Ablation Catheters with Multiple Endoscopes and Imaging Chip Endoscopes and System for Altering an Orientation of an Endoscopic Image

Abstract

An ablation catheter for performing a treatment under direct visualization of a region to be treated includes a catheter body and an energy emitter that is movable relative to the catheter body. The ablation catheter includes first and second imaging devices for providing direct visualization of the region to be treated, with the first imaging device being fixed relative to the catheter body. The first and second imaging devices can be in the form of first and second imaging chip endoscopes.

What is claimed is: 
     
         1 . An ablation catheter for performing a treatment under direct visualization of a region to be treated comprising:
 a catheter body;   an energy emitter that is movable relative to the catheter body; and   first and second imaging devices for providing direct visualization of the region to be treated, the first imaging device being fixed relative to the catheter body.   
     
     
         2 . The ablation catheter of  claim 1 , wherein the first imaging device comprises a first imaging chip endoscope and the second imaging device comprises a second imaging chip endoscope. 
     
     
         3 . The ablation catheter of  claim 1 , wherein the region to be treated comprises an ostium of a pulmonary vein. 
     
     
         4 . The ablation catheter of  claim 1 , wherein the first imaging device is axially offset from the second imaging device. 
     
     
         5 . The ablation catheter of  claim 2 , wherein the first imaging chip endoscope comprises a forward-facing endoscope and the second imaging chip endoscope comprises a side-facing endoscope. 
     
     
         6 . The ablation catheter of  claim 5 , wherein the first imaging chip endoscope has a first field of view between 90 degrees and 130 degrees and the second imaging chip endoscope has a second field of view between 60 degrees and 130 degrees. 
     
     
         7 . The ablation catheter of  claim 5 , further including an aiming beam for selectively illuminating the region to be treated, the second imaging chip endoscope providing a view of the aiming beam, the tissue the aiming beam is illuminating and a surrounding tissue region, thereby allowing ablation to be performed without adjustment of the catheter body. 
     
     
         8 . The ablation catheter of  claim 1 , wherein the second imaging device is fixed relative to the catheter body and is circumferentially offset from the first imaging device. 
     
     
         9 . The ablation catheter of  claim 8 , wherein the second imaging device is oriented 180 degrees from the first imaging device. 
     
     
         10 . The ablation catheter of  claim 1 , wherein the second imaging device is fixedly coupled to the energy emitter and located distal thereto such that the second imaging device moves axially and rotationally in unison with the energy emitter. 
     
     
         11 . The ablation catheter of  claim 2 , wherein a field of view of the first imaging chip endoscope has a first blind spot area, the second imaging chip endoscope being oriented to provide a view of the first blind spot area. 
     
     
         12 . The ablation catheter of  claim 2 , wherein the second imaging chip endoscope has a field of view and the second imaging chip endoscope is positioned such that the aiming beam is in a center region of the field of view of the second imaging chip endoscope. 
     
     
         13 . The ablation catheter of  claim 2 , wherein the first imaging chip endoscope is always located behind the energy emitter and the second imaging chip endoscope is always located forward of the energy emitter. 
     
     
         14 . A computer implemented method for altering orientation of an endoscopic image received during a surgical procedure, the method comprising:
 providing, by at least one computing device configured with a graphical user interface, an image of a catheter configured with a first marker and captured during a surgical procedure, wherein the catheter is in a respective orientation;   providing, by the at least one computing device via the graphical user interface, a second marker that corresponds to the first marker and is rotatable as a function of at least one control included in the graphical user interface, wherein the second marker appears in an orientation that is different than the catheter;   altering, by the at least one computing device in response to at least one selection received in the graphical user interface, the orientation of the second marker to match the orientation of the catheter;   automatically providing, by the at least one computing device via the graphical user interface in response to the altered orientation of the second marker, a first shape that represents at least an obstructed portion of the endoscopic image, wherein the first shape is in a respective orientation;   providing, by the at least one computing device via the graphical user interface, a representation of a second shape that is rotatable as a function of at least one control included in the graphical user interface, wherein the second shape appears in an orientation that is different than the first shape;   altering, by the at least one computing device in response to at least one selection received in the graphical user interface, the orientation of the second shape to match the orientation of the first shape; and   altering, as a function of the altered orientation of the second shape, orientation of the endoscopic image provided on a display device.   
     
     
         15 . The method of  claim 14 , wherein at least one of the first and second markers is an asymmetric marker and at least one of the first and second shapes is a pie-shape wedge. 
     
     
         16 . The method of  claim 14 , wherein altering the orientation of at least one of the second marker and the second shape includes rotation. 
     
     
         17 . The method of  claim 14 , wherein altering the orientation of the endoscopic includes rotating the image to place at least one aspect at a respective position. 
     
     
         18 . The method of  claim 17 , wherein the at least one aspect is the superior aspect and the respective position is the 12 o'clock position. 
     
     
         19 . The method of  claim 14 , wherein the image of the catheter is received from a fluoroscopy device. 
     
     
         20 . The method of  claim 14 , wherein the at least one control is a graphical knob, graphical button, and graphical menu option. 
     
     
         21 . A computer implemented system for altering orientation of an endoscopic image received during a surgical procedure, the system comprising:
 at least one computing device that is configured with one or more instructions that, when executed, cause the at least one computing device to:   provide, via a graphical user interface, an image of a catheter configured with a first marker and captured during a surgical procedure, wherein the catheter is in a respective orientation;   provide, via the graphical user interface, a second marker that corresponds to the first marker and is rotatable as a function of at least one control included in the graphical user interface, wherein the second marker appears in an orientation that is different than the catheter;   alter, in response to at least one selection received in the graphical user interface, the orientation of the second marker to match the orientation of the catheter;   automatically provide, via the graphical user interface in response to the altered orientation of the second marker, a first shape that represents at least an obstructed portion of the endoscopic image, wherein the first shape is in a respective orientation;   provide, via the graphical user interface, a representation of a second shape that is rotatable as a function of at least one control included in the graphical user interface, wherein the second shape appears in an orientation that is different than the first shape;   alter, in response to at least one selection received in the graphical user interface, the orientation of the second shape to match the orientation of the first shape; and   alter, as a function of the altered orientation of the second shape, orientation of the endoscopic image provided on a display device.   
     
     
         22 . The system of  claim 21 , wherein at least one of the first and second markers is an asymmetric marker and at least one of the first and second shapes is a pie-shape wedge. 
     
     
         23 . The system of  claim 21 , wherein altering the orientation of at least one of the second marker and the second shape includes rotation. 
     
     
         24 . The system of  claim 21 , wherein altering the orientation of the endoscopic includes rotating the image to place at least one aspect at a respective position. 
     
     
         25 . The system of  claim 24 , wherein the at least one aspect is the superior aspect and the respective position is the 12 o'clock position. 
     
     
         26 . The system of  claim 21 , wherein the image of the catheter is received from a fluoroscopy device. 
     
     
         27 . The system of  claim 21 , wherein the at least one control is a graphical knob, graphical button, and graphical menu option. 
     
     
         28 . A computer implemented method for altering orientation of an endoscopic image received during a surgical procedure, the method comprising:
 (a) providing, an image of a catheter configured with a first marker and captured during a surgical procedure, wherein the catheter is in a respective orientation, the catheter including at least one imaging device that provides the endoscopic image;   (b) altering, by an at least one computing device in response to at least one selection received in a graphical user interface, the orientation endoscopic image based on the image of the catheter and the orientation of the first marker in the image captured in step (a); and   (c) displaying the altered orientation endoscopic image on a display, the altered orientation endoscope image comprising a real-time video stream.   
     
     
         29 . The method of  claim 28 , wherein the image provided in step (a) is generated by fluoroscopy and the first marker comprises an asymmetric radiopaque marker. 
     
     
         30 . The method of  claim 28 , wherein the step (b) comprises altering the orientation endoscopic image so that a superior location of target tissue depicted within the orientation endoscopic image is positioned at a top of the altered orientation endoscopic image. 
     
     
         31 . The method of  claim 28 , wherein the orientation endoscopic images comprises a combined first real-time video stream from a first imaging device and a second real-time video stream from a second imaging device. 
     
     
         32 . The method of  claim 31 , wherein the first imaging device comprises a first imaging chip endoscope and the second imaging device comprises a second imaging chip endoscope. 
     
     
         33 . The method of  claim 31 , wherein the first imaging device is axially offset from the second imaging device. 
     
     
         34 . The system of  claim 32 , wherein the first imaging chip endoscope comprises a forward-facing endoscope and the second imaging chip endoscope comprises a side-facing endoscope. 
     
     
         35 . The method of  claim 32 , wherein the second imaging device is fixed relative to a catheter body and is circumferentially offset from the first imaging device.