NEUROTOXIC AGENTS AND DEVICES TO TREAT ATRIAL FIBRILLATION

• US 20060282120A1
• Filed: 05/12/2006
• Published: 12/14/2006
• Est. Priority Date: 05/13/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Sih, Haris J.
• Granted Patent: US 8,052,668 B2
• Time in Patent Office: Days
• US Class Current: 607/2
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: A61N 1/0575 with drug delivery
• CPC Class Codes: A61N 1/3625 External stimulators

Abstract

Devices and methods to treat atrial fibrillation via inhibition of nerves which innervate the pulmonary vein are provided.

Claims

1. An apparatus for treating atrial fibrillation, comprising:

a catheter body including at least one lumen and at least one port in communication with the lumen;

first and second inflatable balloons coupled to catheter body, the at least one port located between the first and second balloons;

a conductor extending through the catheter body; and

an expandable electrode coupled to the conductor and positioned between the first and second inflatable balloons.

2. The apparatus of claim 1 wherein the first balloon is located at the distal end of the catheter, the first balloon expandable to block a pulmonary vein.

3. The apparatus of claim 2 wherein the second balloon is expandable to block an opening between an atrium and a pulmonary vein.

4. The apparatus of claim 1 wherein the catheter body includes a first port in communication with a first lumen and a second port in communication with a second lumen, the first and second ports located between the first and second inflatable balloons adapted to deliver one or more neurolytic agents to a portion of a pulmonary vein between the first and second balloons.

5. The apparatus of claim 1 wherein the expandable electrode includes a stent.

6. The apparatus of claim 1 further comprising a guidewire for steerable guidance of the catheter.

7. A method for treating a patient suffering from arrhythmias, comprising:

inserting the catheter of the apparatus of claim 1 into a blood vessel of the patient;

directing the catheter through the blood vessel to the pulmonary vein;

expanding the electrode in the pulmonary vein and applying high frequency stimulation from the electrode to a region of the pulmonary vein;

sensing whether the high frequency stimulation alters heart rate and/or blood pressure of the patient;

inflating the balloons to isolate a region in which high frequency stimulation alters heart rate and/or blood pressure; and

delivering at least one neurolytic agent to the isolated region in an amount effective to normalize heart rate and/or blood pressure in the patient.

8. A method comprising:

a) locally administering a neurolytic compound via a catheter to a region in one or more pulmonary veins of a mammal identified as having one or more ectopic foci in the one or more pulmonary veins, wherein the catheter comprises at least one expandable electrode and at least two inflatable balloons, and wherein the two balloons are inflated to provide for local administration; and

b) detecting or determining whether administration normalizes heart rate and/or blood pressure in the mammal.

9. The method of claim 8 wherein the amount administered is effective to inhibit or prevent atrial fibrillation in the mammal.

10. The method of claim 8 wherein phenol is administered.

11. The method of claim 8 further comprising applying high frequency stimulation to the region during administration.

12. The method of claim 8 wherein one balloon is inflated within a pulmonary vein.

13. The method of claim 12 wherein a second balloon is inflated within an atrium.

14. The method of claim 12 wherein a second balloon is inflated within the pulmonary vein.

15. The method of claim 8 wherein the amount administered normalizes heart rate and/or blood pressure relative to heart rate and/or blood pressure prior to administration and in the absence of high frequency stimulation.

16. The method of claim 8 wherein high frequency stimulation of a region in one or more pulmonary veins is employed to identify the one or more ectopic foci.

17. A method comprising:

a) identifying a region of a pulmonary vein in a mammal in which application of high frequency stimulation via an expanded electrode of a catheter in the pulmonary vein alters heart rate and/or blood pressure, wherein the catheter comprises at least one expandable electrode and at least two inflatable balloons;

b) isolating the region by inflating the two balloons;

c) determining or detecting baseline heart rate and/or blood pressure;

d) administering to the isolated region via the catheter an amount of a neurolytic agent; and

e) detecting or determining whether administration normalizes heart rate and/or blood pressure in the mammal.

18. The method of claim 17 further comprising applying high frequency stimulation after administration is initiated and before heart rate and/or blood pressure are detected or determined.

19. The method of claim 17 wherein phenol is administered.

20. The method of claim 17 further comprising applying high frequency stimulation after c) and before d).