Ablation system and method of use

• US 20050090815A1
• Filed: 08/20/2004
• Published: 04/28/2005
• Est. Priority Date: 04/26/2001
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Jahns, Scott E., Francischelli, David E.
• Granted Patent: US 7,250,048 B2
• Time in Patent Office: Days
• US Class Current: 606/32
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 2017/00092 using thermocouples
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00761 Duration
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00886 Duration
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the impedance of the tissue to be ablated. Rather than attempting to detect a desired drop or a desired increase impedance, completeness of a lesion is detected in response to the measured impedance remaining at a stable level for a desired period of time, referred to as an impedance plateau. The mechanism for determining transmurality of lesions adjacent individual electrodes or pairs may be used to deactivate individual electrodes or electrode pairs, when the lesions in tissue adjacent these individual electrodes or electrode pairs are complete, to create an essentially uniform lesion along the line of electrodes or electrode pairs, regardless of differences in tissue thickness adjacent the individual electrodes or electrode pairs. Complete or partial submersion in a fluid of the ablating portion of the ablation device may be detected prior to, during or following an ablation procedure.

Claims

1. A method of ablating tissue, comprising:

applying ablation energy from an ablation device to a first tissue site;

monitoring submersion of at least a portion of the ablation device at the first tissue site; and

responsive to the degree of submersion of the ablation device at the first tissue site, changing the application of ablating energy to the first tissue site.

2. The method of claim 1 wherein the applying of ablation energy to the first tissue site comprises applying RF energy.

3. The method of claim 1 wherein the step of monitoring submersion of at least a portion of the ablation device at the first tissue site comprises monitoring submersion using one or more submersion sensors.

4. The method of claim 3 wherein the submersion sensors comprise an electrode.

5. The method of claim 3 wherein the submersion sensors comprise a fiber optic sensor.

6. The method of claim 3 wherein the submersion sensors comprise a thermocouple.

7. The method of claim 1 wherein the applying of ablation energy to the first tissue site comprises applying RF energy using an irrigated RF electrode.

8. The method of claim 1 wherein the application of ablating energy to the first tissue site is increased in response to the degree of submersion of the ablation device at the first tissue site.

9. The method of claim 1 wherein the application of ablating energy to the first tissue site is decreased in response to the degree of submersion of the ablation device at the first tissue site.

10. The method of claim 1, further comprising:

applying ablation energy from the ablation device to a second tissue site;

monitoring submersion of at least a portion of the ablation device at the second tissue site; and

responsive to the degree of submersion of the ablation device at the second tissue site, changing the application of ablating energy to the second tissue site.

11. The method of claim 10 wherein the applying of ablation energy to the second tissue site comprises applying RF energy.

12. The method of claim 10 wherein the step of monitoring submersion of at least a portion of the ablation device at the second tissue site comprises monitoring submersion using one or more submersion sensors.

13. The method of claim 12 wherein the submersion sensors comprise an electrode.

14. The method of claim 12 wherein the submersion sensors comprise a fiber optic sensor.

15. The method of claim 12 wherein the submersion sensors comprise a thermocouple.

16. The method of claim 10 wherein the applying of ablation energy to the second tissue site comprises applying RF energy using an irrigated RF electrode.

17. The method of claim 10 wherein the application of ablating energy to the second tissue site is increased in response to the degree of submersion of the ablation device at the second tissue site.

18. The method of claim 10 wherein the application of ablating energy to the second tissue site is decreased in response to the degree of submersion of the ablation device at the second tissue site.

19. A method of ablation, comprising:

applying ablation energy from an ablation device to a tissue site;

monitoring submersion of at least a portion of the ablation device; and

responsive to the amount of submersion of the ablation device, modifying the application of ablating energy to the tissue site.

20. The method of claim 19 wherein the applying of ablation energy to the tissue site comprises applying RF energy.

21. The method of claim 19 wherein the step of monitoring submersion of at least a portion of the ablation device at the tissue site comprises monitoring submersion using at least one submersion sensor.

22. The method of claim 21 wherein at least one submersion sensor comprises an electrode.

23. The method of claim 21 wherein at least one submersion sensor comprises a fiber optic sensor.

24. The method of claim 21 wherein at least one submersion sensor comprises a thermocouple.

25. The method of claim 19 wherein the applying of ablation energy to the tissue site comprises applying RF energy using an irrigated RF electrode.

26. The method of claim 19 wherein the application of ablating energy to the tissue site is increased in response to the amount of submersion of the ablation device at the tissue site.

27. The method of claim 19 wherein the application of ablating energy to the tissue site is decreased in response to the amount of submersion of the ablation device at the tissue site.

28. An ablation device comprising at least one submersion sensor for monitoring submersion of at least a portion of the ablation device in a fluid.

29. The device of claim 28 wherein at least one submersion sensor comprises an electrode.

30. The device of claim 28 wherein at least one submersion sensor comprises a fiber optic sensor.

31. The device of claim 28 wherein at least one submersion sensor comprises a thermocouple.

32. The device of claim 28 wherein the fluid is a biological fluid.

33. The device of claim 28 wherein the fluid is saline.

34. The device of claim 28 wherein the fluid is a CPB fluid.

35. The device of claim 28 wherein the fluid is blood.

36. The device of claim 28 wherein the fluid is a surgical field irrigation fluid.