Force-sensitive mechanism for contact detection in catheter systems.
The catheter system with a piezoelectric sensor-based force sensing mechanism addresses the challenge of measuring contact force during ablation therapy, ensuring optimal lesion formation and preventing tissue damage by providing real-time feedback.
Patent Information
- Application Number
- JP2024570783
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- Priority Date
- 2022-06-02
- Filing Date
- 2023-05-04
- Publication Date
- 2026-01-29
- Estimated Expiration
- 2043-05-04
AI Technical Summary
Existing catheter devices lack the capability to effectively sense the force exerted on target tissue during ablation therapy, making it difficult to determine the quality of lesion formation and potential tissue damage.
A catheter system equipped with a force sensing mechanism, comprising a piezoelectric sensor with a fixed and unfixed portion, and a distal housing protrusion to apply axial force, generating an output indicative of the contact force applied to the tissue.
Enables precise measurement of contact force, aiding in determining lesion quality and preventing tissue damage by providing real-time feedback on the degree of contact between the catheter and tissue.
Smart Images

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Abstract
Description
[Technical Field]
[0001] The present disclosure generally relates to various force-sensing catheter features. [Background technology]
[0002] In ablation therapy, it can be useful to assess contact between the ablation element and the tissue targeted for ablation. In interventional cardiac electrophysiology (EP) procedures, for example, contact can be used to assess the effectiveness of the ablation therapy being performed. Knowing whether a portion of the catheter is contacting the target tissue and how much pressure it is applying can aid in other catheter-based treatments and diagnoses. The tissue exerts a force against the catheter, and measuring this force can assess contact and the degree to which the catheter is compressing the target tissue.
[0003] There is a continuing need for improved catheter devices and corresponding methods of use that are capable of sensing the force that the catheter tip exerts on target tissue. Summary of the Invention
[0004] In Example 1, a catheter is adapted to measure contact forces, the catheter comprising an elongate shaft having a proximal end and a distal end and a distal end portion extending distally from the distal end of the shaft. The distal end portion defines a longitudinal axis extending through the distal end portion and includes a proximal segment, a distal segment located distally of the proximal segment and spaced apart from the proximal segment by a gap, and a force sensing mechanism. The force sensing mechanism includes a proximal housing fixed within the proximal segment, a piezoelectric sensor attached to the proximal housing, the piezoelectric sensor having a first portion fixedly attached to the proximal housing and a second portion not fixedly attached to the proximal housing, and a distal housing fixed within the distal segment, the distal housing including a protrusion configured to contact the second portion of the piezoelectric sensor and apply an axial force to the second portion of the piezoelectric sensor when an external force is applied to the distal segment. The piezoelectric sensor is configured to generate an output in response to an external force applied to the distal segment that is indicative of the amount of axial force applied to a second portion of the piezoelectric sensor.
[0005] In Example 2, in the catheter of Example 1, the proximal housing includes an upper surface, a lower surface, and a cavity extending from the lower surface through the upper surface, a first portion of the piezoelectric sensor fixedly attached to the upper surface, and a second portion of the piezoelectric sensor extending at least partially across the cavity.
[0006] In Example 3, in the catheter of Example 2, the piezoelectric sensor has an arc-shaped or rectangular outer shape when viewed in a direction parallel to the longitudinal axis. In Example 4, in the catheter of Example 2, the piezoelectric sensor has an annular shape when viewed in a direction parallel to the longitudinal axis, the first portion is an outer peripheral portion of the piezoelectric sensor, and the second portion is located radially inward of the first portion of the piezoelectric sensor.
[0007] In Example 5, the catheter of Example 2, wherein the piezoelectric sensor is a generally circular disk and the second portion extends across the cavity. In Example 6, in the catheter of any of Examples 1 to 5, the proximal housing includes a compressible backing material disposed within a portion of the cavity and contacting a second portion of the piezoelectric sensor opposite the protrusion on the distal housing, the backing material resisting deformation of the second portion of the piezoelectric sensor when an external force is applied to the distal segment.
[0008] In Example 7, in the catheter of any of Examples 1-6, the force sensing mechanism includes three piezoelectric sensors mounted to the proximal housing and spaced circumferentially about the longitudinal axis, each of the three piezoelectric sensors having a first portion fixedly mounted to the proximal housing and a second portion deflectable relative to the first portion.
[0009] In Example 8, in the catheter of Example 7, the distal housing includes three protrusions, each protrusion contacting a second portion of a corresponding one of the three piezoelectric sensors and configured to apply an axial force to the second portion of the corresponding piezoelectric sensor when an external force is applied to the distal segment.
[0010] In Example 9, in the catheter of Example 8, each of the three piezoelectric sensors is configured to generate an output indicative of an amount of axial force applied to a second portion of the piezoelectric sensor in response to an external force applied to the distal segment.
[0011] In Example 10, in the catheter of Example 9, the proximal housing includes three cavities extending from the lower surface through the upper surface, each of the three cavities being aligned with a corresponding one of the three piezoelectric sensors, and a second portion of each of the three piezoelectric sensors extending at least partially across the corresponding one of the three cavities.
[0012] In Example 11, in the catheter of Example 10, each piezoelectric sensor has an arc-shaped or rectangular outer shape when viewed in a direction parallel to the longitudinal axis. In Example 12, in the catheter of Example 10, each piezoelectric sensor has an annular shape when viewed in a direction parallel to the longitudinal axis, and the first portion is an outer peripheral portion of the piezoelectric sensor and the second portion is located radially inward of the first portion of the piezoelectric sensor.
[0013] In Example 13, the catheter of Example 10, wherein each piezoelectric sensor is a generally circular disk, and the second portion of each piezoelectric sensor extends across the corresponding cavity. In Example 14, in the catheter of any of Examples 8 to 13, a compressible backing material is disposed within a portion of each cavity and contacts a second portion of the corresponding piezoelectric sensor opposite the corresponding protrusion on the distal housing, and the backing material resists deformation of the second portion of the corresponding piezoelectric sensor when an external force is applied to the distal segment.
[0014] In Example 15, the catheter of Example 1 further comprises a preload mechanism operably coupled to the proximal housing and configured to allow a user to selectively apply a preload to the piezoelectric sensor.
[0015] In Example 16, a catheter is adapted to measure contact forces, the catheter comprising: an elongate shaft having a proximal end and a distal end; and a distal end portion extending distally from the distal end of the shaft. The distal end portion defines a longitudinal axis extending through the distal end portion and comprises a proximal segment, a distal segment located distally of the proximal segment, and a force sensing mechanism including: a proximal housing fixed within the proximal segment; a piezoelectric sensor attached to the proximal housing, the piezoelectric sensor having a first portion fixedly attached to the proximal housing and a second portion not fixedly attached to the proximal housing; and a distal housing fixed within the distal segment, the distal housing including a protrusion configured to contact the second portion of the piezoelectric sensor and apply an axial force to the second portion of the piezoelectric sensor when an external force is applied to the distal segment.
[0016] In Example 17, the catheter of Example 16, wherein the proximal housing includes an upper surface, a lower surface, and a cavity extending from the lower surface through the upper surface, a first portion of the piezoelectric sensor fixedly attached to the upper surface, and a second portion of the piezoelectric sensor extending at least partially across the cavity.
[0017] In Example 18, the catheter of Example 17, wherein the proximal housing includes a compressible backing material disposed within a portion of the cavity and contacting a second portion of the piezoelectric sensor opposite the protrusion on the distal housing, the backing material resisting deformation of the second portion of the piezoelectric sensor when an external force is applied to the distal segment.
[0018] In Example 19, in the catheter of Example 17, the piezoelectric sensor has an arc-shaped or rectangular outer shape when viewed in a direction parallel to the longitudinal axis. In Example 20, in the catheter of Example 17, the piezoelectric sensor has an annular shape when viewed in a direction parallel to the longitudinal axis, the first portion being an outer peripheral portion of the piezoelectric sensor, and the second portion being located radially inward of the first portion of the piezoelectric sensor.
[0019] In Example 21, the catheter of Example 17, wherein the piezoelectric sensors are generally circular disks, and the second portion of each piezoelectric sensor extends across the corresponding cavity. In Example 22, the catheter of Example 1 further comprises a preload mechanism operably coupled to the proximal housing and configured to allow a user to selectively apply a preload to the piezoelectric sensor.
[0020] In Example 23, a catheter adapted to measure contact force is provided, the catheter comprising an elongate shaft having a proximal end and a distal end, and a distal end portion extending distally from the distal end of the shaft. The distal end portion defines a longitudinal axis extending through the distal end portion and includes a proximal segment, a distal segment located distal to the proximal segment, and a force sensing mechanism, the force sensing mechanism including: a proximal housing fixed within the proximal segment, the proximal housing having a lower surface and an upper surface; a plurality of piezoelectric sensors mounted circumferentially spaced apart from one another about the proximal housing, each piezoelectric sensor having a first portion fixedly attached to the proximal housing and a second portion not fixedly attached to the proximal housing; and a distal housing fixed within the distal segment and including a plurality of protrusions, each of the plurality of protrusions contacting a second portion of a corresponding one of the plurality of piezoelectric sensors and configured to apply an axial force to the second portion of the corresponding piezoelectric sensor when an external force is applied to the distal segment, each of the plurality of piezoelectric sensors configured to generate an output indicative of the amount of axial force applied to the second portion of the corresponding piezoelectric sensor in response to an external force applied to the distal segment.
[0021] In Example 24, in the catheter of Example 23, the proximal housing includes a plurality of cavities extending from the lower surface through the upper surface, each of the plurality of cavities being aligned with a corresponding one of the plurality of piezoelectric sensors, and a second portion of each of the plurality of piezoelectric sensors extending at least partially across the corresponding one of the plurality of cavities.
[0022] In Example 25, in the catheter of Example 24, the proximal housing includes a compressible backing material disposed within each of the plurality of cavities and in contact with a second portion of the piezoelectric sensor disposed on a corresponding protrusion opposite to the corresponding protrusion on the distal housing, the backing material resisting deformation of the second portion of the piezoelectric sensor when an external force is applied to the distal segment.
[0023] In Example 26, in the catheter of Example 24, each piezoelectric sensor has an annular shape when viewed in a direction parallel to the longitudinal axis, and the first portion is an outer radial portion of the piezoelectric sensor and the second portion is an inner radial portion of the piezoelectric sensor.
[0024] In Example 27, the catheter of Example 24, each piezoelectric sensor is a generally circular disk, and the second portion of each piezoelectric sensor extends across the corresponding cavity. In Example 28, in the catheter of Example 24, the force sensing mechanism includes three piezoelectric sensors mounted on the proximal housing and spaced circumferentially about the longitudinal axis, each of the three piezoelectric sensors having a first portion fixedly mounted to the proximal housing and a second portion deflectable relative to the first portion, and the distal housing includes three protrusions, each protrusion contacting the second portion of a corresponding one of the three piezoelectric sensors and configured to apply an axial force to the second portion of the corresponding piezoelectric sensor when an external force is applied to the distal segment.
[0025] In Example 29, in the catheter of Example 28, the proximal housing includes three cavities extending from the lower surface through the upper surface, each of the three cavities being aligned with a corresponding one of the three piezoelectric sensors, and a second portion of each of the three piezoelectric sensors extending at least partially across the corresponding one of the three cavities.
[0026] In Example 30, a force sensing mechanism for an ablation catheter is provided, the force sensing mechanism adapted to measure contact force, the force sensing mechanism comprising: a proximal housing having a lower surface and an upper surface; a plurality of piezoelectric sensors attached to the proximal housing and spaced circumferentially apart from one another about the proximal housing, each piezoelectric sensor having a first portion fixedly attached to the proximal housing and a second portion not fixedly attached to the proximal housing; and a distal housing including a plurality of protrusions, each of the plurality of protrusions contacting a second portion of a corresponding one of the plurality of piezoelectric sensors and configured to apply an axial force to the second portion of the corresponding piezoelectric sensor when an external force is applied to the distal housing, and each of the plurality of piezoelectric sensors configured to generate an output indicative of the amount of axial force applied to the second portion of the corresponding piezoelectric sensor in response to an external force applied to the distal housing.
[0027] In Example 31, in the force sensing mechanism of Example 30, the proximal housing includes a plurality of cavities extending from the lower surface through the upper surface, each of the plurality of cavities being aligned with a corresponding one of the plurality of piezoelectric sensors, and a second portion of each of the plurality of piezoelectric sensors extending at least partially across the corresponding one of the plurality of cavities.
[0028] In Example 32, in the force sensing mechanism of Example 31, the proximal housing includes a compressible backing material disposed within each of the plurality of cavities and in contact with a second portion of the piezoelectric sensor disposed on a corresponding protrusion opposite to the corresponding protrusion on the distal housing, the backing material resisting deformation of the second portion of the piezoelectric sensor when an external force is applied to the distal segment.
[0029] In Example 33, in the force sensing mechanism of Example 30, each piezoelectric sensor has a rectangular shape. In Example 34, in the force sensing mechanism of Example 30, each piezoelectric sensor has an annular shape, the first portion is an outer peripheral portion of the piezoelectric sensor, and the second portion is located radially inward of the first portion of the piezoelectric sensor.
[0030] In Example 35, in the force sensing mechanism of Example 30, each piezoelectric sensor is a generally circular disk, and the second portion of each piezoelectric sensor extends across the corresponding cavity. While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive. [Brief explanation of the drawings]
[0031] [Figures 1A-1C] 1A-1C illustrate systems for measuring forces using a catheter, according to various embodiments of the present disclosure. [Figure 2] FIG. 2 is a block diagram of circuitry for controlling various functions described herein. [Figure 3] 1A-1D are perspective views of a distal end of a catheter according to various embodiments of the present disclosure. [Figure 4A] FIG. 4 is a perspective view of a force-sensing mechanism within the catheter of FIG. 3 in accordance with various embodiments of the present disclosure. [Figure 4B] FIG. 4 is a front view of a force-sensing mechanism in the catheter of FIG. 3 in accordance with various embodiments of the present disclosure. [Figure 4C] 4A-4B according to various embodiments of the present disclosure. [Figure 5A] FIG. 4 is a perspective view of an alternative force-sensing mechanism for use in the catheter of FIG. 3 according to various embodiments of the present disclosure. [Figure 5B] FIG. 4 is a front view of an alternative force-sensing mechanism for use in the catheter of FIG. 3, according to various embodiments of the present disclosure. [Figure 5C]4 is a cross-sectional front view of an alternative force-sensing mechanism for use in the catheter of FIG. 3, according to various embodiments of the present disclosure. [Figure 6A] FIG. 4 is a perspective view of an alternative force-sensing mechanism for use in the catheter of FIG. 3 according to various embodiments of the present disclosure. [Figure 6B] FIG. 4 is a perspective view of an alternative force-sensing mechanism for use in the catheter of FIG. 3 according to various embodiments of the present disclosure. [Figure 6C] FIG. 4 is a front view of an alternative force-sensing mechanism for use in the catheter of FIG. 3, according to various embodiments of the present disclosure. [Figure 6D] 4 is a cross-sectional front view of an alternative force-sensing mechanism for use in the catheter of FIG. 3, according to various embodiments of the present disclosure. [Figure 7A] FIG. 4 is a front view of an alternative force-sensing mechanism for use in the catheter of FIG. 3, according to various embodiments of the present disclosure. [Figure 7B] 4A-4C are cross-sectional views of alternative force-sensing mechanisms for use in the catheter of FIG. 3 according to various embodiments of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION
[0032] While the invention is susceptible to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to limit the invention to the specific embodiments described. On the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the appended claims.
[0033] Various cardiac abnormalities can result from inappropriate electrical activity in cardiac tissue. Such inappropriate electrical activity includes, but is not limited to, electrical signal generation, electrical signal conduction, and / or mechanical contraction of the tissue in a manner that does not support efficient and / or effective cardiac function. For example, a region of cardiac tissue may electrically activate prematurely or otherwise become out of sync during the cardiac cycle, causing cardiac cells in that region and / or adjacent regions to contract out of rhythm. This results in abnormal cardiac contractions that are not timed for optimal cardiac output. In some cases, a region of cardiac tissue may develop a defective electrical pathway (e.g., a shunt) that causes arrhythmias such as atrial fibrillation or supraventricular tachycardia. In some cases, inactive tissue (e.g., scar tissue) may be preferable to dysfunctional cardiac tissue.
[0034] Cardiac ablation is a procedure that treats cardiac tissue to inactivate the tissue. The tissue targeted for ablation may be associated with inappropriate electrical activity, as described above. Cardiac ablation can involve the formation of lesions in the tissue to prevent the tissue from inappropriately generating or conducting electrical signals. For example, the formation of lines, circles, or other cardiac tissue lesions can block the propagation of erroneous electrical signals. In some cases, cardiac ablation is intended to cause necrosis of cardiac tissue, allowing scar tissue to reform over the lesions and prevent the scar tissue from being associated with inappropriate electrical activity. Lesion formation therapies include electrical ablation, radiofrequency ablation, cryoablation, microwave ablation, laser ablation, and surgical ablation, among others. While cardiac ablation therapy is referenced herein as an example, various embodiments of the present disclosure may be directed to catheters that deliver ablative and / or non-ablative diagnostic and / or other therapies for other types of tissue.
[0035] Ideally, ablation therapy would be performed minimally invasively, such as with a catheter introduced into the heart through blood vessels, rather than through direct access by surgically opening the heart (e.g., as in a maze surgical procedure). For example, a single catheter could be used to electrophysiologically probe the inner surface of the heart to identify electrical activation patterns. From these patterns, a clinician could identify areas of inappropriate electrical activity and ablate the heart tissue to kill or isolate the tissue associated with the inappropriate electrical activity. However, because catheter-based procedures lack direct access, a clinician may need to interact with the heart tissue solely through a single catheter and keep track of all information collected by the catheter or otherwise related to the procedure. In particular, it can be difficult to determine the location of the treatment element (e.g., proximity to the tissue), the quality of the lesion, and whether the tissue is completely lesioned, insufficiently lesioned (e.g., still capable of generating and / or conducting undesired electrical signals), or excessively lesioned (e.g., burning through or otherwise weakening the heart wall). The quality of the lesion can depend on the degree of contact between the ablation element and the target tissue. For example, an ablation element that is barely contacting the tissue may not be properly positioned to provide an effective ablation treatment. Conversely, pressing the ablation element too hard against the tissue may result in excessive ablation energy or perforation.
[0036] The present disclosure relates, inter alia, to methods, devices, and systems for assessing the degree of contact between a portion of a catheter (e.g., an ablation element) and tissue. Understanding the degree of contact, such as the magnitude and direction of the force generated by contact between the catheter and tissue, can be useful in determining the degree of lesion formation in the target tissue. Information regarding the degree of lesion formation in cardiac tissue can be used, among other things, to determine whether the tissue should be further lesioned or whether the tissue has been successfully ablated. Additionally or alternatively, a contact indicator can be useful in navigating the catheter, because as the catheter advances within the patient, the user may not feel the force exerted by the tissue on the catheter, which could result in damage or perforation of blood vessels or cardiac tissue.
[0037] 1A-1C illustrate one embodiment of a system 100 for sensing data from within the body and / or providing therapy. For example, system 100 may be configured to map cardiac tissue and / or ablate cardiac tissue, among other options. System 100 includes a catheter 110 connected to a control unit 120 via a handle 114. Catheter 110 may comprise an elongated tubular member having a proximal end 115 connected to handle 114 and a distal end 116 configured to be introduced into heart 101 or another region of the body. As shown in FIG. 1A, distal end 116 of catheter 110 is located within the left atrium of heart 101.
[0038] 1B, the distal end 116 of the catheter 110 includes a proximal segment 111, a force sensing mechanism 112, and a distal segment 113. The proximal segment 111 and the distal segment 113 can be coaxially aligned with one another in a reference direction, as shown in FIG. 1B, with the force sensing mechanism 112 bridging the proximal segment 111 and the distal segment 113. Specifically, in the illustrated embodiment, the proximal segment 111 and the distal segment 113 are each coaxially aligned with a common longitudinal axis 109. In one embodiment, the longitudinal axis 109 can extend through the radial centers of the proximal segment 111 and the distal segment 113, respectively, and can extend collectively through the radial center of the distal end 116. In some embodiments, the coaxial alignment of the proximal segment 111 with the distal segment 113 can correspond to the reference direction. As shown, distal end 116 extends in a straight line along at least proximal segment 111 and distal segment 113. In some embodiments, this linear arrangement of proximal segment 111 and distal segment 113 can correspond to a reference direction.
[0039] Distal segment 113, or any other segment, may be in the form of an electrode configured to sense electrical activity, such as electrical cardiac signals. In other embodiments, such electrodes may additionally or alternatively be used to deliver ablation energy to tissue.
[0040] In various embodiments, force sensing mechanism 112 provides force sensing functionality for catheter 110. For example, as shown in FIGS. 1B and 1C , catheter 110 is configured to sense a force exerted on distal segment 113 due to engagement of distal segment 113 with tissue 117 of heart 101. In various embodiments, distal segment 113 can be relatively rigid so that when distal segment 113 engages tissue 117, a force exerted by the tip of distal segment 113 on tissue 117 can be transmitted to proximal segment 111, and the magnitude, and in some embodiments, the direction, of the applied force can be sensed by force sensing mechanism 112. As shown in FIGS. 1B and 1C , the force exerted from the tissue results in a relative displacement between proximal segment 111 and distal segment 113 (those skilled in the art will recognize based on this disclosure that this relative displacement, which may be several micrometers, is shown greatly exaggerated in FIG. 1C for illustrative purposes). One or more sensors in the distal end 116 of the catheter 110 can sense the degree of bending or axial movement of the distal segment 113 relative to the proximal segment 111 to determine the magnitude, and in some embodiments, the direction, of the applied force, as described further herein. Once the distal segment 113 no longer engages the tissue 117, the proximal segment 111 and the distal segment 113 return to the reference orientation shown in FIG. 1B.
[0041] The control unit 120 of the system 100 includes a display 121 (e.g., a liquid crystal display or cathode ray tube) for displaying information. The control unit 120 further includes a user input 122, which may include one or more buttons, toggles, a trackball, a mouse, a touchpad, etc., for receiving user input. The user input 122 may additionally or alternatively be located on the handle 114. The control unit 120 may include control circuitry for performing the functions referred to herein. Some or all of the control circuitry may alternatively be located within the handle 114.
[0042] 2 shows a block diagram illustrating an example of control circuitry capable of performing the functions referred to herein. This or other control circuitry may be housed within control unit 120, which may comprise a single housing or multiple housings with components distributed across multiple housings. The control circuitry may additionally or alternatively be housed within handle 114. The components of control unit 120 may be powered by a power source (not shown), which may provide power to either control unit 120 or the components of system 100, as is known in the art. The power source may be plugged into an electrical outlet and / or may be battery-powered, among other options.
[0043] The control unit 120 may include a catheter interface 123. The catheter interface 123 may include a plug that receives a cord from the handle 114. The catheter 110 may include multiple conductors (not shown, but known in the art) for transmitting electrical signals between the distal end 116 and the proximal end 115 and to the catheter interface 123. Through the catheter interface 123, the control unit 120 (and / or the handle 114, if control circuitry is included in the handle 114) may transmit electrical signals to and / or receive electrical signals from any element within the catheter 110. The catheter interface 123 may transmit signals to any of the components of the control unit 120.
[0044] The control unit 120 may include hardware and software for use in mapping and / or imaging the tissue being treated. For example, in one embodiment, the control unit 120 may include an ultrasound subsystem 124, which includes components for operating the ultrasound functions of the system 100. While the illustrated example of control circuitry shown in FIG. 2 includes the ultrasound subsystem 124, it should be understood that not all embodiments may include the ultrasound subsystem 124 or any circuitry for imaging tissue. The ultrasound subsystem 124 may include a signal generator configured to generate signals for ultrasound transmissions and signal processing components (e.g., high-pass filters) configured to filter and process reflected ultrasound signals received by an ultrasound sensor in sensing mode and transmitted to the ultrasound subsystem 124 through conductors in the catheter 110. The ultrasound subsystem 124 may transmit signals to and / or receive signals from elements in the catheter 110 via the catheter interface 123.
[0045] However, it is emphasized that the ultrasound subsystem 124 or other type of imaging subsystem is strictly optional and need not be included in the control unit 120 . The control unit 120 may include an ablation subsystem 125. The ablation subsystem 125 may include components for operating the ablation functions of the system 100. While the illustrated example of the control circuitry shown in FIG. 2 includes an ablation subsystem, it should be understood that not all embodiments include the ablation subsystem 125 or any circuitry for generating ablation therapy. The ablation subsystem 125 may include an ablation generator that provides different treatment outputs depending on the specific configuration. In one embodiment, the ablation generator is configured to generate a high-frequency alternating current signal for delivering high-frequency ablation energy to one or more electrodes. Alternatively, the ablation subsystem 125 and corresponding ablation generator may be configured to provide relatively high-voltage pulses (monophasic or biphasic) to achieve pulsed-field ablation, thereby generating desired lesions in the target tissue via irreversible electroporation. The ablation subsystem 125 may support any other type of ablation therapy, such as microwave ablation. The ablation subsystem 125 may deliver a signal or other type of ablation energy to the catheter 110 through the catheter interface 123.
[0046] The control unit 120 may include a force-sensing subsystem 126. The force-sensing subsystem 126 may include components for measuring forces experienced by the catheter 110. Such components may include a signal processor, an analog-to-digital converter, an operational amplifier, a comparator, and / or any other circuitry for conditioning and measuring one or more signals. The force-sensing subsystem 126 may provide current to a sensor, such as a piezoelectric sensor (described below with reference to FIGS. 3-7B), within the catheter 110 via the catheter interface 123 and may receive signals from the sensor within the catheter 110 via the catheter interface 123.
[0047] Each of the ultrasound subsystem 124 (if present), the ablation subsystem 125, and the force-sensing subsystem 126 can send signals to and receive signals from the processor 127. The processor 127 can be any type of processor for performing computer functions. For example, the processor 127 can execute program instructions stored in the memory 128 to perform any of the functions mentioned herein, such as determining the magnitude and direction of a force experienced by the catheter 110.
[0048] Control unit 120 further includes an input / output subsystem 129 that can support user input and output functions. For example, input / output subsystem 129 can support display 121 to display any of the information mentioned herein, such as a graphical representation of the tissue, catheter 110, and the magnitude and direction of forces experienced by catheter 110, among other options. Input / output subsystem 129 can log key and / or other input entries via user input 122 and route the entries to other circuitry.
[0049] A single processor 127 or multiple processors may perform the functions of one or more subsystems, and such subsystems may share control circuitry. Although different subsystems are presented herein, the circuitry may be divided among a greater or fewer number of subsystems, which may be housed separately or together. In various embodiments, the circuitry is not distributed among the subsystems, but rather is provided as a unified computing system. Whether distributed or integrated, the components may be electrically connected to coordinate and share resources to perform the functions.
[0050] 3 is a perspective view of a distal portion of a cardiac ablation catheter 300. In an embodiment, the cardiac ablation catheter 300 corresponds to the ablation catheter 110 shown in FIG. 1 and includes a distal assembly 302. As shown, the distal assembly 302 is axially disposed along a longitudinal axis 303 defined by the shaft of the ablation catheter 300 (not shown in FIG. 2). The distal assembly 302 includes a proximal segment 304, a distal segment 305, and a force-sensing mechanism 306. The distal assembly 302 further includes a tip electrode 312 and a ring electrode 314, with the tip electrode 312 disposed at the distal end of the distal assembly 302 and the ring electrode 314 disposed proximal to and spaced apart from the tip electrode 312. In embodiments, distal assembly 302 may include additional electrodes, for example, electrodes 316, 318, positioned proximal to and longitudinally spaced apart from electrodes 312 and 314. In other embodiments within the scope of the present disclosure, more or fewer electrodes may be employed.
[0051] The specific operation of the various electrodes (or electrode pairs) may vary depending on the particular clinical application of ablation catheter 300. In embodiments, electrodes 312, 314, 316, and 318 may be configured to operate as ablation electrodes, sensing electrodes, or both. For example, any or all of electrodes 312, 314, 316, and 318 may be configured to be operable for delivery of ablation energy to target tissue. Additionally or alternatively, any or all of electrodes 312, 314, 316, and 318 may be operable as sensing electrodes configured to sense electrical signals (e.g., intrinsic cardiac activation signals and / or electric fields generated by injected currents for use in impedance-based location tracking, tissue proximity or contact sensing, etc.). In one embodiment, electrodes 312, 314 may be configured to operate as ablation electrodes, for example, to bipolarly deliver ablation energy, particularly pulsed-field ablation energy for localized ablation of cardiac tissue. In embodiments, electrodes 316, 318 may be operable as sensing electrodes or, alternatively, as ablation electrodes. In some cases, electrodes 316, 318 may be configured to measure local impedance and function as position sensors for sensing local electric fields in five degrees of freedom (e.g., five different motions: x, y, z, acceleration, and rotation). In embodiments, except as specifically described herein, electrodes 312, 314, 316, and 318 may be configured according to that described in co-pending and commonly assigned U.S. patent application Ser. No. 63 / 194,716, which is incorporated herein by reference in its entirety.
[0052] It is emphasized, however, that the present disclosure is not limited to the particular electrode configuration and number of electrodes shown in Figure 3. Rather, those skilled in the art will understand that further variations in electrode configuration, number of electrodes, etc. may be employed within the scope of the present disclosure.
[0053] In embodiments, distal assembly 302 further includes insulating material 330 that encapsulates and forms the outer insulating surfaces of proximal segment 304 and distal segment 305. In embodiments, insulating material 330 is formed by an overmolding process. Alternatively, insulating material 330 may be formed using a reflow process, as known in the art, in which one or more tubular segments of insulating material are placed around the partially assembled distal assembly 302 and then heated. In embodiments, using an overmolding process to provide insulating material 330 can provide certain advantages, such as reducing or completely eliminating the need for subsequent processing (such as the injection of medical adhesives to complete the assembly process and provide fluid-tight connections between various components). The insulating material may be commercially available materials such as Pebax® 55D and Pelathane® 55D. Both materials may be used in the overmolding process and adhere to “epoxy-bondable” wire insulation. Pellethane can be adhered to the tip insulator using a primer (e.g., Sivate™ E610) and plasma. Pebax can be adhered to the tip insulator using an adhesive (e.g., Thermedics 1-MP) without plasma.
[0054] As will be appreciated by those skilled in the art, although not shown in FIG. 3 , in various embodiments, ablation catheter 300 may include additional components to enable its functionality. By way of example, in embodiments in which ablation catheter 300 is deflectable or steerable, ablation catheter 300 may include structures, such as steering wires and associated anchor(s), to enable a user to control deflection of a distal portion of ablation catheter 300. In addition, ablation catheter 300 includes electrical conductors disposed within the catheter shaft for electrically coupling electrodes 312, 314, 316, and 318, piezoelectric sensors 340, 342, 344, and other electrical components (e.g., magnetic navigation sensor(s), if present) to the associated functional components of system 100. In general, construction techniques and structures for implementing steerability or deflectability for ablation catheters and electrically coupling electrical components to the control unit of an ablation system are well known, and therefore, those skilled in the art will recognize that a wide range of such technologies may be employed in ablation catheter 300.
[0055] In various embodiments, the proximal segment 304 and the distal segment 305 are spaced apart to allow for small deflections of the distal segment 305 relative to the proximal segment 304 upon application of an external force to the distal segment 305 by patient tissue, although it should be understood that such movement may be extremely small (e.g., on the order of a few micrometers). The force sensing mechanism 306 is operably connected to both the proximal segment 304 and the distal segment 305 and, in the illustrated embodiment, includes a plurality of piezoelectric sensors 340, 342, 344 that are spaced apart circumferentially from one another about the longitudinal axis 303. The sensors 340, 342, 344 are configured to generate a variable output based on the force applied by the distal segment 305 to the target tissue, with the output adjusted to indicate the magnitude of such force.
[0056] In the embodiment of Figure 3, the three piezoelectric sensors 340, 342, 344 are evenly spaced azimuthal apart about the longitudinal axis 303 (evenly circumferentially spaced about the longitudinal axis 303) and are the same radial distance from the longitudinal axis 303. When a force exerted on the distal segment 305 of the catheter 300 is coaxial with the longitudinal axis 303, the outputs from each of the piezoelectric sensors 340, 342, 344 will be substantially equal. Based on these equal changes, the control circuitry can calculate the magnitude of the force exerted on the distal segment 306. The control circuitry can also determine that the force is coaxial with the longitudinal axis 303 because the outputs are identical for each of the three piezoelectric sensors 340, 342, 344.
[0057] If the force is not coaxial with the longitudinal axis 303, the output of each of the piezoelectric sensors 340, 342, 344 will not be equal. Based on this, the magnitude and direction (e.g., unit vector) of the force can be determined by the control circuitry.
[0058] Once assembled, catheter 300 may undergo a calibration step, either at the factory or immediately prior to use by a physician, in which multiple forces of known magnitude and direction may be applied sequentially to distal segment 306, and the outputs of piezoelectric sensors 340, 342, 344 may be calibrated based on the known magnitudes and directions of the applied forces.
[0059] Magnitude may be expressed in grams or another measure of force. Magnitude may be represented as a dynamic line graph, bar graph, or graphic symbol that changes color or intensity over time to indicate new, up-to-date force values. Direction may be represented as a unit vector in a three-dimensional reference frame (e.g., relative to an X-, Y-, and Z-axis coordinate system). In some embodiments, a three-dimensional mapping function may be used to track the three-dimensional position of the distal end of the catheter 300 in the three-dimensional reference frame. A magnetic field may be generated outside the patient and sensed by a magnetic field-sensitive sensor (not shown) in the distal end of the catheter 300 to determine the three-dimensional position and specific orientation of the distal end of the catheter 300 in the three-dimensional reference frame. Direction may be represented relative to the distal end of the catheter 300. For example, a line projecting toward or from the distal segment 306 may represent the direction of force relative to the distal segment 306. Similarly, the magnitude and / or direction of a force can be represented using a graphic symbol that varies in color and / or intensity and / or shape, and such representation can be made on a display as described herein.
[0060] The magnitude and direction of the force can be utilized for navigation by providing an indicator when the catheter contacts tissue and / or to assess tissue lesion formation by determining the degree of contact between the lesion-forming element and the tissue, among other options. In some embodiments, a force less than 10 grams is not optimal for forming a lesion in tissue (e.g., by being too small), while a force greater than 40 grams is similarly not optimal for forming a lesion in tissue (e.g., by being too large). Thus, a range of 10 to 40 grams may be ideal for forming a lesion in tissue, and the force output during lesion formation may provide feedback to the user to allow the user to stay within this range. Of course, other force ranges ideal for lesion formation may be used.
[0061] 4A, 4B, and 4C are perspective, front, and cross-sectional views, respectively, of a force sensing mechanism 406 for use in catheter 110, according to an embodiment of the present disclosure. Force sensing mechanism 406 corresponds functionally to force sensing mechanism 306, described above. In the illustrated embodiment, force sensing mechanism 406 includes multiple (in this case, three) piezoelectric sensors 440, 442, and 444, a rigid proximal housing 450, and a rigid distal housing 454. As shown, piezoelectric sensors 440, 442, and 444 are disposed within and attached to proximal housing 450. In the illustrated embodiment, piezoelectric sensors 440, 442, and 444 have a generally rectangular shape when viewed parallel to the catheter axis, although other embodiments utilize piezoelectric sensors having different shapes or form factors.
[0062] In various embodiments, the proximal housing 450 is fixedly attached to the proximal segment (111 in FIG. 1 , 304 in FIG. 3 ), and the distal housing 454 is fixedly attached to the distal segment (113 in FIG. 1 , 306 in FIG. 3 ) of the catheters 110, 300 described above. Additionally, the proximal housing 450 and the distal housing 454 are separated by a gap 456 that defines the maximum axial movement of the distal segment relative to the proximal segment under the action of an external force, in the absence of an external force applied to the distal segments of the respective catheters. Also, in the illustrated embodiment, a lumen 457 extends longitudinally through both the proximal housing 450 and the distal housing 454 to accommodate passage of catheter components (e.g., leads, irrigation tubing, and the like) into the distal segments of the catheters.
[0063] FIG. 4C is a cross-sectional front view bisecting the force sensing mechanism 406 through the piezoelectric sensor 440. Specific structural details shown in FIG. 4C represent the placement of the piezoelectric sensors 442, 444. As shown in FIG. 4C, the proximal housing has a proximal face 458, an opposing distal face 459, a longitudinal cavity 460, and a distal recess 470 formed in the distal face 459, the distal recess 470 defining a shoulder 475. As further shown in FIG. 4C, the distal housing 454 has a proximal face 478, an opposing distal face 479, and includes an axial protrusion 480 extending proximally from the proximal face 478.
[0064] As shown in FIG. 4C , piezoelectric sensor 440 includes an upper layer 488, a lower layer 490, and a piezoelectric layer 492 disposed between upper layer 488 and lower layer 490. Piezoelectric sensor 440 further comprises a fixed portion 494 and a free portion 496. As further shown, optional backing element 498 is disposed adjacent lower layer 490 within longitudinal cavity 460. For simplicity of explanation, only piezoelectric sensor 440 is shown in detail, but it is emphasized that piezoelectric sensors 442 and 444 each have the same structure as piezoelectric sensor 440. Additionally, the overall structure of force sensing mechanism 406 with respect to the locations of piezoelectric sensors 442, 444 is identical to that shown in FIG. 4C ; i.e., a cross-sectional front view bisecting piezoelectric sensors 442, 444 would appear identical to the structure shown in FIG. 4C , including the presence of recesses, longitudinal cavities, and protrusions and their corresponding relationships with the individual piezoelectric sensors.
[0065] Top layer 488 and bottom layer 490, or at least portions thereof, are electrically conductive and function as electrode layers during operation of piezoelectric sensor 440. Piezoelectric layer 492 also includes a piezoelectric material (e.g., a piezoelectric ceramic such as lead zirconate titanate (PZT) or a piezoelectric polymer such as polyvinylidene fluoride (PVDF)). As recognized in the electromechanical arts, a piezoelectric sensor generates a measurable electrical property when subjected to mechanical stress.
[0066] It is emphasized that the particular, e.g., three-layer, structure of piezoelectric sensor 440 shown herein is exemplary only and is not intended to limit the range of potential piezoelectric designs suitable for use in force sensing mechanism 406. For example, in embodiments, the piezoelectric element itself may be a multi-layer or multi-piece structure. Additionally, top layer 488 and bottom layer 490 may themselves be formed with multi-layer or multi-component structures. In embodiments, all or a portion of the piezoelectric sensors utilized herein may be coated with or encapsulated within a protective and / or insulating outer coating (e.g., epoxy).
[0067] 4C , piezoelectric sensor 440 is disposed within distal recess 470 of proximal housing 450, with fixed portion 494 disposed on shoulder 475 and free portion 496 extending over longitudinal cavity 460. As further shown, backing element 498 abuts lower layer 490 along free portion 496 of piezoelectric sensor 440. In addition, axial protrusion 480 of distal housing 454 is disposed on and bears upon upper layer 488 in the region of free portion 496 of piezoelectric sensor 440. Piezoelectric sensors 442, 444 each have the same positional relationship, each comprising a distal recess, shoulder, and longitudinal cavity in proximal housing 450 and an axial protrusion in distal housing 454, as shown in FIG. 4C for piezoelectric sensor 440. Additionally, in an embodiment, the backing element is positioned within the elongated cavity adjacent to the piezoelectric sensors 442, 444 in the same manner as shown in Figure 4C.
[0068] In an embodiment, the fixed portion 494 of the piezoelectric sensor 440 is rigidly attached to the shoulder 475 of the proximal housing 450, and the free portion 496 of the piezoelectric sensor 440 is effectively cantilevered over the longitudinal cavity 460. The rigid axial protrusion 480 of the distal housing 454 is in direct contact with the top layer 488 of the piezoelectric sensor 440, so that forces applied to the distal segment 305 ( FIG. 3 ) of the catheter are transferred to the free portion 496 of the piezoelectric sensor 440. Additionally, the cantilevered arrangement of the free portion 496 maximizes the piezoelectric effect exhibited by the piezoelectric sensor 440 in response to the transferred force (i.e., the sensor output resulting from the stress induced in the piezoelectric layer 492 and the corresponding piezoelectric effect is substantially greater than in an arrangement in which the piezoelectric sensor is rigidly fixed along its entire length).
[0069] In embodiments, backing element 498, if present, is made from a compressible material (e.g., an elastomer) and functions to provide some support to free portion 496 of piezoelectric sensor 440 and resist deformation of piezoelectric sensor 440 when an external force is applied, but at the same time does not rigidly resist all such deformation. In embodiments, the mechanical properties of backing element 498 may be adjusted to fine-tune the piezoelectric effect exhibited by piezoelectric sensor 440.
[0070] As will be appreciated by those skilled in the art, because piezoelectric sensor 440 is an electromechanical device, electrical leads (not shown) are attached to electrode structures on upper layer 488 and lower layer 490. In embodiments, electrical leads may be routed through longitudinal cavity 460, to lumen 457, or through some other access feature within proximal housing 450. As further shown in FIG. 4C , in embodiments, potting material 499 may be disposed within the open space within proximal housing 450, which potting material 499 may function to seal the internal components of the catheter and force-sensing mechanism 406 and also to enhance the structural attachment between the proximal and distal segments of the catheter. In embodiments, potting material 499 and backing element 498 may be formed from the same compressible material and may be formed in a single manufacturing step, although this is not strictly required. In some embodiments, potting material 499 (or some other compressible material) may be disposed within gap 456. In some embodiments, the backing element 498 and / or the potting material 499 may be omitted entirely.
[0071] It is again emphasized that the configuration shown in FIG. 4C for piezoelectric sensor 440 is representative of piezoelectric sensors 442 and 444. As is commonly recognized in the electromechanical arts, piezoelectric sensors 440, 442, 444 exhibit electrical properties that vary as a function of stresses induced within their respective piezoelectric layers. In embodiments, alternating current electrical signals generated by control unit 120 (FIG. 1A) may be delivered to electrodes on the top and bottom of each piezoelectric sensor 440, 442, 444, and changes in the electrical response exhibited by the piezoelectric layer within each sensor due to varying stresses induced within the piezoelectric layer due to forces transferred to the piezoelectric layer through the distal segment of catheter 110 may be measured relative to calibrated force magnitude values. Exemplary changes in electrical properties measured in such embodiments may include resonant frequency, electrical impedance, or decay time constant. In other embodiments, changes in the piezoelectric capacitance of piezoelectric sensors 440, 442, 444 may be measured directly due to changes in stresses induced within the piezoelectric sensors. This latter embodiment eliminates the requirement for providing an excitation signal from control unit 120, but may be less sensitive than embodiments utilizing such excitation signals.
[0072] 5A, 5B, and 5C are perspective, front, and cross-sectional views, respectively, of a force sensing mechanism 506 for use in catheter 110, according to an embodiment of the present disclosure. Force sensing mechanism 506 corresponds functionally to force sensing mechanism 306, described above. In the illustrated embodiment, force sensing mechanism 506 includes multiple (in this case, three) annular piezoelectric sensors 540, 542, 544, a rigid proximal housing 550, and a rigid distal housing 554. As shown, piezoelectric sensors 540, 542, 544 are disposed within and attached to proximal housing 550.
[0073] In various embodiments, the proximal housing 550 is fixedly attached to the proximal segment (111 in FIG. 1 , 304 in FIG. 3 ), and the distal housing 554 is fixedly attached to the distal segment (113 in FIG. 1 , 306 in FIG. 3 ) of the catheters 110, 300 described above. Additionally, the proximal housing 550 and the distal housing 554 are separated by a gap 556 that defines the maximum axial movement of the distal segment relative to the proximal segment under the action of an external force, in the absence of an external force applied to the distal segments of the respective catheters. Also, in the illustrated embodiment, a lumen 557 extends longitudinally through both the proximal housing 550 and the distal housing 554 to accommodate passage of catheter components (e.g., leads, irrigation tubing, and the like) into the distal segments of the catheters.
[0074] FIG. 5C is a cross-sectional front view bisecting the force sensing mechanism 606 through the piezoelectric sensor 540. Specific structural details shown in FIG. 5C represent the placement of the piezoelectric sensors 542, 544. As shown in FIG. 5C, the proximal housing has a proximal face 558, an opposing distal face 559, a longitudinal cavity 560, and a distal recess 570 formed in the distal face 559, the distal recess 570 defining a shoulder 575. As further shown in FIG. 5C, the distal housing 554 has a proximal face 578, an opposing distal face 579, and includes an axial protrusion 580 extending proximally from the proximal face 578.
[0075] 5C , piezoelectric sensor 540 includes upper layer 588, lower layer 590, and piezoelectric layer 592 disposed between upper layer 588 and lower layer 590. The annular shape of piezoelectric sensor 540 further defines a fixed portion 594 corresponding to an outer circumferential region of piezoelectric sensor 540 and a free portion 596 radially inward of fixed portion 594 and corresponding to an inner radial region of piezoelectric sensor 540. As further shown, the annular shape of piezoelectric sensor 540 defines a generally centrally located opening 597 through piezoelectric sensor 540. As further shown, optional backing element 598 is disposed within elongated cavity 560 adjacent lower layer 590. For ease of explanation, only piezoelectric sensor 540 is shown in detail, although it is emphasized that each of piezoelectric sensors 542 and 544 has the same structure as piezoelectric sensor 540. Additionally, the overall structure of the force sensing mechanism 506 with respect to the location of the piezoelectric sensors 542, 544 is the same as that shown in FIG. 5C, i.e., a cross-sectional view bisecting the piezoelectric sensors 542, 544 would appear identical to the structure shown in FIG. 5C, including the presence of the recesses, elongated cavities, and protrusions and their corresponding relationship to the individual piezoelectric sensors.
[0076] Top layer 588 and bottom layer 590, or at least portions thereof, are electrically conductive and function as electrode layers during operation of piezoelectric sensor 540. Piezoelectric layer 592 also includes a piezoelectric material (e.g., a piezoelectric ceramic such as lead zirconate titanate (PZT) or a piezoelectric polymer such as polyvinylidene fluoride (PVDF)). As recognized in the electromechanical arts, a piezoelectric sensor generates a measurable electrical property when subjected to mechanical stress.
[0077] 5C , distal recess 570 is axially aligned with longitudinal cavity 560, piezoelectric sensor 540 is disposed within distal recess 570 of proximal housing 550, fixed portion 594 is disposed on shoulder 575, and free portion 596 extends over longitudinal cavity 560. As further shown, backing element 598 abuts lower layer 590 along free portion 596 of piezoelectric sensor 540. Additionally, axial protrusion 580 of distal housing 554 is disposed over and spans opening 597 such that the axial protrusion applies a load to upper layer 588 in the region of free portion 596 of piezoelectric sensor 540. Each of the piezoelectric sensors 542, 544 has the same positional relationship, each comprising a distal recess, shoulder, and longitudinal cavity in the proximal housing 550 and an axial protrusion on the distal housing 554, as shown in Figure 5C for piezoelectric sensor 540. Additionally, in embodiments, an optional backing element is disposed in the longitudinal cavity adjacent each piezoelectric sensor 542, 544 in the same manner as shown in Figure 5C.
[0078] In an embodiment, a fixed portion 594 of the piezoelectric sensor 540 is rigidly attached to a shoulder 575 of the proximal housing 550, and a free portion 596 of the piezoelectric sensor 540 extends over the longitudinal cavity 560. Because the rigid axial protrusion 580 of the distal housing 554 is in direct contact with the top layer 588 of the piezoelectric sensor 540, forces applied to the distal segment 305 of the catheter ( FIG. 3 ) are transmitted to the free portion 596 of the piezoelectric sensor 540. Additionally, the placement of the free portion 596 extending over the longitudinal cavity 560 maximizes the piezoelectric effect exhibited by the piezoelectric sensor 540 in response to the transmitted force (i.e., the sensor output resulting from the stress induced in the piezoelectric layer 592 and the corresponding piezoelectric effect is substantially greater than in a placement in which the piezoelectric sensor is rigidly fixed along its entire length).
[0079] In embodiments, backing element 598, if present, is made from a compressible material (e.g., an elastomer) and functions to provide some support to free portion 596 of piezoelectric sensor 540 and resist deformation of piezoelectric sensor 540 when an external force is applied, but at the same time does not rigidly resist all such deformation. In embodiments, the mechanical properties of backing element 598 may be adjusted to fine-tune the piezoelectric effect exhibited by piezoelectric sensor 540.
[0080] As will be appreciated by those skilled in the art, because piezoelectric sensor 540 is an electromechanical device, electrical leads (not shown) are attached to electrode structures on upper layer 588 and lower layer 590. In embodiments, electrical leads may be routed through longitudinal cavity 560, into lumen 557, or through some other access feature within proximal housing 550. As further shown in FIG. 5C , in embodiments, potting material 599 may be disposed within the open space within proximal housing 550, including within opening 597 as shown, and this potting material 599 may function to seal the internal components of the catheter and force-sensing mechanism 506 and also to enhance the structural attachment between the proximal and distal segments of the catheter. In embodiments, potting material 599 and backing element 598 may be formed from the same compressible material and may be formed in a single manufacturing step, although this is not strictly required. In some embodiments, potting material 599 (or some other compressible material) may be disposed within gap 556. In some embodiments, the backing element 598 and / or the potting material 599 may be omitted entirely.
[0081] It is again emphasized that the arrangement shown in FIG. 5C for piezoelectric sensor 540 is representative of piezoelectric sensors 542 and 544. Additionally, in embodiments, piezoelectric sensors 540, 544, and 542 can have configurations other than the annular configuration shown. In particular, in embodiments, piezoelectric sensors 540, 544, and 542 can be configured as substantially circular disks without a central opening, with the respective free portions formed by central portions of the disks that are disposed over corresponding longitudinal cavities.
[0082] Figures 6A-6D show an alternative force sensing mechanism 606 for use in catheter 110, according to an embodiment of the present disclosure. Figures 6A and 6B are exploded perspective views of force sensing mechanism 606. Figure 6C is a front view of force sensing mechanism 606, and Figure 6D is a cross-sectional front view of force sensing mechanism 606 taken along line 6D-6D in Figure 6C.
[0083] Force sensing mechanism 606 corresponds functionally to force sensing mechanism 306 described above. In the illustrated embodiment, force sensing mechanism 606 includes a single annular piezoelectric sensor 640, a rigid proximal housing 650, and a rigid distal housing 654. As shown, piezoelectric sensor 640 is disposed within and attached to proximal housing 650.
[0084] In various embodiments, the proximal housing 650 is fixedly attached to the proximal segment (111 in FIG. 1 , 304 in FIG. 3 ), and the distal housing 654 is fixedly attached to the distal segment (113 in FIG. 1 , 306 in FIG. 3 ) of the catheters 110, 300 described above. Additionally, the proximal housing 650 and the distal housing 654 are separated by a gap 656 that defines the maximum axial movement of the distal segment relative to the proximal segment under the action of an external force, in the absence of an external force applied to the distal segments of the respective catheters. Also, in the illustrated embodiment, a lumen 657 extends longitudinally through both the proximal housing 650 and the distal housing 654 to accommodate passage of catheter components (e.g., leads, irrigation tubing, and the like) into the distal segments of the catheters.
[0085] As shown, the proximal housing 650 has a proximal face 658, an opposing distal face 659, and a distal recess 670 formed in the distal face 659. As seen in the cross-sectional view of FIG. 6C, the distal recess 670 defines a shoulder 675. Additionally, the distal housing 654 has a proximal face 678, an opposing distal face 679, and an annular axial protrusion 680 extending proximally from the proximal face 678.
[0086] 6C , piezoelectric sensor 640 includes an upper layer 688, a lower layer 690, and a piezoelectric layer 692 disposed between upper layer 688 and lower layer 690. The annular shape of piezoelectric sensor 640 further defines a fixed portion 694 corresponding to an outer circumferential region of piezoelectric sensor 640 and a free portion 696 radially inward of fixed portion 694 and corresponding to an inner radial region of piezoelectric sensor 640. As further shown, optional backing element 698 is disposed within recess 670 adjacent lower layer 690.
[0087] Top layer 688 and bottom layer 690, or at least portions thereof, are electrically conductive and function as electrode layers during operation of piezoelectric sensor 640. Piezoelectric layer 692 also includes a piezoelectric material (e.g., a piezoelectric ceramic such as lead zirconate titanate (PZT) or a piezoelectric polymer such as polyvinylidene fluoride (PVDF)). As recognized in the electromechanical arts, a piezoelectric sensor generates a measurable electrical property when subjected to mechanical stress.
[0088] 6C , the piezoelectric sensor 640 is positioned such that the fixed portion 694 is disposed on the shoulder 675 and the free portion 696 extends over the bottom of the recess 670. As further shown, the backing element 698 abuts the lower layer 690 along the free portion 696 of the piezoelectric sensor 640. Additionally, the axial protrusion 680 of the distal housing 654 is positioned such that the axial protrusion 680 applies a load to the upper layer 688 in the region of the free portion 696 of the piezoelectric sensor 640.
[0089] In an embodiment, a fixed portion 694 of the piezoelectric sensor 640 is rigidly attached to the shoulder 675 of the proximal housing 650, and a free portion 696 of the piezoelectric sensor 640 extends over the recess 670. Because the rigid axial protrusion 680 of the distal housing 654 is in direct contact with the top layer 688 of the piezoelectric sensor 640, forces applied to the distal segment 305 of the catheter ( FIG. 3 ) are transmitted to the free portion 696 of the piezoelectric sensor 640. Additionally, the placement of the free portion 696 extending over the longitudinal cavity 660 maximizes the piezoelectric effect exhibited by the piezoelectric sensor 640 in response to the transmitted force (i.e., the sensor output resulting from the stress induced in the piezoelectric layer 692 and the corresponding piezoelectric effect is substantially greater than in a placement in which the piezoelectric sensor is rigidly fixed along its entire length).
[0090] In embodiments, backing element 698, if present, is made from a compressible material (e.g., an elastomer) and functions to provide some support to free portion 696 of piezoelectric sensor 640 and resist deformation of piezoelectric sensor 640 when an external force is applied, but at the same time does not rigidly resist all such deformation. In embodiments, the mechanical properties of backing element 698 may be adjusted to fine-tune the piezoelectric effect exhibited by piezoelectric sensor 640.
[0091] 6C , in embodiments, potting material 699 may be disposed within the open space within proximal housing 650, including within opening 697 as shown, and may function to seal the internal components of the catheter and force-sensing mechanism 606 and to strengthen the structural attachment between the proximal and distal segments of the catheter. In embodiments, potting material 699 and backing element 698 may be formed from the same compressible material and may be formed in a single manufacturing step, although this is not strictly required. In some embodiments, potting material 699 (or some other compressible material) may be disposed within gap 656.
[0092] In operation, the annular piezoelectric sensor 640 is configured to operate similarly to each of the annular piezoelectric sensors 540, 542, 544 described elsewhere herein. However, because the force sensing mechanism 606 includes only a single piezoelectric sensor, the force sensing mechanism 606 is configured to sense only the magnitude (and not the direction) of an applied external force.
[0093] 7A and 7B are front and cross-sectional views, respectively, of an alternative force sensing mechanism 706 for use in the catheter of FIG. 3 in accordance with various embodiments of the present disclosure. Force sensing mechanism 706 is configured in many respects similar to force sensing mechanism 606 and includes a single annular piezoelectric sensor 740, a proximal housing 750, and a distal housing 754 separated by a gap 756. Proximal housing 750 includes an annular recess 770, and piezoelectric sensor 740 is disposed within annular recess 770 with a fixed portion 794 and a free portion 796 in the same manner as piezoelectric sensor 640. In addition, distal housing 754 includes an annular axial protrusion 780 that imparts a load to the free portion 796 of piezoelectric sensor 740 in the same manner as described above in connection with various other embodiments. The illustrated embodiment further includes a backing element 798 that supports the free portion 796 of piezoelectric sensor 740, although in other embodiments, this backing element 798 may be omitted.
[0094] Force sensing mechanism 706 differs from the previous embodiment in that it further includes a semi-annular preload collar 720 operably coupled to proximal housing 750 and distal housing 754. Preload collar 720 is configured to provide a preload and corresponding stress on piezoelectric sensor 740, or alternatively, to facilitate assembly of force sensing mechanism 706 by ensuring intimate contact between annular axial protrusion 780 and piezoelectric sensor 740.
[0095] The preload collar 720 has a generally semicircular shape that corresponds to the shape of the proximal housing 750 and the distal housing 754. As shown, the preload collar 720 has a distal body portion 722 having an upper surface 724 and a lower surface 726, and a shank portion 730 extending proximally from the lower surface 726.
[0096] 7A-7B, the distal housing 754 has an annular slot 732 extending radially inward around the circumference of the distal housing 754, the annular slot 732 being generally rectangular in shape to complement the cross-sectional shape of the distal body portion 722 of the preload collar 720. The annular slot 732 defines a radial bearing surface 734 adjacent the lower surface 726 of the distal body portion 722 of the preload collar 720. Additionally, an annular wall 736 is formed on the outer periphery of the proximal housing 750 radially outward from the recess 770.
[0097] In an embodiment, an outer surface of shank portion 730 is rotatably engaged with an inner surface of annular wall 736 at connection 738 ( FIG. 7B ). Connection 738, shown schematically in FIG. 7B , is configured such that rotation of preload collar 720 relative to distal housing 754 causes preload collar 720 to move axially relative to proximal housing 740 and distal housing 754. In one exemplary embodiment, connection 738 may be configured as a threaded connection with internal and external threads that mate with annular wall 736 and shank portion 720, respectively.
[0098] 7B illustrates the force sensing mechanism 706 in a substantially unloaded state, in which the protrusion 780 is in contact with the piezoelectric sensor 740 but exerts minimal or no force, and the lower surface 726 of the body portion 722 of the preload collar 720 is axially spaced from the radial bearing surface 734 of the distal housing 734. As will be appreciated by those skilled in the art, from the illustrated state, due to the configuration of the connection 738, selective rotation of the preload collar 720 relative to the proximal housing 720 axially translates the preload collar 720 so that the lower surface 726 of the body portion 722 of the preload collar 720 moves into contact with the radial bearing surface 734 of the distal housing 734. Once contact is made between the underside 726 of the body portion 722 of the preload collar 720 and the radial bearing surface 734 of the distal housing 754, further rotation of the preload collar 720 in the same direction urges the distal housing 754 toward the proximal housing 750, causing the annular protrusion 780 to apply a force to the free portion 796 of the piezoelectric sensor 740. In this manner, during assembly of the force sensing mechanism 706, the preload collar 720 can be manipulated to confirm the required contact between the protrusion 780 and the piezoelectric sensor 740, and selective preload can be applied, if necessary, to achieve adjustment of the piezoelectric sensor 740.
[0099] Various embodiments of the present disclosure represent significant advancements over conventional catheter force sensing technology. In particular, the embodiments described herein eliminate the need for complex spring mechanisms utilized in prior art catheters. Similarly, the piezoelectric sensors of various embodiments are relatively low cost compared to the inductive position sensors utilized in prior art catheters.
[0100] Various modifications and additions can be made to the exemplary embodiments described without departing from the scope of the present invention. For example, while the above-described embodiments refer to particular features, the scope of the present invention also includes embodiments having different combinations of features and embodiments that do not include all of the described features. Accordingly, the scope of the present invention is intended to embrace all such alternatives, modifications, and variations that fall within the scope of the claims, together with all equivalents thereof.
Claims
1. 1. A catheter adapted to measure contact force, comprising: an elongate shaft having a proximal end and a distal end; a distal end portion extending distally from the distal end of the shaft, the distal end portion defining a longitudinal axis extending therethrough, the distal end portion comprising: a proximal segment; a distal segment located distal to the proximal segment, the distal segment being spaced apart from the proximal segment; and a force sensing mechanism, the force sensing mechanism comprising: a proximal housing secured within the proximal segment; a piezoelectric sensor attached to the proximal housing, the piezoelectric sensor having a first portion fixedly attached to the proximal housing and a second portion not fixedly attached to the proximal housing; a distal housing fixed within the distal segment, the distal housing including a protrusion configured to contact the second portion of the piezoelectric sensor and to apply an axial force to the second portion of the piezoelectric sensor when an external force is applied to the distal segment; The catheter, wherein the piezoelectric sensor is configured to generate an output in response to an external force applied to the distal segment, the output indicative of an amount of axial force applied to the second portion of the piezoelectric sensor.
2. 2. The catheter of claim 1, wherein the proximal housing includes an upper surface, a lower surface, and a cavity extending proximally from the upper surface, the first portion of the piezoelectric sensor fixedly attached to the upper surface, and the second portion of the piezoelectric sensor extending at least partially across the cavity.
3. The catheter of claim 2 , wherein the piezoelectric sensor has an arc-shaped or rectangular outer shape when viewed in a direction parallel to the longitudinal axis.
4. 3. The catheter of claim 2, wherein the piezoelectric sensor has an annular shape when viewed in a direction parallel to the longitudinal axis, the first portion is an outer peripheral portion of the piezoelectric sensor, and the second portion is located radially inward of the first portion of the piezoelectric sensor.
5. The catheter of claim 2 , wherein the piezoelectric sensor is a generally circular disk and the second portion extends across the cavity.
6. 6. The catheter of claim 1, wherein the proximal housing includes a compressible backing material disposed within a portion of the cavity and contacting the second portion of the piezoelectric sensor opposite the protrusion on the distal housing, the backing material resisting deformation of the second portion of the piezoelectric sensor when an external force is applied to the distal segment.
7. 6. The catheter of claim 1, wherein the force sensing mechanism includes three piezoelectric sensors mounted to the proximal housing and spaced circumferentially about the longitudinal axis, each of the three piezoelectric sensors having a first portion fixedly mounted to the proximal housing and a second portion deflectable relative to the first portion.
8. 8. The catheter of claim 7, wherein the distal housing includes three protrusions, each protrusion contacting the second portion of a corresponding one of the three piezoelectric sensors and configured to apply an axial force to the second portion of the corresponding piezoelectric sensor when an external force is applied to the distal segment.
9. 9. The catheter of claim 8, wherein each of the three piezoelectric sensors is configured to generate an output in response to an external force applied to the distal segment, the output indicative of an amount of axial force applied to the second portion of the piezoelectric sensor.
10. 10. The catheter of claim 9, wherein the proximal housing includes three cavities extending proximally from a top surface, each of the three cavities aligned with a corresponding one of the three piezoelectric sensors, and the second portion of each of the three piezoelectric sensors extending at least partially across the corresponding one of the three cavities.
11. The catheter of claim 10 , wherein each piezoelectric sensor has an arcuate or rectangular profile when viewed parallel to the longitudinal axis.
12. 11. The catheter of claim 10, wherein each piezoelectric sensor has an annular shape when viewed parallel to the longitudinal axis, the first portion being an outer peripheral portion of the piezoelectric sensor, and the second portion being located radially inward of the first portion of the piezoelectric sensor.
13. The catheter of claim 10 , wherein each piezoelectric sensor is a generally circular disk, and the second portion of each piezoelectric sensor extends across the corresponding cavity.
14. 9. The catheter of claim 8, wherein a compressible backing material is disposed within a portion of each cavity and contacts the second portion of the corresponding piezoelectric sensor opposite the corresponding protrusion on the distal housing, the backing material resisting deformation of the second portion of the corresponding piezoelectric sensor when an external force is applied to the distal segment.
15. The catheter of claim 1 , further comprising a preload mechanism operably coupled to the proximal housing and configured to allow a user to selectively preload the piezoelectric sensor.
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