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Mapping catheter as well as mapping catheter apparatus and associated methodMapping catheter as well as mapping catheter apparatus and associated method description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20070179378, Mapping catheter as well as mapping catheter apparatus and associated method. Brief Patent Description - Full Patent Description - Patent Application Claims
CROSS REFERENCE TO RELATED APPLICATIONS [0001]This application claims priority of German application No. 10 2006 001 849.4 filed Jan. 13, 2006, which is incorporated by reference herein in its entirety. FIELD OF THE INVENTION [0002]The invention relates to a mapping catheter for determination of data of an area of an organ embodied as a flat surface, especially of the heart, able to be presented as graphical data, as well as to an associated apparatus and an associated method. BACKGROUND OF THE INVENTION [0003]Mapping catheters are known from electrophysiological applications in which catheters are used to generate images, with which for example voltages or excitations in tissue are recorded, and these values are used for a later visualization. Examples of electrophysiological processes are for example high-frequency ablation procedures, in which lesions are created with the aid of an ablation catheter for example in the endocard or in the epicard of the heart, to remove pathological excitation centers or conduction centers and thereby to treat arrhythmias. [0004]In addition a reduced perfusion of anatomical areas in the heart, but also in other organs, can give rise to cicatricial tissue which in the area of the heart muscle for example can lead to pathological conduction centers which can trigger arrhythmias of the heart chamber, known as atrial fibrillation. [0005]Catheters are also used in other areas of visualization processes, delivering data from which images can be created, with this being done for example under the direction of a technician or a scientist. As a result the images can be used to make decisions relating to diagnoses or treatment techniques. [0006]An x-ray imaging process is currently undertaken to visualize an ablation catheter for example, but this does not result in a sufficiently good visualization in respect to the anatomy of the heart for example. In addition electroanatomical imaging systems are used to represent data relating to the position or orientation of the catheter together with voltage or excitation images. If necessary overlaying techniques are used to represent the morphology together with the electroanatomical data or the catheter. [0007]The images available to date however only provide restricted information, in which anatomical structures and changes of a pathological nature or changes caused by previous treatments and such like can only be seen inadequately or cannot be seen at all. SUMMARY OF THE INVENTION [0008]The underlying object of the invention is thus to provide a mapping catheter improved in this respect as well as a mapping catheter apparatus and an associated method. [0009]To achieve this object the invention makes provision, with a mapping catheter of the type stated at the beginning, in the distal area of the mapping catheter provided for introduction into the organ, for at least one thermosensor for determining temperature-related data to be arranged at a tip of the mapping catheter essentially aligned in the direction of the longitudinal axis of the mapping catheter. [0010]The catheter thus features, in the direction in which it is guided, meaning the axial direction, a temperature or thermosensor pointing forwards, with which temperature-related data can be determined, which thus senses a change or generates measurement data depending on the ambient temperature or the thermal conditions of the environment of a tissue or material touched by the thermosensor. The thermosensor is essentially aligned in the direction of the longitudinal axis of the catheter, i.e. in an axial direction, with an arrangement in parallel to the longitudinal axis, if necessary at a certain distance from it, also being recorded. The tip of the catheter can if necessary be embodied flat for this purpose, so that if necessary a number of sensors, pointing forwards in each case, are accommodated on it. [0011]The basic idea of using thermosensors is that areas of the organ through which blood flows less strongly, for example endocard or epicard areas with a lower blood flow, have a lower temperature than normal areas with a strong blood flow. A reduced blood flow can be caused for example by changes in the anatomy such as for example lesions after ablations or through cicatricial tissue for example after a myocardial infarction. This means that a better visualization of anatomical or pathological peculiarities, which have a role to play especially in electrophysiological treatments, is possible. [0012]In addition the invention relates to a mapping catheter for determining data able to be presented as images of an area of an organ embodied as a flat surface, the outstanding feature of which is that in the distal area of the mapping catheter, provided for introduction into the organ, at least one element which can be folded out into a gird-like structure is provided, on which at least one thermosensor is arranged for determination of temperature-related data. This mapping catheter thus likewise features one or more thermosensors, which, depending on the ambient temperature or the temperature of tissue touched by the catheter, can sense changes or record and forward data. These thermosensors are accommodated on a grid-like structure which is embodied for example in the form of a net or mesh, if necessary made of a metallic material or of wire. [0013]The grid-like structure expediently has the characteristic of enabling blood to pass through it so that the flow of blood in the area of the organ, which in particular can be a hollow organ, is not adversely affected. The structure involved is thus one which allows material to pass through it, in which sensors are arranged at the points of the grid for example. [0014]Naturally the thermosensors of the grid-like structure can also be aligned in an axial direction pointing forwards. Likewise it is possible for thermosensors to be provided on a grid-type structure in addition to one or more thermosensors at the tip of the mapping catheter, as described above. [0015]In accordance with the invention at least one grid-type structure can be embodied in the unfolded state as an open surface, especially as a screen-type surface, or as a closed surface, especially as a balloon-type surface. Thus for example a wire mesh can be folded out into a screen-type structure, on which thermosensors are arranged over a specific area in order to detect temperature data over a larger surface or at a number of points of the endocard for example. In addition it is possible for the grid or the mesh to be unfolded into a closed form similar to a balloon, in order in this way to achieve contact with the surrounding tissues such as the endocard all the way round. [0016]A number of thermosensors can be arranged in the distal area of the mapping catheter, which, in the unfolded state if necessary, are aligned at least partly in different directions. Examples which can be mentioned are arrangements of around 5 to 100 sensors for example such that a catheter tip which is embodied as a flat surface features up to 10 sensors or a grid-type structure is equipped at various grid points with around 10 sensors which can measure the ambient temperature or the tissue temperature. Alignment in different directions, i.e. not necessarily in the direction of the movement of the catheter, enables the structure of the organ to be understood or covered. [0017]The thermosensors can be aligned at least partly essentially radially and/or diagonally to the longitudinal axis of the mapping catheter. Wall structures, of vessels or tubular organs for example, can be recorded by radially-aligned thermosensors, whereby with an arrangement on grid-type meshes, the inner area of larger hollow organs can also be covered by thermosensors. For this purpose a diagonal alignment of the sensors may be required if the shape of the organ deviates from an essentially cylindrical form, for example for recording the temperatures of the atria or of the ventricles of the heart. [0018]The thermosensor or thermosensors can be aligned to place it or them on the area of the organ embodied as a flat surface. Thus with at least one sensor, as a rule with a plurality of sensors, the temperature can be determined directly on the surface of the organ. If a number of sensors are on the surface of the organ simultaneously, the sensors, where necessary using suitable signal lines, can deliver temperature data of different organ areas at the same times, which can subsequently be compared to each other in order to detect differences. Direct application to the internal area or external area of the organ prevents measurement errors, caused by surrounding blood for example. [0019]In addition the mapping catheter can feature means for, especially local, cooling and/or heating of at least one part of the area of an organ embodied as a flat surface, preferably in the area of at least one thermosensor. With the means for cooling down or heating-up of tissue or of a local area of tissue it is possible to not only measure absolute differences in temperature but to focus on the temperature changes after a cooling down or heating up which expediently is undertaken for this purpose in the area of the thermosensor or thermosensors. Thus, as regards the even temperature environment, it is easier to make possible an exact distinction between the temperatures or the temperature differences. [0020]In accordance with the invention the means can comprise at least one cooling element, especially a Peltier element, and/or at least one heating element, especially a heating coil and/or a lumen for injecting a cold and/or hot liquid, especially a saline solution. 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