Prolapse detection and tool dislodgement detection

Abstract

A tool dislodgement detection apparatus includes an MPS outputting position and orientation (P&O) readings for determining tool motion. A control generates an alarm based on the tool motion and dislodgement criteria. The criteria includes whether the tool motion meets a condition based on the type of medical procedure or tool, the tool parking position, a patient characteristic (e.g., age, weight, gender) or a physician preference. The criteria includes when the correlation between the tool motion and the cardiac, respiration and patient motion changes abruptly. In a prolapse detection apparatus, guidewire tip P&O readings determine a tip motion vector. The control generates an alarm using the motion vector and predetermined criteria. The criteria include a substantial change in the tip orientation not accompanied by a corresponding position change and a change in the motion vector by about 180° accompanied by a corresponding position change no greater than a threshold.

1 .- 8 . (canceled) 
     
     
         9 . An apparatus for detecting a prolapse condition of a guidewire from a desired position, comprising:
 a localization system configured to output a position and orientation (P&O) reading indicative of the P&O of a distal tip of the guidewire in a coordinate system; and   a control configured to determine a motion vector of said tip based on a plurality of said P&O readings, said control being further configured to generate an alarm signal indicative of a prolapse condition in accordance with at least said motion vector and predetermined criteria.   
     
     
         10 . The apparatus of  claim 9  wherein said predetermined criteria includes a change in the orientation of said tip exceeding a predetermined minimum threshold that is not accompanied by a corresponding change in the position of said tip. 
     
     
         11 . The apparatus of  claim 9  wherein said predetermined criteria includes a change in the motion vector by substantially one-hundred and eighty degrees accompanied by a corresponding change in position no greater than a predetermined threshold. 
     
     
         12 . The apparatus of  claim 11  wherein said control is configured to determine said predetermined threshold based on an image or an electroanatomical model of a region of interest (ROI). 
     
     
         13 . The apparatus of  claim 12  wherein said image is a fluoroscopic image. 
     
     
         14 . The apparatus of  claim 11  wherein said guidewire is configured to travel through a bodily lumen of the patient wherein the lumen has a determined diameter, said predetermined threshold corresponding to the same order of magnitude as said determined diameter. 
     
     
         15 . The apparatus of  claim 9  wherein said guidewire includes a first location sensor disposed in a distal section and configured to be coupled to said localization system for producing said plurality of P&O readings, said apparatus further including a proximal motion detecting device configured to detect at least one characteristic of the motion of the proximal end of said guidewire. 
     
     
         16 . The apparatus of  claim 15  wherein said predetermined prolapse detection criteria includes determining whether a first amount of advancement of the guidewire at the proximal end corresponds to a second amount of advancement of the guidewire at the distal end. 
     
     
         17 . The apparatus of  claim 15  wherein said proximal motion detecting device comprises a detector disposed at a proximal hub of said apparatus configured to optically detect the motion of the proximal end of said guidewire. 
     
     
         18 . The apparatus of  claim 9  wherein said guidewire includes a first location sensor disposed in a distal section and configured to be coupled to said localization system for producing said plurality of P&O readings, said apparatus further including a second location sensor disposed at the proximal end of said guidewire configured to detect at least one characteristic of the motion of the proximal end of said guidewire. 
     
     
         19 . The apparatus of  claim 18  wherein said predetermined prolapse detection criteria includes determining when a P&O difference between said first location sensor and said second location sensor is below a predetermined value. 
     
     
         20 . The apparatus of  claim 9  wherein said alarm signal comprises one of a visual indication, an audible indication, a tactile indication and a combination of one or more of the foregoing. 
     
     
         21 . The apparatus of  claim 9  wherein said guidewire includes a first location sensor disposed in a distal section configured to be coupled to said localization system, said localization system being configured to sample at periodic intervals an output of said location sensor for producing said plurality of P&O readings.