Methods for imaging and ablating body tissue

• US 10,154,831 B2
• Filed: 08/04/2017
• Issued: 12/18/2018
• Est. Priority Date: 11/17/2008
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: VytronUS, Inc. (Johnson & Johnson)
• Inventors: Thapliyal, Hira V., Gallup, David A., Arenson, James W., Mohr, III, John Paul, Proulx, Tim, Brommer, Robert A.
• Primary Examiner(s): Smith, Ruth S
• Application Number:
  US15/669,675
• Publication Number:
  US 20170354397A1
• Time in Patent Office: 501 Days
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 Details of catheter construction
• CPC Class Codes: A61B 8/4494 characterised by the arrangement of the transducer elements devices for short-range imaging using particular transducer elements arrangements under G01S15/8909; arrangements of transducers in generation of mechanical vibrations of infrasonic, sonic or ultrasonic frequency B06B1/0607
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

A method for creating a transmural lesion in tissue includes positioning a distal portion of a catheter near the tissue, where an ultrasound transducer is attached to the distal portion and is operatively coupled to a console and processor. The tissue is imaged by energizing the ultrasound transducer at a first power level to produce an ultrasound beam, where the imaging determines a thickness of the tissue, and a gap distance between the ultrasound transducer and the tissue. The tissue is ablated by energizing the ultrasound transducer at a second power level to produce the ultrasound beam. Energy delivered to the tissue during the ablating is controlled, using the processor, where the processor adjusts a speed of the ultrasound beam moving across the tissue based on the thickness and gap distance, to create the transmural lesion.

Claims

1. A method for creating a transmural lesion in tissue, the method comprising:

positioning a distal portion of a catheter near the tissue, wherein an ultrasound transducer is attached to the distal portion and is operatively coupled to a console and processor;

imaging the tissue by energizing the ultrasound transducer at a first power level to produce an ultrasound beam, wherein the imaging determines a thickness of the tissue, and a gap distance between the ultrasound transducer and the tissue;

ablating the tissue by energizing the ultrasound transducer at a second power level to produce the ultrasound beam; and

controlling energy delivered to the tissue during the ablating, using the processor, wherein the processor adjusts a speed of the ultrasound beam moving across the tissue based on the thickness and gap distance, to create the transmural lesion.

2. The method of claim 1, wherein the ultrasound transducer is energized at a first frequency level during the imaging and a second frequency level while ablating.

3. The method of claim 1, wherein there is no direct contact between the ultrasound transducer and the tissue during imaging or the ablating.

4. The method of claim 1, wherein the transmural lesion has a tear drop shape.

5. The method of claim 1, wherein during the ablating, the transmural lesion is created while an outer layer of tissue remains substantially undamaged.

6. The method of claim 1, wherein during the ablating, the transmural lesion is created while an endocardial surface of the tissue remains uncharred.

7. The method of claim 1, wherein the ultrasound transducer comprises a single, flat transducer element.

8. The method of claim 7, wherein the ultrasound transducer comprises an inactive portion surrounded by an active portion.

9. The method of claim 7, wherein a heat sink is attached to the ultrasound transducer.

10. The method of claim 7, wherein a matching layer is coupled to the ultrasound transducer.

11. The method of claim 1, wherein the processor further adjusts a catheter position to maintain a preferred value for the gap distance during the ablating.

12. The method of claim 1, wherein the processor further adjusts a catheter position to achieve a preset depth for the transmural lesion.

13. The method of claim 1, wherein the processor indicates to an operator to reposition the catheter for the ablating.

14. The method of claim 1, further comprising supplying a cooling fluid in fluid communication with the ultrasound transducer.

15. The method of claim 14, wherein a temperature sensor is coupled to the ultrasound transducer for monitoring temperature of the ultrasound transducer.

16. The method of claim 14, wherein the processor controls flow of the cooling fluid to maintain a temperature of the ultrasound transducer within a desired operating range.

17. The method of claim 14, wherein the processor controls flow of the cooling fluid based on detected characteristics of the tissue.

18. The method of claim 1, wherein the processor, based on the thickness and the gap distance, controls the ultrasound beam by modifying an electrical signal sent to the ultrasound transducer.

19. The method of claim 1, wherein the processor uses the speed, the energy delivered, and a beamwidth of the ultrasound beam to deliver a desired energy density to the tissue.

20. The method of claim 1, wherein the imaging further comprises determining an incident beam angle, and the incident beam angle is used to determine the speed of the ultrasound beam during ablation.

21. The method of claim 1, wherein the second power level is different from the first power level.