CATHETER WITH CORONARY SINUS OSTIUM ANCHOR

• US 20120108953A1
• Filed: 10/29/2010
• Published: 05/03/2012
• Est. Priority Date: 10/29/2010
• Status: Active Grant

• Current Assignee: Medtronic Ablation Frontiers LLC (Medtronic Plc)
• Original Assignee: Medtronic Ablation Frontiers LLC (Medtronic Plc)
• Inventors: MARKOWITZ, H. Toby, THOMPSON-NAUMAN, Amy E.
• Granted Patent: US 9,655,666 B2
• Time in Patent Office: Days
• US Class Current: 600/424
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00273 Anchoring means for temporary attachment of a device to tissue
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence

Abstract

A method of treating cardiac tissue is provided, including positioning a first chamber of a medical device adjacent an atrial wall; directing a cryogenic coolant into the first chamber; anchoring the first chamber to the atrial wall through cryoadhesion; directing a distal portion of the medical device into the coronary sinus; and positioning a cardiac lead through at least a portion of the coronary sinus with the distal portion. The method may include measuring a temperature of the first chamber; removing the first chamber from the atrial wall once a predetermined threshold temperature of the first chamber is reached; anchoring a second chamber of the medical device to a portion of the coronary sinus; and/or perfusing blood flow through at least a portion of the second chamber.

Claims

1. A medical device, comprising:

an elongate body having a proximal portion and a distal portion;

an electrode on the distal portion;

a chamber positioned on the elongate body between approximately 1 cm to 10 cm proximally of the electrode; and

a cryogenic coolant source in fluid communication with the chamber.

2. The medical device of claim 1, wherein the chamber is defined by a balloon.

3. The medical device of claim 1, further comprising a temperature sensor in thermal communication with the chamber.

4. The medical device of claim 1, further comprising an expandable chamber disposed on the elongate body between the first chamber and the electrode.

5. The medical device of claim 1, further comprising at least one of an electrical current generator, a voltage sensing apparatus, and an electrical property assessment device in electrical communication with the electrode.

6. A method of operating a medical device in a patient, comprising:

positioning a first chamber of a medical device adjacent a first tissue region;

directing a cryogenic coolant into the first chamber;

anchoring the first chamber to the first tissue region through cryoadhesion;

positioning at least one of a diagnostic element and a therapeutic element of the medical device adjacent a second tissue region; and

operating the at least one of a diagnostic element and therapeutic element proximate to the second tissue region.

7. The method of claim 6, wherein the at least one of a diagnostic element and therapeutic element includes a thermal ablation element, and wherein operating the ablation element includes ablating at least a portion of the second tissue region.

8. The method of claim 6, wherein positioning the at least one of a diagnostic element and therapeutic element includes moving the at least one of a diagnostic element and therapeutic element with respect to the first chamber.

9. The method of claim 6, wherein the at least one of a diagnostic element and therapeutic element includes a cardiac lead.

10. The method of claim 6, wherein the first tissue region includes cardiac tissue.

11. The method of claim 10, wherein the second tissue region includes a portion of the coronary sinus.

12. The method of claim 11, further comprising anchoring a second chamber of the medical device to a portion of the coronary sinus.

13. The method of claim 6, further comprising measuring a temperature of the first chamber.

14. The method of claim 6, further comprising:

obtaining positional information of the at least one of a diagnostic element and a therapeutic element; and

storing the positional information.

15. The method of claim 14, wherein obtaining positional information includes at least one of:

conducting a current through the at least one of a diagnostic element and a therapeutic element; and

measuring a voltage with the at least one of a diagnostic element and a therapeutic element.

16. The method of claim 15, wherein obtaining positional information includes determining an impedance between i) the at least one of a diagnostic element and a therapeutic element and ii) a reference electrode positioned about the patient.

17. The method of claim 15, further comprising:

registering the obtained positional information to a historical positional information set.

18. The method of claim 6, further comprising:

obtaining positional information of the first chamber; and

storing the positional information.

19. The method of claim 18, wherein obtaining positional information includes at least one of:

conducting a current through at least a portion of the first chamber; and

measuring a voltage with at least a portion of the first chamber.

20. The method of claim 19, wherein obtaining positional information includes determining an impedance between the portion of the first chamber and a reference electrode located proximate to the patient.

21. A method of treating a patient, comprising:

performing a first procedure, the first procedure including;

positioning at least one of a diagnostic element and a therapeutic element of a first medical device adjacent a first tissue region;

operating the at least one of a diagnostic element and therapeutic element proximate to the first tissue region;

obtaining positional information of the at least one of a diagnostic element and a therapeutic element;

generating a first map based on the positional information; and

performing a second procedure, the second procedure including;

positioning at least one of a diagnostic element and a therapeutic element of a second medical device adjacent a second tissue region;

operating the at least one of a diagnostic element and therapeutic element proximate a tissue region;

obtaining positional information of the at least one of a diagnostic element and a therapeutic element;

generating a second map based on the positional information;

registering the second map to the first map.

22. The method of claim 21, wherein the first procedure further comprises:

positioning a first chamber of the first medical device adjacent a third tissue region different from the first tissue region; and

anchoring the first chamber to the third tissue region.

23. The method of claim 22, wherein the second procedure further comprises:

positioning a first chamber of the second medical device adjacent a fourth tissue region different from the second tissue region; and

anchoring the first chamber to the fourth tissue region.

24. The method of claim 21, wherein the first tissue region and the second tissue region are substantially co-located.

25. A method of treating cardiac tissue, comprising:

directing a distal portion of a medical device into a coronary sinus;

positioning a first chamber of a medical device adjacent an atrial wall;

directing a cryogenic coolant into the first chamber;

anchoring the first chamber to the atrial wall through cryoadhesion; and

positioning a cardiac lead through at least a portion of the coronary sinus with the distal portion.