Clinical feedback of ablation efficacy during ablation procedure

Abstract

There is provided a method and system for combining physiology information with ultrasound based anatomic structures during an ablation procedure. The embodiments relate to methods and systems that construct a 2D or 3D representation of an anatomical structure based on ultrasound data and superimpose thereon graphical information representative of physiologic characteristics of the anatomic structure in real-time or near real-time during an ablation procedure.

1 . A method of obtaining real-time or near real-time feedback as to the efficacy of an ablation procedure on a subject of interest at an ablation site, the method comprising the steps of: 
 receiving signals from an ultrasound probe located proximate the ablation site and, based thereon producing ultrasound data representative of a scan plane including the ablation site;    generating an ultrasound image based on the ultrasound data, the ultrasound image being representative of an anatomical structure of a portion of the ablation site contained in the scan plane;    receiving physiology signals from a physiology catheter located proximate the ablation site and, based thereon producing physiology data representative of physiologic activity of the portion of the ablation site contained in the scan plane;    forming a display image combining the ultrasound image and physiology data and saving the image in a electrophysiology recording system;    detecting a change in the subject Of interest proximate the ablation site;    receiving, in real-time or near real-time, signals from the ultrasound probe located proximate the ablation site and, based thereon producing a second ultrasound data representative of the scan plane including the ablation site;    generating, in real-time or near real-time, a second ultrasound image based on the second ultrasound data, the second ultrasound image being representative of the change in the anatomical structure of a portion of the ablation site contained in the scan plane;    receiving, in real-time or near real-time, physiology signals from the physiology catheter located proximate the ablation site and, based thereon producing a second physiology data representative of physiologic activity of the portion of the ablation site contained in the scan plane; and    forming, in real-time or near real-time, a second display image combining the second ultrasound image and second physiology data and saving the second image in the electrophysiology recording system.    
   
   
       2 . The method of  claim 1 , further comprising the steps of comparing the first and second display images of the combined ultrasound image and physiology data, wherein the efficacy of the ablation procedure can be determined.  
   
   
       3 . The method of  claim 1 , wherein detecting a change in the subject of interest includes determining tissue characterization as being one of conducting and non-conducting tissue.  
   
   
       4 . The method of  claim 1 , wherein the display image includes physiology data mapped onto an anatomical structure contained in and defined by the ultrasound image.  
   
   
       5 . The method of  claim 1 , wherein the ultrasound signal is received from an ultrasound probe constituting at least one of an intravascular ultrasound (IVUS) catheter, an echocardiography (ICE) catheter, a transesophageal probe, an interventional probe and a surface probe.  
   
   
       6 . The method of  claim 1 , wherein the physiology data is received from a physiology catheter constituting at least one of an electrophysiology (EP) catheter and a hemodynamic (HD) catheter.  
   
   
       7 . The method of  claim 1 , further comprising receiving ECG signals from ECG leads provided on the surface of the subject; deriving cardiac cycle data based on one of the ECG signals and intracardiac signals obtained from an electrophysiology catheter; and utilizing the cardiac cycle data to synchronize the ultrasound images and physiology data.  
   
   
       8 . The method of  claim 1 , further comprising tracking a position of an ultrasound probe and a physiology catheter, and generating tracking information denoting positions of the ultrasound probe and physiology catheter with respect to a common reference coordinate system.  
   
   
       9 . The method of  claim 1 , further comprising registering the ultrasound image and physiology data within a common coordinate reference system.  
   
   
       10 . The method of  claim 1 , further comprising receiving ECG signals from ECG leads placed on a subject, and generating timing information from the ECG signals, the timing information being representative of cyclical points in a subject's cardiac cycle.  
   
   
       11 . The method of  claim 1 , further comprising generating and displaying new ultrasound images at a frame rate of at least seven frames per second.  
   
   
       12 . The method of  claim 1 , further comprising forming a volumetric ultrasound data set for a series of the scan planes, the display image constituting a three-dimensional representation of the ultrasound image and physiology data.  
   
   
       13 . The method of  claim 1 , wherein the ultrasound image and physiology data combined in the display image are obtained at a common time in a cyclical motion of the region of interest.  
   
   
       14 . The method of  claim 1 , wherein the ultrasound image is representative of least one of B-mode, power Doppler, color flow, M-mode, anatomic M-mode, ARFI mode, strain and strain rate information.  
   
   
       15 . The method of  claim 1 , wherein the physiology data is denoted in the display image as at least one of gray scale information and color information combined with the ultrasound image.  
   
   
       16 . The method of  claim 1 , further comprising accessing a lookup table based on the ultrasound image data and physiology data to define pixel values of the display image, the lookup table identifying pixel values to be used in the display image based on the ultrasound image data and physiology data.  
   
   
       17 . The method of  claim 1 , further comprising presenting, in the display image, the ultrasound image data as gray scale information and the physiology data as color information.  
   
   
       18 . The method of  claim 1 , further comprising providing a user interface the permits an operator to designate a point on the subject of interest, in response to the user designation, presenting a graph of physiology data over a period of time associated with a designated point on the region of interest.  
   
   
       19 . A method of obtaining real-time or near real-time feedback as to the efficacy of an ablation procedure on a subject of interest at an ablation site, the method comprising the steps of: 
 receiving signals from an ultrasound probe located proximate the ablation site and, based thereon producing ultrasound data representative of a scan plane including the ablation site;    generating an ultrasound image based on the ultrasound data, the ultrasound image being representative of an anatomical structure of a portion of the ablation site contained in the scan plane;    receiving physiology signals from a physiology catheter located proximate the ablation site and, based thereon producing physiology data representative of physiologic activity of the portion of the ablation site contained in the scan plane;    forming a display image combining the ultrasound image and physiology data and saving the image in a electrophysiology recording system;    detecting a change in the subject of interest proximate the ablation site;    receiving, in real-time or near real-time, signals from the ultrasound probe located proximate the ablation site and, based thereon producing a second ultrasound data representative of the scan plane including the ablation site;    generating, in real-time or near real-time, a second ultrasound image based on the second ultrasound data, the second ultrasound image being representative of the change in the anatomical structure of a portion of the ablation site contained in the scan plane;    receiving, in real-time or near real-time, physiology signals from the physiology catheter located proximate the ablation site and, based thereon producing a second physiology data representative of physiologic activity of the portion of the ablation site contained in the scan plane;    forming, in real-time or near real-time, a second display image combining the second ultrasound image and second physiology data and saving the second image in the electrophysiology recording system; and    tracking a position of an ultrasound probe and a physiology catheter, and generating tracking information denoting positions of the ultrasound probe and physiology catheter with respect to a common reference coordinate system and registering the ultrasound image and physiology data within a common coordinate reference system.    
   
   
       20 . The method of  claim 19 , further comprising the steps of comparing the first and second display images of the combined ultrasound image and physiology data, wherein the efficacy of the ablation procedure can be determined.  
   
   
       21 . The method of  claim 19 , wherein detecting a change in the subject of interest includes determining tissue characterization as being one of conducting and non-conducting tissue.  
   
   
       22 . The method of  claim 19 , wherein the display image includes physiology data mapped onto an anatomical structure contained in and defined by the ultrasound image.  
   
   
       23 . The method of  claim 19 , wherein the ultrasound signal is received from-an ultrasound probe constituting at least one of an intravascular ultrasound (IVUS) catheter, an echocardiography (ICE) catheter, a transesophageal probe, an interventional probe and a surface probe.  
   
   
       24 . The method of  claim 19 , wherein the physiology data is received from a physiology catheter constituting at least one of an electrophysiology (EP) catheter and a hemodynamic (HD) catheter.  
   
   
       25 . The method of  claim 19 , further comprising receiving ECG signals from ECG leads provided on the surface of the subject; deriving cardiac cycle data based on one of the ECG signals and intracardiac signals obtained from an electrophysiology catheter; and utilizing the cardiac cycle data to synchronize the ultrasound images and physiology data.  
   
   
       26 . The method of  claim 19 , further comprising receiving ECG signals from ECG leads placed on a subject, and generating timing information from the ECG signals, the timing information being representative of cyclical points in a subject's cardiac cycle.  
   
   
       27 . The method of  claim 19 , further comprising generating and displaying new ultrasound images at a frame rate of at least seven frames per second.  
   
   
       28 . The method of  claim 19 , further comprising forming a volumetric ultrasound data set for a series of the scan planes, the display image constituting a three-dimensional representation of the ultrasound image and physiology data.  
   
   
       29 . The method of  claim 19 , wherein the ultrasound image and physiology data combined in the display image are obtained at a common time in a cyclical motion of the region of interest.  
   
   
       30 . The method of  claim 19 , wherein the ultrasound image is representative of least one of B-mode, power Doppler, color flow, M-mode, anatomic M-mode, ARFI mode, strain and strain rate information.  
   
   
       31 . The method of  claim 19 , wherein the physiology data is denoted in the display image as at least one of gray scale information and color information combined with the ultrasound image.  
   
   
       32 . The method of  claim 19 , further comprising accessing a lookup table based on the ultrasound image data and physiology data to define pixel values of the display image, the lookup table identifying pixel values to be used in the display image based on the ultrasound image data and physiology data.  
   
   
       33 . The method of  claim 19 , further comprising presenting, in the display image, the ultrasound image data as gray scale information and the physiology data as color information.  
   
   
       34 . The method of  claim 19 , further comprising providing a user interface the permits an operator to designate a point on the subject of interest, in response to the user designation, presenting a graph of physiology data over a period of time associated with a designated point on the region of interest.  
   
   
       35 . A method of obtaining real-time or neat real-time feedback as to the efficacy of an ablation procedure on a subject of interest at an ablation site, the method comprising the steps of: 
 receiving signals from an ultrasound probe located proximate the ablation site and, based thereon producing ultrasound data representative of a scan plane including the ablation site;    generating an ultrasound image based on the ultrasound data, the ultrasound image being representative of an anatomical structure of a portion of the ablation site contained in the scan plane;    receiving physiology signals from a physiology catheter located proximate the ablation site and, based thereon producing physiology data representative of physiologic activity of the portion of the ablation site contained in the scan plane;    forming a display image combining the ultrasound image and physiology data and saving the image in a electrophysiology recording system;    detecting a change in the subject of interest proximate the ablation site;    receiving, in real-time or near real-time, signals from the ultrasound probe located proximate the ablation site and, based thereon producing a second ultrasound data representative of the scan plane including the ablation site;    generating, in real-time or near real-time, a second ultrasound image based on the second ultrasound data, the second ultrasound image being representative of the change in the anatomical structure of a portion of the ablation site contained in the scan plane;    receiving, in real-time or near real-time, physiology signals from the physiology catheter located proximate the ablation site and, based thereon producing a second physiology data representative of physiologic activity of the portion of the ablation site contained in the scan plane;    forming, in real-time or near real-time, a second display image combining the second ultrasound image and second physiology data and saving the second image in the electrophysiology recording system; and    forming a volumetric ultrasound data set for a series of the scan planes, the display image constituting a three-dimensional representation of the ultrasound image and physiology data, wherein the ultrasound image and physiology data combined in the display image are obtained at a common time in a cyclical motion of the region of interest.    
   
   
       36 . The method of  claim 35 , further comprising the steps of comparing the first and second display images of the combined ultrasound image and physiology data, wherein the efficacy of the ablation procedure can be determined.  
   
   
       37 . The method of  claim 35 , wherein detecting a change in the subject of interest includes determining tissue characterization as being one of conducting and non-conducting tissue.  
   
   
       38 . The method of  claim 35 , wherein the display image includes physiology data mapped onto an anatomical structure contained in and defined by the ultrasound image.  
   
   
       39 . The method of  claim 35 , wherein the ultrasound signal is received from an ultrasound probe constituting at least one of an intravascular ultrasound (IVUS) catheter, an echocardiography (ICE) catheter, a transesophageal probe, an interventional probe and a surface probe.  
   
   
       40 . The method of  claim 35 , wherein the physiology data is received from a physiology catheter constituting at least one of an electrophysiology (EP) catheter and a hemodynamic (HD) catheter.  
   
   
       41 . The method of  claim 35 , further comprising receiving ECG signals from ECG leads provided on the surface of the subject; deriving cardiac cycle data based on one of the ECG signals and intracardiac signals obtained from an electrophysiology catheter; and utilizing the cardiac cycle data to synchronize the ultrasound images and physiology data.  
   
   
       42 . The method of  claim 35 , further comprising tracking a position of an ultrasound probe and a physiology catheter, and generating tracking information denoting positions of the ultrasound probe and physiology catheter with respect to a common reference coordinate system.  
   
   
       43 . The method of  claim 35 , further comprising registering the ultrasound image and physiology data within a common coordinate reference system.  
   
   
       44 . The method of  claim 35 , further comprising receiving ECG signals from ECG leads placed on a subject, and generating timing information from the ECG signals, the timing information being representative of cyclical points in a subject's cardiac cycle.  
   
   
       45 . The method of  claim 35 , further comprising generating and displaying new ultrasound images at a frame rate of at least seven frames per second.  
   
   
       46 . The method of  claim 35 , wherein the ultrasound image is representative of least one of B-mode, power Doppler, color flow, M-mode, anatomic M-mode, ARFI mode, strain and strain rate information.  
   
   
       47 . The method of  claim 35 , wherein the physiology data is denoted in the display image as at least one of gray scale information and color information combined with the ultrasound image.  
   
   
       48 . The method of  claim 35 , further comprising accessing a lookup table based on the ultrasound image data and physiology data to define pixel values of the display image, the lookup table identifying pixel values to be used in the display image based on the ultrasound image data and physiology data.  
   
   
       49 . The method of  claim 35 , further comprising presenting, in the display image, the ultrasound image data as gray scale information and the physiology data as color information.  
   
   
       50 . The method of  claim 35 , further comprising providing a user interface the permits an operator to designate a point on the subject of interest, in response to the user designation, presenting a graph of physiology data over a period of time associated with a designated point on the region of interest.