Apparatus and method for ablating tissue

• US 20040260278A1
• Filed: 04/12/2004
• Published: 12/23/2004
• Est. Priority Date: 10/22/1996
• Status: Abandoned Application

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Inventors: Vaska, Matthias, Richman, Roxanne L., Anderson, Scott C., Gallup, David A., Podmore, Jonathan L., Pless, Benjamin, Ulstad, Jack E. Jr., Crowe, John E.
• Application Number:
  US10/823,411
• Publication Number:
  US 20040260278A1
• Time in Patent Office: Days
• US Class Current: 606/32
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00232 having an irregular shape
• CPC Class Codes: A61B 2018/00261 arranged in a line
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00839 : Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/142 : at least partly surrounding the target, e.g. concave, curved or in the form of a cave
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/3629 : in combination with non-electric therapy
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

The invention provides apparatus and methods for ablating tissue and is particularly useful for creating lesions in the heart wall for the treatment of atrial fibrillation. The apparatus has a suction well which is adhered to the tissue to be ablated. The ablating element is surrounded by the suction well. A fluid is delivered to the ablating element to conduct RF energy to the tissue and/or to cool the tissue. The device is preferably formed with a number of cells with each cell having a suction well and at least one ablating element. The device also preferably has a locking mechanism for locking one part of the device to another part of the device to form a closed loop for ablating around structures such as the pulmonary veins.

Claims

1-33. -33. Canceled.

34. A method of delivering energy to ablate tissue, comprising the steps of:

providing a device having an ablating element;

positioning the device at a tissue site, the tissue site having a near surface and a far surface;

measuring a temperature change at the tissue site over a period of time;

analyzing the temperature change to provide a tissue characterization; and

ablating the tissue in response to the tissue characterization.

35. The method of claim 34, wherein:

the analyzing and ablating steps are controlled by a control system;

the positioning step is carried out with the tissue site having a near surface and a far surface; and

the ablating step being carried out by maintaining the near surface temperature at a temperature of 0-80□

C during the ablating step.

36. The method of claim 34, wherein:

the providing step is carried out with the device having an ablating element; and

the method also including the step of changing the temperature of the tissue with the ablating element; and

the ablating step is carried out with the ablating element.

37. The method of claim 34, wherein:

the positioning step is carried out with the device being in contact with the epicardium.

38. The method of claim 34, wherein:

the ablating step is carried out using the results of the measuring step to approximate when the far surface achieves a target temperature.

39. The method of claim 34, wherein:

the ablating step is carried out with input of at least one variable from a list of variables consisting of presence of fat, amount of fat, flow rate of blood, tissue thickness and temperature of blood.

40. The method of claim 34, wherein:

the ablating step is carried out with a plurality of ablating elements, wherein no more than 50% of the ablating elements are activated at one time.

41. The method of claim 34, wherein:

the providing step is carried out with the device having a plurality of suction wells, at least one of the ablating elements being positioned in each of the suction wells.

42. A device for ablating tissue, comprising:

an elongate body having an end, the elongate body having at least one ablating element; and

a plurality of suction wells in the body, the suction wells being positioned along the length of the body.

43. The device of claim 42, wherein:

the elongate body has a plurality of ablating elements.

44. The device of claim 43, wherein:

the suction wells are coupled to a suction lumen.

45. The device of claim 47, further comprising:

a second suction lumen coupled to another plurality of suction wells.

47. The device of claim 42, wherein:

the suction well surrounds the ablating element.

48. The device of claim 44, wherein:

the suction well is formed by an inner lip and an outer lip;

the device further comprising a fluid inlet and a fluid outlet, the fluid inlet and outlet being configured to pass a fluid into and out of a space bounded by the inner lip.

46. The device of claim 46, wherein:

the suction lumen is formed by a tube attached to the body.

49. The device of claim 46, wherein:

the fluid outlet is coupled to a suction lumen which is also coupled to at least one of the suction wells.

50. A method of creating a continuous ablation lesion in heart tissue, comprising the steps of:

providing a first ablating section and a second ablating section, the first and second ablating sections each having an end and an ablating element;

positioning the first and second ablating sections in contact with the epicardium;

wrapping the first and second ablating sections around at least one vessel;

interlocking the first and second sections to form a closed loop around the at least one vessel.

51. A method of creating a continuous lesion in tissue, comprising the steps of:

providing an ablating device having an ablating element;

positioning the ablating device in contact with the epicardium;

ablating tissue to create a first lesion;

moving the ablating device to a location adjacent the first lesion;

ablating tissue with the ablating element to create a second lesion which is continuous with the first lesion.

52. A method of creating a lesion from an epicardial location, comprising the steps of:

providing a first device and a second device slidably coupled to the first device, at least one of the first and second devices having an ablating element;

introducing the first and second devices into the pericardial space;

ablating tissue to form a first lesion with the ablating element;

moving at least one of the first and second devices relative to the other; and

forming a second lesion after the moving step.

53. A method of ablating cardiac tissue, comprising the steps of:

providing an ablating device having an ablating element and a suction well, the suction well being coupled to a suction line which is coupled to a vacuum source, the ablating device also having means for determining when the suction well is adhered to the epicardium;

positioning the ablating device against the patient'"'"'s epicardium;

adhering the ablating device to the epicardium with the suction well; and

ablating tissue with the ablating element after the adhering step.

54. The method of claim 53, wherein:

the providing step is carried out with the determining means being a sensor selected from the group of sensors consisting of a flow rate sensor, a pressure sensor and an electric circuit.

55-74. -74. Canceled