Electrode Catheter for Ablation Purposes and Related Method Thereof

• US 20100211064A1
• Filed: 03/20/2008
• Published: 08/19/2010
• Est. Priority Date: 03/22/2007
• Status: Active Grant

• Current Assignee: University of Virginia
• Original Assignee: University of Virginia Patent Foundation (University of Virginia)
• Inventors: Gillies, George T., Mahapatra, Srijoy
• Granted Patent: US 9,211,405 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00035 with return means
• CPC Class Codes: A61B 2018/00279 deployable
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61N 1/06 for high-frequency therapy

Abstract

An electrode catheter for use with an endocardial ablation catheter, wherein the electrode catheter receives the transmitted energy for ablating a portion of the heart. The electrode catheter comprises a proximal portion, a distal portion, and a longitudinal structure there between; and an electrode in communication with said electrode catheter, wherein said electrode receives the transmitted energy from the endocardial ablation catheter, or alternatively an epicardial ablation catheter.

Claims

1. An electrode catheter disposed in the middle mediastinum of the thorax of a subject for use with an endocardial ablation catheter, which transmits energy for ablating a portion of a heart, said electrode catheter comprising:

a proximal portion, a distal portion, and a longitudinal structure there between; and

an electrode in communication with said electrode catheter, wherein said electrode receives the transmitted energy from the endocardial ablation catheter.

2. The device of claim 1, wherein said middle mediastinum includes the pericardial space.

3. The device of claim 1, wherein said middle mediastinum includes outside the pericardium.

4. The device of claim 1, wherein said middle mediastinum includes inside the pericardium.

5. The device of claim 1, wherein said middle mediastinum includes a first ventricle of the heart.

6. The device of claim 5, wherein said endocardial ablation catheter is positioned in a second ventricle of the heart.

7. The device of claim 6, wherein said first ventricle is the right ventricle of the heart and said second ventricle is the left ventricle of the heart.

8. The device of claim 6, wherein said first ventricle is the left ventricle of the heart and said second ventricle is the right ventricle of the heart.

9. The device of claim 1, further comprising:

at least one distal fluid aperture at said distal portion, said at least one distal fluid aperture in communication with a fluid lumen extending longitudinally through said longitudinal structure toward said proximal end, wherein said at least one distal fluid aperture is adapted for passage of fluid.

10. The device of claim 9, wherein said passage comprises emitting fluid.

11. The device of claim 9, wherein said passage comprises extracting fluid.

12. The device of claim 9, wherein said passage comprises emitting and extracting fluid.

13. The device of claim 9, further comprising:

at least one proximal fluid aperture at said proximal portion, wherein said at least one proximal fluid aperture is in communication with said fluid lumen, and wherein said at least one proximal fluid aperture is adapted for passage of fluid.

14. The device of claim 13, wherein said passage comprises emitting fluid.

15. The device of claim 13, wherein said passage comprises extracting fluid.

16. The device of claim 13, wherein said passage comprises emitting and extracting fluid.

17. The device of claim 13, further comprising a fluid control means for controlling said fluid passage.

18. The device of claim 17, wherein said control means comprises a control handle in communication with said electrode catheter.

19. The device of claim 17, wherein said control means is in communication with an external fluid source.

20. The device of claim 13, wherein said fluid may be used to cool said electrode.

21. The device of claim 13, wherein said fluid may be used to distend proximate anatomical structures.

22. The device of claim 1, further comprising a stabilizing means for stabilizing said electrode catheter.

23. The device of claim 22, wherein said stabilization means comprises at least one deployable member.

24. The device of claim 22, wherein said stabilization means comprises one or more protrusions for engaging proximal anatomical structures.

25. The device of claim 22, wherein said stabilization means comprises a non-conducting material.

26. The device of claim 22, further comprising a control means for controlling or adjusting said stabilization means.

27. The device of claim 26, wherein said control means comprises a control handle in communication with said electrode catheter.

28. The device of claim 1, further comprising a steering means for positioning said electrode catheter.

29. The device of claim 28, further comprising a second steering means for steering said electrode catheter.

30. The device of claim 28, wherein said steering means allows orienting said electrode catheter about one center of curvature.

31. The device of claim 28, wherein said steering means allows orienting said electrode catheter about two or more centers of curvature.

32. The device of claim 28, wherein said steering means comprises at least one of the following:

guide wire, pull string, positional adjustment device, tensioning line, or digitating distal tip.

33. The device of claim 28, further comprising a control means for controlling said steering means.

34. The device of claim 33, wherein said control means comprises a control handle in communication with said electrode catheter.

35. The device of claim 1, further comprising an electrical lead in communication with said electrode for supplying energy to said electrode.

36. The device of claim 35, further comprising a control handle in communication with said electrode catheter, wherein said control handle is controllably connected to said electrical lead.

37. The device of claim 1, wherein said electrode is made of a conducting material.

38. The device of claim 37, wherein said conducting material comprises at least one of the following:

platinum, gold, silver, iridium or any other type of conducting material, alloy or metal.

39. The device of claim 1, wherein said electrode is contoured for the receiving of said transmitted energy.

40. The device of claim 1, wherein said electrode is contoured to be compatible with proximate anatomical structures.

41. The device of claim 1 wherein said electrode is semi-cylindrical in shape.

42. The device of claim 1, wherein said electrode is disposed on said distal portion of said electrode catheter.

43. The device of claim 1, wherein said electrode has a longitudinal length of between about 20 mm and about 50 mm.

44. The device of claim 1, wherein said electrode catheter has a total length of less than about 200 cm.

45. The device of claim 1, wherein said electrode catheter has a total length of less than about 100 cm.

46. The device of claim 1, wherein said electrode catheter has a total length of less than about 50 cm.

47. The device of claim 1, wherein said electrode catheter has a total length of less than about 25 cm.

48. The device of claim 1, wherein said electrode catheter has a total length of less than about 20 cm.

49. The device of claim 1, wherein said device is used in conjunction with said endocardial ablation catheter for the purpose of achieving localized burning of heart tissues.

50. The device of claim 49, wherein said localized burning of heart tissue results from a roughly triangular-pattern of current density.

51. The device of claim 1, which when used in conjunction with said endocardial ablation catheter, results in a roughly triangular-shaped pattern of current density.

52. The device of claim 1, wherein navigation of said electrode catheter is carried out through a puncture of the thorax.

53. The device of claim 52, wherein said puncture of the thorax comprises a sub-xiphoid puncture.

54. The device of claim 52, wherein a pressure probe needle is used in navigating said electrode catheter.

55. The device of claim 54, wherein said pressure probe needle comprises an access needle.

56. The device of claim 54, wherein said pressure probe needle comprises a sensor for sensing pressure in the thorax.

57. The device of claim 52, further comprising an access needle, said access needle adapted to be inserted into the thorax.

58. The device of claim 57, further comprising a guidewire, wherein said guidewire is adapted to be inserted into said access needle.

59. An electrode catheter disposed in the intra-cardiac space of a subject for use with an epicardial ablation catheter, which transmits energy for ablating a portion of a heart, said electrode catheter comprising:

a proximal portion, a distal portion, and a longitudinal structure there between; and

an electrode in communication with said electrode catheter, wherein said electrode receives the transmitted energy from the epicardial ablation catheter.

60. The device of claim 59, wherein said intra-cardiac space includes the left ventricle.

61. The device of claim 59, wherein said intra-cardiac space includes the right ventricle.

62. The device of claim 59, further comprising a stabilizing means for stabilizing said electrode catheter.

63. The device of claim 62, wherein said stabilization means comprises at least one deployable member.

64. The device of claim 59, further comprising a steering means for navigating said electrode catheter into position in said intra-cardiac space.

65. The device of claim 64, wherein said steering means comprises at least one of the following:

guide wire, pull string, tensioning line, or digitating distal tip.

66. The device of claim 59 further comprising an electrical lead in communication with said electrode for supplying energy to said electrode.

67. The device of claim 59 wherein said electrode is contoured for receiving said energy from said epicardial ablation catheter.

68. The device of claim 59, wherein said electrode catheter is used in conjunction with said epicardial ablation catheter for the purpose of achieving localized burning of heart tissues.

69. A method for use with an endocardial ablation catheter, which transmits energy for ablating a portion of a heart, said method comprising:

disposing an electrode in the middle mediastinum of the thorax of a subject; and

receiving the transmitted energy from the endocardial ablation catheter.

70. The method of claim 69, wherein navigation of said electrode is carried out through a sub-xiphoid puncture.

71. The method of claim 69, wherein said mediastinum includes the pericardial space.

72. The method of claim 69, wherein said mediastinum includes outside the pericardium.

73. The method of claim 69, wherein said mediastinum includes inside the pericardium.

74. The method of claim 69, wherein said middle mediastinum includes a first ventricle of the heart.

75. The method of claim 74, wherein said endocardial ablation catheter is positioned a second ventricle of the heart.

76. The method of claim 75, wherein said first ventricle is the right ventricle of the heart and said second ventricle is the left ventricle of the heart.

77. The method of claim 75, wherein said first ventricle is the left ventricle of the heart and said second ventricle is the right ventricle of the heart.

78. The method of claim 69, wherein said electrode is made from a conducting material.

79. The method of claim 69, wherein said electrode is contoured for said receiving of the transmitted energy.

80. The method of claim 69, wherein said electrode is contoured to be compatible with proximate anatomical structures.

81. The method of claim 69, wherein said electrode is between 20 mm and 50 mm.

82. The method of claim 69, wherein said electrode is disposed on a catheter.

83. The method of claim 82, wherein said disposing comprises said catheter being inserted into the middle mediastinum of the thorax by inserting said catheter into access needle.

84. The method of claim 83, further comprising a guidewire, wherein said guidewire is adapted to be inserted into said access needle.

85. The method of claim 82, wherein said electrode is disposed on said distal portion of said catheter.

86. The method of claim 82, wherein said catheter further comprises a means for the passage of fluid through said catheter.

87. The method of claim 86, wherein said fluid is used to cool said electrode.

88. The method of claim 86, wherein said fluid is used to distend proximal anatomical structures.

89. The method of claim 82, wherein said catheter further comprises a stabilization means for holding said electrode in a position facing said endocardial ablation catheter.

90. The method of claim 82, wherein said catheter further comprises at least one steering means for positioning said electrode.

91. A method for use with an epicardial ablation catheter, which transmits energy for ablating a portion of a heart, said method comprising:

disposing an electrode in the intra-cardiac space of a subject; and

receiving the transmitted energy from the epicardial ablation catheter.

92. The method of claim 91, wherein said intra-cardiac space includes the left ventricle.

93. The device of claim 91, wherein said intra-cardiac space includes the right ventricle.

94. The method of claim 91, further comprising:

stabilizing said electrode catheter.

95. The method of claim 94, wherein said stabilizing means comprises at least one deployable member.

96. The method of claim 91, further comprising:

steering means for navigating said electrode catheter into position in said intra-cardiac space.

97. The method of claim 91, wherein said electrode catheter is used in conjunction with said epicardial ablation catheter for the purpose of achieving localized burning of heart tissues.