US 11,628,304 B2Granted

Detection and mapping of phrenic nerve by pacing

AssigneeBiosense Webster (Israel) Ltd.

InventorsAssaf Govari, Andres Claudio Altmann, Israel Zilberman

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Abstract

An apparatus includes an interface and a processor. The interface is configured to receive one or more magnetic-positioning signals from one or more position sensors coupled to one or more body-surface patches attached to a body of a patient, the magnetic-positioning signals indicative of respective positions of the position sensors. The processor is configured to (i) detect an inadvertent stimulation of a phrenic nerve of the patient, which occurs due to cardiac pacing applied by an intra-cardiac electrode in a heart of the patient, (ii) estimate, based on the magnetic-positioning signals, a motion of one or more of the body-surface patches occurring during the detected stimulation of the phrenic nerve, (iii) estimate, based on the estimated motion of the body-surface patches, a distance between the pacing electrode and the phrenic nerve, and (iv) send an output derived from the estimated distance to the output device.

Claims18

Dependent claims

An apparatus for identifying proximity of an ablation catheter to a phrenic nerve of a patient's heart, comprising:

an interface, configured to receive magnetic-positioning signals from a first pair of position sensors, each coupled to a patch attached to a patient's skin and a second position sensor coupled to the catheter, the magnetic-positioning signals indicative of respective positions of the position sensors;
and
a pacing stimulator configured direct current to an electrode of the catheter for delivering a pacing signal to a pacing location;
a processor, configured to:
identify a pattern of the motion indicative of phrenic nerve stimulation due to pacing based on the magnetic-positioning signals from the first pair of position sensors;
and
estimate distance between the pacing location and the phrenic nerve based on the identified pattern and the magnetic-positioning signals from the second position sensor;
prior to delivering an ablation signal at a selected location, determine if the selected location is within a predefined distance from the phrenic nerve based on the selected location, the pacing location and the distance estimated;
and
a display configured to initiate a warning not to ablate at the selected location, based on determining that the selected location is within the predefined distance.

7 more elements

Dependencies are inferred from the claim text.