U.S. patent application number 15/144135 was filed with the patent office on 2016-11-03 for user interface devices for electrophysiology lab diagnostic and therapeutic equipment.
The applicant listed for this patent is St. Jude Medical, Atrial Fibrillation Division, Inc. Invention is credited to Eric Betzler, Charles Bryan Byrd, Israel A. Byrd, Sandeep Dani, Eric S. Olson.
Application Number | 20160320930 15/144135 |
Document ID | / |
Family ID | 47677954 |
Filed Date | 2016-11-03 |
United States Patent
Application |
20160320930 |
Kind Code |
A1 |
Byrd; Charles Bryan ; et
al. |
November 3, 2016 |
User interface devices for electrophysiology lab diagnostic and
therapeutic equipment
Abstract
In an electrophysiology (EP) lab, a bedside interface device
allows an EP physician to directly control various diagnostic and
therapeutic systems, including an electro-anatomic mapping system.
The bedside interface device can include a computer with wireless
communication capability as well as a touch-responsive display
panel and voice recognition. The bedside interface device can also
be a hand-graspable wireless remote control device that is
configured to detect motions or gestures made with the remote
control by the physician, allowing the physician to directly
interact with the mapping system. The bedside interface device can
also be a motion capture camera configured to determine motion
patterns of the physician's arms, legs, trunk, face and the like,
which are defined in advance to correspond to commands for the
mapping system. The bedside interface device may also include voice
recognition capabilities to allow a physician to directly issue
verbal commands to the mapping system.
Inventors: |
Byrd; Charles Bryan;
(Oakdale, MN) ; Betzler; Eric; (Andover, MN)
; Dani; Sandeep; (Eden Prairie, MN) ; Byrd; Israel
A.; (Richfield, MN) ; Olson; Eric S.;
(Maplewood, MN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
St. Jude Medical, Atrial Fibrillation Division, Inc |
St. Paul |
MN |
US |
|
|
Family ID: |
47677954 |
Appl. No.: |
15/144135 |
Filed: |
May 2, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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13208924 |
Aug 12, 2011 |
9330497 |
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15144135 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2560/0493 20130101;
G06F 3/0482 20130101; G06T 19/003 20130101; A61B 90/37 20160201;
G06F 3/167 20130101; G06F 3/04886 20130101; G06F 3/04883 20130101;
G06T 2210/41 20130101 |
International
Class: |
G06F 3/0482 20060101
G06F003/0482; G06F 3/0488 20060101 G06F003/0488; A61B 90/00
20060101 A61B090/00; G06F 3/16 20060101 G06F003/16 |
Claims
1.-20. (canceled)
21. A device for allowing a user to communicate with a plurality of
electrophysiological systems, comprising: an electronic control
unit, a display panel, and a microphone; user interface logic
stored in a memory configured to be executed by said electronic
control unit and configured to display on said display panel a user
interface which includes a first group of buttons corresponding to
a plurality of electrophysiological (EP) diagnostic and therapeutic
systems; and voice recognition logic stored in said memory
configured to be executed by said electronic control unit and
configured to analyze user speech input captured by said microphone
to identify a user-spoken command; wherein said user interface
logic is configured to allow the user to select one button from
said first group of buttons according to said identified command to
thereby select a corresponding one of said plurality of EP systems
and to present, in response to said user selection, an
application-specific user interface on said display panel that
enables access to and control of said one user-selected EP system
while maintaining said display of said first group of buttons;
wherein said user interface logic is further configured to allow
the user to interact with said application-specific user interface,
said voice recognition logic being configured to identify a further
spoken command with respect to said application-specific user
interface wherein said electronic control unit is configured to
communicate said further spoken command to the user-selected one EP
system.
22. The device of claim 21 where said application-specific user
interface of said one user-selected EP system comprises at least a
second group of buttons displayed on said display panel that is
different from said first group of buttons.
23. The device of claim 21 wherein said user interface logic is
configured to present on said display panel, for each one of said
plurality of EP systems when selected by the user, a respective
application-specific user interface that enables access to and
control of said user-selected EP system.
24. The device of claim 21 wherein said display panel comprises a
touch-responsive display panel, and wherein said user interface
logic is configured to receive from the user a user touch input
from said touch-responsive display panel, said user interface logic
being further configured to allow the user to select one button
from said first group of buttons according to said user touch
input.
25. The device of claim 21 wherein said user interface logic is
further configured to switch between respective
application-specific user interfaces via a common interface
displayed on said display panel, wherein said common interface
includes said first group of buttons.
26. The device of claim 21 wherein said electronic control unit
communicates said identified command wirelessly.
27. The device of claim 21 wherein the user interface logic is
further configured to alter an appearance of said one user-selected
button of said first group of buttons so as to be visually
distinguishable from remaining, non-selected buttons of said first
group of buttons, thereby visually indicating to the user which
corresponding EP system has been selected.
28. The device of claim 27 wherein said one user-selected button is
altered so as to have one of a depressed appearance and shaded
appearance.
29. The device of claim 21 further comprising a user profile stored
in said memory and associated with the user, wherein said voice
recognition logic is further configured to identify said command
using said user profile.
30. The device of claim 29 wherein the user is a first user and the
user profile is a first user profile, further comprising a second
user and a second user profile associated with the second user
wherein said second user profile is stored in said memory.
31. The device of claim 30 wherein said voice recognition logic is
configured to identify a spoken command of the second user by using
said second profile.
32. The device of claim 30 wherein each of the first and second
users have unique commands associated therewith stored in
respective first and second user profiles.
33. The device of claim 30 wherein the currently active user
profile is displayed on said display panel.
34. The device of claim 21 wherein said user interface logic is
further configured to allow the user to enable or disable the
operation of said voice recognition logic.
35. The device of claim 21 further comprising a sterile drape
configured to protect said display panel from contamination.
36. The device of claim 21 wherein said plurality of EP systems
includes an electro-anatomic mapping system, an EP monitoring and
recording system, a cardiac stimulator, an EP data editing system,
a medical positioning system, and an imaging system.
37. A device for allowing a user to communicate with a plurality of
electrophysiological systems, comprising: an electronic control
unit, a touch-responsive display panel, and a microphone; user
interface logic stored in a memory configured to be executed by
said electronic control unit and configured to display on said
display panel a user interface which includes a common interface
comprising a first group of buttons corresponding to a plurality of
electrophysiological (EP) diagnostic and therapeutic systems, said
user interface logic is further configured to receive from the user
a user touch input from said touch-responsive display panel; voice
recognition logic stored in said memory configured to be executed
by said electronic control unit and configured to analyze user
speech input captured by said microphone to identify a user-spoken
command; wherein said user interface logic is configured to allow
the user to select one button from said common interface using one
of (i) said user interface logic according to said user touch, and
(ii) said voice recognition logic according to said identified
user-spoken command, to thereby select a corresponding one of said
plurality of EP systems and to present, in response to said user
selection, an application-specific user interface on said display
panel that enables access to and control of said one user-selected
EP system while maintaining said display of said common interface;
wherein said user interface logic is further configured to allow
the user to interact with said application-specific user interface,
said voice recognition logic being configured to identify a further
spoken command with respect to said application-specific user
interface wherein said electronic control unit is configured to
communicate said further spoken command to the user-selected one EP
system.
38. A device for allowing a user to communicate with a plurality of
electrophysiological systems, comprising: an electronic control
unit coupled to a memory; a microphone; an input means for
acquiring a user input comprising a display panel; user interface
logic stored in said memory configured to be executed by said
electronic control unit and configured to display on said display
panel a user interface which includes a first group of buttons
corresponding to a plurality of electrophysiological (EP)
diagnostic and therapeutic systems; and voice recognition logic
stored in said memory configured to be executed by said electronic
control unit and configured to analyze user speech input captured
by said microphone to identify a user-spoken command; wherein said
user interface logic is configured to allow the user to select one
button from said first group of buttons according to said
identified command to thereby select a corresponding one of said
plurality of EP systems and to present, in response to said user
selection, an application-specific user interface on said display
panel that enables access to and control of said one user-selected
EP system while maintaining said display of said first group of
buttons; wherein said user interface logic is further configured to
allow the user to interact with said application-specific user
interface and obtain a further command taken with respect to said
application-specific user interface, and wherein said electronic
control unit is configured to communicate said further command to
said user-selected one EP system.
Description
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This application is a continuation patent application of
U.S. patent application Ser. No. 13/208,924 (the '924 application),
filed 12 Aug. 2011. The '924 application is hereby incorporated by
reference in its entirety as though fully set forth herein.
BACKGROUND OF THE INVENTION
[0002] a. Field of the Invention
[0003] The instant disclosure relates generally to
electrophysiology lab integration, and more particularly to user
interfaces and devices therefore for electrophysiology lab
diagnostic and therapeutic equipment.
[0004] b. Background Art
[0005] It is known to provide an electrophysiology lab in a medical
facility. Such a lab may have use of a wide variety of diagnostic
and therapeutic equipment useful in rendering medical service to a
patient, such as imaging systems (e.g., fluoroscopy, intracardiac
echocardiography, etc.), an electro-anatomic visualization, mapping
and navigation system, ablation energy sources (e.g., radio
frequency (RF) ablation generator), a recording system (e.g., for
ECG, cardiac signals, etc.), a cardiac stimulator and the like. In
a typical configuration, as seen by reference to FIG. 1, a
procedure room 10 (i.e., a sterile environment) may have an
associated control area or room 12, which is commonly outfitted
with one or more control stations 141, 14.sub.2, . . . 14.sub.n
that are operated by one or more control technicians. Each control
station may include a respective display monitor, keyboard and
mouse for use by the technician. Depending on the lab setup, the
control station(s) may be across the room, or outside of the
procedure room 10 completely, perhaps configured with a common
window to allow the technician(s) to observe the procedure room
through the window. These control station(s) allow access to and
may be used to control the diagnostic and therapeutic equipment
mentioned above.
[0006] In conventional practice, an electrophysiology (EP)
physician 16 is scrubbed into a sterile procedure and typically
manipulates one or more catheters (not shown) in a sterile drape
covered body of the patient 18. The physician's sterile gloved
hands are typically engaged with the catheter handle and shaft next
to the patient and he or she is therefore unable to directly make
changes himself to any of the EP systems. The procedure room 10
typically includes one or more monitors (e.g., an integrated
multi-display monitor 20 is shown) arranged so that the physician
16 can see the monitor 20 on which is displayed various patient
information being produced by the diagnostic and therapeutic
equipment mentioned above. In FIG. 1, multiple applications, for
example, an electro-anatomic mapping application (e.g., EnSite
Velocity.TM.) and an EP signal acquisition and recording
application, direct a visual output to a respective display area of
monitor 20. When changes to an application are needed, the
physician 16 verbalizes such commands to the control technicians in
the control area/room 12 who are working at the various control
stations 14.sub.1, 14.sub.2, . . . 14.sub.n. The multiple
technicians at multiple control stations use multiple
keyboard/mouse sets to control the multiple applications. The
verbal commands between the physician and the technician occur
throughout the procedure.
[0007] For example, the EP physician 16 can verbally communicate
(i.e., to the control technician--a mapping system operator) the
desired view of the map to be displayed, when to collect points,
when to separate anatomic locations, and other details of creating
and viewing an anatomic map. The EP physician 16 can also
communicate which signal traces to show, the desired amplitude,
when to drop a lesion marker, and when to record a segment, to name
a few. Where the technician is in a separate room, communication
can be facilitated using radio.
[0008] While some commands are straightforward, for example, "LAO
View", "record that" and "stop pacing", other commands are not as
easy to clearly communicate. For example, how much rotation of a
model the command "rotate a little to the right" means can be
different as between the physician and the technician. This type of
command therefore involves a question of degree. Also, depending on
the physician-technician relationship, other requests related to
the mapping system views and setup can be misinterpreted. For
example, a request to "rotate right" may mean to rotate the model
right (i.e., rotate view left) when originating from one physician
but can alternatively mean rotate view right (i.e., rotate model
left) when coming from another physician. This type of command
therefore involves physician-technician agreement as to convention.
Furthermore, implementation of requests for event markers, segment
recordings, lesion markers and the like can be delayed by the time
it takes the technician to hear, understand and act on a
physician's command. Ambient discussions and/or equipment noise in
and around the EP lab can increase this delay.
[0009] There is therefore a need for improvements in EP lab
integration that minimize or eliminate one or more problems are set
forth above.
BRIEF SUMMARY OF THE INVENTION
[0010] One advantage of the methods and apparatuses described,
depicted and claimed herein is that they provide an EP physician
with the capability of directly controlling an EP diagnostic or
therapeutic system, such as an electro-anatomic mapping system.
This capability eliminates the need for the physician to first
communicate his/her wishes to a control technician, who in turn
must hear, interpret and act on the physician's command. The
improved control paradigm results in reduced times for medical
procedures.
[0011] A device for allowing a user to control an electro-anatomic
mapping system includes an electronic control unit (ECU) and input
means, using the ECU, for acquiring a user input with respect to a
view of an anatomical model of at least a portion of a body of a
patient. The user input is selected from the group comprising a
user touch, a user multi-touch, a user gesture, a verbal command, a
motion pattern of a user-controlled object, a user motion pattern
and a user electroencephalogram. The ECU is configured to
communicate the acquired input to the mapping system for further
processing.
[0012] In an embodiment, the acquired user input can correspond to
any of a variety of mapping systems commands, for example only at
least one of: (1) creating a map with respect to the view; (2)
collecting points with respect to the view; (3) segmenting regions
by anatomy with respect to the view; (4) rotating the view; (5)
enlarging or reducing a portion of the view; (6) panning the view;
(7) selecting one of a plurality of maps for the view; (8)
selecting a signal trace; (9) adjusting a signal amplitude; (10)
adjusting a sweep speed; (11) recording a segment; (12) placing an
event marker; (13) placing a lesion marker with respect to the
view; (14) activating a replay feature of a stored, temporally
varying physiologic parameter and (15) activating a replay of a
stored video clip.
[0013] In an embodiment, the input means includes a
touch-responsive display panel coupled to the ECU. The input means
also includes user interface logic (executed by the ECU) configured
to display a user interface on the touch-responsive display panel.
The user interface logic is further configured to allow a user to
interact with the touch-responsive panel for acquiring the
above-mentioned user input with respect to the anatomical model.
The user interface in combination with the touch-panel allows the
user to provide input by way of touch, multi-touch, and gesture. In
a further embodiment, the device further includes voice recognition
logic configured to recognize a set of predefined verbal commands
spoken by the user (e.g., the physician). In a still further
embodiment, the device includes wireless communications
functionality, improving portability of the device within a
procedure room or the control room. In a still further embodiment,
the user interface logic is configured to present a plurality of
application-specific user interfaces associated with a plurality of
different diagnostic or therapeutic systems. Through this
capability, the user can rapidly switch between
application-specific user interfaces (e.g., such as that for an
electro-anatomic mapping system, an EP recording system, an
ultrasound imaging system, a cardiac stimulator, etc.), while
remaining bedside of the patient, and without needing to
communicate via a control technician.
[0014] In another embodiment, the input means includes a remote
control having a handle configured to be grasped by the user. The
remote control includes logic configured to acquire the
above-mentioned user input. The user input may include
user-controlled motion patterns of the remote control, as well as
user key-presses on the remote control. The device is also
configured to communicate the acquired user input to the mapping
system.
[0015] In yet another embodiment, the input means includes a motion
capture apparatus configured to acquire imaging of movements of the
user. The device includes logic configured to identify a motion
pattern using the acquired imaging from the motion capture
apparatus. The logic is further configured to produce a command,
based on the identified motion pattern, and communicate the command
to the electro-anatomic mapping system for further processing. The
motion capture apparatus provides the capability of receiving input
by way of physician gestures (e.g., hand, arm, leg, trunk, facial,
etc.). In a further embodiment, the device further includes voice
recognition logic configured to identify verbal commands spoken by
the user.
[0016] Corresponding methods are also presented.
[0017] The foregoing and other aspects, features, details,
utilities, and advantages of the present disclosure will be
apparent from reading the following description and claims, and
from reviewing the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] FIG. 1 is a block diagram view of a conventional
electrophysiology lab having a sterile procedure room and an
associated control room.
[0019] FIG. 2 is a block diagram view of an embodiment of an
electrophysiology lab having a bedside interface device for
controlling diagnostic and therapeutic equipment.
[0020] FIG. 3A is a plan view of a first embodiment of a bedside
interface device comprising a touch panel computer, suitable for
use in the EP lab of FIG. 2, and showing a first
application-specific user interface.
[0021] FIG. 3B is an isometric view of a sterile drape configured
to isolate the touch panel computer of FIG. 3A.
[0022] FIG. 4A is a view of a monitor shown in FIG. 2, showing
multiple inset displays associated with a plurality of diagnostic
and/or therapeutic systems.
[0023] FIG. 4B is a view of the monitor of FIG. 4A, showing a
zoomed-in window of the display associated with an electro-anatomic
mapping system.
[0024] FIG. 5 is a plan view of the touch panel computer of FIG. 3A
showing a second application-specific user interface.
[0025] FIG. 6 is a plan view of the touch panel computer of FIG. 3A
showing a third application-specific user interface.
[0026] FIG. 7A is a diagrammatic and block diagram view of a second
embodiment of the bedside interface device comprising an electronic
wand system.
[0027] FIG. 7B is a diagrammatic view of a third embodiment of the
bedside interface device wherein a catheter is integrated with the
remote control portion of FIG. 7A.
[0028] FIG. 8 is a diagrammatic and block diagram view of a fourth
embodiment of the bedside interface device comprising a motion
capture apparatus.
[0029] FIGS. 9-10 are diagrammatic views of fifth and sixth
embodiments of the bedside interface device comprising touch
responsive surface devices that can be covered in a sterile
bag.
[0030] FIG. 11 is a diagrammatic view of a seventh embodiment of
the bedside interface device comprising a customized joystick that
can be covered in a sterile bag.
[0031] FIGS. 12-13 are diagrammatic views of eighth and ninth
embodiments of the bedside interface device comprising holographic
mouse and keyboard input devices, respectively.
DETAILED DESCRIPTION OF THE INVENTION
[0032] Referring now to the drawings wherein like reference
numerals are used to identify identical or similar components in
the various views, FIG. 2 is a diagrammatic overview of an
electrophysiology (EP) laboratory in which embodiments of the
present invention may be used. FIG. 2 shows a sterile procedure
room 10 where an EP physician 16 is set to perform one or more
diagnostic and/or therapeutic procedures. It should be understood
that the separate control area/room 12 of FIG. 1 (not shown in FIG.
2) may continue to be used in conjunction with the bedside
interface device to be described below. FIG. 2 also shows
multi-display monitor 20 as well as a procedure table or bed 22.
While procedure room 10 may include multiple, individual monitors,
monitor 20 may be a multi-display monitor configured to display a
plurality of different input channels in respective display areas
on the monitor. In an embodiment, the monitor 20 may be a
commercially available product sold under the trade designation
VantageView.TM. from St. Jude Medical, Inc. of St. Paul, Minn.,
USA, which can have a 3840.times.2160 Quad-HD screen resolution
with the flexibility to accept up to sixteen (16) digital or analog
image inputs while displaying up to eight (8) images on one screen
at one time. The procedure table 22, which may be of conventional
construction, is configured to receive a patient (not shown) on
whom diagnostic and/or therapeutic procedure(s) are to be
performed.
[0033] FIG. 2 further shows means or apparatus 24 for facilitating
physician interaction with one or more diagnostic and/or
therapeutic systems. Means or apparatus 24 includes a bedside
interface device 26 and optionally one or more base interfaces 28.
Means or apparatus 24 provides the mechanism for the EP physician
16 to directly interact with such systems without the need for the
intermediate step of verbalizing commands to a control technician,
as described in connection with FIG. 1. In this regard, bedside
interface device 26 is configured to present a user interface or
other input logic with which the user (e.g., the EP physician 16)
can directly interact or from which an input can be acquired. In
multiple embodiments, various modes of interaction are presented,
such as interaction via a user touch, a user multi-touch, a user
gesture, a verbal command, a motion pattern of a user-controlled
device, a user motion pattern and a user electroencephalogram. In
addition, bedside interface device 26 can be configured to
communicate with one or more of the diagnostic/therapeutic systems
either wirelessly (as shown) or via a wired connection (not
shown).
[0034] The base interface 28 is configured to interpret and/or
facilitate directing the input acquired by the bedside interface
device 26 to the appropriate one or more diagnostic and/or
therapeutic systems (e.g., an electro-anatomic mapping system). In
an embodiment, base interface 28 is centralized (as shown), wherein
all communications with bedside device 26 occur through base
interface 28. In a further embodiment, base interface 28 may be
functionally distributed, wherein interface functions are located
within each diagnostic or therapeutic system. In a still further
embodiment, communications between bedside interface 26 and certain
ones of the diagnostic/therapeutic systems can be centralized,
while communications with other ones of the diagnostic/therapeutic
systems can occur directly (i.e., separately).
[0035] The means or apparatus 24 addresses a number of the
shortcomings of the conventional practice as described in the
Background. For example, means or apparatus 24 allows the EP
physician 16 to directly input levels of degree, for example, how
much to rotate a view, as opposed to trying to verbally communicate
"how much" to a control technician. Further, the use of means or
apparatus 24 avoids the potential confusion that can sometimes
occur between the EP physician and the control technician as to
convention (i.e., does "rotate right" mean rotate the view or the
model?). In addition, the use of means or apparatus 24 reduces or
eliminates the inherent time delay between the time when the EP
physician verbally issues a command and the time when the command
is understood and acted upon by the technician.
[0036] With continued reference to FIG. 2, the physician 16 will
typically have access to a plurality of diagnostic and/or
therapeutic systems in order to perform one or more medical
procedures. In the illustrative embodiment, the physician 16 may
have access to a first imaging system, such as a fluoroscopic
imaging system 30, a second imaging system, such as an intracardiac
ultrasound or echocardiography (ICE) imaging system 32, an
electro-anatomic positioning, mapping, and visualization system 34,
a further positioning system, such as a medical positioning system
(magnetic-field based) 36, a patient data (electrophysiological
(EP) data) monitoring and recording system 38, a cardiac stimulator
40, an EP data editing/monitoring system 42 and an ablation system
44. FIG. 2 schematically shows a communication mechanism 46 which
facilitates communication between and among the various systems
described above. It should be understood, however, that the
communications mechanism 46 may not necessarily function to enable
communications between each and every system shown.
[0037] The fluoroscopic imaging system 30 may comprise conventional
apparatus known in the art, for example, single plane or bi-plane
configurations. A display area 48 that is shown on monitor 20
corresponds to the display output of fluoroscopic imaging system
30.
[0038] The intracardiac ultrasound and/or intracardiac
echocardiography (ICE) imaging system 32 may also comprise
conventional apparatus known in the art. For example, in one
embodiment, the system 32 may comprise a commercial system
available under the trade designation ViewMate.TM. Z intracardiac
ultrasound system compatible with a ViewFlex.TM. PLUS intracardiac
echocardiography (ICE) catheter, from St. Jude Medical, Inc. of St.
Paul, Minn., USA. The system 32 is configured to provide real-time
image guidance and visualization, for example, of the cardiac
anatomy. Such high fidelity images can be used to help direct
diagnosis or therapy during complex electrophysiology procedures. A
display area 50 that is shown on monitor 20 corresponds to the
display output of the ultrasound imaging system 32.
[0039] The system 34 is configured to provide many advanced
features, such as visualization, mapping, navigation support and
positioning (i.e., determine a position and orientation (P&O)
of a sensor-equipped medical device, for example, a P&O of a
distal tip portion of a catheter). Such functionality can be
provided as part of a larger visualization, mapping and navigation
system, for example, an ENSITE VELOCITY.TM. cardiac
electro-anatomic mapping system running a version of EnSite
NavX.TM. navigation and visualization technology software
commercially available from St. Jude Medical, Inc., of St. Paul,
Minn. and as also seen generally by reference to U.S. Pat. No.
7,263,397 entitled "METHOD AND APPARATUS FOR CATHETER NAVIGATION
AND LOCATION AND MAPPING IN THE HEART" to Hauck et al., or U.S.
Patent Publication No. 2007/0060833 A1 to Hauck entitled "METHOD OF
SCALING NAVIGATION SIGNALS TO ACCOUNT FOR IMPEDANCE DRIFT IN
TISSUE", both owned by the common assignee of the present
invention, and both hereby incorporated by reference in their
entireties as though fully set forth herein. System 34 can be
configured to perform further advanced functions, such as motion
compensation and adjustment functions. Motion compensation may
include, for example, compensation for respiration-induced patient
body movement, as described in copending U.S. patent application
Ser. No. 12/980,515, entitled "DYNAMIC ADAPTIVE RESPIRATION
COMPENSATION WITH AUTOMATIC GAIN CONTROL", which is hereby
incorporated by reference in its entirety as though fully set forth
herein. System 34 can be used in connection with or for various
medical procedures, for example, EP studies or cardiac ablation
procedures.
[0040] System 34 is further configured to generate and display
three dimensional (3D) cardiac chamber geometries or models,
display activation timing and voltage data to identify arrhythmias,
and to generally facilitate guidance of catheter movement in the
body of the patient. For example, a display area 52 that is shown
on monitor 20 corresponds to the display output of system 34, can
be viewed by physician 16 during a procedure, which can visually
communicate information of interest or need to the physician. The
display area 52 in FIG. 2 shows a 3D cardiac model, which, as will
be described below in greater detail, may be modified (i.e.,
rotated, zoomed, etc.) pursuant to commands given directly by
physician 16 via the bedside interface device 26.
[0041] System 36 is configured to provide positioning information
with respect to suitably configured medical devices (i.e., those
including a positioning sensor). System 36 may use, at least in
part, a magnetic field based localization technology, comprising
conventional apparatus known in the art, for example, as seen by
reference to U.S. Pat. No. 7,386,339 entitled "MEDICAL IMAGING AND
NAVIGATION SYSTEM", U.S. Pat. No. 6,233,476 entitled "MEDICAL
POSITIONING SYSTEM", and U.S. Pat. No. 7,197,354 entitled "SYSTEM
FOR DETERMINING THE POSITION AND ORIENTATION OF A CATHETER", all of
which are hereby incorporated by reference in their entirety as
though fully set forth herein. System 36 may comprise a gMPS.TM.
medical positioning system commercially offered by MediGuide Ltd.
of Haifa, Israel and now owned by St. Jude Medical, Inc. of St.
Paul, Minn., USA. System 36 may alternatively comprise variants,
which employ magnetic field generator operation, at least in part,
such as a combination magnetic field and current field-based system
such as the CARTO.TM. 3 System available from Biosense Webster, and
as generally shown with reference to one or more of U.S. Pat. No.
6,498,944 entitled "Intrabody Measurement," U.S. Pat. No. 6,788,967
entitled "Medical Diagnosis, Treatment and Imaging Systems," and
U.S. Pat. No. 6,690,963 entitled "System and Method for Determining
the Location and Orientation of an Invasive Medical Instrument,"
the entire disclosures of which are incorporated herein by
reference as though fully set forth herein.
[0042] EP monitoring and recording system 38 is configured to
receive, digitize, display and store electrocardiograms, invasive
blood pressure waveforms, marker channels, and ablation data.
System 38 may comprise conventional apparatus known in the art. In
one embodiment, system 38 may comprise a commercially available
product sold under the trade designation EP-WorkMate.TM. from St.
Jude Medical, Inc. of St. Paul, Minn., USA. The system 38 can be
configured to record a large number of intracardiac channels, may
be further configured with an integrated cardiac stimulator (shown
in FIG. 2 as stimulator 40), as well as offering storage and
retrieval capabilities of an extensive database of patient
information. Display areas 54, 56 shown on monitor 20 correspond to
the display output of EP monitoring and recording system 38.
[0043] Cardiac stimulator 40 is configured to provide electrical
stimulation of the heart during EP studies. Stimulator 40 can be
provided in either a stand-alone configuration, or can be
integrated with EP monitoring and recording system 38, as shown in
FIG. 2. Stimulator 40 is configured to allow the user to initiate
or terminate tachy-arrhythmias manually or automatically using
preprogrammed modes of operation. Stimulator 40 may comprise
conventional apparatus known in the art. In an embodiment,
stimulator 40 can comprise a commercially available cardiac
stimulator sold under the trade designation EP-4.TM. available from
St. Jude Medical, Inc. of St. Paul, Minn., USA. The display area 58
shown on monitor 20 corresponds to the display output of the
cardiac stimulator 40.
[0044] EP data editing/monitoring system 42 is configured to allow
editing and monitoring of patient data (EP data), as well as
charting, analysis, and other functions. System 42 can be
configured for connection to EP data recording system 38 for
real-time patient charting, physiological monitoring, and data
analysis during EP studies/procedures. System 42 may comprise
conventional apparatus known in the art. In an embodiment, system
42 may comprise a commercially available product sold under the
trade designation EP-NurseMate.TM. available from St. Jude Medical,
Inc. of St. Paul, Minn., USA.
[0045] To the extent the medical procedure involves tissue ablation
(e.g., cardiac tissue ablation), ablation system 44 can be
provided. The ablation system 44 may be configured with various
types of ablation energy sources that can be used in or by a
catheter, such as radio-frequency (RF), ultrasound (e.g.
acoustic/ultrasound or HIFU), laser, microwave, cryogenic,
chemical, photo-chemical or other energy used (or combinations
and/or hybrids thereof) for performing ablative procedures. RF
ablation embodiments may and typically will include other
structure(s) not shown in FIG. 2, such as one or more body surface
electrodes (skin patches) for application onto the body of a
patient (e.g., an RF dispersive indifferent electrode/patch), an
irrigation fluid source (gravity feed or pump), and an RF ablation
generator (e.g., such as a commercially available unit sold under
the model number IBI-1500T RF Cardiac Ablation Generator, available
from St. Jude Medical, Inc.).
[0046] FIG. 3A is a plan view of a first embodiment of a bedside
interface device comprising a computer 26a, suitable for use in the
EP lab of FIG. 2, and showing a first application-specific user
interface. The computer 26a includes a touch-responsive display
panel and thus may be referred to hereinafter sometimes as a touch
panel computer. The touch panel computer 26a, as shown in inset in
FIG. 3A, includes an electronic control unit (ECU) having a
processor 60 and a computer-readable memory 62, user interface (UI)
logic 64 stored in the memory 62 and configured to be executed by
processor 60, a microphone 66 and voice recognition logic 68. In an
embodiment, voice recognition logic 68 is also stored in memory 62
and is configured to be executed by processor 60. In an embodiment,
the touch panel computer 26a is configured for wireless
communication to base interface 28 (best shown in FIG. 2). In
addition, the touch panel computer 26a is configured to draw
operating power at least from a battery-based power
source--eliminating the need for a power cable. The resulting
portability (i.e., no cables needed for either communications or
power) allows touch panel computer 26a to be carried around by the
EP physician 16 or other lab staff to provide control over the
linked systems (described below) while moving throughout the
procedure room 10 or even the control room 12. In another
embodiment, touch panel computer 26a can be wired for one or both
of communications and power, and can also be fixed to the bedrail
or in the sterile field.
[0047] In the illustrated embodiment, the UI logic 64 is configured
to present a plurality of application-specific user interfaces,
each configured to allow a user (e.g., the EP physician 16) to
interact with a respective one of a plurality of diagnostic and/or
therapeutic systems (and their unique interface or control
applications). As shown in FIG. 3A, the UI logic 64 is configured
to present on the touch panel surface of computer 26a a plurality
of touch-sensitive objects (i.e., "buttons", "flattened joystick",
etc), to be described below. In the illustrative embodiment, the UI
logic 64 produces a first, application-selection group of buttons,
designated as group 70, and which are located near the top of the
touch panel. Each of the buttons in group 70 are associated with a
respective diagnostic and/or therapeutic system (and control or
interface application therefore). For example, the six buttons
labeled "EnSite", "WorkMate", "EP4", "NurseMate", "MediGuide",
"ViewMate" correspond to electro-anatomic mapping system 34 (for
mapping control), EP recording system 38 (for patient data
recording control), stimulator 40 (for stimulator control), EP data
editing and monitoring system 42 (for charting) and ultrasound
imaging system 32 (for ultrasound control), respectively.
[0048] When a user selects one of the buttons in group 70, the UI
logic 64 configures the screen display of computer 26a with an
application-specific user interface tailored for the control of and
interface with the particular EP system selected by the user. In
FIG. 3A, the "EnSite" system is selected, so the UI logic 64 alters
the visual appearance of the "EnSite" button so that it is visually
distinguishable from the other, non-selected buttons in group 70.
For example, when selected, the "EnSite" button may appear
depressed or otherwise shaded differently than the other,
non-selected buttons in group 70. This always lets the user know
what system is selected. The UI logic 64, in an embodiment, also
maintains the application-selection buttons in group 70 at the top
of the screen regardless of the particular application selected by
the user. This arrangement allows the user to move from system
(application) to system (application) quickly and control each one
independently.
[0049] With continued reference to FIG. 3A, UI logic 64 presents an
application-specific user interface tailored and optimized for
control of and interaction with system 34. This user interface
includes a second, common-task group of selectable buttons,
designated group 72, a third, view-mode group of selectable
buttons, designated group 74, a fourth, view-select group of
selectable buttons, designated group 76, a flattened joystick 78
configured to receive view-manipulation input from the user, a
voice recognition control button 80, and a settings button 82. Each
group will be addressed in turn.
[0050] The second group 72 of buttons includes a listing of common
tasks performed by an EP physician when interacting with system 34.
Each of the buttons in group 72 are associated with a respective
task (and resulting action). For example, the five buttons in group
72 are labeled "Zoom In", "Zoom Out", "Add Lesion", "Freeze Point",
and "Save Point". The "Zoom In" and "Zoom Out" buttons allow the
user to adjust the apparent size of the 3D model displayed on
monitor 20 (i.e., enlarging or reducing the 3D model on the
monitor).
[0051] For example, FIG. 4A is a view of the monitor 20 of FIG. 2,
showing multiple inset displays for different applications, where
the display area (window) 52.sub.1 shows the EnSite.TM. display
output of a 3D electro-anatomic model at a first magnification
level. FIG. 4B is a further view of monitor 20, showing a zoomed-in
view of the same display area (window), now designated 52.sub.2,
which has an increased magnification level and thus apparent size.
This change of course allows the physician to see details in window
52.sub.2 that may not be easy to see in window 52.sub.1.
[0052] Referring again to FIG. 3A, the "Add Lesion" button is
configured to add a lesion marker to the 3D model. Other commands
can be also be executed using the "Freeze Point" and "Save Point"
buttons. It should be understood that variations are possible.
[0053] Each of the buttons in group 74 are associated with a
respective display mode, which alters the display output of system
34 to suit the wishes of the physician. For example, the three
selectable buttons labeled "Dual View", "Right View", and "Map
View" re-configure the display output of system 34, as will appear
on monitor 20.
[0054] Each of the buttons in group 76 are associated with a
respective viewpoint from which the 3D electro-anatomic model is
"viewed" (i.e., as shown in window 52 on monitor 20). Three of the
five selectable buttons, namely those labeled "LAO", "AP", and
"RAO", allow the user to reconfigure the view point from which the
3D electro-anatomic model is viewed (i.e., left anterior oblique,
anterior-posterior, right anterior oblique, respectively). The
remaining two buttons, namely those labeled "Center at Surface" and
"Center at Electrode" allow the user to invoke, respectively, the
following functions: (1) center the anatomy shape in the middle of
the viewing area; and (2) center the current mapping electrode or
electrodes in the middle of the viewing area.
[0055] The flattened joystick 78 is a screen object that allows the
user to rotate the 3D model displayed in the window 52. In
addition, as the point of contact (i.e., physician's finger) with
the joystick object 78 moves from the center or neutral position,
for example at point 83, towards the outer perimeter (e.g., through
point 84 to point 86), the magnitude of the input action increases.
For example, the acceleration of rotation of the model or cursor
will increase. While FIG. 3A shows the joystick object 78 as having
three (3) gradations or concentric bands, it should be appreciated
that this is for clarity only and not limiting in number. For
example, in an embodiment, a relatively larger number of gradations
or bands, such as ten (10), may be provided so as to effectively
provide for a substantially continuous increase in sensitivity (or
magnitude) as the point of contact moves toward the outer radius.
In another embodiment, a single gradient may be continuous from the
center position, point 83, to the outer edge of the joystick object
78, with the centermost portion of the gradient being the brightest
in intensity or color and the outermost portion of the gradient
being the darkest in intensity or color, for example. In yet
another embodiment, a single gradient may be continuous from the
center position, point 83, to the outer edge of the joystick object
78, with the centermost portion of the gradient being the darkest
in intensity or color and the outermost portion of the gradient
being brightest in intensity or color, for example.
[0056] In a further embodiment, UI logic 64 can be further
configured to present an additional button labeled "Follow Me" (not
shown), which, when selected by the user, configures the
electro-anatomic mapping system 34 for "follow me" control. This
style of control is not currently available using a conventional
keyboard and mouse interface. For "follow me" control, UI logic 64
is configured to receive a rotation input from the user via the
touch panel (e.g., joystick 78); however, the received input is
interpreted by system 34 as a request to rotate the endocardial
surface rendering (the "map") while maintaining the mapping
catheter still or stationary on the display. In an embodiment, the
physician can set the position and orientation of the mapping
catheter, where it will remain stationary after the "Follow Me"
button is selected.
[0057] Another feature of the touch panel computer 26a is that it
incorporates, in an embodiment, voice recognition technology. As
described above, computer 26a includes microphone 66 for capturing
speech (audio) and voice recognition logic 68 for analyzing the
captured speech to extract or identify spoken commands. The voice
recognition feature can be used in combination with the touch panel
functionality of computer 26a. The microphone 66 may comprise
conventional apparatus known in the art, and can be a voice
recognition optimized microphone particularly adapted for use in
speech recognition applications (e.g., an echo-cancelling
microphone). Voice recognition logic 68 may comprise conventional
apparatus known in the art. In an embodiment, voice recognition
logic 68 may be a commercially available component, such as
software available under the trade designation DRAGON DICTATION.TM.
speech recognition software.
[0058] In an embodiment, computer 26a is configured to recognize a
defined set of words or phrases adapted to control various
functions of the multiple applications that are accessible or
controllable by computer 26a. The voice recognition feature can
itself be configured to recognize unique words or phrases to
selectively enable or disable the voice recognition feature.
Alternatively (or in addition to), a button, such as button 80 in
FIG. 3A, can be used to enable or disable the voice recognition
feature. In this regard, the enable/disable button can be either a
touch-sensitive button (i.e., screen object), or can be hardware
button.
[0059] Voice recognition logic 68 is configured to interact with
the physician or other user to "train" the logic (e.g., having the
user speak known words) so as to improve word and/or phrase
recognition. The particulars for each user so trained can be stored
in a respective voice (user) profile, stored in memory 62. For
example, in FIG. 3A, the currently active voice profile is listed
in dashed-line box 89. In an embodiment, each user can have unique
commands, which may also be stored in the respective voice profile.
In a further embodiment, the language need not be English, and can
be other languages. This flexibility as to language choice enlarges
the audience of users who can use the device 26a. The voice
recognition feature presents a number of advantages, including the
fact that the physician 16 does not have to remove his/her hands
from the catheter or other medical device being manipulated. In
addition, the absence of contact or need to touch computer 26a
maintains a sterile condition. The voice recognition feature can
also be used either alone or in combination with other
technologies.
[0060] With continued reference to FIG. 3A, UI logic 64 also
presents a "Settings" button 82. When the "Settings" button 82 is
selected, UI logic 64 generates another screen display that allows
the user to adjust and/or set/reset various settings associated
with the application currently selected. In an embodiment, the
"Settings" button can also allow adjustment of parameters that are
more global in nature (i.e., apply to more than one application).
For example only, through "Settings", the physician or another user
can edit all of the phrases associated with a particular physician
or specify a timeout (i.e., the elapsed amount of time, after which
the computer will stop listening (or not) for voice commands). The
physician or another user can also edit miscellaneous parameters,
such as communication settings and the like.
[0061] FIG. 3B is an isometric view of a sterile drape 88
configured to protect the touch panel computer 26a of FIG. 3A from
contamination and to maintain the physician's sterility.
Conventional materials and construction techniques can be used to
make drape 88.
[0062] FIG. 5 is a plan view of touch panel computer 26a showing a
different application-specific user interface, now relating to EP
monitoring and recording system 38 (i.e., "EP-WorkMate"). In the
illustrative embodiment, UI logic 64 produces the same
application-selection group 70 of buttons along the top of the
touch panel, for quick and easy movement by the user between
applications. A second, common-tasks group of buttons, designated
as group 90, are shown below group 70. For example, the three
buttons labeled "Record", "Update", and "Add Map Point" can execute
the identified function. Likewise, additional groups of buttons are
shown, grouped by function, for example the signals-adjustment
group 92, the events group 94, the timer group 96 and the print
group 98. It should be understood that variations are possible,
depending on the items that can be adjusted or controlled on the
destination system. It warrants emphasizing that UI logic 64 thus
presents a unique user interface tailored to the requirements of
the particular application selected. Each group includes items that
are commonly asked for by the physician. For example, in the
signals group 92, the Speed +/- buttons can be used to change the
viewed waveform sweep speed as the physician may need more or less
detail; the Page +/- buttons can be used to change the page of
signals being viewed (e.g., from surface ECG signals to
intracardiac signals); and the Amplitude +/- buttons can be used to
change the signal amplitudes up or down. As a further example, in
the Events group 94, the enumerated Events buttons cause a mark to
be created in the patient charting log to indicate a noteworthy
(i.e., important) item or event, such as the patient was just
defibrillated or entered a tachy-arrhythmia. Note that these items
are all user definable and speakable (capable of being tied to the
voice recognition function). The physician also needs to keep track
of certain periods of time. Thus, in the Timer group 96, the timer
buttons can be used to keep track of such periods of time, for
example, such as a certain time after an ablation (e.g., 30
minutes) to verify that the ablation procedure is still effective.
Finally, regarding the print group 98, various print buttons are
provided so as to avoid requiring a physician to verbally indicate
(e.g., by way of shouting out "print that document to the case" or
the like) and to include such documents in a final report.
[0063] FIG. 6 is a plan view of touch panel computer 26a showing in
exemplary fashion a further, different application-specific user
interface relating to the ultrasound imaging system 32
("ViewMate"). As with the other application-specific user
interfaces, the user interface presented in FIG. 6 repeats the
common, application-selection group of buttons, designated group
70. A further group of buttons and adjustment mechanisms are
located in group 100. The controls (buttons, sliders) provided for
this user interface completely eliminate the need to have a
separate ultrasound keyboard to control the console. The user
interface shown can be different, independent on the kind of
machine being controlled, but at a minimum may typically provide a
way to control the receive gain, the depth setting, the focus zone,
the TGC (i.e., time gain compensation) curve, the monitoring mode
(e.g., B, M, color Doppler, Doppler), image recording, as well as
other image attributes and states. Note, trackpad object 101 is
shown in the center of the user interface. The capability provided
by UI logic 64 to rapidly switch applications and present to the
bedside user an application-specific user interface minimizes or
eliminates many of the shortcomings set forth in the
Background.
[0064] It should be understood that variations in UI logic 64 are
possible. For example, certain applications can be linked (in
software) so that multiple applications can be controlled with a
single command (e.g., the Record command). In another embodiment,
UI logic 64 can be configured to provide additional and/or
substitute functions, such as, without limitation, (1) map
creation; (2) collecting points; (3) segmenting regions by anatomy;
(4) map view (rotate and zoom); (5) select/manipulate a number of
maps and view each; (6) selection of signal trace display; (7)
adjust EP signal amplitude; (8) sweep speed; (9) provide single
button (or touch, multi-touch, gesture) for recording a segment,
placing an event marker, and/or placing a lesion marker.
[0065] It should be further understood that the screen layouts in
the illustrative embodiment are exemplary only and not limiting in
nature. The UI logic 64 can thus implement alternative screen
layouts for interaction by the user. For example, while the screen
displays in FIGS. 3A, 5 and 6 show an approach that incorporates
the top level menu items on every screen, multi-level menus can
also be used. For example, the screen layouts can be arranged such
that a user descends down a series of screens to further levels of
control. To return to upper levels (and to the "home" screen), a
"Back" button or the like can be provided. Alternatively, a "Home"
button can be provided.
[0066] In a still further embodiment, UI logic 64 can be configured
for bi-directional display of information, for example, on the
touch-responsive display panel. As one example, the "EnSite" user
interface (FIG. 3A) can be configured so that the EnSite.TM. model
is sent to the computer 26a and displayed on the touch-responsive
display panel. The user interface provided by UI logic 64 can allow
the user to drag his or her finger on the panel to rotate the
model. The display of the model provides context with respect to
the act of dragging. Other information can be displayed as well,
such as a waveform. In various embodiments, all or a portion of the
items/windows displayed on monitor 20 (see, e.g., FIGS. 2, 4A, and
4B) may be displayed or mirrored on the touch-responsive display
panel. For example, display area or window 52 may be displayed on
the touch-responsive display panel allowing the physician or other
user to directly modify the features of window 52 at the patient's
bedside. Other display areas/windows, such as windows 50, 54, 56,
58, and/or 48 (see FIG. 2) may also be displayed and/or modified on
the touch-panel display panel. One further example involves
displaying feedback information or messages originating from the
various devices or systems back to the touch-responsive display
panel. In this regard, the UI logic 64 can configure any of the
user-interfaces to have a message area, which can show
informational messages, warning messages or critical error messages
for viewing by the user. The message area feature provides a way to
immediately alert the physician to such messages, rather than the
physician having to watch for messages on multiple displays.
[0067] FIG. 7A is a diagrammatic and block diagram view of a second
embodiment of the bedside interface device, comprising an
electronic wand system 26b. As with touch panel computer 26a, wand
system 26b is configured to allow the EP physician to take control,
bedside of the patient, of an EP diagnostic or therapeutic system,
such as the electro-anatomic mapping system 34. The wand system 26b
includes a wireless remote control portion 102, an optical emitter
portion 104, and a base interface 28b, which may be coupled to the
desired, target EP system through either a wired or wireless
connection. The wand system 26b incorporates remote control
technology, and includes the ability to detect and interpret motion
of the remote control indicative of an EP physician's command or
other instruction, detect and interpret key-presses on the remote
control, and/or detect and interpret motion/keypress
combinations.
[0068] Since the wand system 26b is contemplated as being used in
the sterile procedure room, multiple embodiments are contemplated
for avoiding contamination. In this regard, wand system 26b may be
configured with a disposable remote control portion 102, with a
reusable remote control portion 102 that is contained within an
enclosure compatible with sterilization procedures, with a reusable
remote control portion 102 adapted to be secured in a
sterilization-compatible wrapper, or with a reusable remote control
portion 102 that is encased in a sterile but disposable
wrapper.
[0069] With continued reference to FIG. 7A, remote control portion
102 may include an optical detector 106, an electronic processor
108, a memory 110, an optional accelerometer 112 and a wireless
transmitter/receiver 114. The processor 108 is configured to
execute a control program that is stored in memory 110, to achieve
the functions described below. The optical emitter 104 is
configured to emit a light pattern 105 that can be detected and
recognized by optical detector 106. For example, the light pattern
may be a pair of light sources spaced apart by a predetermined,
known distance. The control program in remote 102 can be configured
to assess movement of the light pattern 105 as detected by detector
106 (e.g., by assessing a time-based sequence of images captured by
detector 106). For example, in the exemplary light pattern
described above, processor 108 can be configured to determine the
locations of the light sources (in pixel space). In an embodiment,
the control program in remote 102 may only discern the light
pattern 105 itself (e.g., the locations in pixel space) and
transmit this information to base interface 28b, which in turn
assesses the movement of the detected light pattern in order to
arrive at a description of the motion of the remote 102. In a still
further embodiment, various aspects of the processing may be
divided between processor 108 and a processor (not shown) contained
in base interface 28b. The processor 106 communicates with base
interface 28b via the wireless transmitter/receiver 114, which may
be any type of wireless communication method now known or hereafter
developed (e.g., such as those technologies or standards branded
Bluetooth.TM., Wi-Fi.TM., etc.). The processor 108 is configured to
transmit wirelessly to interface 28b the detected keypresses and
information concerning the motion of the remote control 102 (e.g.,
the information about or derived from the images from the optical
detector 106). In an embodiment, the motion of remote control 102
may also be determined, or supplemented by, readings from
accelerometer 112 (which may be single-axis or multi-axis, such as
a 3-axis accelerometer). In some instances, rapid motion may be
better detected using an accelerometer than using optical methods.
In an embodiment, electronic wand system 26b may be similar to (but
differing in application, as described herein) a commercially
available game controller sold under the trade designation Wii
Remote Controller, from Nintendo of America, Inc.
[0070] Either the remote 102 or the base interface 28b (or both,
potentially in some division of computing labor) is configured to
identify a command applicable to the one of the EP
diagnostic/therapeutic systems, such as electro-anatomic mapping
system 34, based on the detected motion of the remote 102.
Alternatively, the command may be indentified based on a key press,
or a predetermined motion/key press combination. Once the remote
102 and/or interface 28b indentifies the command it is transmitted
to the appropriate EP system. In an electro-anatomic mapping system
embodiment, the wireless remote control 102 is configured to allow
an EP physician to issues a wide variety of commands, for example
only, any of the commands (e.g., 3D model rotation, manipulation,
etc.) described above in connection with touch panel computer 26a.
By encoding at least some of the control through the wireless
remote control 102 that the EP physician controls, one or more of
the shortcomings of conventional EP labs, as described in the
Background, can be minimized or eliminated. As with touch panel
computer 26a, electronic wand system 26b can reduce procedure times
as the EP physician will spend less time playing "hot or cold" with
the mapping system operator (i.e., the control technician), but
instead can set the display to his/her needs throughout the medical
procedure.
[0071] FIG. 7B shows a further embodiment, designated interface
device 26c. Interface device 26 integrates the remote control 102
described above into the handle of a catheter 115. Through the
foregoing, the physician need not take his hands off the catheter,
but rather can issue direct, physical commands (e.g., via
key-presses) while retaining control of the catheter. Additionally,
one or more of the keys or a slider switch on the catheter handle
may serve as a safety mechanism to prevent inadvertent activation
of one or more commands while operating the catheter. In such an
embodiment, after advancing the catheter into a patient's body, the
safety mechanism may be deactivated or otherwise turned off such
that the physician can issue commands and then he or she may
reactivate or turn on the safety mechanism and resume manipulating
the catheter without fear of modifying the view or model shown on
an on-screen display, for example. The catheter 115 may further
comprise one or more electrodes on a distal portion of the catheter
shaft and a manual or motorized steering mechanism (not shown) to
enable the distal portion of the catheter shaft to be steered in at
least one direction. In at least one embodiment, the catheter
handle may be generally symmetric on opposing sides and include
identical or nearly identical sets of controls on opposing sides of
the handle so that a physician need not worry about which side of
the catheter handle contains the keys. In another embodiment, the
catheter handle may be generally cylindrical in shape and include
an annular and/or rotatable control feature for issuing at least
one command, again so the physician need not worry about the
catheter handle's orientation in his or her hand(s). Exemplary
catheters, handles, and steering mechanisms are shown and described
in U.S. Pat. No. 5,861,024 to Rashidi, U.S. patent application
publication no. 2010/0314031 to Heideman et al., U.S. Pat. No.
7,465,288 to Dudney et al., and U.S. Pat. No. 6,671,533 to Chen et
al., each of which is hereby incorporated by reference as though
fully set forth herein.
[0072] FIG. 8 is a diagrammatic and block diagram view of a fourth
embodiment of the bedside interface device, comprising a motion
capture apparatus 26d. As with touch panel computer 26a, wand
system 26b and integrated system 26c, motion capture apparatus 26d
is configured to allow the EP physician to take control, bedside of
the patient, of an EP diagnostic or therapeutic system, such as
electro-anatomical mapping system 34. The motion capture apparatus
26d includes a capture apparatus 116 having both an optical
sub-system 118 and a microphone sub-system 120 where the apparatus
116 is coupled to a base interface 28b. The apparatus 116 is
configured to optically detect the motion or physical gestures of
the EP physician or other user when such movements occur within a
sensing volume 122. The base interface 28b may be coupled to the
desired, target EP system through either a wired or wireless
connection.
[0073] The motion capture apparatus 26d includes the capability to
detect hand/arm/leg/trunk/facial motions (e.g., gestures) of the EP
physician or other user and translate the detected patterns into a
desired command. Apparatus 26d also includes audio capture and
processing capability and thus also has the capability to detect
speech and translate the same into desired commands. In an
embodiment, apparatus 26d is configured to detect and interpret
combinations and sequences of gestures and speech into desired
commands. The base interface 28b is configured to communicate the
commands (e.g., rotation, zoom, pan of a 3D anatomical model) to
the appropriate EP diagnostic or therapeutic system (e.g., the
electro-anatomic mapping system 34). In an embodiment, the motion
capture apparatus 26d may comprise commercially available
components, for example, the Kinect.TM. game control system,
available from Microsoft, Redmond, Wash., USA. A so-called
Kinect.TM. software development kit (SDK) is available, which
includes drivers, rich application programming interfaces (API's),
among other things contents, that enables access to the
capabilities of the Kinect.TM. device. In particular, the SDK
allows access to raw sensor streams (e.g., depth sensor, color
camera sensor, and four-element microphone array), skeletal
tracking, advanced audio (i.e., integration with Windows speech
recognition) as well as other features.
[0074] Since there is no contact contemplated by EP physician 16
during use of motion capture apparatus 26d, contamination and
subsequent sterilization issues are eliminated or reduced. In
addition, the lack of contact with apparatus 26d for control
purposes allows the EP physician to keep his hands on the catheter
or other medical device(s) being manipulated during an EP
procedure. By encoding at least some of the control through the
motion capture apparatus 26d, with which the EP physician
interacts, one or more of the shortcomings of conventional EP labs,
as described in the Background, can be minimized or eliminated. As
with the previous embodiments, the motion capture apparatus 26d can
reduce procedure times.
[0075] It should be understood that variations are possible. For
example, the motion capture apparatus 26d can be used in concert
with sensors and/or emitters in a sterile glove to assist the
apparatus 26d to discriminate commands intended to be directed to
one of the EP systems, versus EP physician hand movements that
result from his/her manipulation of the catheter or medical device,
versus other movement in the EP lab in general. In another
embodiment, the motion capture apparatus 26d may discriminate such
commands by being "activated" by a user when a specific verbal
command is issued (e.g., "motion capture on") and then
"deactivated" by the user when another specific verbal command is
issued (e.g., "motion capture off").
[0076] FIGS. 9-10 are diagrammatic views of fifth and sixth
embodiments of the bedside interface device, comprising touch
responsive devices. FIGS. 9 and 10 show touch-screen mouse pad
devices 26e and 26f, respectively. These devices can be covered in
a sterile bag. The EP physician 16 can move the mouse cursor from
application to application and control each such application
independently. Devices 26e, 26f may comprise conventional apparatus
known in the art.
[0077] FIG. 11 is a diagrammatic view of a seventh embodiment of
the bedside interface device comprising a customized joystick 26g.
Joystick 26g can also be covered in a sterile bag. The device 26g
can be used to be provide application-specific control a particular
application function(s), such as rotating a 3D model (system 34),
adding lesion markers, and the like.
[0078] FIGS. 12-13 are diagrammatic views of eighth and ninth
embodiments of the bedside interface device comprising holographic
mouse and keyboard input devices, respectively. Holographic mouse
26h deploys light beam pattern 124, which is used by the mouse 26h
to acquire user input (i.e., movement of the physician's finger,
instead of moving a conventional mouse). The movement input can be
used in the same manner as that obtained from a conventional mouse.
Holographic keyboard 26i also deploys a light beam pattern 126
corresponding to a keyboard. A physician's finger can be used to
"select" the key much in the same manner as a conventional
keyboard, but without any physical contact. Devices 26h, 26i have
the advantage of being sterile without any disposables, and can
incorporate wireless communications and may be powered using
batteries (i.e., no cables needed).
[0079] It should be understood that variations are possible. For
example, in a further embodiment, primary control by the physician
in manipulating or interacting with the mapping system may be
through use of voice control alone (i.e., a microphone coupled with
voice recognition logic), apart from its inclusion with other modes
or devices for user interaction described above. In a still further
embodiment, the physician can be equipped with headgear that
monitors head movements to determine at what location on the
screen/monitor the physician is looking. In effect, such headgear
can act as a trackball to move or otherwise manipulate an image (or
view of a model) on the monitor in accordance with the physician's
head movements. In a yet further embodiment, the physician can be
equipped with headgear that monitors head movements and/or also
monitors brainwave patterns (e.g., to record a user
electroencephalogram (EEG)). Such monitored data can be analyzed to
derive or infer user input or commands for controlling an image (or
view of a model), as described above. An EEG-based embodiment may
comprise conventional apparatus known in the art, for example,
commercially available products respectively sold under the trade
designation MindWave.TM. headset from NeuroSky, Inc., San Jose,
Calif., USA, or the Emotiv EPOC.TM. personal interface neuroheadset
from Emotiv, Kwun Tong, Hong Kong. In a still further embodiment,
the physician can be equipped with an eye tracking apparatus,
wherein monitored eye movements constitute the user input to be
interpreted by the system (e.g., the eye movements can be
interpreted as a cursor movement or other command).
[0080] It should also be appreciated that while the foregoing
description pertains to an EP physician manually controlling a
catheter through the use of a manually-actuated handle or the like,
other configurations are possible, such as robotically-actuated
embodiments. For example, a catheter movement controller (not
shown) described above may be incorporated into a larger robotic
catheter guidance and control system, for example, as seen by
reference to U.S. application Ser. No. 12/751,843 filed Mar. 31,
2010 entitled ROBOTIC CATHETER SYSTEM (published as U.S. patent
application publication no. 2010/0256558), owned by the common
assignee of the present invention and hereby incorporated by
reference in its entirety as though fully set forth herein. Such a
robotic catheter system may be configured to manipulate and
maneuver catheters within a lumen or a cavity of a human body,
while the bedside interface devices described herein can be used to
access and control the EP diagnostic and/or therapeutic systems. In
at least one embodiment, a bedside interface device as described
herein may also be used to access and control the robotic catheter
system.
[0081] In accordance with another embodiment, an article of
manufacture includes a computer storage medium having a computer
program encoded thereon, where the computer program includes code
for acquiring user input based on at least one of a plurality of
input modes, such as by touch, multi-touch, gesture, motion
pattern, voice recognition and the like, and identifying one or
more commands or requests for an EP diagnostic and/or therapeutic
system. Such embodiments may be configured to execute one or more
processors, multiple processors that are integrated into a single
system or are distributed over and connected together through a
communications network, and where the network may be wired or
wireless.
[0082] It should be understood that while the foregoing description
describes various embodiments of a bedside interface device in the
context of the practice of electrophysiology, and specifically
catheterization, the teachings are not so limited and can be
applied to other clinical settings.
[0083] It should be understood that the an electronic control unit
as described above may include conventional processing apparatus
known in the art, capable of executing preprogrammed instructions
stored in an associated memory, all performing in accordance with
the functionality described herein. It is contemplated that the
methods described herein may be programmed, with the resulting
software being stored in an associated memory and where so
described, may also constitute the means for performing such
methods. Implementation of an embodiment of the invention, in
software, in view of the foregoing enabling description, would
require no more than routine application of programming skills by
one of ordinary skill in the art. Such a system may further be of
the type having both ROM, RAM, a combination of non-volatile and
volatile (modifiable) memory so that the software can be stored and
yet allow storage and processing of dynamically produced data
and/or signals.
[0084] Although numerous embodiments of this invention have been
described above with a certain degree of particularity, those
skilled in the art could make numerous alterations to the disclosed
embodiments without departing from the spirit or scope of this
invention. All directional references (e.g., plus, minus, upper,
lower, upward, downward, left, right, leftward, rightward, top,
bottom, above, below, vertical, horizontal, clockwise, and
counterclockwise) are only used for identification purposes to aid
the reader's understanding of the present invention, and do not
create limitations, particularly as to the position, orientation,
or use of the invention. Joinder references (e.g., attached,
coupled, connected, and the like) are to be construed broadly and
may include intermediate members between a connection of elements
and relative movement between elements. As such, joinder references
do not necessarily infer that two elements are directly connected
and in fixed relation to each other. It is intended that all matter
contained in the above description or shown in the accompanying
drawings shall be interpreted as illustrative only and not
limiting. Changes in detail or structure may be made without
departing from the spirit of the invention as defined in the
appended claims.
* * * * *