Esophageal monitoring
An esophageal monitoring device includes a camera and, optionally, one or more lights to enable visualization of an interior of a subject's esophagus. Visualization of the interior of the subject's esophagus before and after a left atrial ablation procedure may enable a healthcare provider to determine whether or not the left atrial ablation procedure has damaged the subject's esophagus before the subject experiences any symptoms of such damage. An esophageal monitoring device may also include sensors and/or markers that enable a determination of its location within a subject's esophagus. Such an esophageal monitoring device may be configured for three-dimensional mapping, and enable the generation of an accurate three-dimensional map of the physical relationship between a subject's esophagus and the left atrium of his or her heart. Methods of monitoring a subject's esophagus while a left atrial ablation procedure is being conducted on the subject's heart are also disclosed.
1. A system for monitoring a condition of an esophagus during a left atrial ablation procedure, comprising:
an esophageal monitoring device that monitors a condition of the esophagus during the left atrial ablation procedure, including:
a proximal element;
a monitoring element at a distal end of the proximal element, the monitoring element comprising at least one elongated element carrying a plurality of sensors and deployable to position all sensors of the monitoring element in a substantially two-dimensional arrangement across an area occupied by at least a portion of the monitoring element, the monitoring element having a shape that positions the plurality of sensors against an inner surface of the esophagus during the left atrial ablation procedure; and
a photoimaging device that enables visualization of a surface adjacent to the esophageal monitoring device, entirely around an inner surface of the esophagus at a location adjacent to the photoimaging device, following the left atrial ablation procedure, the photoimaging device being affixed at or adjacent to a distal end of the at least one elongated element of the monitoring element; and
an insertion component comprising a lumen and having:
a retracted arrangement with the monitoring element residing within the lumen and the photoimaging device located at or just outside of a distal end of the insertion component;
a deployed arrangement with the monitoring element and the photoimaging device extended distally beyond the distal end of the insertion component.
2. The system of claim 1 , wherein the plurality of sensors comprises a plurality of temperature sensors.
3. The system of claim 2 , wherein the plurality of sensors further comprises a plurality of pressure sensors or force sensors.
4. The system of claim 1 , wherein the monitoring element comprises a plurality of parallel branches, each branch of the plurality of parallel branches of the monitoring element carrying a plurality of sensors, the plurality of sensors of the plurality of parallel branches of the monitoring element comprising the plurality of sensors in the substantially two-dimensional arrangement across the area occupied by the monitoring element.
5. The system of claim 4 , wherein the plurality of parallel branches of the monitoring element are capable of being folded upon one another to facilitate insertion of the monitoring element into the esophagus and removal of the monitoring element from the esophagus.
6. The system of claim 1 , wherein the esophageal monitoring device further includes:
a light source oriented to illuminate the inner surface of the esophagus.
7. The system of claim 6 , wherein the light source is configured to emit at least one wavelength of electromagnetic radiation that will reveal trauma to the inner surface of the esophagus not revealed by illumination of the inner surface of the esophagus with white light.
8. The system of claim 1 , further comprising:
a position reference monitor capable of determining a distance the esophageal monitoring device has been inserted into the esophagus.
9. The system of claim 8 , wherein the esophageal monitoring device further includes:
a plurality of distance markers positioned at fixed distances along a length of the proximal element of the esophageal monitoring device.
10. The system of claim 9 , wherein distance markers of the plurality of distance markers are positioned at 5 mm intervals along the length of the proximal element of the esophageal monitoring device.
11. The system of claim 9 , wherein the position reference monitor is capable of:
detecting a distance marker of the plurality of distance markers on the proximal element as the distance marker passes the position reference monitor; and
causing the photoimaging device to obtain and/or mark an image upon detecting the distance marker.