# US 2014/0155721 A1 · Correction of shift and drift in impedance-based medical device navigation using measured impedances at external patch electrodes

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- Number: US 2014/0155721 A1
- Document ID: US20140155721A1
- Status: Published application
- Kind: A1
- Application number: 13/690,737
- Filed: 2012-11-30
- Published: 2014-06-05
- Earliest claimed: 2012-11-30
- Assignees: St. Jude Medical, Atrial Fibrillation Division, Inc.
- Inventors: John A. Hauck; Jeffrey A. Schweitzer; Lev A. Koyrakh
- Web page: https://patentgrep.com/patent/US20140155721A1

## CPC

- A61B 5/063: {using impedance measurements}
- A61B 5/6801: {specially adapted to be attached to or worn on the body surface}
- A61B 5/742: {using visual displays (displays for heart-related electrical signals, e.g. ECG, A61B5/339)}
- A61B 5/053: Measuring electrical impedance or conductance of a portion of the body
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A system and method are provided for determining characteristics of a device electrode disposed on a medical device within a body. A plurality of measurement electrodes are coupled to an external surface of the body and establish transmission paths for current through the body. An electronic control unit (ECU) is configured to cause transmission of current between a pair of active electrodes selected from the measurement electrodes and thereby generate a voltage on the device electrode. The ECU receives impedance signals from a plurality of passive electrodes among the measurement electrodes other than the active electrodes. The ECU establishes a virtual reference electrode at a reference position within the body responsive to the impedance signals and computes a position of the device responsive to the voltage on the device electrode and the reference position of the reference electrode. The ECU may also compute impedances at the device and measurement electrodes.

## Claims

### Claim 1

A system for determining one or more characteristics of a device electrode disposed on a medical device within a body, comprising:
an electronic control unit configured to:
cause transmission of a current between a first pair of active electrodes, said first pair of active electrodes selected from among a plurality of measurements electrodes each coupled to an external surface of said body, to thereby generate a first voltage on said device electrode;
receive impedance signals from a plurality of passive electrodes, each of said passive electrodes comprising one of said plurality of measurement electrodes other than one of said first pair of active electrodes, each of said impedance signals indicative of an impedance at one of said plurality of passive electrodes;
establish a virtual reference electrode at a reference position within said body responsive to said impedance signals;
generate a position value responsive to said first voltage on said device electrode and said reference position of said reference electrode; and,
scale said position value using a scaling value computed in response to said impedance signals.

### Claim 2 (depends on 1)

The system of claim 1 wherein said electronic control unit is further configured to determine an impedance at said device electrode.

### Claim 3 (depends on 2)

The system of claim 2 wherein said electronic control unit is further configured, in determining said impedance, to compute said impedance responsive to a first impedance indicative signal generated by said device electrode and a second impedance indicative signal generated by an impedance reference electrode.

### Claim 4 (depends on 2)

The system of claim 2 wherein said electronic control unit is further configured to determine an impedance at a first passive electrode of said plurality of passive electrodes responsive to said impedance signal generated by said first passive electrode and an impedance indicative signal generated by an impedance reference electrode.

### Claim 5 (depends on 4)

The system of claim 4 wherein said impedance reference electrode is disposed on another medical device within said body.

### Claim 6 (depends on 5)

The system of claim 5 wherein said another medical device comprises a coronary sinus catheter.

### Claim 7 (depends on 1)

The system of claim 1 wherein said electronic control unit is further configured, in computing said position of said medical device, to:
generate a position value responsive to said first voltage on said device electrode and said reference position of said reference electrode; and,
scale said position value using a scaling value computed in response to said impedance signals.

### Claim 8 (depends on 1)

The system of claim 1 wherein said electronic control unit is further configured, in scaling said position value, to:
calculate a mean of an absolute value of an impedance at one of said plurality of passive electrodes continuously as a function of time Pm(t);
save an initial calculated mean of the absolute value of said impedance as Pa; and,
multiply said position value by the ratio Pa/Pm(t).

### Claim 9 (depends on 1)

The system of claim 1 wherein said electronic control unit is further configured, in establishing said virtual reference electrode at said reference position, to:
determine a position for said virtual reference electrode along a first axis extending through said body;
determine a position for said virtual reference electrode along a second axis extending through said body perpendicular to said first-axis; and,
determine a position for said virtual reference electrode along a third axis extending through said body perpendicular to said first axis and said second axis.

### Claim 10 (depends on 9)

The system of claim 9 wherein said electronic control unit is further configured, in determining a position for said virtual reference electrode along said first axis to:
sum impedances at a subset of passive electrodes of said plurality of passive electrodes to obtain a cumulative impedance value; and,
divide said cumulative impedance value by the number of said passive electrodes in said subset of passive electrodes.

### Claim 11

An article of manufacture, comprising:
a computer readable storage medium having a computer program encoded thereon that, when executed by an electronic control unit, determines one or more characteristics of a device electrode disposed on a medical device within a body, the computer program including code for:
causing transmission of a current between a first pair of active electrodes, said first pair of active electrodes selected from among a plurality of measurements electrodes each coupled to an external surface of said body, to thereby generate a first voltage on said device electrode;
receiving impedance signals from a plurality of passive electrodes, each of said passive electrodes comprising one of said plurality of measurement electrodes other than one of said first pair of active electrodes, each of said impedance signals indicative of an impedance at one of said plurality of passive electrodes;
establishing a virtual reference electrode at a reference position within said body responsive to said impedance signals;
generating a position value responsive to said first voltage on said device electrode and said reference position of said reference electrode; and,
scaling said position value using a scaling value computed in response to said impedance signals.

### Claim 12 (depends on 11)

The article of manufacture of claim 11 wherein said computer program further includes code for determining an impedance at said device electrode.

### Claim 13 (depends on 12)

The article of manufacture of claim 12 wherein the code for determining said impedance includes code for computing said impedance responsive to a first impedance indicative signal generated by said device electrode and a second impedance indicative signal generated by an impedance reference electrode.

### Claim 14 (depends on 11)

The article of manufacture of claim 11 wherein said computer program further includes code for determining an impedance at a first passive electrode of said plurality of passive electrodes responsive to said impedance signal generated by said first passive electrode and an impedance indicative signal generated by an impedance reference electrode.

### Claim 15 (depends on 11)

The article of manufacture of claim 11 wherein said code for scaling said position value includes code for:
calculating a mean of an absolute value of an impedance at one of said plurality of passive electrodes continuously as a function of time Pm(t);
saving an initial calculated mean of the absolute value of said impedance as Pa; and,
multiplying said position value by the ratio Pa/Pm(t).

### Claim 16 (depends on 11)

The article of manufacture of claim 11 wherein said code for establishing said virtual reference electrode at said reference position includes code for:
determining a position for said virtual reference electrode along a first axis extending through said body;
determining a position for said virtual reference electrode along a second axis extending through said body perpendicular to said first-axis; and,
determining a position for said virtual reference electrode along a third axis extending through said body perpendicular to said first axis and said second axis.

### Claim 17 (depends on 16)

The article of manufacture of claim 16 wherein said code for determining a position for said virtual reference electrode along said first axis includes code for:
summing impedances at a subset of passive electrodes of said plurality of passive electrodes to obtain a cumulative impedance value; and,
dividing said cumulative impedance value by the number of said passive electrodes in said subset of passive electrodes.

### Claim 18

A method for determining one or more characteristics of a device electrode disposed on a medical device within a body, the method comprising:
causing transmission of a current between a first pair of active electrodes, said first pair of active electrodes selected from among a plurality of measurements electrodes each coupled to an external surface of said body, to thereby generate a first voltage on said device electrode;
receiving impedance signals from a plurality of passive electrodes, each of said passive electrodes comprising one of said plurality of measurement electrodes other than one of said first pair of active electrodes, each of said impedance signals indicative of an impedance at one of said plurality of passive electrodes;
establishing a virtual reference electrode at a reference position within said body responsive to said impedance signals;
generating a position value responsive to said first voltage on said device electrode and said reference position of said reference electrode; and,
scaling said position value using a scaling value computed in response to said impedance signals.

### Claim 19 (depends on 18)

The method of claim 18 further comprising determining an impedance at said device electrode.

### Claim 20 (depends on 19)

The method of claim 19 wherein determining said impedance includes computing said impedance responsive to a first impedance indicative signal generated by said device electrode and a second impedance indicative signal generated by an impedance reference electrode.

### Claim 21 (depends on 18)

The method of claim 18 further comprising determining an impedance at a first passive electrode of said plurality of passive electrodes responsive to said impedance signal generated by said first passive electrode and an impedance indicative signal generated by an impedance reference electrode.

### Claim 22 (depends on 18)

The method of claim 18 wherein scaling said position value includes:
calculating a mean of an absolute value of an impedance at one of said plurality of passive electrodes continuously as a function of time Pm(t);
saving an initial calculated mean of the absolute value of said impedance as Pa; and,
multiplying said position value by the ratio Pa/Pm(t).

### Claim 23 (depends on 18)

The method of claim 18 wherein establishing said virtual reference electrode at said reference position includes
determining a position for said virtual reference electrode along a first axis extending through said body;
determining a position for said virtual reference electrode along a second axis extending through said body perpendicular to said first-axis; and,
determining a position for said virtual reference electrode along a third axis extending through said body perpendicular to said first axis and said second axis.

### Claim 24 (depends on 23)

The method of claim 23 wherein determining a position for said virtual reference electrode along said first axis includes:
summing impedances at a subset of passive electrodes of said plurality of passive electrodes to obtain a cumulative impedance value; and,
dividing said cumulative impedance value by the number of said passive electrodes in said subset of passive electrodes.
