Ablation catheter, system, and method of use thereof

• US 20030060821A1
• Filed: 11/01/2002
• Published: 03/27/2003
• Est. Priority Date: 04/25/2000
• Status: Abandoned Application

• Current Assignee: Bruce H. Kenknight, Gregory P. Walcott, Jeffrey A. Hall, Kay G. Neal, Wade A. Bowe
• Original Assignee: Bruce H. Kenknight, Gregory P. Walcott, Jeffrey A. Hall, Kay G. Neal, Wade A. Bowe
• Inventors: KenKnight, Bruce H., Bowe, Wade A., Hall, Jeffrey A., Walcott, Gregory P., Kay, G. Neal
• Application Number:
  US10/285,919
• Publication Number:
  US 20030060821A1
• Time in Patent Office: Days
• US Class Current: 606/41
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22068 Centering
• 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 2018/00261 arranged in a line
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00375 Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00815 measured by a thermistor
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/1435 Spiral

Abstract

A cardiac ablation apparatus for producing a circumferential ablation that electrically isolates a heart chamber wall portion from vessel such as a pulmonary vein extending into said wall portion comprises (a) an elongate centering catheter having a distal end portion; (b) an expandable centering element connected to said centering catheter distal end portion and configured for positioning within said vessel when in a retracted configuration, and for securing said elongate centering catheter in a substantially axially aligned position with respect to said vessel when said centering element is in an expanded configuration; (c) an ablation catheter slidably connected to said centering catheter said ablation element having a distal end portion, and (d) an expandable ablation element connected to said ablation catheter distal end portion. The ablation element is configured to form a circumferential ablation on the wall around the elongate centering catheter when the centering catheter is axially aligned with respect to the vessel. In a further embodiment, a non-expandable, compliant centering element is employed, such as an elastic finger. Systems incorporating such an apparatus and methods of use thereof are also disclosed.

Claims

1. A cardiac ablation apparatus for producing a circumferential ablation that electrically isolates a chamber wall portion of a heart from a vessel extending into said wall portion, said apparatus comprising:

(a) an elongate centering catheter having a distal end portion;

(b) an expandable centering element connected to said centering catheter distal end portion and configured for positioning within said vessel when in a retracted configuration, and for securing said elongate centering catheter in a substantially axially aligned position with respect to said vessel when said centering element is in an expanded configuration;

(c) an ablation catheter slidably connected to said centering catheter said ablation element having a distal end portion, and

(d) an expandable ablation element connected to said ablation catheter distal end portion, said ablation element configured to form a circumferential ablation on said wall portion around said elongate centering catheter when said centering catheter is axially aligned with respect to said vessel.

2. A cardiac ablation apparatus according to claim 1, wherein said centering element comprises a balloon.

3. A cardiac ablation apparatus according to claim 1, wherein said centering element comprises an expandable stent.

4. A cardiac ablation apparatus according to claim 1, wherein said centering element comprises a preformed stylet.

5. A cardiac ablation apparatus according to claim 1, wherein said ablation element comprises a preformed stylet.

6. A cardiac ablation apparatus according to claim 1, wherein said ablation element comprises a balloon.

7. A cardiac ablation apparatus according to claim 1, wherein said ablation element comprises an expandable stent.

8. A cardiac ablation apparatus according to claim 1, wherein said ablation element comprises a plurality of expandable legs.

9. A cardiac ablation apparatus according to claim 1, further comprising a guide wire, and wherein said centering catheter is slidably received on said guide wire.

10. A cardiac ablation apparatus according to claim 1, wherein said centering catheter further comprises a steering stylet and a steering tendon operatively associated with said steering stylet.

11. A cardiac ablation apparatus according to claim 1, wherein said chamber is an atrium and said vessel is a pulmonary vein.

12. A cardiac ablation system for producing a circumferential ablation that electrically isolates a chamber wall portion of a heart from a vessel extending into said wall portion, said system comprising:

(a) an elongate centering catheter having a distal end portion;

(b) an expandable centering element connected to said centering catheter distal end portion and configured for positioning within said vessel when in a retracted configuration, and for securing said elongate centering catheter in a substantially axially aligned position with respect to said vessel when said centering element is in an expanded configuration;

(c) an ablation catheter slidably connected to said centering catheter, said ablation catheter having a distal end portion; and

(d) an expandable ablation element connected to said ablation catheter distal end portion, said ablation element configured to form a circumferential ablation on said wall portion around said elongate centering catheter when said centering catheter is axially aligned with respect to said vessel; and

(e) a power supply operably associated with said ablation element.

13. A cardiac ablation system according to claim 12, wherein said centering element comprises a balloon.

14. A cardiac ablation system according to claim 12, wherein said centering element comprises an expandable stent.

15. A cardiac ablation system according to claim 12, wherein said centering element comprises a preformed stylet.

16. A cardiac ablation system according to claim 12, wherein said ablation element comprises a preformed stylet.

17. A cardiac ablation system according to claim 12, wherein said ablation element comprises a balloon.

18. A cardiac ablation system according to claim 12, wherein said ablation element comprises an expandable stent.

19. A cardiac ablation system according to claim 12, wherein said ablation element comprises a plurality of expandable legs.

20. A cardiac ablation system according to claim 12, further comprising a guide wire, and wherein said centering catheter is slidably received on said guide wire.

21. A cardiac ablation system according to claim 12, wherein said centering catheter further comprises a steering stylet and a steering tendon operatively associated with said steering stylet;

and wherein said system further comprises a steering mechanism operatively associated with said steering tendon and steering stylet.

22. A cardiac ablation system according to claim 12, wherein said power supply comprises a radio frequency ablation power supply.

23. A cardiac ablation system according to claim 12, wherein said power supply comprises a thermal ablation power supply.

24. A cardiac ablation system according to claim 12, further comprising a first expansion actuator operatively associated with said centering element.

25. A cardiac ablation system according to claim 24, further comprising a second expansion actuator operatively associated with said ablation element.

26. A cardiac ablation system according to claim 12, wherein said chamber comprises an atrium and said vessel comprises a pulmonary vein.

27. A cardiac ablation method for producing a circumferential ablation that electrically isolates a chamber wall portion of a heart from a vessel extending into said wall portion, said method comprising the steps of:

(a) inserting an elongate centering catheter having a distal end portion through an chamber into said vessel, said distal end portion having an expandable centering element for engaging said vessel connected thereto;

(b) expanding said centering element in said vessel to secure said elongate centering catheter in a substantially axially aligned position with respect to said vessel;

then

(c) inserting an ablation catheter slidably connected to said centering catheter into said chamber, said ablation catheter having an expandable ablation element connected to the distal end portion thereof;

then

(d) positioning said ablation element on said chamber wall portion; and

then

(e) forming a circumferential ablation around said elongate centering catheter on said wall portion in said chamber and outside of said vessel.

28. A method according to claim 27, wherein the inner diameter of said circumferential ablation is greater than the inner diameter of said vessel.

29. A method according to claim 27, further comprising the step of adjusting the diameter of said ablation element after inserting said ablation catheter into said chamber, and before forming said circumferential ablation.

30. A method according to claim 27, wherein said chamber is an atrium and said vessel is a pulmonary vein.

31. A cardiac ablation apparatus for producing a circumferential ablation that electrically isolates a chamber wall portion of a heart from a vessel extending into said wall portion, said apparatus comprising:

(a) an elongate catheter having a distal end portion;

(b) a nonexpandable, compliant, centering element connected to said catheter distal end portion and configured for positioning within said vessel; and

(c) an expandable ablation element connected to said catheter distal end portion, said ablation element configured to form a circumferential ablation on said wall portion around said centering element when said centering element is positioned in said vessel.

32. A cardiac ablation apparatus according to claim 31, wherein said centering element comprises an elastic finger.

33. A cardiac ablation apparatus according to claim 31, wherein said ablation element comprises a preformed stylet.

34. A cardiac ablation apparatus according to claim 31, wherein said ablation element comprises a balloon.

35. A cardiac ablation apparatus according to claim 31, wherein said ablation element comprises an expandable stent.

36. A cardiac ablation apparatus according to claim 31, wherein said ablation element comprises a plurality of expandable legs.

37. A cardiac ablation apparatus according to claim 31, wherein said catheter further comprises a steering stylet and a steering tendon operatively associated with said steering stylet.

38. A cardiac ablation apparatus according to claim 31, wherein said chamber is an atrium and said vessel is a pulmonary vein.

39. A cardiac ablation system for producing a circumferential ablation that electrically isolates a chamber wall portion of a heart from a vessel extending into said wall portion, said system comprising:

(a) an elongate catheter having a distal end portion;

(b) a nonexpandable, compliant, centering element connected to said catheter distal end portion and configured for positioning within said vessel; and

(c) an expandable ablation element connected to said catheter distal end portion, said ablation element configured to form a circumferential ablation on said wall portion around said centering element when said centering element is positioned in said vessel; and

(d) a power supply operably associated with said ablation element.

40. A cardiac ablation system according to claim 39, wherein said centering element comprises an elastic finger.

41. A cardiac ablation system according to claim 39, wherein said ablation element comprises a preformed stylet.

42. A cardiac ablation system according to claim 39, wherein said ablation element comprises a balloon.

43. A cardiac ablation system according to claim 39, wherein said ablation element comprises an expandable stent.

44. A cardiac ablation system according to claim 39, wherein said ablation element comprises a plurality of expandable legs.

45. A cardiac ablation system according to claim 39, wherein said catheter further comprises a steering stylet and a steering tendon operatively associated with said steering stylet;

and wherein said system further comprises a steering mechanism operatively associated with said steering tendon and steering stylet.

46. A cardiac ablation system according to claim 39, wherein said power supply comprises a radio frequency ablation power supply.

47. A cardiac ablation system according to claim 39, wherein said power supply comprises a thermal ablation power supply.

48. A cardiac ablation system according to claim 39, further comprising an expansion actuator operatively associated with said ablation element.

49. A cardiac ablation system according to claim 39, wherein said chamber comprises an atrium and said vessel comprises a pulmonary vein.

50. A cardiac ablation method for producing a circumferential ablation that electrically isolates a chamber wall portion of a heart from a vessel extending into said wall portion, said method comprising the steps of:

(a) inserting an elongate catheter having a distal end portion through an chamber into said vessel, said distal end portion having a nonexpandable, compliant centering element connected thereto, said centering element having an outer diameter smaller than the inner diameter of said vessel, said distal end portion further having an ablation element connected thereto;

(b) positioning said ablation element on said chamber wall portion; and

then

(c) forming a circumferential ablation around said centering element on said wall portion in said chamber and outside of said vessel.

51. A cardiac ablation method according to claim 50, wherein said centering element comprises an elastic finger.

52. A method according to claim 51, wherein the inner diameter of said circumferential ablation is greater than the inner diameter of said vessel.

53. A method according to claim 51, further comprising the step of adjusting the diameter of said ablation element after inserting said ablation catheter into said chamber, and before forming said circumferential ablation.

54. A method according to claim 51, wherein said chamber is an atrium and said vessel is a pulmonary vein.