Systems and methods for conducting electrophysiological testing using high-voltage energy pulses to stun tissue

• US 20010012918A1
• Filed: 02/28/2001
• Published: 08/09/2001
• Est. Priority Date: 07/28/1995
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: David K. Swanson
• Inventors: Swanson, David K.
• Granted Patent: US 6,421,556 B2
• Time in Patent Office: Days
• US Class Current: 600/510
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• 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 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2018/00041 Heating, e.g. defrosting
• CPC Class Codes: A61B 2018/00065 porous
• CPC Class Codes: A61B 2018/00107 Coatings on the energy applicator
• CPC Class Codes: A61B 2018/00136 with polymer
• CPC Class Codes: A61B 2018/00148 with metal
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/1286 having a specific transformer
• CPC Class Codes: A61B 2018/1465 Deformable electrodes
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2562/0215 Silver or silver chloride containing
• CPC Class Codes: A61B 2562/043 : in a linear array
• CPC Class Codes: A61B 2562/046 : in a matrix array
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6853 : with a balloon
• CPC Class Codes: A61B 5/6855 : with a distal curved tip
• CPC Class Codes: A61B 5/6856 : with a distal loop
• CPC Class Codes: A61B 5/6858 : with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/6859 : with multiple distal splines
• CPC Class Codes: A61N 1/36185 : Selection of the electrode configuration
• CPC Class Codes: A61N 1/3622 : comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3686 : configured for selecting the electrode configuration on a lead A61N1/3688 takes precedence
• CPC Class Codes: A61N 1/3702 : Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

Systems and methods for diagnosing and treating tissue transmit an electrical energy pulse that temporarily stuns a zone of tissue, temporarily rendering it electrically unresponsive. The systems and methods sense an electrophysiological effect due to the transmitted pulse. The systems and methods alter an electrophysiological property of tissue in or near the zone based, at least in part, upon the sensed electrophysiological effect. The alteration of the electrophysiological property can be accomplished, for example, by tissue ablation or by the administration of medication. In a preferred implementation, radio frequency energy is used to both temporarily stun tissue and to ablate tissue through a common electrode.

Claims

1. An electrophysiological method, comprising the steps of:

transmitting an electrical energy pulse that temporarily renders a zone of tissue electrically unresponsive for at least one second; and

sensing an electrophysiological effect due to the transmitted pulse.

2. A method as claimed in

claim 1

, further comprising the step of:

altering an electrophysiological property of the tissue in or near the zone based, at least in part, upon the sensed electrophysiological effect.

3. A method as claimed in

claim 2

, wherein the step of altering an electrophysiological property comprises ablating the tissue in or near the zone.

4. A method as claimed in

claim 3

, wherein the step of ablating tissue comprises applying electrical energy to the tissue in or near the zone.

5. A method as claimed in

claim 1

, wherein the transmitted electrical energy pulse comprises a radio frequency energy waveform.

6. A method as claimed in

claim 1

, further comprising the step of:

modifying the tissue in or near the zone based, at least in part, upon the sensed electrophysiological effect.

7. A method as claimed in

claim 1

, wherein the zone comprises an elongate continuous zone.

8. A method as claimed in

claim 1

, wherein the transmitted electrical energy pulse comprises a plurality of electrical energy pulses transmitted at spaced locations.

16. A method as claimed in

claim 1

, wherein the transmitted electrical energy pulse comprises a plurality of electrical energy pulses transmitted at spaced locations.

9. An electrophysiological method, comprising the steps of;

sensing at least one electrical event in a region of tissue;

transmitting into an area of the region an electrical energy pulse that temporarily renders tissue in the area electrically unresponsive for at least one second; and

sensing a change in the electrical event while the tissue in the area is electrically unresponsive.

10. A method as claimed in

claim 9

, further comprising the step of;

altering an electrophysiological property of the tissue in or near the area based, at least in part, upon the sensed electrophysiological effect.

11. A method as claimed in

claim 10

, wherein the step of altering an electrophysiological property comprises ablating the tissue in or near the area.

12. A method as claimed in

claim 11

, wherein the step of ablating tissue comprises applying electrical energy to the tissue in or near the area.

13. A method as claimed in

claim 9

, wherein the transmitted electrical energy pulse comprises a radio frequency energy waveform.

14. A method as claimed in

claim 9

, further comprising the step of:

modifying the tissue in or near the zone based, at least in part, upon the sensed electrophysiological effect.

15. A method as claimed in

claim 9

, wherein the area comprises an elongate continuous area.

17. An electrophysiological system, comprising

an energy transmission device;

and

an energy source, coupled to the energy transmission device, adapted to transmit an energy pulse through the energy transmission device that temporarily renders a zone of tissue electrically unresponsive for at least one second.

18. A system as claimed in

claim 17

, further comprising:

a sensing device adapted to sense an electrophysiological effect due to the transmitted pulse.

19. A system as claimed in

claim 17

, wherein the energy source is adapted to transmit energy through the energy transmission device that alters an electrophysiological property of the tissue in or near the zone.

20. A system as claimed in

claim 17

, wherein the energy pulse comprises an electrical energy pulse.

21. A system as claimed in

claim 17

, wherein the energy pulse comprises a frequency energy waveform.

22. A system as claimed in

claim 17

, wherein the energy transmission device comprises an electrode.

23. A system as claimed in

claim 17

, wherein the energy transmission device comprises a plurality of spaced electrodes.

24. A system as claimed in

claim 23

, wherein the plurality of electrodes define spacing therebetween such that the zone of electrically unresponsive tissue is a continuous zone that spans the area between the electrodes.

25. A system as claimed in

claim 24

, wherein the energy pulse comprises a plurality of energy pulse transmitted sequentially through respective electrodes in the plurality of spaced electrodes.

26. A system as claimed in

claim 17

, wherein the energy transmission device comprises a porous electrode.

27. A system as claimed in

claim 17

, further comprising:

a relatively short shaft defining a distal end and a proximal end, the distal end supporting the energy transmission device;

a handle associated with the proximal end of the relatively short shaft.

28. A system as claimed in

claim 26

, wherein the relatively short shaft is malleable.