes an electromagnetic navigation or trackingsystem 44 that includes atransmitter coil array 46, thecoil array controller 48, anavigation probe interface 50, anelectromagnetic catheter 52 or any other type of instrument and adynamic reference frame 54. Further, it should further be noted that theentire tracking system 44 or parts of thetracking system 44 may be incorporated into theimaging device 12, including thework station 34 andradiation sensors 24. Incorporating thetracking system 44 will provide an integrated imaging and tracking system. Any combination of these components may also be incorporated into theimaging device 12, which again can include a fluoroscopic C-arm imaging device or any other appropriate imaging device. - The
transmitter coil array 46 is shown attached to the receivingsection 20 of the C-arm 16. However, it should be noted that thetransmitter coil array 46 may also be positioned at any other location as well. For example, thetransmitter coil array 46 may be positioned at thex-ray source 18, within or atop the OR table 56 positioned below thepatient 14, on siderails associated with the table 56, or positioned on the patient 14 in proximity to the region being navigated, such as on the patient's chest. Thetransmitter coil array 46 includes a plurality of coils that are each operable to generate distinct electromagnetic fields into the navigation region of thepatient 14, which is sometimes referred to as patient space. Representative electromagnetic systems are set forth in U.S. Pat. No. 5,913,820, entitled “Position Location System,” issued Jun. 22, 1999, and U.S. Pat. No. 5,592,939, entitled “Method and System for Navigating a Catheter Probe,” issued Jan. 14, 1997, each of which are hereby incorporated by reference. - The
transmitter coil array 46 is controlled or driven by thecoil array controller 48. Thecoil array controller 48 drives each coil in thetransmitter coil array 46 in a time division multiplex or a frequency division multiplex manner. In this regard, each coil may be driven separately at a distinct time or all of the coils may be driven simultaneously with each being driven by a different frequency. Upon driving the coils in thetransmitter coil array 46 with thecoil array controller 48, electromagnetic fields are generated within thepatient 14 in the area where the medical procedure is being performed, which is again sometimes referred to as patient space. The electromagnetic fields generated in the patient space induces currents insensors 58 positioned in thecatheter 52. These induced signals from thecatheter 52 are delivered to thenavigation probe interface 50 and subsequently forwarded to thecoil array controller 48. Thenavigation probe interface 50 provides all the necessary electrical isolation for thenavigation system 10. Thenavigation probe interface 50 also includes amplifiers, filters and buffers required to directly interface with thesensors 58 incatheter 52. Alternatively, thecatheter 52 may employ a wireless communications channel as opposed to being coupled directly to thenavigation probe interface 50. - The
catheter 52 may be equipped with at least one, and generally multiple,localization sensors 58. Thecatheter 52 may also be a steerable catheter that includes a handle at a proximal end and themultiple location sensors 58 fixed to the catheter body and spaced axially from one another along the distal segment of thecatheter 52. Thecatheter 52, as shown inFIG. 1 , includes fourlocalization sensors 58. Thelocalization sensors 58 are generally formed as electromagnetic receiver coils, such that the electromagnetic field generated by thetransmitter coil array 46 induces current in the electromagnetic receiver coils orsensors 58. Thecatheter 52 may also be equipped with one or more sensors, which are operable to sense various physiological signals. For example, thecatheter 52 may be provided with electrodes for sensing myopotentials or action potentials. An absolute pressure sensor may also be included, as well as other electrode sensors. Thecatheter 52 may also be provided with an open lumen to allow the delivery of a medical device or pharmaceutical/cell/gene agents. For example, thecatheter 52 may be used as a guide catheter for deploying a medical lead, such as a cardiac lead for use in cardiac pacing and/or defibrillation or tissue ablation. The open lumen may alternatively be used to locally deliver pharmaceutical agents, cell, or genetic therapies. A representative catheter which may be used is that which is disclosed in U.S. Patent Publication No. 2004/0097805 entitled “Navigation System for Cardiac Therapies”, filed Jul. 14, 2003, which is hereby incorporated by reference. - In an alternate embodiment, the electromagnetic sources or generators may be located within the
catheter 52 and one or more receiver coils may be provided externally to thepatient 14, forming a receiver coil array similar to thetransmitter coil array 46. In this regard, the sensor coils 58 would generate electromagnetic fields, which would be received by the receiving coils in the receiving coil array similar to thetransmitter coil array 46. Other types of localization sensors or systems may also be used, which may include an emitter, which emits energy, such as light, sound, or electromagnetic radiation, and a receiver that detects the energy at a position away from the emitter. This change in energy, from the emitter to the receiver, is used to determine the location of the receiver relative to the emitter. Other types of tracking systems include optical, acoustic, electrical field, RF and accelerometers. Accelerometers enable both dynamic sensing due to motion and static sensing due to gravity. An additional representative alternative localization and tracking system is set forth in U.S. Pat. No. 5,983,126, entitled “Catheter Location System and Method,” issued Nov. 9, 1999, which is hereby incorporated by reference. Alternatively, the localization system may be a hybrid system that includes components from various systems. - The
dynamic reference frame 54 of theelectromagnetic tracking system 44 is also coupled to thenavigation probe interface 50 to forward the information to thecoil array controller 48. Thedynamic reference frame 54 is a small magnetic field detector that is designed to be fixed to the patient 14 adjacent to the region being navigated so that any movement of thepatient 14 is detected as relative motion between thetransmitter coil array 46 and thedynamic reference frame 54. This relative motion is forwarded to thecoil array controller 48, which updates registration correlation and maintains accurate navigation, further discussed herein. Thedynamic reference frame 54 can be configured as a pair of orthogonally oriented coils, each having the same center or may be configured in any other non-coaxial coil configuration. Thedynamic reference frame 54 may be affixed externally to thepatient 14, adjacent to the region of navigation, such as on the patient's chest, as shown inFIG. 1 or on the patient's back. Thedynamic reference frame 54 can be affixed to the patient's skin, by way of a stick-on adhesive patch. Thedynamic reference frame 54 may also be removably attachable tofiducial markers 60 also positioned on the patient's body as further discussed herein. - Alternatively, the
dynamic reference frame 54 may be internally attached, for example, to the wall of the patient's heart or other soft tissue using a temporary lead that is attached directly to the heart. This provides increased accuracy since this lead will track the regional motion of the heart. Gating, as further discussed herein, will also increase the navigational accuracy of thesystem 10. An exemplarydynamic reference frame 54 andfiducial marker 60, is set forth in U.S. Pat. No. 6,381,485, entitled “Registration of Human Anatomy Integrated for Electromagnetic Localization,” issued Apr. 30, 2002, which is hereby incorporated by reference. It should further be noted that multipledynamic reference frames 54 may also be employed. For example, an externaldynamic reference frame 54 may be attached to the chest of thepatient 14, as well as to the back of thepatient 14. Since certain regions of the body may move more than others due to motions of the heart or the respiratory system, eachdynamic reference frame 54 may be appropriately weighted to increase accuracy even further. In this regard, thedynamic reference frame 54 attached to the back may be weighted higher than thedynamic reference frame 54 attached to the chest, since thedynamic reference frame 54 attached to the back is relatively static in motion. - The catheter and
navigation system 10 further includes a gating device or an ECG orelectrocardiogram 62, which is attached to thepatient 14, viaskin electrodes 64, and in communication with thecoil array controller 48. Respiration and cardiac motion can cause movement of cardiac structures relative to thecatheter 52, even when thecatheter 52 has not been moved. Therefore, localization data may be acquired on a time-gated basis triggered by a physiological signal. For example, the ECG or EGM signal may be acquired from theskin electrodes 64 or from a sensing electrode included on thecatheter 52 or from a separate reference probe. As will be discussed more fully below, a characteristic of this signal may be used as to gate or trigger image acquisition during the imaging phase with theimaging device 12. By event gating at a point in a cycle the image data and/or the navigation data, the icon of the location of thecatheter 52 relative to the heart at the same point in the cardiac cycle may be displayed on thedisplay 36, further discussed herein. - Additionally or alternatively, a sensor regarding respiration may be used to trigger data collection at the same point in the respiration cycle. Additional external sensors can also be coupled to the
navigation system 10. These could include a capnographic sensor that monitors exhaled CO2 concentration. From this, the end expiration point can be easily determined. The respiration, both ventriculated and spontaneous causes an undesirable elevation or reduction, respectively, in the baseline pressure signal. By measuring systolic and diastolic pressures at the end expiration point, the coupling of respiration noise is minimized. As an alternative to the CO2 sensor, an airway pressure sensor can be used to determine end expiration. - Briefly, the
navigation system 10 operates as follows. Thenavigation system 10 creates a translation map between all points in the radiological image generated from theimaging device 12 and the corresponding points in the patient's anatomy in patient space. After this map is established, whenever a tracked instrument, such as thecatheter 52 or pointing device is used, thework station 34, in combination with thecoil array controller 48 and the C-arm controller 28, uses the translation map to identify the corresponding point on the pre-acquired image, which is exhibited ondisplay 36. This identification is known as navigation or localization. An icon representing the localized point or instruments are shown on thedisplay 36 within several two-dimensional image planes, as well as on three and four dimensional images and models. - To enable navigation, the
navigation system 10 must be able to detect both the position of the patient's anatomy and the position of thecatheter 52 or other surgical instrument. Knowing the location of these two items allows thenavigation system 10 to compute and display the position of thecatheter 52 in relation to the patient 14 on the radiological images. Thetracking system 44 is employed to track thecatheter 52 and the anatomy simultaneously. - The
tracking system 44 essentially works by positioning thetransmitter coil array 46 adjacent to the patient space to generate a low-energy magnetic field generally referred to as a navigation field. Because every point in the navigation field or patient space is associated with a unique field strength, theelectromagnetic tracking system 44 can determine the position of thecatheter 52 by measuring the field strength at thesensor 58 location. Thedynamic reference frame 54 is fixed to the patient 14 to identify the location of the patient in the navigation field. Theelectromagnetic tracking system 44 continuously recomputes the relative position of thedynamic reference frame 54 and thecatheter 52 during localization and relates this spatial information to patient registration data to enable image guidance of thecatheter 52 within thepatient 14. - Patient registration is the process of determining how to correlate the position of the instrument or
catheter 52 on the patient 14 to the position on the diagnostic or pre-acquired images. To register thepatient 14, the physician or user may use point registration by selecting and storing particular points from the pre-acquired images and then touching the corresponding points on the patient's anatomy with apointer probe 66. Thenavigation system 10 analyzes the relationship between the two sets of points that are selected and computes a match, which correlates every point in the image data with its corresponding point on the patient's anatomy or the patient space. The points that are selected to perform registration are the fiducial arrays orlandmarks 60. Again, the landmarks orfiducial points 60 are identifiable on the images and identifiable and accessible on thepatient 14. Thelandmarks 60 can beartificial landmarks 60 that are positioned on the patient 14 or anatomical landmarks that can be easily identified in the image data. Thesystem 10 may also perform registration using anatomic surface information or path information, further discussed herein. Thesystem 10 may also perform 2D to 3D registration by utilizing the acquired 2D images to register 3D volume images by use of contour algorithms, point algorithms or density comparison algorithms, as is known in the art. An exemplary 2D to 3D registration procedure, as set forth in U.S. Patent Publication No. 2004/0215671, entitled “Method and Apparatus for Performing 2D to 3D Registration,” which is hereby incorporated by reference. The registration process may also be synched to an anatomical function, for example, by the use of theECG device 62, further discussed herein. - In order to maintain registration accuracy, the
navigation system 10 continuously tracks the position of the patient 14 during registration and navigation. This is because thepatient 14,dynamic reference frame 54, andtransmitter coil array 46 may all move during the procedure, even when this movement is not desired. Therefore, if thenavigation system 10 did not track the position of the patient 14 or area of the anatomy, any patient movement after image acquisition would result in inaccurate navigation within that image. Thedynamic reference frame 54 allows theelectromagnetic tracking system 44 to register and track the anatomy. Because thedynamic reference frame 54 is attached to thepatient 14, any movement of the anatomy or thetransmitter coil array 46 is detected as the relative motion between thetransmitter coil array 46 and thedynamic reference frame 54. This relative motion is communicated to thecoil array controller 48, via thenavigation probe interface 50, which updates the registration correlation to thereby maintain accurate navigation. - Turning now to
FIG. 3 , a logic flow diagram illustrating an exemplary operation of thenavigation system 10 is set forth in further detail. First, should theimaging device 12 or the fluoroscopic C-arm imager 12 not include adigital receiving section 20, theimaging device 12 is first calibrated using thecalibration process 68. Thecalibration process 68 begins atblock 70 by generating an x-ray by thex-ray source 18, which is received by thex-ray receiving section 20. Thex-ray image 70 is then captured or imported atimport block 72 from the C-arm controller 28 to thework station 34. Thework station 34 performs intrinsic calibration atcalibration block 74, as discussed above, utilizing thecalibration markers 26, shown inFIGS. 2 a and 2 b. This results in an empty image being calibrated atblock 76. This calibrated empty image is utilized for subsequent calibration and registration, further discussed herein. - Once the
imaging device 12 has been calibrated, thepatient 14 is positioned within the C-arm 16 between thex-ray source 18 and thex-ray receiving section 20. The navigation process begins atdecision block 78 where it is determined whether or not an x-ray image of thepatient 14 has been taken. If the x-ray image has not been taken, the process proceeds to block 80 where the x-ray image is generated at thex-ray source 18 and received at thex-ray receiving section 20. In some embodiments, when thex-ray source 18 is generating x-rays, theradiation sensors 24 identified inblock 82 may activate to identify that thex-ray image 80 is being taken. This enables thetracking system 44 to identify where the C-arm 16 is located relative to the patient 14 when the image data is being captured. In some embodiments, however, thetracking system 44 may not need to be triggered by theradiation sensors 24. - The process then proceeds to
decision block 84 where it is determined if the x-ray image acquisition will be gated to physiological activity of thepatient 14. If so, theimage device 12 will capture the x-ray image at this desired gating time. For example, the physiological change may be the beating heart, which is identified by ECG gating atblock 86. The ECG gating enables the x-ray image acquisition to take place at the end of diastole atblock 88, as will be more fully discussed below. Diastole is the period of time between contractions of the atria or the ventricles during which blood enters the relaxed chambers from systemic circulation and the lungs. Diastole is often measured as the blood pressure at the instant of maximum cardiac relaxation. ECG gating of myocardial injections also enables optimal injection volumes and injection rates to achieve maximum cell retention. The optimal injection time period may go over one heart cycle. During the injection, relative motion of the catheter tip to the endocardial surface needs to be minimized. Conductivity electrodes at the catheter tip may be used to maintain this minimized motion. Also, gating the delivery of volumes can be used to increase or decrease the volume delivered over time (i.e., ramp-up or ramp-down during cycle). Again, the image may be gated to any physiological change like the heartbeat, respiratory functions, etc. The image acquired atblock 88 is then imported to thework station 34 atblock 90. If it is not desired to physiologically gate the image acquisition cycle, the process will proceed from thex-ray image block 80 directly to theimage import block 90. - Once the image is received and stored in the
work station 34, the process proceeds to calibration and registration atblock 92. First, atdecision block 94, it is determined whether theimaging device 12 has been calibrated, if so, the empty image calibration information fromblock 76 is provided for calibration registration atblock 92. The empty image calibration information fromblock 76 is used to correct image distortion by establishing projective transformations using known calibration marker locations (seeFIGS. 2 a and 2 b).Calibration registration 92 also requires tracking of thedynamic reference frame 54. In this regard, it is first determined atdecision block 96 whether or not the dynamic reference frame is visible, viablock 98. With thedynamic reference frame 54 visible or in the navigation field and the calibration information provided, thework station 34 and thecoil array controller 48, via thenavigation probe interface 50 performs thecalibration registration 92 functions. In addition to monitoring thedynamic reference frame 54, the fiducial array orlandmarks 60 may also be used for image registration. - Once the
navigation system 10 has been calibrated and registered, navigation of an instrument, such as thecatheter 52 is performed. In this regard, once it is determined atdecision block 100 that thecatheter 54 is visible or in the navigation field atblock 102, an icon representing thecatheter 52 is superimposed over the pre-acquired images atblock 104. Should it be determined to match the superimposed image of thecatheter 52 with the motion of the heart atdecision block 106, ECG gating atblock 108 is performed. Thecatheter 52 may then be navigated, vianavigation block 110 throughout the anatomical area of interest in thepatient 14. - The ECG gating at
blocks FIGS. 4-7 . The ECG gating signals generated byblocks wave detector 112 as shown inFIG. 4 , or adiastole detector 140 as shown inFIGS. 5 and 6 . In addition, the ECG gating signals generate atblocks blocks - As discussed above, the ECG gating performed at
blocks wave detector 112 as illustrated inFIG. 4 . The R-wave detector 112 has two phases: alearning phase 114 and adetection phase 116. In this regard, the threshold characteristics associated with the ECG signals from the patient are initially acquired during thelearning phase 114. Once thelearning phase 114 has been completed, thedetection phase 116 associated with the R-wave detector 112 is performed which generates a gating signal by comparing the characteristics of the current ECG signal to the thresholds calculated during thelearning phase 114. - As shown in
FIG. 4 , thelearning phase 114 of the R-wave detector 112 includesblock 118 in which the ECG signal is initially acquired. Once the ECG signal is acquired atblock 118, thelearning phase 114 calculates certain characteristics of the ECG signal atblock 120 including slew, turning point and amplitude. The slew of the ECG signal is the slope of the ECG signal taken by selecting 10 samples within a 25 millisecond window. The turning point represents the running sum of 20 samples taken at a rate of 400 samples per second and represents a near term extrema of the ECG signal. The amplitude determined atblock 120 is simply the amplitude of a ECG signal. - Once the slew, turning point and amplitude of the ECG signal are calculated at the
block 120, thelearning phase 114 of the R-wave detector 112 adds these values to a threshold database atblock 122. The threshold database contains a 10 period moving average of the slew, turning point and amplitude of the ECG signals. Once the values for slew, turning point and amplitude have been added to the threshold database atblock 122, thelearning phase 114 determines whether the learning phase is completed atblock 124 by calculating whether 10 cardiac cycles have occurred since thelearning phase 114 began. If 10 cardiac cycles have occurred, then the R-wave detector 112 initiates thedetection phase 116. However, if fewer then 10 cardiac cycles have occurred, thelearning phase 114 acquires another ECG signal atblock 118. - As discussed above, if the
learning phase 114 has obtained information from 10 cardiac cycles, the R-wave detector 112 then initiates thedetection phase 116. As shown inFIG. 4 , thedetection phase 116 initially acquires the current ECG signal atblock 126. After the current ECG signal is acquired atblock 126, thedetection phase 116 then calculates the slew, turning point and amplitude of the current ECG signal atblock 128. The slew, turning point and amplitude are calculated in the same manner as discussed above with respect to block 120. - After the slew, turning point and amplitude have been calculated at
block 128, thedetection phase 116 then determines whether the slew of the current ECG signal is greater than a threshold atblock 130. In this regard, the slew threshold may be about 0.9 times the average slew that is stored in the threshold database atblock 122 during thelearning phase 114. It will be understood, however, that other values for the slew threshold may be used. If the slew of the current ECG signal is greater than the threshold as determined atblock 130, then thedetection phase 116 determines whether the amplitude of the current ECG signal is greater than an amplitude threshold. In this regard, thedetection phase 116 determines whether the amplitude of the current ECG signal is greater than about 0.9 times the average amplitude of the ECG signal stored in the threshold database atblock 122 during thelearning phase 114. If the amplitude of the current ECG signal is less than the amplitude threshold as compared atblock 132, a new sample is acquired atblock 126. However, if the amplitude of the current ECG signal is greater than the amplitude threshold as determined byblock 132, then thedetection phase 116 compares atblock 134 the turning point of the current ECG signal to the turning point threshold. In this regard, thedetection phase 116 determines whether the turning point of the current ECG signal is greater or lesser than the turning point threshold stored in the threshold database atblock 122. If the turning point of the current ECG signal is less than the turning point threshold determined atblock 134, then thedetection phase 116 assumes that the current ECG signal does not contain an R-wave and therefore a new sample is acquired atblock 126. - However, if the turning point of the current ECG sample is greater than the turning point threshold as determined at
block 134, then thedetection phase 116 assumes that the ECG signal contains an R-wave. When this occurs, a gating signal is generated byblock 138 following a delay period from onset of the R-wave that was detected. For example, thedetection phase 116 may generate a gating signal after a delay of 70% of the interval between adjacent R-waves (hereinafter the “R-R interval”). In this case, if the temporal spacing between two adjacent R-waves is 670 milliseconds, a gating signal may be generated after a delay of approximately 469 milliseconds after the R-wave that was detected. However, other delay periods may be suitable. - As discussed above, the ECG gating at
blocks diastole detector 140 as illustrated inFIGS. 5 and 6 . Thediastole detector 140 has alearning phase 142 and agating phase 144. Thelearning phase 142 of thediastole detector 140 calculates the mean and standard deviation of the R-R interval as will be fully discussed below. Thegating phase 144 of thediastole detector 140 is used for confirming that a diastolic region of the ECG signal is present before causing a gating signal to be generated atblocks learning phase 142 and thegating phase 144 of thediastole detector 140 will now be described in greater detail. - In the
learning phase 142 of thediastole detector 140, the presence of an R-wave is first detected atblock 146. In this regard, the R-wave detector 112, as shown inFIG. 4 , may be used for detecting the presence of an R-wave. However, other suitable R-wave detectors may be used. After the R-wave is detected atblock 146, the time interval between the current R-wave and immediately proceeding R-wave is calculated atblock 148. After the R-R interval has been calculated atblock 148, thelearning phase 142 determines whether the R-R interval is too short at block 150 (e.g., when arrhythmias may have occurred). In one embodiment, the R-R interval may be too short if the R-R interval is less than about 300-350 milliseconds. If the R-R interval is too short as determined byblock 150, thelearning phase 142 then waits until the next R-wave occurs as indicated byblock 146. If the R-R interval is sufficiently long as determined byblock 150, thelearning phase 142 then adds the R-R interval as well as the slew to the interval database atblock 152. Once the R-R interval is added to the interval database, thelearning phase 142 then calculates the mean and standard deviation of the R-R intervals stored in the database, as well as determines the minimum slew of the slew data of the ECG signals that have been evaluated during thelearning phase 142. After the mean and standard deviation of the R-R interval are calculated, thediastole detector 140 determines whether the learning phase is complete atblock 156. The learning phase may be determined to be complete after it has processed 10 cardiac cycles of sufficient length, as described above. - Once the
learning phase 156 is complete, the gating phase of thediastole detector 140 is initiated. In this regard, thegating phase 144 initially determines the location of a diastolic detection window. The diastolic detection window is the region of the ECG signal in which the heart is believed to be in diastole, and in which ECG signals are evaluated to confirm the heart is in diastole. The width of the diastolic detection window may be about 75 milliseconds, though other suitable widths may be used. The location of the diastolic detection window with respect to the current ECG signal may be determined by the variation of the R-R interval calculated during thelearning phase 142. In this regard, if there is a relatively high standard deviation in the R-R interval as calculated atblock 154, there is a relatively high likelihood of that the ECG signal may contain arrhythmias or ectopic beats. Under these circumstances, it may be desirable to center the diastolic detection window at approximately 45% of the R-R interval following the onset of an R-wave. In contrast, if the standard deviation of the R-R interval calculated atblock 154 is relatively small, then it is likely that the ECG signal corresponds to normal sinus rhythms. In this case, the diastolic detection window may be centered later in the cardiac cycle, such as at 70% (or about 62% to about 80%) of the duration R-R interval following the detection of an R-wave. It is to be understood, however, that the diastolic detection window may be centered at other suitable locations. - After the location of the diastolic detection window is determined at 158, the
gating phase 144 detects the presence of an R-wave block 160 (such as by using the R-wave detector 112). Once an R-wave is detected atblock 160, the current ECG signals located in the diastolic detection window are recorded during the diastolic detection window by waiting until the diastolic detection window opens by means ofblocks 162 and 164. Once the diastolic detection window has opened, thegating phase 144 determines whether an R-wave has occurred within the diastolic detection window atblock 166. This may be performed using the R-wave detector 112 shown inFIG. 4 , though other suitable R-wave detectors may be used. If an R-wave has occurred during the diastolic detection window, thegating phase 144 may prevent the generation of a gating signal atblocks block 160. If no R-wave has been detected during the diastolic detection window as determined byblock 166, then thegating phase 144 may determine whether the slew associated with the current ECG signal is relatively high. In this regard, thegating phase 144 may select 30 samples (at a rate of 400 samples per second) and determine whether the slew is greater than 5 times the minimum slew as calculated atblock 154. If the slew of the ECG signal is sufficiently high, thegating phase 144 may not cause the generation of a gating signal fromblocks block 160. - If the slew of the current ECG signal is not high as determined at
block 168, thegating phase 144 may determine whether there is a DC offset associated with the current ECG signal. If there is a DC offset to the current ECG signal, then thegating phase 144 may also not cause the generation of a gating signal atblocks block 160. If there is no DC offset, then thegating phase 144 may trigger the generation of a gating signal atblocks block 172. - It will be appreciated that the check for DC offset at
block 170 may occur during normal sinus rhythms and may not generally be necessary when arrhythmias may be present. In addition, also during normal sinus rhythms, once a gating signal is generated byblocks gating phase 144 may prevent the generation of another gating signal fromblocks - As discussed above, the ECG gating at
blocks wave detector 174 as illustrated inFIG. 7 . The onset R-wave detector 174 is used for sensing the onset of an R-wave during a cardiac cycle, and causing the navigation system to display the previously acquired image of the catheter when the heart was in diastole. As indicated byblock 176, the onset R-wave detector 174 initially acquires the ECG signal as well as the catheter image. Once the ECG signal and catheter image has been acquired atblock 176, the onset R-wave detector 174 may calculate the slew and amplitude characteristics of the ECG signal atblock 178. In addition, the onset R-wave detector 174 may store the catheter image in a frame buffer atblock 180. If the slew or the amplitude of the ECG signal exceed respectively thresholds (as determined byblocks 182 and 184), the onset R-wave detector 174 determines that R-wave onset has occurred and, therefore, retrieves the previous catheter image from the frame buffer for use to register the image of the catheter as illustrated byblock 186. If either of the slew or the amplitude are not greater than their respective thresholds as determined byblock block 176. - The description of the invention is merely exemplary in nature and, thus, variations that do not depart from the gist of the invention are intended to be within the scope of the invention. Such variations are not to be regarded as a departure from the spirit and scope of the invention.
Claims (25)
1. An image guided navigation system for guiding an instrument through a region of a patient, said image guided navigation system comprising:
an anatomical gating device operable to sense a first physiological event and a second physiological event, the first physiological event being different from the second physiological event;
an imaging device operable to capture image data of the region of the patient in response to the second physiological event by comparing one characteristic of the first physiological event with respect a first threshold and when a second characteristic of said second physiological event to a second threshold;
a tracking device operable to track the position of the instrument in the region of the patient;
a controller in communication with said anatomical gating device, said imaging device and said tracking device and operable to register said image data with the region of the patient in response to the first and second physiological events, said controller further operable to superimpose an icon representing the instrument onto the image data of the region of the patient based upon the position tracked by said tracking device; and
a display operable to display the image data of the region of the patient with the superimposed icon of the instrument.
2. The image guided navigation system for guiding an instrument through a region of a patient as set forth in claim 1 , wherein the first physiological event is the generation of an R-wave during a cardiac cycle and the second physiological event is diastole during a cardiac cycle.
3. The image guided navigation system for guiding an instrument through a region of a patient as set forth in claim 2 , the anatomical gating device generates a diastolic detection window for confirming whether the patient is in diastole before capturing image data.
4. The image guided navigation system for guiding an instrument through a region of a patient as set forth in claim 3 , wherein the anatomical gating device is operable to confirm diastole during the diastolic detection window by comparing at least one characteristic of the ECG signal to one previously stored characteristic being selected from the group consisting of the presence of an R-wave, slew and DC offset.
5. The image guided navigation system for guiding an instrument through a region of a patient as set forth in claim 3 , wherein the diastolic detection window extends from about 62% to about 80% of the duration of the R-R interval following the detection of an R-wave.
6. The image guided navigation system for guiding an instrument through a region of a patient as set forth in claim 3 , wherein the diastolic detection window is centered at about 70% of the duration of the R-R interval following the detection of an R-wave during normal sinus rhythms.
7. The image guided navigation system for guiding an instrument through a region of a patient as set forth in claim 3 , wherein the diastolic detection window is centered at about 45% of the duration of the R-R interval following R-wave detection during arrhythmias.
8. The image guided navigation system for guiding an instrument through a region of a patient as set forth in claim 1 , wherein the first physiological event is associated with the presence of an R-wave of an ECG signal, the anatomical gating device operable to determine the presence of an R-wave by comparing at least one characteristic of the ECG signal to at least one corresponding threshold, the at least one characteristic selected from the group consisting of slew, turning point and amplitude.
9. The image guided navigation system for guiding an instrument through a region of a patient as set forth in claim 1 , wherein the anatomical gating device is operable to detect the onset of systole by calculating slew, amplitude and turning point of an ECG signal to determine the presence of an R-wave in the ECG signal, and generate a diastolic detection window in response to the variability of the interval between adjacent R-waves in the ECG signal.
10. The image guided navigation system as defined in claim 1 wherein said imaging device is selected from a group of 2D, 3D or 4D imaging devices comprising a C-arm fluoroscopic imager, a magnetic resonance imager (MRI), a computed tomography (CT) imager, a positron emission tomography (PET) imager, an isocentric fluoroscopy imager, a bi-plane fluoroscopy imager, an ultrasound imager, a multi-slice computed tomography (MSCT) imager, positron emission tomography-computed tomography (PET/CT), high definition computed tomography (HDCT), dual source computed tomography, a high-frequency ultrasound (HIFU) imager, an optical coherence tomography (OCT) imager, an intra-vascular ultrasound imager (IVUS), an ultrasound imager, an intra-operative CT imager, an intra-operative MRI imager, a single photon emission computer tomography (SPECT) imager, and a combination thereof.
11. The image guided navigation system as defined in claim 1 , wherein said instrument is operable to deliver a therapy to the patient, the therapy is selected from a group comprising lead placement, drug delivery, gene delivery, cell delivery, ablation, mitral valve repair, aortic valve repair, leadless pacemaker placement, leadless pressure sensor placement, and a combination thereof.
12. The image guided navigation system as defined in claim 1 , wherein said instrument is selected from a group comprising a catheter, a guide wire, a stylet, an insert, a needle and a combination thereof.
13. Method for image guiding an instrument in a region of a patient, the method comprising:
identifying a first physiological event;
comparing at least one characteristic of the first physiological event to a first predetermined threshold;
identifying a second physiological event different from the first physiological event;
comparing at least one characteristic of the second physiological event to a second predetermined threshold;
capturing image data during the second physiological event when the at least one characteristic of the first physiological event exceeds the first threshold and when the at least one characteristic of the second physiological event exceeds the second threshold;
registering the captured image data to the patient during the second physiological event; and
displaying the location of the instrument on the image data of the region of the patient by superimposing an icon of the instrument on the image data.
14. The method for guiding an instrument to a region of a patient as set forth in claim 13 , wherein the identification of a first physiological event is the identification of an R-wave during a cardiac cycle.
15. The method for guiding an instrument to a region of a patient as set forth in claim 14 , wherein identifying a second physiological event is the identification of diastole during a cardiac cycle.
16. The method for guiding an instrument to a region of a patient as set forth in claim 15 , wherein the identification of an R-wave during a cardiac cycle includes comparing at least one characteristic of an ECG signal to a corresponding threshold, the at least one characteristic selected from the group consisting of slew, turning point and amplitude.
17. The method for guiding an instrument to a region of a patient as set forth in claim 15 , wherein the identification of diastole during the cardiac cycle includes comparing at least one characteristic of an ECG signal to a previously stored characteristic selected from the group consisting of the presence of an R-wave, slew and DC offset.
18. A method for image guiding an instrument in a region of a patient, said method comprising:
generating a gating signal from an anatomical gating device, the gating signal responsive to the presence of arrhythmias and ectopic beats;
capturing image data during diastole in response to the gating signal generated by the anatomical gating device;
registering the captured image data to the patient; and
displaying the location of the instrument on the image data of the region of the patient by superimaging an icon of the instrument on the image data.
19. The method for image guiding an instrument in a region of a patient as set forth in claim 18 , further comprising detecting at the onset of systole by calculating slew, amplitude and turning point of an ECG signal to determine the presence of an R-wave in the ECG signal, and generating a diastolic detection window in response to the variability of the interval between adjacent R-waves in the ECG signal.
20. The method for image guiding an instrument in a region of a patient as set forth in claim 19 , wherein generating a diastolic detection window includes comparing the turning point of the ECG signal to a predetermined threshold.
21. The method for image guiding an instrument in a region of a patient as set forth in claim 19 , wherein generating a diastolic detection window includes comparing the amplitude of the ECG signal to a predetermined threshold.
22. The method for image guiding an instrument in a region of a patient as set forth in claim 20 , wherein the diastolic detection window is centered at about 45% to about 70% of the duration of the R-R interval following the onset of an R-wave.
23. The method for image guiding an instrument in a region of a patient as set forth in claim 20 , wherein the width of the diastolic detection window is about 75 milliseconds.
24. The method for image guiding an instrument in a region of a patient as set forth in claim 18 , wherein generating a gating signal from the anatomical gating device includes determining whether the onset of an R-wave has occurred.
25. The method for image guiding an instrument in a region of a patient as set forth in claim 24 , wherein displaying the location of the instrument on the image data includes displaying a previously acquired image of the instrument when the onset of an R-wave has occurred.
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Cited By (223)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20100210938A1 (en) * | 2002-11-19 | 2010-08-19 | Medtronic Navigation, Inc | Navigation System for Cardiac Therapies |
US20100298695A1 (en) * | 2009-05-19 | 2010-11-25 | Medtronic, Inc. | System and Method for Cardiac Lead Placement |
US8175681B2 (en) | 2008-12-16 | 2012-05-08 | Medtronic Navigation Inc. | Combination of electromagnetic and electropotential localization |
WO2012106063A1 (en) | 2011-02-03 | 2012-08-09 | Medtronic, Inc. | Display of an acquired cine loop for procedure navigation |
WO2013082581A1 (en) * | 2011-12-01 | 2013-06-06 | Neochord, Inc. | Surgical navigation for repair of heart valve leaflets |
US8467853B2 (en) | 2002-11-19 | 2013-06-18 | Medtronic Navigation, Inc. | Navigation system for cardiac therapies |
US8494614B2 (en) | 2009-08-31 | 2013-07-23 | Regents Of The University Of Minnesota | Combination localization system |
US8494613B2 (en) | 2009-08-31 | 2013-07-23 | Medtronic, Inc. | Combination localization system |
US8880185B2 (en) | 2010-06-11 | 2014-11-04 | Boston Scientific Scimed, Inc. | Renal denervation and stimulation employing wireless vascular energy transfer arrangement |
US8939970B2 (en) | 2004-09-10 | 2015-01-27 | Vessix Vascular, Inc. | Tuned RF energy and electrical tissue characterization for selective treatment of target tissues |
US8951251B2 (en) | 2011-11-08 | 2015-02-10 | Boston Scientific Scimed, Inc. | Ostial renal nerve ablation |
US8974451B2 (en) | 2010-10-25 | 2015-03-10 | Boston Scientific Scimed, Inc. | Renal nerve ablation using conductive fluid jet and RF energy |
US9023034B2 (en) | 2010-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Renal ablation electrode with force-activatable conduction apparatus |
US9028485B2 (en) | 2010-11-15 | 2015-05-12 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9028472B2 (en) | 2011-12-23 | 2015-05-12 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9050106B2 (en) | 2011-12-29 | 2015-06-09 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US9060761B2 (en) | 2010-11-18 | 2015-06-23 | Boston Scientific Scime, Inc. | Catheter-focused magnetic field induced renal nerve ablation |
US9079000B2 (en) | 2011-10-18 | 2015-07-14 | Boston Scientific Scimed, Inc. | Integrated crossing balloon catheter |
US9084609B2 (en) | 2010-07-30 | 2015-07-21 | Boston Scientific Scime, Inc. | Spiral balloon catheter for renal nerve ablation |
US9089350B2 (en) | 2010-11-16 | 2015-07-28 | Boston Scientific Scimed, Inc. | Renal denervation catheter with RF electrode and integral contrast dye injection arrangement |
US9119632B2 (en) | 2011-11-21 | 2015-09-01 | Boston Scientific Scimed, Inc. | Deflectable renal nerve ablation catheter |
US9119600B2 (en) | 2011-11-15 | 2015-09-01 | Boston Scientific Scimed, Inc. | Device and methods for renal nerve modulation monitoring |
US9125666B2 (en) | 2003-09-12 | 2015-09-08 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation of atherosclerotic material |
US9125667B2 (en) | 2004-09-10 | 2015-09-08 | Vessix Vascular, Inc. | System for inducing desirable temperature effects on body tissue |
US9155589B2 (en) | 2010-07-30 | 2015-10-13 | Boston Scientific Scimed, Inc. | Sequential activation RF electrode set for renal nerve ablation |
US9162046B2 (en) | 2011-10-18 | 2015-10-20 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US9173696B2 (en) | 2012-09-17 | 2015-11-03 | Boston Scientific Scimed, Inc. | Self-positioning electrode system and method for renal nerve modulation |
US9186210B2 (en) | 2011-10-10 | 2015-11-17 | Boston Scientific Scimed, Inc. | Medical devices including ablation electrodes |
US9186209B2 (en) | 2011-07-22 | 2015-11-17 | Boston Scientific Scimed, Inc. | Nerve modulation system having helical guide |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US9192435B2 (en) | 2010-11-22 | 2015-11-24 | Boston Scientific Scimed, Inc. | Renal denervation catheter with cooled RF electrode |
US9220561B2 (en) | 2011-01-19 | 2015-12-29 | Boston Scientific Scimed, Inc. | Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury |
US9220558B2 (en) | 2010-10-27 | 2015-12-29 | Boston Scientific Scimed, Inc. | RF renal denervation catheter with multiple independent electrodes |
US9265969B2 (en) | 2011-12-21 | 2016-02-23 | Cardiac Pacemakers, Inc. | Methods for modulating cell function |
US9277955B2 (en) | 2010-04-09 | 2016-03-08 | Vessix Vascular, Inc. | Power generating and control apparatus for the treatment of tissue |
US9297845B2 (en) | 2013-03-15 | 2016-03-29 | Boston Scientific Scimed, Inc. | Medical devices and methods for treatment of hypertension that utilize impedance compensation |
US9326751B2 (en) | 2010-11-17 | 2016-05-03 | Boston Scientific Scimed, Inc. | Catheter guidance of external energy for renal denervation |
US9327100B2 (en) | 2008-11-14 | 2016-05-03 | Vessix Vascular, Inc. | Selective drug delivery in a lumen |
US9358365B2 (en) | 2010-07-30 | 2016-06-07 | Boston Scientific Scimed, Inc. | Precision electrode movement control for renal nerve ablation |
US9364284B2 (en) | 2011-10-12 | 2016-06-14 | Boston Scientific Scimed, Inc. | Method of making an off-wall spacer cage |
US9387008B2 (en) | 2011-09-08 | 2016-07-12 | Stryker European Holdings I, Llc | Axial surgical trajectory guide, and method of guiding a medical device |
US9408661B2 (en) | 2010-07-30 | 2016-08-09 | Patrick A. Haverkost | RF electrodes on multiple flexible wires for renal nerve ablation |
US9420955B2 (en) | 2011-10-11 | 2016-08-23 | Boston Scientific Scimed, Inc. | Intravascular temperature monitoring system and method |
US9433760B2 (en) | 2011-12-28 | 2016-09-06 | Boston Scientific Scimed, Inc. | Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements |
US9463062B2 (en) | 2010-07-30 | 2016-10-11 | Boston Scientific Scimed, Inc. | Cooled conductive balloon RF catheter for renal nerve ablation |
US9486355B2 (en) | 2005-05-03 | 2016-11-08 | Vessix Vascular, Inc. | Selective accumulation of energy with or without knowledge of tissue topography |
US9526909B2 (en) | 2014-08-28 | 2016-12-27 | Cardiac Pacemakers, Inc. | Medical device with triggered blanking period |
US9579030B2 (en) | 2011-07-20 | 2017-02-28 | Boston Scientific Scimed, Inc. | Percutaneous devices and methods to visualize, target and ablate nerves |
US9592391B2 (en) | 2014-01-10 | 2017-03-14 | Cardiac Pacemakers, Inc. | Systems and methods for detecting cardiac arrhythmias |
US9636173B2 (en) | 2010-10-21 | 2017-05-02 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for renal neuromodulation |
US9649156B2 (en) | 2010-12-15 | 2017-05-16 | Boston Scientific Scimed, Inc. | Bipolar off-wall electrode device for renal nerve ablation |
US9669230B2 (en) | 2015-02-06 | 2017-06-06 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US9668811B2 (en) | 2010-11-16 | 2017-06-06 | Boston Scientific Scimed, Inc. | Minimally invasive access for renal nerve ablation |
US20170166781A1 (en) * | 2013-12-10 | 2017-06-15 | Iconex Llc | Adhesive label with water-based release coating |
US9687166B2 (en) | 2013-10-14 | 2017-06-27 | Boston Scientific Scimed, Inc. | High resolution cardiac mapping electrode array catheter |
US9693821B2 (en) | 2013-03-11 | 2017-07-04 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9707036B2 (en) | 2013-06-25 | 2017-07-18 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation using localized indifferent electrodes |
US9713730B2 (en) | 2004-09-10 | 2017-07-25 | Boston Scientific Scimed, Inc. | Apparatus and method for treatment of in-stent restenosis |
US9770606B2 (en) | 2013-10-15 | 2017-09-26 | Boston Scientific Scimed, Inc. | Ultrasound ablation catheter with cooling infusion and centering basket |
US9808311B2 (en) | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US9808300B2 (en) | 2006-05-02 | 2017-11-07 | Boston Scientific Scimed, Inc. | Control of arterial smooth muscle tone |
US9827039B2 (en) | 2013-03-15 | 2017-11-28 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9837044B2 (en) | 2015-03-18 | 2017-12-05 | Samsung Electronics Co., Ltd. | Electronic device and method of updating screen of display panel thereof |
US9833283B2 (en) | 2013-07-01 | 2017-12-05 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US9853743B2 (en) | 2015-08-20 | 2017-12-26 | Cardiac Pacemakers, Inc. | Systems and methods for communication between medical devices |
US9895194B2 (en) | 2013-09-04 | 2018-02-20 | Boston Scientific Scimed, Inc. | Radio frequency (RF) balloon catheter having flushing and cooling capability |
US9907609B2 (en) | 2014-02-04 | 2018-03-06 | Boston Scientific Scimed, Inc. | Alternative placement of thermal sensors on bipolar electrode |
US9925001B2 (en) | 2013-07-19 | 2018-03-27 | Boston Scientific Scimed, Inc. | Spiral bipolar electrode renal denervation balloon |
US9943365B2 (en) | 2013-06-21 | 2018-04-17 | Boston Scientific Scimed, Inc. | Renal denervation balloon catheter with ride along electrode support |
US9956414B2 (en) | 2015-08-27 | 2018-05-01 | Cardiac Pacemakers, Inc. | Temporal configuration of a motion sensor in an implantable medical device |
US9956033B2 (en) | 2013-03-11 | 2018-05-01 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9962223B2 (en) | 2013-10-15 | 2018-05-08 | Boston Scientific Scimed, Inc. | Medical device balloon |
US9968787B2 (en) | 2015-08-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Spatial configuration of a motion sensor in an implantable medical device |
US9974607B2 (en) | 2006-10-18 | 2018-05-22 | Vessix Vascular, Inc. | Inducing desirable temperature effects on body tissue |
EP3332730A1 (en) * | 2017-08-08 | 2018-06-13 | Siemens Healthcare GmbH | Method and tracking system for tracking a medical object |
US10010373B2 (en) | 2008-07-31 | 2018-07-03 | Medtronic, Inc. | Navigation system for cardiac therapies using gating |
US10022182B2 (en) | 2013-06-21 | 2018-07-17 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation having rotatable shafts |
US10029107B1 (en) | 2017-01-26 | 2018-07-24 | Cardiac Pacemakers, Inc. | Leadless device with overmolded components |
US10050700B2 (en) | 2015-03-18 | 2018-08-14 | Cardiac Pacemakers, Inc. | Communications in a medical device system with temporal optimization |
US10046167B2 (en) | 2015-02-09 | 2018-08-14 | Cardiac Pacemakers, Inc. | Implantable medical device with radiopaque ID tag |
US20180235509A1 (en) * | 2017-02-22 | 2018-08-23 | Biosense Webster (Israel) Ltd. | Catheter identification system and method |
US10065041B2 (en) | 2015-10-08 | 2018-09-04 | Cardiac Pacemakers, Inc. | Devices and methods for adjusting pacing rates in an implantable medical device |
US10085799B2 (en) | 2011-10-11 | 2018-10-02 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US10092760B2 (en) | 2015-09-11 | 2018-10-09 | Cardiac Pacemakers, Inc. | Arrhythmia detection and confirmation |
US10137305B2 (en) | 2015-08-28 | 2018-11-27 | Cardiac Pacemakers, Inc. | Systems and methods for behaviorally responsive signal detection and therapy delivery |
US10159842B2 (en) | 2015-08-28 | 2018-12-25 | Cardiac Pacemakers, Inc. | System and method for detecting tamponade |
US10166069B2 (en) | 2014-01-27 | 2019-01-01 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters having jacketed neuromodulation elements and related devices, systems, and methods |
US10183170B2 (en) | 2015-12-17 | 2019-01-22 | Cardiac Pacemakers, Inc. | Conducted communication in a medical device system |
US10188829B2 (en) | 2012-10-22 | 2019-01-29 | Medtronic Ardian Luxembourg S.A.R.L. | Catheters with enhanced flexibility and associated devices, systems, and methods |
US10213610B2 (en) | 2015-03-18 | 2019-02-26 | Cardiac Pacemakers, Inc. | Communications in a medical device system with link quality assessment |
US10220213B2 (en) | 2015-02-06 | 2019-03-05 | Cardiac Pacemakers, Inc. | Systems and methods for safe delivery of electrical stimulation therapy |
US10226631B2 (en) | 2015-08-28 | 2019-03-12 | Cardiac Pacemakers, Inc. | Systems and methods for infarct detection |
US10251708B2 (en) * | 2017-04-26 | 2019-04-09 | International Business Machines Corporation | Intravascular catheter for modeling blood vessels |
US10265122B2 (en) | 2013-03-15 | 2019-04-23 | Boston Scientific Scimed, Inc. | Nerve ablation devices and related methods of use |
US10271898B2 (en) | 2013-10-25 | 2019-04-30 | Boston Scientific Scimed, Inc. | Embedded thermocouple in denervation flex circuit |
EP3488787A1 (en) * | 2017-11-27 | 2019-05-29 | Koninklijke Philips N.V. | Ultrasound image generation system for generating an intravascular ultrasound image |
US10321946B2 (en) | 2012-08-24 | 2019-06-18 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices with weeping RF ablation balloons |
US10328272B2 (en) | 2016-05-10 | 2019-06-25 | Cardiac Pacemakers, Inc. | Retrievability for implantable medical devices |
US10342609B2 (en) | 2013-07-22 | 2019-07-09 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US10350423B2 (en) | 2016-02-04 | 2019-07-16 | Cardiac Pacemakers, Inc. | Delivery system with force sensor for leadless cardiac device |
US10357159B2 (en) | 2015-08-20 | 2019-07-23 | Cardiac Pacemakers, Inc | Systems and methods for communication between medical devices |
US10391319B2 (en) | 2016-08-19 | 2019-08-27 | Cardiac Pacemakers, Inc. | Trans septal implantable medical device |
US10398464B2 (en) | 2012-09-21 | 2019-09-03 | Boston Scientific Scimed, Inc. | System for nerve modulation and innocuous thermal gradient nerve block |
US10413733B2 (en) | 2016-10-27 | 2019-09-17 | Cardiac Pacemakers, Inc. | Implantable medical device with gyroscope |
US10413357B2 (en) | 2013-07-11 | 2019-09-17 | Boston Scientific Scimed, Inc. | Medical device with stretchable electrode assemblies |
US10426962B2 (en) | 2016-07-07 | 2019-10-01 | Cardiac Pacemakers, Inc. | Leadless pacemaker using pressure measurements for pacing capture verification |
US10434314B2 (en) | 2016-10-27 | 2019-10-08 | Cardiac Pacemakers, Inc. | Use of a separate device in managing the pace pulse energy of a cardiac pacemaker |
US10434317B2 (en) | 2016-10-31 | 2019-10-08 | Cardiac Pacemakers, Inc. | Systems and methods for activity level pacing |
US10463305B2 (en) | 2016-10-27 | 2019-11-05 | Cardiac Pacemakers, Inc. | Multi-device cardiac resynchronization therapy with timing enhancements |
US10512784B2 (en) | 2016-06-27 | 2019-12-24 | Cardiac Pacemakers, Inc. | Cardiac therapy system using subcutaneously sensed P-waves for resynchronization pacing management |
US10543037B2 (en) | 2013-03-15 | 2020-01-28 | Medtronic Ardian Luxembourg S.A.R.L. | Controlled neuromodulation systems and methods of use |
US10549127B2 (en) | 2012-09-21 | 2020-02-04 | Boston Scientific Scimed, Inc. | Self-cooling ultrasound ablation catheter |
US10548663B2 (en) | 2013-05-18 | 2020-02-04 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters with shafts for enhanced flexibility and control and associated devices, systems, and methods |
US10561330B2 (en) | 2016-10-27 | 2020-02-18 | Cardiac Pacemakers, Inc. | Implantable medical device having a sense channel with performance adjustment |
US10583303B2 (en) | 2016-01-19 | 2020-03-10 | Cardiac Pacemakers, Inc. | Devices and methods for wirelessly recharging a rechargeable battery of an implantable medical device |
US10583301B2 (en) | 2016-11-08 | 2020-03-10 | Cardiac Pacemakers, Inc. | Implantable medical device for atrial deployment |
US10588620B2 (en) | 2018-03-23 | 2020-03-17 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US10617874B2 (en) | 2016-10-31 | 2020-04-14 | Cardiac Pacemakers, Inc. | Systems and methods for activity level pacing |
US10632313B2 (en) | 2016-11-09 | 2020-04-28 | Cardiac Pacemakers, Inc. | Systems, devices, and methods for setting cardiac pacing pulse parameters for a cardiac pacing device |
US10639486B2 (en) | 2016-11-21 | 2020-05-05 | Cardiac Pacemakers, Inc. | Implantable medical device with recharge coil |
US10660703B2 (en) | 2012-05-08 | 2020-05-26 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices |
US10660698B2 (en) | 2013-07-11 | 2020-05-26 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation |
US10668294B2 (en) | 2016-05-10 | 2020-06-02 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker configured for over the wire delivery |
JP2020089411A (en) * | 2018-12-03 | 2020-06-11 | 朝日インテック株式会社 | Care system and image generation method |
US10688304B2 (en) | 2016-07-20 | 2020-06-23 | Cardiac Pacemakers, Inc. | Method and system for utilizing an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US10695178B2 (en) | 2011-06-01 | 2020-06-30 | Neochord, Inc. | Minimally invasive repair of heart valve leaflets |
US10695124B2 (en) | 2013-07-22 | 2020-06-30 | Boston Scientific Scimed, Inc. | Renal nerve ablation catheter having twist balloon |
US10722720B2 (en) | 2014-01-10 | 2020-07-28 | Cardiac Pacemakers, Inc. | Methods and systems for improved communication between medical devices |
US10722300B2 (en) | 2013-08-22 | 2020-07-28 | Boston Scientific Scimed, Inc. | Flexible circuit having improved adhesion to a renal nerve modulation balloon |
US10737102B2 (en) | 2017-01-26 | 2020-08-11 | Cardiac Pacemakers, Inc. | Leadless implantable device with detachable fixation |
US10737092B2 (en) | 2017-03-30 | 2020-08-11 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US10736690B2 (en) | 2014-04-24 | 2020-08-11 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters and associated systems and methods |
US10751173B2 (en) | 2011-06-21 | 2020-08-25 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US10758737B2 (en) | 2016-09-21 | 2020-09-01 | Cardiac Pacemakers, Inc. | Using sensor data from an intracardially implanted medical device to influence operation of an extracardially implantable cardioverter |
US10758724B2 (en) | 2016-10-27 | 2020-09-01 | Cardiac Pacemakers, Inc. | Implantable medical device delivery system with integrated sensor |
US10765303B2 (en) | 2018-02-13 | 2020-09-08 | Auris Health, Inc. | System and method for driving medical instrument |
US10765871B2 (en) | 2016-10-27 | 2020-09-08 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
US10765487B2 (en) | 2018-09-28 | 2020-09-08 | Auris Health, Inc. | Systems and methods for docking medical instruments |
US10780278B2 (en) | 2016-08-24 | 2020-09-22 | Cardiac Pacemakers, Inc. | Integrated multi-device cardiac resynchronization therapy using P-wave to pace timing |
US10806535B2 (en) | 2015-11-30 | 2020-10-20 | Auris Health, Inc. | Robot-assisted driving systems and methods |
US10813539B2 (en) | 2016-09-30 | 2020-10-27 | Auris Health, Inc. | Automated calibration of surgical instruments with pull wires |
US10821288B2 (en) | 2017-04-03 | 2020-11-03 | Cardiac Pacemakers, Inc. | Cardiac pacemaker with pacing pulse energy adjustment based on sensed heart rate |
US10835305B2 (en) | 2012-10-10 | 2020-11-17 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices and methods |
US10835753B2 (en) | 2017-01-26 | 2020-11-17 | Cardiac Pacemakers, Inc. | Intra-body device communication with redundant message transmission |
US10870008B2 (en) | 2016-08-24 | 2020-12-22 | Cardiac Pacemakers, Inc. | Cardiac resynchronization using fusion promotion for timing management |
US10874861B2 (en) | 2018-01-04 | 2020-12-29 | Cardiac Pacemakers, Inc. | Dual chamber pacing without beat-to-beat communication |
US10881869B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Wireless re-charge of an implantable medical device |
US10881863B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with multimode communication |
US10894163B2 (en) | 2016-11-21 | 2021-01-19 | Cardiac Pacemakers, Inc. | LCP based predictive timing for cardiac resynchronization |
US10905872B2 (en) | 2017-04-03 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device with a movable electrode biased toward an extended position |
US10905886B2 (en) | 2015-12-28 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device for deployment across the atrioventricular septum |
US10905889B2 (en) | 2016-09-21 | 2021-02-02 | Cardiac Pacemakers, Inc. | Leadless stimulation device with a housing that houses internal components of the leadless stimulation device and functions as the battery case and a terminal of an internal battery |
US10912924B2 (en) | 2014-03-24 | 2021-02-09 | Auris Health, Inc. | Systems and devices for catheter driving instinctiveness |
US10918875B2 (en) | 2017-08-18 | 2021-02-16 | Cardiac Pacemakers, Inc. | Implantable medical device with a flux concentrator and a receiving coil disposed about the flux concentrator |
US10945786B2 (en) | 2013-10-18 | 2021-03-16 | Boston Scientific Scimed, Inc. | Balloon catheters with flexible conducting wires and related methods of use and manufacture |
US10952790B2 (en) | 2013-09-13 | 2021-03-23 | Boston Scientific Scimed, Inc. | Ablation balloon with vapor deposited cover layer |
US10966709B2 (en) | 2018-09-07 | 2021-04-06 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US10987179B2 (en) * | 2017-12-06 | 2021-04-27 | Auris Health, Inc. | Systems and methods to correct for uncommanded instrument roll |
US10994145B2 (en) | 2016-09-21 | 2021-05-04 | Cardiac Pacemakers, Inc. | Implantable cardiac monitor |
US11000679B2 (en) | 2014-02-04 | 2021-05-11 | Boston Scientific Scimed, Inc. | Balloon protection and rewrapping devices and related methods of use |
US11020016B2 (en) | 2013-05-30 | 2021-06-01 | Auris Health, Inc. | System and method for displaying anatomy and devices on a movable display |
US11026583B2 (en) | 2017-04-26 | 2021-06-08 | International Business Machines Corporation | Intravascular catheter including markers |
US11051681B2 (en) | 2010-06-24 | 2021-07-06 | Auris Health, Inc. | Methods and devices for controlling a shapeable medical device |
US11052258B2 (en) | 2017-12-01 | 2021-07-06 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials within a search window from a ventricularly implanted leadless cardiac pacemaker |
US11058880B2 (en) | 2018-03-23 | 2021-07-13 | Medtronic, Inc. | VFA cardiac therapy for tachycardia |
US11065459B2 (en) | 2017-08-18 | 2021-07-20 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
US11071870B2 (en) | 2017-12-01 | 2021-07-27 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials and determining a cardiac interval from a ventricularly implanted leadless cardiac pacemaker |
US11116988B2 (en) | 2016-03-31 | 2021-09-14 | Cardiac Pacemakers, Inc. | Implantable medical device with rechargeable battery |
US11129602B2 (en) * | 2013-03-15 | 2021-09-28 | Auris Health, Inc. | Systems and methods for tracking robotically controlled medical instruments |
US11141048B2 (en) | 2015-06-26 | 2021-10-12 | Auris Health, Inc. | Automated endoscope calibration |
US11147633B2 (en) | 2019-08-30 | 2021-10-19 | Auris Health, Inc. | Instrument image reliability systems and methods |
US11147979B2 (en) | 2016-11-21 | 2021-10-19 | Cardiac Pacemakers, Inc. | Implantable medical device with a magnetically permeable housing and an inductive coil disposed about the housing |
US11160615B2 (en) | 2017-12-18 | 2021-11-02 | Auris Health, Inc. | Methods and systems for instrument tracking and navigation within luminal networks |
US11173030B2 (en) | 2018-05-09 | 2021-11-16 | Neochord, Inc. | Suture length adjustment for minimally invasive heart valve repair |
US11173012B2 (en) * | 2013-03-15 | 2021-11-16 | TriAgenics, Inc. | Therapeutic tooth bud ablation |
US11185703B2 (en) | 2017-11-07 | 2021-11-30 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker for bundle of his pacing |
US11202671B2 (en) | 2014-01-06 | 2021-12-21 | Boston Scientific Scimed, Inc. | Tear resistant flex circuit assembly |
US11207532B2 (en) | 2017-01-04 | 2021-12-28 | Cardiac Pacemakers, Inc. | Dynamic sensing updates using postural input in a multiple device cardiac rhythm management system |
US11207527B2 (en) | 2016-07-06 | 2021-12-28 | Cardiac Pacemakers, Inc. | Method and system for determining an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US11207141B2 (en) | 2019-08-30 | 2021-12-28 | Auris Health, Inc. | Systems and methods for weight-based registration of location sensors |
US11213676B2 (en) | 2019-04-01 | 2022-01-04 | Medtronic, Inc. | Delivery systems for VfA cardiac therapy |
US11235163B2 (en) | 2017-09-20 | 2022-02-01 | Cardiac Pacemakers, Inc. | Implantable medical device with multiple modes of operation |
US11235159B2 (en) | 2018-03-23 | 2022-02-01 | Medtronic, Inc. | VFA cardiac resynchronization therapy |
US11235161B2 (en) | 2018-09-26 | 2022-02-01 | Medtronic, Inc. | Capture in ventricle-from-atrium cardiac therapy |
US11241203B2 (en) | 2013-03-13 | 2022-02-08 | Auris Health, Inc. | Reducing measurement sensor error |
US11246654B2 (en) | 2013-10-14 | 2022-02-15 | Boston Scientific Scimed, Inc. | Flexible renal nerve ablation devices and related methods of use and manufacture |
US11253360B2 (en) | 2018-05-09 | 2022-02-22 | Neochord, Inc. | Low profile tissue anchor for minimally invasive heart valve repair |
US11253189B2 (en) | 2018-01-24 | 2022-02-22 | Medtronic Ardian Luxembourg S.A.R.L. | Systems, devices, and methods for evaluating neuromodulation therapy via detection of magnetic fields |
US11260216B2 (en) | 2017-12-01 | 2022-03-01 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials during ventricular filling from a ventricularly implanted leadless cardiac pacemaker |
US11278357B2 (en) | 2017-06-23 | 2022-03-22 | Auris Health, Inc. | Robotic systems for determining an angular degree of freedom of a medical device in luminal networks |
US11280690B2 (en) | 2017-10-10 | 2022-03-22 | Auris Health, Inc. | Detection of undesirable forces on a robotic manipulator |
US11285326B2 (en) | 2015-03-04 | 2022-03-29 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US11298195B2 (en) | 2019-12-31 | 2022-04-12 | Auris Health, Inc. | Anatomical feature identification and targeting |
US11305127B2 (en) | 2019-08-26 | 2022-04-19 | Medtronic Inc. | VfA delivery and implant region detection |
US11376126B2 (en) | 2019-04-16 | 2022-07-05 | Neochord, Inc. | Transverse helical cardiac anchor for minimally invasive heart valve repair |
US11400296B2 (en) | 2018-03-23 | 2022-08-02 | Medtronic, Inc. | AV synchronous VfA cardiac therapy |
US11484409B2 (en) | 2015-10-01 | 2022-11-01 | Neochord, Inc. | Ringless web for repair of heart valves |
US11490782B2 (en) | 2017-03-31 | 2022-11-08 | Auris Health, Inc. | Robotic systems for navigation of luminal networks that compensate for physiological noise |
US11503986B2 (en) | 2018-05-31 | 2022-11-22 | Auris Health, Inc. | Robotic systems and methods for navigation of luminal network that detect physiological noise |
US11510736B2 (en) | 2017-12-14 | 2022-11-29 | Auris Health, Inc. | System and method for estimating instrument location |
US11529523B2 (en) | 2018-01-04 | 2022-12-20 | Cardiac Pacemakers, Inc. | Handheld bridge device for providing a communication bridge between an implanted medical device and a smartphone |
US11529129B2 (en) | 2017-05-12 | 2022-12-20 | Auris Health, Inc. | Biopsy apparatus and system |
US11534247B2 (en) | 2017-06-28 | 2022-12-27 | Auris Health, Inc. | Instrument insertion compensation |
US11534250B2 (en) | 2014-09-30 | 2022-12-27 | Auris Health, Inc. | Configurable robotic surgical system with virtual rail and flexible endoscope |
US11589989B2 (en) | 2017-03-31 | 2023-02-28 | Neochord, Inc. | Minimally invasive heart valve repair in a beating heart |
US11596471B2 (en) * | 2019-03-22 | 2023-03-07 | Boston Scientific Scimed, Inc. | Tracking catheters based on a model of an impedance tracking field |
US11602372B2 (en) | 2019-12-31 | 2023-03-14 | Auris Health, Inc. | Alignment interfaces for percutaneous access |
US11660147B2 (en) | 2019-12-31 | 2023-05-30 | Auris Health, Inc. | Alignment techniques for percutaneous access |
US11666393B2 (en) | 2017-06-30 | 2023-06-06 | Auris Health, Inc. | Systems and methods for medical instrument compression compensation |
US11679265B2 (en) | 2019-02-14 | 2023-06-20 | Medtronic, Inc. | Lead-in-lead systems and methods for cardiac therapy |
US11697025B2 (en) | 2019-03-29 | 2023-07-11 | Medtronic, Inc. | Cardiac conduction system capture |
US11712173B2 (en) | 2018-03-28 | 2023-08-01 | Auris Health, Inc. | Systems and methods for displaying estimated location of instrument |
US11712188B2 (en) | 2019-05-07 | 2023-08-01 | Medtronic, Inc. | Posterior left bundle branch engagement |
US11759090B2 (en) | 2018-05-31 | 2023-09-19 | Auris Health, Inc. | Image-based airway analysis and mapping |
US11771309B2 (en) | 2016-12-28 | 2023-10-03 | Auris Health, Inc. | Detecting endolumenal buckling of flexible instruments |
US11813463B2 (en) | 2017-12-01 | 2023-11-14 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with reversionary behavior |
US11813464B2 (en) | 2020-07-31 | 2023-11-14 | Medtronic, Inc. | Cardiac conduction system evaluation |
US11813466B2 (en) | 2020-01-27 | 2023-11-14 | Medtronic, Inc. | Atrioventricular nodal stimulation |
US11864961B2 (en) | 2013-03-15 | 2024-01-09 | TriAgenics, Inc. | Therapeutic tooth bud ablation |
US11911168B2 (en) | 2020-04-03 | 2024-02-27 | Medtronic, Inc. | Cardiac conduction system therapy benefit determination |
US11925774B2 (en) | 2012-11-28 | 2024-03-12 | Auris Health, Inc. | Method of anchoring pullwire directly articulatable region in catheter |
US11951313B2 (en) | 2018-11-17 | 2024-04-09 | Medtronic, Inc. | VFA delivery systems and methods |
US11969157B2 (en) * | 2023-04-28 | 2024-04-30 | Auris Health, Inc. | Systems and methods for tracking robotically controlled medical instruments |
Families Citing this family (28)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
AU2011213558A1 (en) | 2010-02-08 | 2012-09-27 | Access Scientific, Inc. | Access device |
US9095262B2 (en) | 2011-01-05 | 2015-08-04 | Mehdi Razavi | Guided ablation devices, systems, and methods |
US8571684B2 (en) | 2011-05-02 | 2013-10-29 | Pacesetter, Inc. | Implantable lead assembly having a position tracking sensor and method of manufacturing the lead assembly |
JP6133309B2 (en) | 2011-10-19 | 2017-05-24 | トゥエルヴ, インコーポレイテッド | Prosthetic heart valve device |
US11202704B2 (en) | 2011-10-19 | 2021-12-21 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US9763780B2 (en) | 2011-10-19 | 2017-09-19 | Twelve, Inc. | Devices, systems and methods for heart valve replacement |
EP2750630B1 (en) | 2011-10-19 | 2021-06-30 | Twelve, Inc. | Device for heart valve replacement |
US9039757B2 (en) | 2011-10-19 | 2015-05-26 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US9579198B2 (en) | 2012-03-01 | 2017-02-28 | Twelve, Inc. | Hydraulic delivery systems for prosthetic heart valve devices and associated methods |
US20150282734A1 (en) | 2014-04-08 | 2015-10-08 | Timothy Schweikert | Medical device placement system and a method for its use |
US10013808B2 (en) | 2015-02-03 | 2018-07-03 | Globus Medical, Inc. | Surgeon head-mounted display apparatuses |
US10835715B2 (en) * | 2016-08-08 | 2020-11-17 | Angiodynamics Va Llc | System and method for locating a catheter tip |
US10575950B2 (en) | 2017-04-18 | 2020-03-03 | Twelve, Inc. | Hydraulic systems for delivering prosthetic heart valve devices and associated methods |
US10646338B2 (en) | 2017-06-02 | 2020-05-12 | Twelve, Inc. | Delivery systems with telescoping capsules for deploying prosthetic heart valve devices and associated methods |
US20190254753A1 (en) | 2018-02-19 | 2019-08-22 | Globus Medical, Inc. | Augmented reality navigation systems for use with robotic surgical systems and methods of their use |
US11191504B2 (en) * | 2018-07-31 | 2021-12-07 | Canon Medical Systems Corporation | X-ray diagnosis apparatus comprising a blood vessel running information acquiring function, a position specification function, and a diaphragm control function |
US11944388B2 (en) | 2018-09-28 | 2024-04-02 | Covidien Lp | Systems and methods for magnetic interference correction |
US11877806B2 (en) | 2018-12-06 | 2024-01-23 | Covidien Lp | Deformable registration of computer-generated airway models to airway trees |
US11464581B2 (en) | 2020-01-28 | 2022-10-11 | Globus Medical, Inc. | Pose measurement chaining for extended reality surgical navigation in visible and near infrared spectrums |
US11382699B2 (en) | 2020-02-10 | 2022-07-12 | Globus Medical Inc. | Extended reality visualization of optical tool tracking volume for computer assisted navigation in surgery |
US11207150B2 (en) | 2020-02-19 | 2021-12-28 | Globus Medical, Inc. | Displaying a virtual model of a planned instrument attachment to ensure correct selection of physical instrument attachment |
US11607277B2 (en) | 2020-04-29 | 2023-03-21 | Globus Medical, Inc. | Registration of surgical tool with reference array tracked by cameras of an extended reality headset for assisted navigation during surgery |
US11382700B2 (en) | 2020-05-08 | 2022-07-12 | Globus Medical Inc. | Extended reality headset tool tracking and control |
US11153555B1 (en) | 2020-05-08 | 2021-10-19 | Globus Medical Inc. | Extended reality headset camera system for computer assisted navigation in surgery |
US11510750B2 (en) | 2020-05-08 | 2022-11-29 | Globus Medical, Inc. | Leveraging two-dimensional digital imaging and communication in medicine imagery in three-dimensional extended reality applications |
CN112022186A (en) * | 2020-08-13 | 2020-12-04 | 南昌大学 | Special PET (positron emission tomography) system and imaging method for novel coronavirus |
US11737831B2 (en) | 2020-09-02 | 2023-08-29 | Globus Medical Inc. | Surgical object tracking template generation for computer assisted navigation during surgical procedure |
CN115553818B (en) * | 2022-12-05 | 2023-03-28 | 湖南省人民医院(湖南师范大学附属第一医院) | Myocardial biopsy system based on fusion positioning |
Citations (24)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US593510A (en) * | 1897-11-09 | Electric-circuit controller | ||
US3939824A (en) * | 1973-10-09 | 1976-02-24 | General Electric Company | Physiological waveform detector |
US4181135A (en) * | 1978-03-03 | 1980-01-01 | American Optical Corporation | Method and apparatus for monitoring electrocardiographic waveforms |
US4259966A (en) * | 1979-08-22 | 1981-04-07 | American Optical Corporation | Heart rate analyzer |
US4419998A (en) * | 1980-08-08 | 1983-12-13 | R2 Corporation | Physiological electrode systems |
US4446873A (en) * | 1981-03-06 | 1984-05-08 | Siemens Gammasonics, Inc. | Method and apparatus for detecting heart sounds |
US5592939A (en) * | 1995-06-14 | 1997-01-14 | Martinelli; Michael A. | Method and system for navigating a catheter probe |
US5740808A (en) * | 1996-10-28 | 1998-04-21 | Ep Technologies, Inc | Systems and methods for guilding diagnostic or therapeutic devices in interior tissue regions |
US5913820A (en) * | 1992-08-14 | 1999-06-22 | British Telecommunications Public Limited Company | Position location system |
US5983126A (en) * | 1995-11-22 | 1999-11-09 | Medtronic, Inc. | Catheter location system and method |
US6118845A (en) * | 1998-06-29 | 2000-09-12 | Surgical Navigation Technologies, Inc. | System and methods for the reduction and elimination of image artifacts in the calibration of X-ray imagers |
US6192280B1 (en) * | 1999-06-02 | 2001-02-20 | Medtronic, Inc. | Guidewire placed implantable lead with tip seal |
US6381485B1 (en) * | 1999-10-28 | 2002-04-30 | Surgical Navigation Technologies, Inc. | Registration of human anatomy integrated for electromagnetic localization |
US6470207B1 (en) * | 1999-03-23 | 2002-10-22 | Surgical Navigation Technologies, Inc. | Navigational guidance via computer-assisted fluoroscopic imaging |
US6556695B1 (en) * | 1999-02-05 | 2003-04-29 | Mayo Foundation For Medical Education And Research | Method for producing high resolution real-time images, of structure and function during medical procedures |
US20030114749A1 (en) * | 2001-11-26 | 2003-06-19 | Siemens Aktiengesellschaft | Navigation system with respiration or EKG triggering to enhance the navigation precision |
US6708052B1 (en) * | 2001-04-11 | 2004-03-16 | Harbor Ucla Research And Education Institute | Method and apparatus for cardiac imaging with minimized cardiac motion artifact |
US20040077941A1 (en) * | 2002-10-21 | 2004-04-22 | Ge Medical Systems Global Technology Company, Llc | Method and system for image improvement with ECG gating and dose reduction in CT imaging |
US20040097805A1 (en) * | 2002-11-19 | 2004-05-20 | Laurent Verard | Navigation system for cardiac therapies |
US20040215071A1 (en) * | 2003-04-25 | 2004-10-28 | Frank Kevin J. | Method and apparatus for performing 2D to 3D registration |
US20050038337A1 (en) * | 2003-08-11 | 2005-02-17 | Edwards Jerome R. | Methods, apparatuses, and systems useful in conducting image guided interventions |
US6950689B1 (en) * | 1998-08-03 | 2005-09-27 | Boston Scientific Scimed, Inc. | Dynamically alterable three-dimensional graphical model of a body region |
US20060079759A1 (en) * | 2004-10-13 | 2006-04-13 | Regis Vaillant | Method and apparatus for registering 3D models of anatomical regions of a heart and a tracking system with projection images of an interventional fluoroscopic system |
US20060173373A1 (en) * | 2005-02-02 | 2006-08-03 | Samsung Electronics Co., Ltd. | Bio signal measuring apparatus and method |
Family Cites Families (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4336810A (en) * | 1980-09-30 | 1982-06-29 | Del Mar Avionics | Method and apparatus for arrhythmia analysis of ECG recordings |
US4393877A (en) | 1981-05-15 | 1983-07-19 | Mieczyslaw Mirowski | Heart rate detector |
US4694837A (en) | 1985-08-09 | 1987-09-22 | Picker International, Inc. | Cardiac and respiratory gated magnetic resonance imaging |
US5113869A (en) | 1990-08-21 | 1992-05-19 | Telectronics Pacing Systems, Inc. | Implantable ambulatory electrocardiogram monitor |
US5935160A (en) | 1997-01-24 | 1999-08-10 | Cardiac Pacemakers, Inc. | Left ventricular access lead for heart failure pacing |
US7734715B2 (en) | 2001-03-01 | 2010-06-08 | Ricoh Company, Ltd. | System, computer program product and method for managing documents |
US7599730B2 (en) * | 2002-11-19 | 2009-10-06 | Medtronic Navigation, Inc. | Navigation system for cardiac therapies |
JP4912154B2 (en) * | 2004-10-29 | 2012-04-11 | 株式会社日立メディコ | Nuclear magnetic resonance imaging system |
US20100030061A1 (en) | 2008-07-31 | 2010-02-04 | Canfield Monte R | Navigation system for cardiac therapies using gating |
-
2008
- 2008-07-31 US US12/183,688 patent/US20100030061A1/en not_active Abandoned
-
2009
- 2009-07-16 EP EP09790512.9A patent/EP2203124B1/en active Active
- 2009-07-16 WO PCT/US2009/050795 patent/WO2010014420A1/en active Application Filing
-
2016
- 2016-12-02 US US15/368,128 patent/US10010373B2/en active Active
Patent Citations (25)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US593510A (en) * | 1897-11-09 | Electric-circuit controller | ||
US3939824A (en) * | 1973-10-09 | 1976-02-24 | General Electric Company | Physiological waveform detector |
US4181135A (en) * | 1978-03-03 | 1980-01-01 | American Optical Corporation | Method and apparatus for monitoring electrocardiographic waveforms |
US4259966A (en) * | 1979-08-22 | 1981-04-07 | American Optical Corporation | Heart rate analyzer |
US4419998A (en) * | 1980-08-08 | 1983-12-13 | R2 Corporation | Physiological electrode systems |
US4446873A (en) * | 1981-03-06 | 1984-05-08 | Siemens Gammasonics, Inc. | Method and apparatus for detecting heart sounds |
US5913820A (en) * | 1992-08-14 | 1999-06-22 | British Telecommunications Public Limited Company | Position location system |
US5592939A (en) * | 1995-06-14 | 1997-01-14 | Martinelli; Michael A. | Method and system for navigating a catheter probe |
US5983126A (en) * | 1995-11-22 | 1999-11-09 | Medtronic, Inc. | Catheter location system and method |
US5740808A (en) * | 1996-10-28 | 1998-04-21 | Ep Technologies, Inc | Systems and methods for guilding diagnostic or therapeutic devices in interior tissue regions |
US6118845A (en) * | 1998-06-29 | 2000-09-12 | Surgical Navigation Technologies, Inc. | System and methods for the reduction and elimination of image artifacts in the calibration of X-ray imagers |
US6950689B1 (en) * | 1998-08-03 | 2005-09-27 | Boston Scientific Scimed, Inc. | Dynamically alterable three-dimensional graphical model of a body region |
US6556695B1 (en) * | 1999-02-05 | 2003-04-29 | Mayo Foundation For Medical Education And Research | Method for producing high resolution real-time images, of structure and function during medical procedures |
US6470207B1 (en) * | 1999-03-23 | 2002-10-22 | Surgical Navigation Technologies, Inc. | Navigational guidance via computer-assisted fluoroscopic imaging |
US6192280B1 (en) * | 1999-06-02 | 2001-02-20 | Medtronic, Inc. | Guidewire placed implantable lead with tip seal |
US6381485B1 (en) * | 1999-10-28 | 2002-04-30 | Surgical Navigation Technologies, Inc. | Registration of human anatomy integrated for electromagnetic localization |
US6708052B1 (en) * | 2001-04-11 | 2004-03-16 | Harbor Ucla Research And Education Institute | Method and apparatus for cardiac imaging with minimized cardiac motion artifact |
US20040176681A1 (en) * | 2001-04-11 | 2004-09-09 | Songshou Mao | Method and apparatus for cardiac imaging with minimized cardiac motion artifact |
US20030114749A1 (en) * | 2001-11-26 | 2003-06-19 | Siemens Aktiengesellschaft | Navigation system with respiration or EKG triggering to enhance the navigation precision |
US20040077941A1 (en) * | 2002-10-21 | 2004-04-22 | Ge Medical Systems Global Technology Company, Llc | Method and system for image improvement with ECG gating and dose reduction in CT imaging |
US20040097805A1 (en) * | 2002-11-19 | 2004-05-20 | Laurent Verard | Navigation system for cardiac therapies |
US20040215071A1 (en) * | 2003-04-25 | 2004-10-28 | Frank Kevin J. | Method and apparatus for performing 2D to 3D registration |
US20050038337A1 (en) * | 2003-08-11 | 2005-02-17 | Edwards Jerome R. | Methods, apparatuses, and systems useful in conducting image guided interventions |
US20060079759A1 (en) * | 2004-10-13 | 2006-04-13 | Regis Vaillant | Method and apparatus for registering 3D models of anatomical regions of a heart and a tracking system with projection images of an interventional fluoroscopic system |
US20060173373A1 (en) * | 2005-02-02 | 2006-08-03 | Samsung Electronics Co., Ltd. | Bio signal measuring apparatus and method |
Non-Patent Citations (1)
Title |
---|
"A Pseudodifferential Amplifier for Bioelectric Events With DC-Offset Compensation Using Two-Wired Amplifying Electrodes" by T. Degen and H. Jackel. IEEE Trans Biomed Eng. Vol. 53, No. 2, pgs. 300-310 (2006) * |
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---|---|---|---|---|
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US20100210938A1 (en) * | 2002-11-19 | 2010-08-19 | Medtronic Navigation, Inc | Navigation System for Cardiac Therapies |
US8467853B2 (en) | 2002-11-19 | 2013-06-18 | Medtronic Navigation, Inc. | Navigation system for cardiac therapies |
US8046052B2 (en) * | 2002-11-19 | 2011-10-25 | Medtronic Navigation, Inc. | Navigation system for cardiac therapies |
US9510901B2 (en) | 2003-09-12 | 2016-12-06 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation |
US9125666B2 (en) | 2003-09-12 | 2015-09-08 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation of atherosclerotic material |
US10188457B2 (en) | 2003-09-12 | 2019-01-29 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation |
US8939970B2 (en) | 2004-09-10 | 2015-01-27 | Vessix Vascular, Inc. | Tuned RF energy and electrical tissue characterization for selective treatment of target tissues |
US9125667B2 (en) | 2004-09-10 | 2015-09-08 | Vessix Vascular, Inc. | System for inducing desirable temperature effects on body tissue |
US9713730B2 (en) | 2004-09-10 | 2017-07-25 | Boston Scientific Scimed, Inc. | Apparatus and method for treatment of in-stent restenosis |
US9486355B2 (en) | 2005-05-03 | 2016-11-08 | Vessix Vascular, Inc. | Selective accumulation of energy with or without knowledge of tissue topography |
US9808300B2 (en) | 2006-05-02 | 2017-11-07 | Boston Scientific Scimed, Inc. | Control of arterial smooth muscle tone |
US10413356B2 (en) | 2006-10-18 | 2019-09-17 | Boston Scientific Scimed, Inc. | System for inducing desirable temperature effects on body tissue |
US9974607B2 (en) | 2006-10-18 | 2018-05-22 | Vessix Vascular, Inc. | Inducing desirable temperature effects on body tissue |
US10213252B2 (en) | 2006-10-18 | 2019-02-26 | Vessix, Inc. | Inducing desirable temperature effects on body tissue |
US10010373B2 (en) | 2008-07-31 | 2018-07-03 | Medtronic, Inc. | Navigation system for cardiac therapies using gating |
US9327100B2 (en) | 2008-11-14 | 2016-05-03 | Vessix Vascular, Inc. | Selective drug delivery in a lumen |
US8731641B2 (en) | 2008-12-16 | 2014-05-20 | Medtronic Navigation, Inc. | Combination of electromagnetic and electropotential localization |
US8175681B2 (en) | 2008-12-16 | 2012-05-08 | Medtronic Navigation Inc. | Combination of electromagnetic and electropotential localization |
US20100298695A1 (en) * | 2009-05-19 | 2010-11-25 | Medtronic, Inc. | System and Method for Cardiac Lead Placement |
WO2010135420A1 (en) * | 2009-05-19 | 2010-11-25 | Medtronic, Inc. | System for cardiac lead placement |
US8494614B2 (en) | 2009-08-31 | 2013-07-23 | Regents Of The University Of Minnesota | Combination localization system |
US8494613B2 (en) | 2009-08-31 | 2013-07-23 | Medtronic, Inc. | Combination localization system |
US9277955B2 (en) | 2010-04-09 | 2016-03-08 | Vessix Vascular, Inc. | Power generating and control apparatus for the treatment of tissue |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US8880185B2 (en) | 2010-06-11 | 2014-11-04 | Boston Scientific Scimed, Inc. | Renal denervation and stimulation employing wireless vascular energy transfer arrangement |
US11857156B2 (en) | 2010-06-24 | 2024-01-02 | Auris Health, Inc. | Methods and devices for controlling a shapeable medical device |
US11051681B2 (en) | 2010-06-24 | 2021-07-06 | Auris Health, Inc. | Methods and devices for controlling a shapeable medical device |
US9084609B2 (en) | 2010-07-30 | 2015-07-21 | Boston Scientific Scime, Inc. | Spiral balloon catheter for renal nerve ablation |
US9408661B2 (en) | 2010-07-30 | 2016-08-09 | Patrick A. Haverkost | RF electrodes on multiple flexible wires for renal nerve ablation |
US9155589B2 (en) | 2010-07-30 | 2015-10-13 | Boston Scientific Scimed, Inc. | Sequential activation RF electrode set for renal nerve ablation |
US9463062B2 (en) | 2010-07-30 | 2016-10-11 | Boston Scientific Scimed, Inc. | Cooled conductive balloon RF catheter for renal nerve ablation |
US9358365B2 (en) | 2010-07-30 | 2016-06-07 | Boston Scientific Scimed, Inc. | Precision electrode movement control for renal nerve ablation |
US9855097B2 (en) | 2010-10-21 | 2018-01-02 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter apparatuses, systems, and methods for renal neuromodulation |
US10342612B2 (en) | 2010-10-21 | 2019-07-09 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter apparatuses, systems, and methods for renal neuromodulation |
US9636173B2 (en) | 2010-10-21 | 2017-05-02 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for renal neuromodulation |
US8974451B2 (en) | 2010-10-25 | 2015-03-10 | Boston Scientific Scimed, Inc. | Renal nerve ablation using conductive fluid jet and RF energy |
US9220558B2 (en) | 2010-10-27 | 2015-12-29 | Boston Scientific Scimed, Inc. | RF renal denervation catheter with multiple independent electrodes |
US9848946B2 (en) | 2010-11-15 | 2017-12-26 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9028485B2 (en) | 2010-11-15 | 2015-05-12 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9089350B2 (en) | 2010-11-16 | 2015-07-28 | Boston Scientific Scimed, Inc. | Renal denervation catheter with RF electrode and integral contrast dye injection arrangement |
US9668811B2 (en) | 2010-11-16 | 2017-06-06 | Boston Scientific Scimed, Inc. | Minimally invasive access for renal nerve ablation |
US9326751B2 (en) | 2010-11-17 | 2016-05-03 | Boston Scientific Scimed, Inc. | Catheter guidance of external energy for renal denervation |
US9060761B2 (en) | 2010-11-18 | 2015-06-23 | Boston Scientific Scime, Inc. | Catheter-focused magnetic field induced renal nerve ablation |
US9192435B2 (en) | 2010-11-22 | 2015-11-24 | Boston Scientific Scimed, Inc. | Renal denervation catheter with cooled RF electrode |
US9023034B2 (en) | 2010-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Renal ablation electrode with force-activatable conduction apparatus |
US9649156B2 (en) | 2010-12-15 | 2017-05-16 | Boston Scientific Scimed, Inc. | Bipolar off-wall electrode device for renal nerve ablation |
US9220561B2 (en) | 2011-01-19 | 2015-12-29 | Boston Scientific Scimed, Inc. | Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury |
WO2012106063A1 (en) | 2011-02-03 | 2012-08-09 | Medtronic, Inc. | Display of an acquired cine loop for procedure navigation |
US10695178B2 (en) | 2011-06-01 | 2020-06-30 | Neochord, Inc. | Minimally invasive repair of heart valve leaflets |
US11712334B2 (en) | 2011-06-21 | 2023-08-01 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US10751173B2 (en) | 2011-06-21 | 2020-08-25 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US11523900B2 (en) | 2011-06-21 | 2022-12-13 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US9579030B2 (en) | 2011-07-20 | 2017-02-28 | Boston Scientific Scimed, Inc. | Percutaneous devices and methods to visualize, target and ablate nerves |
US9186209B2 (en) | 2011-07-22 | 2015-11-17 | Boston Scientific Scimed, Inc. | Nerve modulation system having helical guide |
US9387008B2 (en) | 2011-09-08 | 2016-07-12 | Stryker European Holdings I, Llc | Axial surgical trajectory guide, and method of guiding a medical device |
US9186210B2 (en) | 2011-10-10 | 2015-11-17 | Boston Scientific Scimed, Inc. | Medical devices including ablation electrodes |
US9420955B2 (en) | 2011-10-11 | 2016-08-23 | Boston Scientific Scimed, Inc. | Intravascular temperature monitoring system and method |
US10085799B2 (en) | 2011-10-11 | 2018-10-02 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US9364284B2 (en) | 2011-10-12 | 2016-06-14 | Boston Scientific Scimed, Inc. | Method of making an off-wall spacer cage |
US9079000B2 (en) | 2011-10-18 | 2015-07-14 | Boston Scientific Scimed, Inc. | Integrated crossing balloon catheter |
US9162046B2 (en) | 2011-10-18 | 2015-10-20 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US8951251B2 (en) | 2011-11-08 | 2015-02-10 | Boston Scientific Scimed, Inc. | Ostial renal nerve ablation |
US9119600B2 (en) | 2011-11-15 | 2015-09-01 | Boston Scientific Scimed, Inc. | Device and methods for renal nerve modulation monitoring |
US9119632B2 (en) | 2011-11-21 | 2015-09-01 | Boston Scientific Scimed, Inc. | Deflectable renal nerve ablation catheter |
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US8938283B2 (en) | 2011-12-01 | 2015-01-20 | Neochord, Inc. | Surgical navigation for repair of heart valve leaflets |
US9393080B2 (en) | 2011-12-01 | 2016-07-19 | Neochord, Inc. | Surgical navigation for repair of heart valve leaflets |
US9265969B2 (en) | 2011-12-21 | 2016-02-23 | Cardiac Pacemakers, Inc. | Methods for modulating cell function |
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US9402684B2 (en) | 2011-12-23 | 2016-08-02 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
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US9592386B2 (en) | 2011-12-23 | 2017-03-14 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
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US9186211B2 (en) | 2011-12-23 | 2015-11-17 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9072902B2 (en) | 2011-12-23 | 2015-07-07 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
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US10321946B2 (en) | 2012-08-24 | 2019-06-18 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices with weeping RF ablation balloons |
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US10398464B2 (en) | 2012-09-21 | 2019-09-03 | Boston Scientific Scimed, Inc. | System for nerve modulation and innocuous thermal gradient nerve block |
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US11925774B2 (en) | 2012-11-28 | 2024-03-12 | Auris Health, Inc. | Method of anchoring pullwire directly articulatable region in catheter |
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US9956033B2 (en) | 2013-03-11 | 2018-05-01 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US11241203B2 (en) | 2013-03-13 | 2022-02-08 | Auris Health, Inc. | Reducing measurement sensor error |
US9808311B2 (en) | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US11864961B2 (en) | 2013-03-15 | 2024-01-09 | TriAgenics, Inc. | Therapeutic tooth bud ablation |
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US9297845B2 (en) | 2013-03-15 | 2016-03-29 | Boston Scientific Scimed, Inc. | Medical devices and methods for treatment of hypertension that utilize impedance compensation |
US10265122B2 (en) | 2013-03-15 | 2019-04-23 | Boston Scientific Scimed, Inc. | Nerve ablation devices and related methods of use |
US20230263512A1 (en) * | 2013-03-15 | 2023-08-24 | Auris Health, Inc. | Systems and methods for tracking robotically controlled medical instruments |
US20210386413A1 (en) * | 2013-03-15 | 2021-12-16 | Auris Health, Inc. | Systems and methods for tracking robotically controlled medical instruments |
US9827039B2 (en) | 2013-03-15 | 2017-11-28 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US11173012B2 (en) * | 2013-03-15 | 2021-11-16 | TriAgenics, Inc. | Therapeutic tooth bud ablation |
US11129602B2 (en) * | 2013-03-15 | 2021-09-28 | Auris Health, Inc. | Systems and methods for tracking robotically controlled medical instruments |
US10543037B2 (en) | 2013-03-15 | 2020-01-28 | Medtronic Ardian Luxembourg S.A.R.L. | Controlled neuromodulation systems and methods of use |
US10548663B2 (en) | 2013-05-18 | 2020-02-04 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters with shafts for enhanced flexibility and control and associated devices, systems, and methods |
US11020016B2 (en) | 2013-05-30 | 2021-06-01 | Auris Health, Inc. | System and method for displaying anatomy and devices on a movable display |
US9943365B2 (en) | 2013-06-21 | 2018-04-17 | Boston Scientific Scimed, Inc. | Renal denervation balloon catheter with ride along electrode support |
US10022182B2 (en) | 2013-06-21 | 2018-07-17 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation having rotatable shafts |
US9707036B2 (en) | 2013-06-25 | 2017-07-18 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation using localized indifferent electrodes |
US9833283B2 (en) | 2013-07-01 | 2017-12-05 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US10413357B2 (en) | 2013-07-11 | 2019-09-17 | Boston Scientific Scimed, Inc. | Medical device with stretchable electrode assemblies |
US10660698B2 (en) | 2013-07-11 | 2020-05-26 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation |
US9925001B2 (en) | 2013-07-19 | 2018-03-27 | Boston Scientific Scimed, Inc. | Spiral bipolar electrode renal denervation balloon |
US10695124B2 (en) | 2013-07-22 | 2020-06-30 | Boston Scientific Scimed, Inc. | Renal nerve ablation catheter having twist balloon |
US10342609B2 (en) | 2013-07-22 | 2019-07-09 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US10722300B2 (en) | 2013-08-22 | 2020-07-28 | Boston Scientific Scimed, Inc. | Flexible circuit having improved adhesion to a renal nerve modulation balloon |
US9895194B2 (en) | 2013-09-04 | 2018-02-20 | Boston Scientific Scimed, Inc. | Radio frequency (RF) balloon catheter having flushing and cooling capability |
US10952790B2 (en) | 2013-09-13 | 2021-03-23 | Boston Scientific Scimed, Inc. | Ablation balloon with vapor deposited cover layer |
US11246654B2 (en) | 2013-10-14 | 2022-02-15 | Boston Scientific Scimed, Inc. | Flexible renal nerve ablation devices and related methods of use and manufacture |
US9687166B2 (en) | 2013-10-14 | 2017-06-27 | Boston Scientific Scimed, Inc. | High resolution cardiac mapping electrode array catheter |
US9962223B2 (en) | 2013-10-15 | 2018-05-08 | Boston Scientific Scimed, Inc. | Medical device balloon |
US9770606B2 (en) | 2013-10-15 | 2017-09-26 | Boston Scientific Scimed, Inc. | Ultrasound ablation catheter with cooling infusion and centering basket |
US10945786B2 (en) | 2013-10-18 | 2021-03-16 | Boston Scientific Scimed, Inc. | Balloon catheters with flexible conducting wires and related methods of use and manufacture |
US10271898B2 (en) | 2013-10-25 | 2019-04-30 | Boston Scientific Scimed, Inc. | Embedded thermocouple in denervation flex circuit |
US20170166781A1 (en) * | 2013-12-10 | 2017-06-15 | Iconex Llc | Adhesive label with water-based release coating |
US11202671B2 (en) | 2014-01-06 | 2021-12-21 | Boston Scientific Scimed, Inc. | Tear resistant flex circuit assembly |
US9592391B2 (en) | 2014-01-10 | 2017-03-14 | Cardiac Pacemakers, Inc. | Systems and methods for detecting cardiac arrhythmias |
US10722720B2 (en) | 2014-01-10 | 2020-07-28 | Cardiac Pacemakers, Inc. | Methods and systems for improved communication between medical devices |
US10166069B2 (en) | 2014-01-27 | 2019-01-01 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters having jacketed neuromodulation elements and related devices, systems, and methods |
US11154353B2 (en) | 2014-01-27 | 2021-10-26 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters having jacketed neuromodulation elements and related devices, systems, and methods |
US9907609B2 (en) | 2014-02-04 | 2018-03-06 | Boston Scientific Scimed, Inc. | Alternative placement of thermal sensors on bipolar electrode |
US11000679B2 (en) | 2014-02-04 | 2021-05-11 | Boston Scientific Scimed, Inc. | Balloon protection and rewrapping devices and related methods of use |
US10912924B2 (en) | 2014-03-24 | 2021-02-09 | Auris Health, Inc. | Systems and devices for catheter driving instinctiveness |
US10736690B2 (en) | 2014-04-24 | 2020-08-11 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters and associated systems and methods |
US11464563B2 (en) | 2014-04-24 | 2022-10-11 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters and associated systems and methods |
US9526909B2 (en) | 2014-08-28 | 2016-12-27 | Cardiac Pacemakers, Inc. | Medical device with triggered blanking period |
US11534250B2 (en) | 2014-09-30 | 2022-12-27 | Auris Health, Inc. | Configurable robotic surgical system with virtual rail and flexible endoscope |
US10238882B2 (en) | 2015-02-06 | 2019-03-26 | Cardiac Pacemakers | Systems and methods for treating cardiac arrhythmias |
US10220213B2 (en) | 2015-02-06 | 2019-03-05 | Cardiac Pacemakers, Inc. | Systems and methods for safe delivery of electrical stimulation therapy |
US9669230B2 (en) | 2015-02-06 | 2017-06-06 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US11020595B2 (en) | 2015-02-06 | 2021-06-01 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US11224751B2 (en) | 2015-02-06 | 2022-01-18 | Cardiac Pacemakers, Inc. | Systems and methods for safe delivery of electrical stimulation therapy |
US10046167B2 (en) | 2015-02-09 | 2018-08-14 | Cardiac Pacemakers, Inc. | Implantable medical device with radiopaque ID tag |
US11020600B2 (en) | 2015-02-09 | 2021-06-01 | Cardiac Pacemakers, Inc. | Implantable medical device with radiopaque ID tag |
US11285326B2 (en) | 2015-03-04 | 2022-03-29 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US11476927B2 (en) | 2015-03-18 | 2022-10-18 | Cardiac Pacemakers, Inc. | Communications in a medical device system with temporal optimization |
US10946202B2 (en) | 2015-03-18 | 2021-03-16 | Cardiac Pacemakers, Inc. | Communications in a medical device system with link quality assessment |
US9837044B2 (en) | 2015-03-18 | 2017-12-05 | Samsung Electronics Co., Ltd. | Electronic device and method of updating screen of display panel thereof |
US10050700B2 (en) | 2015-03-18 | 2018-08-14 | Cardiac Pacemakers, Inc. | Communications in a medical device system with temporal optimization |
US10213610B2 (en) | 2015-03-18 | 2019-02-26 | Cardiac Pacemakers, Inc. | Communications in a medical device system with link quality assessment |
US11141048B2 (en) | 2015-06-26 | 2021-10-12 | Auris Health, Inc. | Automated endoscope calibration |
US10357159B2 (en) | 2015-08-20 | 2019-07-23 | Cardiac Pacemakers, Inc | Systems and methods for communication between medical devices |
US9853743B2 (en) | 2015-08-20 | 2017-12-26 | Cardiac Pacemakers, Inc. | Systems and methods for communication between medical devices |
US9956414B2 (en) | 2015-08-27 | 2018-05-01 | Cardiac Pacemakers, Inc. | Temporal configuration of a motion sensor in an implantable medical device |
US10709892B2 (en) | 2015-08-27 | 2020-07-14 | Cardiac Pacemakers, Inc. | Temporal configuration of a motion sensor in an implantable medical device |
US9968787B2 (en) | 2015-08-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Spatial configuration of a motion sensor in an implantable medical device |
US10137305B2 (en) | 2015-08-28 | 2018-11-27 | Cardiac Pacemakers, Inc. | Systems and methods for behaviorally responsive signal detection and therapy delivery |
US10226631B2 (en) | 2015-08-28 | 2019-03-12 | Cardiac Pacemakers, Inc. | Systems and methods for infarct detection |
US10159842B2 (en) | 2015-08-28 | 2018-12-25 | Cardiac Pacemakers, Inc. | System and method for detecting tamponade |
US10589101B2 (en) | 2015-08-28 | 2020-03-17 | Cardiac Pacemakers, Inc. | System and method for detecting tamponade |
US10092760B2 (en) | 2015-09-11 | 2018-10-09 | Cardiac Pacemakers, Inc. | Arrhythmia detection and confirmation |
US11484409B2 (en) | 2015-10-01 | 2022-11-01 | Neochord, Inc. | Ringless web for repair of heart valves |
US10065041B2 (en) | 2015-10-08 | 2018-09-04 | Cardiac Pacemakers, Inc. | Devices and methods for adjusting pacing rates in an implantable medical device |
US10813711B2 (en) | 2015-11-30 | 2020-10-27 | Auris Health, Inc. | Robot-assisted driving systems and methods |
US11464591B2 (en) | 2015-11-30 | 2022-10-11 | Auris Health, Inc. | Robot-assisted driving systems and methods |
US10806535B2 (en) | 2015-11-30 | 2020-10-20 | Auris Health, Inc. | Robot-assisted driving systems and methods |
US10933245B2 (en) | 2015-12-17 | 2021-03-02 | Cardiac Pacemakers, Inc. | Conducted communication in a medical device system |
US10183170B2 (en) | 2015-12-17 | 2019-01-22 | Cardiac Pacemakers, Inc. | Conducted communication in a medical device system |
US10905886B2 (en) | 2015-12-28 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device for deployment across the atrioventricular septum |
US10583303B2 (en) | 2016-01-19 | 2020-03-10 | Cardiac Pacemakers, Inc. | Devices and methods for wirelessly recharging a rechargeable battery of an implantable medical device |
US10350423B2 (en) | 2016-02-04 | 2019-07-16 | Cardiac Pacemakers, Inc. | Delivery system with force sensor for leadless cardiac device |
US11116988B2 (en) | 2016-03-31 | 2021-09-14 | Cardiac Pacemakers, Inc. | Implantable medical device with rechargeable battery |
US10328272B2 (en) | 2016-05-10 | 2019-06-25 | Cardiac Pacemakers, Inc. | Retrievability for implantable medical devices |
US10668294B2 (en) | 2016-05-10 | 2020-06-02 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker configured for over the wire delivery |
US10512784B2 (en) | 2016-06-27 | 2019-12-24 | Cardiac Pacemakers, Inc. | Cardiac therapy system using subcutaneously sensed P-waves for resynchronization pacing management |
US11497921B2 (en) | 2016-06-27 | 2022-11-15 | Cardiac Pacemakers, Inc. | Cardiac therapy system using subcutaneously sensed p-waves for resynchronization pacing management |
US11207527B2 (en) | 2016-07-06 | 2021-12-28 | Cardiac Pacemakers, Inc. | Method and system for determining an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US10426962B2 (en) | 2016-07-07 | 2019-10-01 | Cardiac Pacemakers, Inc. | Leadless pacemaker using pressure measurements for pacing capture verification |
US10688304B2 (en) | 2016-07-20 | 2020-06-23 | Cardiac Pacemakers, Inc. | Method and system for utilizing an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US10391319B2 (en) | 2016-08-19 | 2019-08-27 | Cardiac Pacemakers, Inc. | Trans septal implantable medical device |
US10870008B2 (en) | 2016-08-24 | 2020-12-22 | Cardiac Pacemakers, Inc. | Cardiac resynchronization using fusion promotion for timing management |
US10780278B2 (en) | 2016-08-24 | 2020-09-22 | Cardiac Pacemakers, Inc. | Integrated multi-device cardiac resynchronization therapy using P-wave to pace timing |
US11464982B2 (en) | 2016-08-24 | 2022-10-11 | Cardiac Pacemakers, Inc. | Integrated multi-device cardiac resynchronization therapy using p-wave to pace timing |
US10994145B2 (en) | 2016-09-21 | 2021-05-04 | Cardiac Pacemakers, Inc. | Implantable cardiac monitor |
US10905889B2 (en) | 2016-09-21 | 2021-02-02 | Cardiac Pacemakers, Inc. | Leadless stimulation device with a housing that houses internal components of the leadless stimulation device and functions as the battery case and a terminal of an internal battery |
US10758737B2 (en) | 2016-09-21 | 2020-09-01 | Cardiac Pacemakers, Inc. | Using sensor data from an intracardially implanted medical device to influence operation of an extracardially implantable cardioverter |
US11712154B2 (en) * | 2016-09-30 | 2023-08-01 | Auris Health, Inc. | Automated calibration of surgical instruments with pull wires |
US10813539B2 (en) | 2016-09-30 | 2020-10-27 | Auris Health, Inc. | Automated calibration of surgical instruments with pull wires |
US20210121052A1 (en) * | 2016-09-30 | 2021-04-29 | Auris Health, Inc. | Automated calibration of surgical instruments with pull wires |
US10434314B2 (en) | 2016-10-27 | 2019-10-08 | Cardiac Pacemakers, Inc. | Use of a separate device in managing the pace pulse energy of a cardiac pacemaker |
US10463305B2 (en) | 2016-10-27 | 2019-11-05 | Cardiac Pacemakers, Inc. | Multi-device cardiac resynchronization therapy with timing enhancements |
US11305125B2 (en) | 2016-10-27 | 2022-04-19 | Cardiac Pacemakers, Inc. | Implantable medical device with gyroscope |
US10561330B2 (en) | 2016-10-27 | 2020-02-18 | Cardiac Pacemakers, Inc. | Implantable medical device having a sense channel with performance adjustment |
US10765871B2 (en) | 2016-10-27 | 2020-09-08 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
US10758724B2 (en) | 2016-10-27 | 2020-09-01 | Cardiac Pacemakers, Inc. | Implantable medical device delivery system with integrated sensor |
US10413733B2 (en) | 2016-10-27 | 2019-09-17 | Cardiac Pacemakers, Inc. | Implantable medical device with gyroscope |
US10434317B2 (en) | 2016-10-31 | 2019-10-08 | Cardiac Pacemakers, Inc. | Systems and methods for activity level pacing |
US10617874B2 (en) | 2016-10-31 | 2020-04-14 | Cardiac Pacemakers, Inc. | Systems and methods for activity level pacing |
US10583301B2 (en) | 2016-11-08 | 2020-03-10 | Cardiac Pacemakers, Inc. | Implantable medical device for atrial deployment |
US10632313B2 (en) | 2016-11-09 | 2020-04-28 | Cardiac Pacemakers, Inc. | Systems, devices, and methods for setting cardiac pacing pulse parameters for a cardiac pacing device |
US10881869B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Wireless re-charge of an implantable medical device |
US10894163B2 (en) | 2016-11-21 | 2021-01-19 | Cardiac Pacemakers, Inc. | LCP based predictive timing for cardiac resynchronization |
US10639486B2 (en) | 2016-11-21 | 2020-05-05 | Cardiac Pacemakers, Inc. | Implantable medical device with recharge coil |
US11147979B2 (en) | 2016-11-21 | 2021-10-19 | Cardiac Pacemakers, Inc. | Implantable medical device with a magnetically permeable housing and an inductive coil disposed about the housing |
US10881863B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with multimode communication |
US11771309B2 (en) | 2016-12-28 | 2023-10-03 | Auris Health, Inc. | Detecting endolumenal buckling of flexible instruments |
US11207532B2 (en) | 2017-01-04 | 2021-12-28 | Cardiac Pacemakers, Inc. | Dynamic sensing updates using postural input in a multiple device cardiac rhythm management system |
US10835753B2 (en) | 2017-01-26 | 2020-11-17 | Cardiac Pacemakers, Inc. | Intra-body device communication with redundant message transmission |
US10737102B2 (en) | 2017-01-26 | 2020-08-11 | Cardiac Pacemakers, Inc. | Leadless implantable device with detachable fixation |
US11590353B2 (en) | 2017-01-26 | 2023-02-28 | Cardiac Pacemakers, Inc. | Intra-body device communication with redundant message transmission |
US10029107B1 (en) | 2017-01-26 | 2018-07-24 | Cardiac Pacemakers, Inc. | Leadless device with overmolded components |
US20180235509A1 (en) * | 2017-02-22 | 2018-08-23 | Biosense Webster (Israel) Ltd. | Catheter identification system and method |
CN108452424A (en) * | 2017-02-22 | 2018-08-28 | 韦伯斯特生物官能(以色列)有限公司 | Marking catheter system and method |
US10737092B2 (en) | 2017-03-30 | 2020-08-11 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US11490782B2 (en) | 2017-03-31 | 2022-11-08 | Auris Health, Inc. | Robotic systems for navigation of luminal networks that compensate for physiological noise |
US11589989B2 (en) | 2017-03-31 | 2023-02-28 | Neochord, Inc. | Minimally invasive heart valve repair in a beating heart |
US10821288B2 (en) | 2017-04-03 | 2020-11-03 | Cardiac Pacemakers, Inc. | Cardiac pacemaker with pacing pulse energy adjustment based on sensed heart rate |
US10905872B2 (en) | 2017-04-03 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device with a movable electrode biased toward an extended position |
US10251708B2 (en) * | 2017-04-26 | 2019-04-09 | International Business Machines Corporation | Intravascular catheter for modeling blood vessels |
US11026583B2 (en) | 2017-04-26 | 2021-06-08 | International Business Machines Corporation | Intravascular catheter including markers |
US11712301B2 (en) | 2017-04-26 | 2023-08-01 | International Business Machines Corporation | Intravascular catheter for modeling blood vessels |
US10390888B2 (en) * | 2017-04-26 | 2019-08-27 | International Business Machines Corporation | Intravascular catheter for modeling blood vessels |
US11529129B2 (en) | 2017-05-12 | 2022-12-20 | Auris Health, Inc. | Biopsy apparatus and system |
US11759266B2 (en) | 2017-06-23 | 2023-09-19 | Auris Health, Inc. | Robotic systems for determining a roll of a medical device in luminal networks |
US11278357B2 (en) | 2017-06-23 | 2022-03-22 | Auris Health, Inc. | Robotic systems for determining an angular degree of freedom of a medical device in luminal networks |
US11534247B2 (en) | 2017-06-28 | 2022-12-27 | Auris Health, Inc. | Instrument insertion compensation |
US11666393B2 (en) | 2017-06-30 | 2023-06-06 | Auris Health, Inc. | Systems and methods for medical instrument compression compensation |
US11540884B2 (en) | 2017-08-08 | 2023-01-03 | Siemens Healthcare Gmbh | Method and tracking system for tracking a medical object |
EP3332730A1 (en) * | 2017-08-08 | 2018-06-13 | Siemens Healthcare GmbH | Method and tracking system for tracking a medical object |
US11065459B2 (en) | 2017-08-18 | 2021-07-20 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
US10918875B2 (en) | 2017-08-18 | 2021-02-16 | Cardiac Pacemakers, Inc. | Implantable medical device with a flux concentrator and a receiving coil disposed about the flux concentrator |
US11235163B2 (en) | 2017-09-20 | 2022-02-01 | Cardiac Pacemakers, Inc. | Implantable medical device with multiple modes of operation |
US11280690B2 (en) | 2017-10-10 | 2022-03-22 | Auris Health, Inc. | Detection of undesirable forces on a robotic manipulator |
US11796410B2 (en) | 2017-10-10 | 2023-10-24 | Auris Health, Inc. | Robotic manipulator force determination |
US11185703B2 (en) | 2017-11-07 | 2021-11-30 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker for bundle of his pacing |
CN111655158A (en) * | 2017-11-27 | 2020-09-11 | 皇家飞利浦有限公司 | Ultrasound image generation system for generating intravascular ultrasound images |
WO2019101567A1 (en) | 2017-11-27 | 2019-05-31 | Koninklijke Philips N.V. | Ultrasound image generation system for generating an intravascular ultrasound image |
EP3488787A1 (en) * | 2017-11-27 | 2019-05-29 | Koninklijke Philips N.V. | Ultrasound image generation system for generating an intravascular ultrasound image |
US11260216B2 (en) | 2017-12-01 | 2022-03-01 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials during ventricular filling from a ventricularly implanted leadless cardiac pacemaker |
US11071870B2 (en) | 2017-12-01 | 2021-07-27 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials and determining a cardiac interval from a ventricularly implanted leadless cardiac pacemaker |
US11813463B2 (en) | 2017-12-01 | 2023-11-14 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with reversionary behavior |
US11052258B2 (en) | 2017-12-01 | 2021-07-06 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials within a search window from a ventricularly implanted leadless cardiac pacemaker |
US11801105B2 (en) | 2017-12-06 | 2023-10-31 | Auris Health, Inc. | Systems and methods to correct for uncommanded instrument roll |
US10987179B2 (en) * | 2017-12-06 | 2021-04-27 | Auris Health, Inc. | Systems and methods to correct for uncommanded instrument roll |
US11510736B2 (en) | 2017-12-14 | 2022-11-29 | Auris Health, Inc. | System and method for estimating instrument location |
US11160615B2 (en) | 2017-12-18 | 2021-11-02 | Auris Health, Inc. | Methods and systems for instrument tracking and navigation within luminal networks |
US10874861B2 (en) | 2018-01-04 | 2020-12-29 | Cardiac Pacemakers, Inc. | Dual chamber pacing without beat-to-beat communication |
US11529523B2 (en) | 2018-01-04 | 2022-12-20 | Cardiac Pacemakers, Inc. | Handheld bridge device for providing a communication bridge between an implanted medical device and a smartphone |
US11253189B2 (en) | 2018-01-24 | 2022-02-22 | Medtronic Ardian Luxembourg S.A.R.L. | Systems, devices, and methods for evaluating neuromodulation therapy via detection of magnetic fields |
US10765303B2 (en) | 2018-02-13 | 2020-09-08 | Auris Health, Inc. | System and method for driving medical instrument |
US10588620B2 (en) | 2018-03-23 | 2020-03-17 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US11400296B2 (en) | 2018-03-23 | 2022-08-02 | Medtronic, Inc. | AV synchronous VfA cardiac therapy |
US11235159B2 (en) | 2018-03-23 | 2022-02-01 | Medtronic, Inc. | VFA cardiac resynchronization therapy |
US11058880B2 (en) | 2018-03-23 | 2021-07-13 | Medtronic, Inc. | VFA cardiac therapy for tachycardia |
US11612389B2 (en) | 2018-03-23 | 2023-03-28 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US11819699B2 (en) | 2018-03-23 | 2023-11-21 | Medtronic, Inc. | VfA cardiac resynchronization therapy |
US11950898B2 (en) | 2018-03-28 | 2024-04-09 | Auris Health, Inc. | Systems and methods for displaying estimated location of instrument |
US11712173B2 (en) | 2018-03-28 | 2023-08-01 | Auris Health, Inc. | Systems and methods for displaying estimated location of instrument |
US11253360B2 (en) | 2018-05-09 | 2022-02-22 | Neochord, Inc. | Low profile tissue anchor for minimally invasive heart valve repair |
US11173030B2 (en) | 2018-05-09 | 2021-11-16 | Neochord, Inc. | Suture length adjustment for minimally invasive heart valve repair |
US11957584B2 (en) | 2018-05-09 | 2024-04-16 | Neochord, Inc. | Suture length adjustment for minimally invasive heart valve repair |
US11503986B2 (en) | 2018-05-31 | 2022-11-22 | Auris Health, Inc. | Robotic systems and methods for navigation of luminal network that detect physiological noise |
US11759090B2 (en) | 2018-05-31 | 2023-09-19 | Auris Health, Inc. | Image-based airway analysis and mapping |
US10966709B2 (en) | 2018-09-07 | 2021-04-06 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US11235161B2 (en) | 2018-09-26 | 2022-02-01 | Medtronic, Inc. | Capture in ventricle-from-atrium cardiac therapy |
US10765487B2 (en) | 2018-09-28 | 2020-09-08 | Auris Health, Inc. | Systems and methods for docking medical instruments |
US11497568B2 (en) | 2018-09-28 | 2022-11-15 | Auris Health, Inc. | Systems and methods for docking medical instruments |
US11951313B2 (en) | 2018-11-17 | 2024-04-09 | Medtronic, Inc. | VFA delivery systems and methods |
JP7309350B2 (en) | 2018-12-03 | 2023-07-18 | 朝日インテック株式会社 | Treatment system and image generation method |
WO2020116387A1 (en) * | 2018-12-03 | 2020-06-11 | 朝日インテック株式会社 | Treatment system and image generation method |
JP2020089411A (en) * | 2018-12-03 | 2020-06-11 | 朝日インテック株式会社 | Care system and image generation method |
US11679265B2 (en) | 2019-02-14 | 2023-06-20 | Medtronic, Inc. | Lead-in-lead systems and methods for cardiac therapy |
US11596471B2 (en) * | 2019-03-22 | 2023-03-07 | Boston Scientific Scimed, Inc. | Tracking catheters based on a model of an impedance tracking field |
US11697025B2 (en) | 2019-03-29 | 2023-07-11 | Medtronic, Inc. | Cardiac conduction system capture |
US11213676B2 (en) | 2019-04-01 | 2022-01-04 | Medtronic, Inc. | Delivery systems for VfA cardiac therapy |
US11376126B2 (en) | 2019-04-16 | 2022-07-05 | Neochord, Inc. | Transverse helical cardiac anchor for minimally invasive heart valve repair |
US11918468B2 (en) | 2019-04-16 | 2024-03-05 | Neochord, Inc. | Transverse helical cardiac anchor for minimally invasive heart valve repair |
US11712188B2 (en) | 2019-05-07 | 2023-08-01 | Medtronic, Inc. | Posterior left bundle branch engagement |
US11305127B2 (en) | 2019-08-26 | 2022-04-19 | Medtronic Inc. | VfA delivery and implant region detection |
US11944422B2 (en) | 2019-08-30 | 2024-04-02 | Auris Health, Inc. | Image reliability determination for instrument localization |
US11207141B2 (en) | 2019-08-30 | 2021-12-28 | Auris Health, Inc. | Systems and methods for weight-based registration of location sensors |
US11147633B2 (en) | 2019-08-30 | 2021-10-19 | Auris Health, Inc. | Instrument image reliability systems and methods |
US11298195B2 (en) | 2019-12-31 | 2022-04-12 | Auris Health, Inc. | Anatomical feature identification and targeting |
US11602372B2 (en) | 2019-12-31 | 2023-03-14 | Auris Health, Inc. | Alignment interfaces for percutaneous access |
US11660147B2 (en) | 2019-12-31 | 2023-05-30 | Auris Health, Inc. | Alignment techniques for percutaneous access |
US11813466B2 (en) | 2020-01-27 | 2023-11-14 | Medtronic, Inc. | Atrioventricular nodal stimulation |
US11911168B2 (en) | 2020-04-03 | 2024-02-27 | Medtronic, Inc. | Cardiac conduction system therapy benefit determination |
US11813464B2 (en) | 2020-07-31 | 2023-11-14 | Medtronic, Inc. | Cardiac conduction system evaluation |
US11969157B2 (en) * | 2023-04-28 | 2024-04-30 | Auris Health, Inc. | Systems and methods for tracking robotically controlled medical instruments |
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EP2203124B1 (en) | 2014-10-15 |
US20170189124A1 (en) | 2017-07-06 |
EP2203124A1 (en) | 2010-07-07 |
WO2010014420A1 (en) | 2010-02-04 |
US10010373B2 (en) | 2018-07-03 |
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