Precision control systems for tissue visualization and manipulation assemblies

Abstract

Precision control systems for tissue visualization and manipulation assemblies are described herein where such devices may utilise a variety of apparatus and methods for facilitating advancement, articulation, control, navigation, etc. of systems which may be used to visual and/or treat tissue regions. Additionally, methods and devices for enhancing navigation of the device through a patient body are also described.

1 . A computer-assisted heart treatment system for treating a tissue of a heart, wherein blood is disposed within a chamber of the heart, the heart, treatment system comprising: 
 an articulatable catheter;    an imaging assembly carried by the catheter, the imaging assembly configured to obtain, while blood is disposed in the chamber, an image of a tissue surface within the chamber;    a display coupleable to the imaging assembly so as to display tire tissue surface image;    a computer-controlled guidance assembly coupled to the catheter so as to move the imaging assembly; and    a processor coupled to the computer-controlled guidance assembly so that the articulation of the catheter effects repositioning of the imaging assemble registered to the displayed tissue surface.    
     
     
         2 . The system, of  claim 1  further comprising a tracking system transmitting position feedback signals to the processor, wherein the processor transmits drive signals for the computer-controlled guidance assembly using the position feedback signals.  
     
     
         3 . The system, of  claim 2  wherein the imaging assembly comprises an imaging element and a barrier or membrane, and wherein the imaging assembly is pivotably coupled to the articulatable catheter.  
     
     
         4 . The system of  claim 3  wherein the barrier or membrane is pivotably coupled to the articulatable catheter such that the membrane is movable within a first plane in response to signals from the computer-controlled guidance assembly, and wherein the barrier or membrane is further pivotably coupled to the articulatable catheter such that the barrier or membrane is movable within a second plane transverse to the first plane in response to signals from the computer-controlled guidance assembly.  
     
     
         5 . The system of  claim 3  wherein the articulatable catheter comprises a steerable segment proximal to the barrier or membrane and having a spine and a plurality of reduced sections along the segment to facilitate steering of the segment.  
     
     
         6 . The system of  claim 5  wherein the plurality of reduced sections are located circumferentially such that the segment is steerable in more than one plane.  
     
     
         7 . The system of  claim 1  wherein the computer-controlled guidance assembly comprises one or more drive assemblies coupled to the distal end of the catheter via a respective pullwire.  
     
     
         8 . The system of  claim 7  wherein the drive assemblies comprise a member rotatably positioned upon an axle such that rotation of the member in a first rotational direction urges the catheter to deflect in a first direction and rotation of the member in a second rotational direction opposite to the first rotational direction urges the catheter to deflect in a second direction opposite to the first direction.  
     
     
         9 . The system of  claim 1  further comprising an instrument guidance assembly configured to retract an outer sheath relative to the articulatable catheter.  
     
     
         10 . The system of  claim 1  further comprising an instrument driver upon which the catheter is mounted and extends from.  
     
     
         11 . A computer-assisted heart treatment system for treating a tissue of a heart, wherein blood is disposed within a chamber of the heart, the heart treatment system comprising: 
 an articulatable catheter;    an imaging assembly carried by the catheter, the imaging assembly configured to obtain, while blood is disposed in the chamber, an image of a tissue surface within the chamber;    a computer-control led guidance assembly coupled to the catheter so as to move the imaging assembly in response to drive signals;    a tracking system transmitting position feedback signals in response to movement of the imaging assembly; and    a processor coupled to the computer-controlled guidance assembly and the tracking system, the processor configured to transmits the drive signals using the position feedback signals.    
     
     
         12 . A tissue treatment system, comprising: 
 a barrier or membrane having a first low-profile configuration and a second expanded, configuration defining an open area therein;    an articulatable catheter upon which the membrane projects distally; and    at least one magnetic element positioned within or along the barrier or membrane.    
     
     
         13 . The system of  claim 12  wherein the barrier or membrane is configured in a conical shape.  
     
     
         14 . The system of  claim 12  further comprising an imaging element positioned within or along the barrier or membrane such that tissue adjacent to the open area is able to be visualized via the imaging element.  
     
     
         15 . The system of  claim 12  wherein the open area is in communication with a fluid lumen defined through the catheter, and further comprising a fluid, reservoir fluidly coupled to the barrier or membrane via the fluid lumen.  
     
     
         16 . The system of  claim 12  wherein the at least one magnetic element comprises a magnetic ring positioned circumferentially about a lip of the barrier or membrane.  
     
     
         17 . The system of  claim 12  wherein the at least, one magnetic element comprises one or more coils positioned about one or more respective support struts extending along the barrier or membrane.  
     
     
         18 . The system of  claim 12  wherein the at least one magnetic element comprises a magnetic disc positioned upon, a support member extending through the barrier or membrane.  
     
     
         19 . The system of  claim 12  further comprising at least two external magnets positioned in proximity to a patient body and independently moveable, wherein movement by the at least two external magnets relative to the patient body results in a corresponding movement by the at least one magnetic element within the patient body.  
     
     
         20 . The system of  claim 12  further comprising at least two ultrasonic transducers positioned along the barrier or membrane and a third ultrasonic transducer positioned proximal to the barrier or membrane.  
     
     
         21 . The system of  claim 20  further comprising an external plate assembly having at least three ultrasonic transducers positioned over the plate assembly at known distances relative to one another.  
     
     
         22 . The system of  claim 21  further comprising an electromagnetic element moveable over the plate assembly, whereby movement by the electromagnetic element relative to the patient body results in a corresponding movement by the at least one magnetic element within the patient body.  
     
     
         23 . A computer assisted method of treating a tissue surface region within a chamber of a heart, comprising: 
 positioning a distal portion of a catheter within the chamber, the catheter coupled to a computer-controlled guidance assembly;    locally displacing blood with a transparent fluid from an open area disposed within a portion of the chamber, the open area disposed adjacent the tissue region;    visualizing, on a display, the tissue region within the open area as imaged through the transparent fluid, and    articulating the catheter with the computer-controlled guidance assembly so that movement of the catheter within the chamber is registered, with the tissue surface region shown on the display.    
     
     
         24 . The method of  claim 23  wherein positioning comprises advancing the barrier or membrane into a left atrial chamber of a heart.  
     
     
         25 . The method of  claim 23  wherein positioning comprises deploying the barrier or membrane from a low-profile delivery configuration into an expanded deployed configuration.  
     
     
         26 . The method of  claim 23  wherein positioning comprises stabilizing a position of the barrier or membrane relative to the tissue region.  
     
     
         27 . The method of  claim 23  wherein displacing an opaque fluid comprises infusing the transparent fluid into the open area through a fluid delivery lumen defined through the catheter.  
     
     
         28 . The method of  claim 27  wherein infusing the transparent fluid comprises pumping saline, plasma, water, or perfluorinated liquid into the open area such that blood is displaced from therefrom.  
     
     
         29 . The method of  claim 23  wherein positioning comprises rotating one or more drive assemblies coupled to a distal end of the catheter via a respective pullwire.  
     
     
         30 . The method of  claim 29  wherein rotation of the drive assemblies in a first rotational direction urges the catheter to deflect in a first direction and rotation of the member in a second rotational direction opposite to the first rotational direction urges the catheter to deflect in a second direction opposite to the first direction.