Method and apparatus for epicardial left atrial appendage isolation in patients with atrial fibrillation

• US 20050033287A1
• Filed: 07/01/2004
• Published: 02/10/2005
• Est. Priority Date: 07/01/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sra, Jasbir S.
• Granted Patent: US 7,344,543 B2
• Time in Patent Office: Days
• US Class Current: 606/46
• 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 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00044 Sensing electrocardiography, i.e. ECG
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure

Abstract

A catheter apparatus is provided for use in the isolation of a patient'"'"'s left atrial appendage (LAA) having a catheter shaft, a probe axially disposed within the catheter shaft, and a control mechanism coupled to both the catheter shaft and the probe. The catheter shaft includes a main body that extends along a central axis and a coaxial tip section attached to the main body. The tip section can be deflected from the central axis in a controlled manner. The probe can be extended outward from the catheter shaft and has a distal end that is brought into contact with the LAA. The control mechanism controls longitudinal movement of the catheter shaft, the degree of deflection of the tip section, and axial movement of the probe with respect to the catheter shaft. Preferably, the distal end is able to form a pre-stressed loop when the probe is fully extended from the catheter shaft, the loop being selected to have a size that will allow it to substantially encircle the base of the LAA. In another aspect of this invention, it provides a method for isolating the LAA having the steps of introducing a catheter apparatus through an incision in the patient'"'"'s chest, navigating the catheter apparatus to the LAA, and using the catheter apparatus to isolate the LAA.

Claims

1. A catheter apparatus for use in the isolation of a left atrial appendage (LAA) on a patient comprising:

a catheter shaft having a main body extending along a central axis and a coaxial tip section joined to the main body, the tip section being deflectable whereby the tip section can be selectively curved away from the central axis;

a probe slidably disposed within the catheter shaft, the probe having a distal end and being selectively movable axially within the catheter shaft, whereby the distal end can be brought into contact with the LAA; and

a control mechanism coupled to the catheter shaft and the probe wherein the control mechanism controls axial movement and deflection of the catheter shaft and movement of the probe with respect to the catheter shaft.

2. The apparatus of claim 1 wherein the catheter shaft is rotatable about the central axis.

3. The apparatus of claim 2 wherein the distal end has a pre-stressed curve whereby the distal end curves as the probe is extended from the catheter shaft.

4. The apparatus of claim 3 wherein the distal end includes a spline.

5. The apparatus of claim 4 wherein the spline is fabricated from nickel-titanium having shape memory.

6. The apparatus of claim 3 wherein the distal end forms a loop when the probe is fully extended from the catheter shaft, the loop being sized to substantially circumscribe a base of the LAA.

7. The apparatus of claim 6 wherein the loop substantially defines a plane substantially perpendicular to the central axis.

8. The apparatus of claim 6 wherein the loop is substantially coplanar with the central axis.

9. The apparatus of claim 5 wherein the control mechanism is a steering handle.

10. The apparatus of claim 9 wherein the steering handle includes a first actuator mechanically connected with respect to the catheter shaft whereby rotation and axial movement of the catheter shaft is actuated by the first actuator.

11. The apparatus of claim 10 wherein the steering handle includes a second actuator mechanically connected with respect to the tip section whereby actuation of the second actuator deflects the tip section away from the central axis.

12. The apparatus of claim 11 wherein the steering handle includes a third actuator mechanically connected with respect to the probe whereby actuation of the third actuator moves the probe axially within the catheter shaft.

13. The apparatus of claim 12 wherein the probe includes a proximal coil and the steering handle includes a fourth actuator mechanically connected to the proximal coil whereby actuation of the fourth actuator disengages the distal end from the probe at the proximal coil.

14. A method for isolating a left atrial appendage (LAA) on a patient comprising:

introducing a catheter apparatus through an incision in the patient'"'"'s chest,

navigating the catheter apparatus to the LAA; and

using the catheter apparatus to isolate the LAA.

15. The method of claim 14 wherein the catheter apparatus includes:

a catheter shaft having a main body rotatable about a central axis and a coaxial tip section joined to the main body, the tip section being deflectable whereby the tip section can be selectively curved away from the central axis;

a probe slidably disposed within the catheter shaft, the probe being selectively movable axially within the catheter shaft and having a distal end, the distal end having a pre-stressed curve whereby the distal end curves as the probe is extended from the catheter shaft; and

a steering handle coupled to both the catheter shaft and the probe wherein the steering handle controls rotation and axial movement of the catheter shaft, deflection of the tip section with respect to the central axis, and movement of the probe with respect to the catheter shaft.

16. The method of claim 15 wherein the distal end includes a spline.

17. The method of claim 16 wherein the curve of the distal end forms a loop when the probe is fully extended from the catheter shaft, the loop being sized to substantially circumscribe a base of the LAA and substantially defining a plane substantially perpendicular to the central axis.

18. The method of claim 17 wherein the probe includes a proximal coil and the steering handle is mechanically connected to the proximal coil whereby the steering handle controls disengagement of the distal end from the probe at the proximal coil.