Assessment of electrode coupling for tissue ablation

• US 10,182,860 B2
• Filed: 02/02/2016
• Issued: 01/22/2019
• Est. Priority Date: 12/06/2005
• Status: Active Grant

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Inventors: Paul, Saurav, Cao, Hong, Belhe, Kedar R., Thao, Riki
• Primary Examiner(s): Della, Jaymi
• Application Number:
  US15/013,065
• Publication Number:
  US 20160220298A1
• Time in Patent Office: 1,085 Days
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00732 Frequency
• CPC Class Codes: A61B 2018/00869 Phase
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/128 generating two or more frequencies
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter

Abstract

An electrode catheter and a method for assessing electrode-tissue contact and coupling are disclosed. An exemplary electrode catheter comprises an electrode adapted to apply electrical energy. A measurement circuit is adapted to measure impedance between the electrode and ground as the electrode approaches a target tissue. A processor determines a contact and coupling condition for the target tissue based at least in part on reactance of the impedance measured by the measurement circuit. In another exemplary embodiment, the electrode catheter determines the contact and coupling condition based at least in part on a phase angle of the impedance.

Claims

1. A medical system comprising

a first electrical power source configured to provide a first electrical signal to an ablation catheter having an ablation electrode;

and

a first coupling assessment module, wherein said first coupling assessment module is configured to assess a first coupling between the ablation catheter and a target tissue targeted by said ablation electrode, and wherein said first coupling assessment module uses said first electrical signal to assess said first coupling;

a second electrical power source configured to provide a second electrical signal to said ablation catheter; and

a second coupling assessment module, wherein said second coupling assessment module is configured to assess a second coupling between the ablation catheter and the target tissue, and wherein said second coupling assessment module uses said second electrical signal to assess said second coupling.

2. The system of claim 1, wherein at least one of said first and second coupling assessment systems are configured to measure an impedance related value between the ablation electrode and the target tissue.

3. The system of claim 1, further comprising;

a switch operable to connect the ablation electrode with said first electrical power source in a first switch position, and operable to connect the ablation electrode with said second electrical power source in a second switch position.

4. The system of claim 3, wherein said second electrical signal is of a different magnitude than said first electrical signal, and wherein a frequency of said first and second electrical signals are substantially equal.

5. The system of claim 1, further comprising:

a processor configured to process said first coupling and said second coupling in relation to at least one set of predetermined benchmark values to determine a current level of ablation energy level passing between the ablation electrode and the target tissue and categorize said current level of ablation energy as being in at least a range of insufficient ablation energy for lesion formation and a range of elevated ablation energy for lesion formation.

6. The system of claim 5, further comprising:

an output module configured to generate an output signal for receipt by an output device, upon said current level of ablation energy being categorized in one of said range of insufficient ablation energy and said range of elevated ablation energy.

7. The system of claim 1, wherein said first and second coupling assessment modules are of an identical configuration.

8. The system of claim 1, wherein said first coupling assessment module is available for assessing said coupling during an ablation procedure, and wherein said second electrode coupling assessment module is available for assessing said coupling only other than during execution of said ablation procedure.

9. The system of claim 1, wherein said first coupling assessment module is configured to assess an electrical coupling condition indicative of electrical energy passing between the ablation electrode and the target tissue.

10. The system of claim 9, wherein said second electrode coupling assessment module is configured to assess a mechanical coupling condition indicative of physical contact between the ablation electrode and the target tissue.

11. A medical system, comprising:

guidance instrumentation for guiding an ablation electrode of an electrode catheter relative to target tissue of a patient;

a first coupling assessment system configured to assess a first coupling condition between the ablation electrode and the target tissue and generate a first coupling output;

a second coupling assessment system configured to assess a second coupling condition between the ablation electrode and the target tissue and generate a second coupling output;

a processor configured to process said first and second coupling outputs and categorize a level of coupling between the ablation electrode and the target tissue as being one of insufficient for lesion formation, sufficient for lesion formation and elevated for lesion formation; and

an output associated with said guidance instrumentation for outputting said level of coupling between said ablation electrode and the target tissue.

12. The system of claim 11, wherein said first electrode coupling assessment system is configured to assess an electrical coupling condition indicative of electrical energy passing between the ablation electrode and the target tissue.

13. The system of claim 12, wherein said second electrode coupling assessment system is configured to assess a mechanical coupling condition indicative of physical contact between the ablation electrode and the target tissue.

14. The system of claim 11, wherein at least one of said first and second electrode coupling assessment systems is configured to measure an impedance related value between the ablation electrode and the target tissue.

15. A method for performing a medical procedure, comprising:

providing first and second electrical signals to an ablation electrode of an ablation catheter positioned relative to a target tissue;

using a first coupling assessment module, generating an first output indicative of a first coupling condition between the ablation electrode of the ablation catheter and the target tissue based on the first electrical signal;

using a second coupling assessment module, generating a second output indicative of a second coupling condition between the ablation electrode of the ablation catheter and the target tissue based on the second electrical signal;

processing the first and second outputs to identify a level of coupling between the ablation electrode of the ablation catheter and the target tissue; and

outputting an indication of the level of coupling between the ablation electrode and the target tissue.

16. The method of claim 15, wherein processing the first and second outputs further comprises categorizing the level of coupling between the ablation electrode and the target tissue as being one of insufficient for lesion formation, sufficient for lesion formation and elevated for lesion formation.

17. The method of claim 16, wherein processing the first and second outputs further comprises processing said first and second outputs in relation to at least one set of predetermined benchmark values to determine the level of coupling between the ablation electrode and the target tissue.

18. The method of claim 15, wherein using the first coupling assessment module or using the second coupling assessment module comprises measuring an impedance related value between the ablation electrode and the target tissue.

19. The method of claim 15, wherein generating the first output comprises generating an output indicative of electrical energy passing between the ablation electrode and the target tissue.

20. The method of claim 19, wherein generating the second output comprises generating an output indicative of physical contact between the ablation electrode and the target tissue.