Laser pulmonary vein isolation

• US 20040054360A1
• Filed: 09/17/2002
• Published: 03/18/2004
• Est. Priority Date: 09/17/2002
• Status: Active Grant

• Current Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Original Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Inventors: Leatham, Marcia, Govari, Assaf, Ben-Haim, Shlomo, Schwartz, Yitzhack, Yaron, Uri
• Granted Patent: US 6,997,924 B2
• Time in Patent Office: Days
• US Class Current: 606/15
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence

Abstract

A catheter introduction apparatus provides an optical assembly for emission of laser light energy. In one application, the catheter and the optical assembly are introduced percutaneously, and transseptally advanced to the ostium of a pulmonary vein. An anchoring balloon is expanded to position a mirror near the ostium of the pulmonary vein, such that light energy is reflected and directed circumferentially around the ostium of the pulmonary vein when a laser light source is energized. A circumferential ablation lesion is thereby produced, which effectively blocks electrical propagation between the pulmonary vein and the left atrium.

Claims

1. A method for electrically isolating a cardiac chamber, comprising the steps of:

introducing an optical assembly at a pulmonary vein proximate an ostium of said pulmonary vein;

anchoring said optical assembly at said pulmonary vein using an anchor; and

thereafter conducting laser light energy in a path extending from said optical assembly to a circumferential ablation region of said pulmonary vein.

2. The method according to claim 1, wherein said path avoids said anchor.

3. The method according to claim 1, wherein said step of conducting said laser light energy is performed by directing said laser light energy into a circumferential line that intersects said ablation region.

4. The method according to claim 1, wherein said anchor comprises a balloon, and anchoring is performed by expanding said balloon to engage said pulmonary vein.

5. The method according to claim 1, wherein said step of introducing is performed via a fossa ovalis of a heart, further comprising the step of directing preliminary laser light energy onto said fossa ovalis to ablate tissue thereof to facilitate passage of said optical assembly therethrough.

6. The method according to claim 1, wherein said step of conducting said laser light energy is performed in exactly one application.

7. The method according to claim 1, wherein said step of conducting said laser light energy is performed in a series of pulses.

8. The method according to claim 7, wherein a duration of each of said pulses is less than 100 milliseconds.

9. The method according to claim 1, wherein said step of introducing is performed by disposing said optical assembly on an intravascular catheter;

and

passing a distal portion of said intravascular catheter through a blood vessel into a heart.

10. The method according to claim 1, wherein said step of conducting said laser light energy further comprises reflecting said laser light energy.

11. The method according to claim 10, wherein reflecting said laser light energy comprises disposing a mirror in a path of said laser light energy external to said anchor.

12. The method according to claim 10, wherein reflecting said laser light energy comprises disposing a light-reflective coating on an external surface of said anchor and reflecting said laser light energy from said light-reflective coating.

13. The method according to claim 1, wherein said laser light energy has a wavelength of about 13 microns.

14. An apparatus for electrically isolating a cardiac chamber, comprising:

an intravascular catheter adapted for introduction into a pulmonary vein proximate an ostium thereof;

an anchor disposed at a distal end of said catheter for fixation thereof at said pulmonary vein; and

an optical assembly for conducting laser light energy in a path extending to a circumferential ablation region of said pulmonary vein.

15. The apparatus according to claim 14, wherein said optical assembly is substantially in a non-contacting relationship with said anchor.

16. The apparatus according to claim 14, wherein said path avoids said anchor.

17. The apparatus according to claim 14, wherein said optical assembly comprises:

an optical fiber for conducting said laser light energy from a light source;

a lens disposed at an exit face of said optical fiber; and

a reflector disposed in said path external to said anchor for directing said laser light energy into a circumferential line that intersects said ablation region.

18. The apparatus according to claim 17, wherein said lens comprises a graded index lens.

19. The apparatus according to claim 17, wherein said reflector comprises a parabolic mirror.

20. The apparatus according to claim 17, wherein said reflector comprises a light reflecting external surface of said anchor.

21. The apparatus according to claim 14, wherein said anchor comprises a balloon, adapted to inflate to engage said pulmonary vein.

22. The apparatus according to claim 21, wherein said balloon is bilobate.

23. The apparatus according to claim 21, wherein a proximal portion of said balloon in an inflated state thereof is more expanded than a distal portion of said balloon in an inflated state thereof.

24. The apparatus according to claim 14, wherein said laser light energy is applied to said ablation region in exactly one application.

25. The apparatus according to claim 14, wherein said laser light energy is applied to said ablation region in a series of pulses.

26. The apparatus according to claim 25, wherein a duration of each of said pulses is less than 100 milliseconds.

27. The apparatus according to claim 14, wherein said laser light energy has a wavelength of about 13 microns.