MONITORING AND TRACKING BIPOLAR ABLATION

• US 20130158545A1
• Filed: 12/15/2011
• Published: 06/20/2013
• Est. Priority Date: 12/15/2011
• Status: Active Grant

• Current Assignee: Biosense Webster Israel Ltd. (Johnson & Johnson)
• Original Assignee: Biosense Webster Israel Ltd. (Johnson & Johnson)
• Inventors: Govari, Assaf, Ephrath, Yaron, Altman, Andres Claudio
• Granted Patent: US 10,456,196 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 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]

Abstract

Methods and systems treat abnormal cardiac electrical activity employing a probe having first and second ablation electrodes disposed on a distal portion of the probe and a sensing electrode disposed between the first and second ablation electrodes, bringing the probe into contact with cardiac tissue, and applying energy through the first and second ablation electrodes to ablate target tissue along an ablation path, monitoring cardiac electrical activity using the sensing electrode to detect the cardiac electrical activity. After making an observation that the cardiac electrical activity is no longer detectable by the sensing electrode, energy application is terminated.

Claims

1. A method for treating abnormal cardiac electrical activity, comprising the steps of:

providing a probe having first and second ablation electrodes disposed on a distal portion of the probe and a sensing electrode disposed between the first and second ablation electrodes;

bringing the probe into contact with a target tissue in a heart of a subject;

applying energy through the first and second ablation electrodes to ablate the target tissue along an ablation path;

while performing the step of applying energy, monitoring cardiac electrical activity using the sensing electrode to detect the cardiac electrical activity;

making an observation that the cardiac electrical activity is no longer detectable by the sensing electrode; and

responsively to the observation terminating the step of applying energy.

2. The method according to claim 1, wherein the cardiac electrical activity is near-field activity.

3. The method according to claim 2, wherein there is a phase shift of 90°

between an E field and an H field of the cardiac electrical activity.

4. The method according to claim 1, wherein applying energy comprises alternating between a bipolar mode of operation wherein the first and second ablation electrodes function as bipolar electrodes and a unipolar mode of operation wherein at least one of the first and second ablation electrodes functions as a unipolar electrode.

5. The method according to claim 1, further comprising:

monitoring the step of applying energy by graphically displaying a map of a portion of the heart that includes the target tissue and a progression of energy application along the ablation path.

6. The method according to claim 5, wherein applying energy further comprises alternating between a bipolar mode of operation wherein the first and second ablation electrodes function as bipolar electrodes and a unipolar mode of operation wherein at least one of the first and second ablation electrodes functions as a unipolar electrode, and wherein monitoring cardiac electrical activity comprises tagging the map to indicate first and second portions of the ablation path associated with the bipolar mode of operation and the unipolar mode of operation, respectively.

7. The method according to claim 1, wherein the probe has at least two sensing electrodes disposed between the first and second ablation electrodes.

8. A medical apparatus, comprising:

a probe having first and second ablation electrodes disposed on a distal portion of the probe and a sensing electrode disposed between the first and second ablation electrodes;

an ablation energy generator connected to the first and second ablation electrodes; and

a monitor connected to the sensing electrode and operative to detect cardiac electrical activity via the sensing electrode when the probe is brought into contact with a target tissue in a heart of a subject, the monitor comprising a graphical display operative for displaying a map of a portion of the heart that includes the target tissue and a progression of energy application along an ablation path.

9. The apparatus according to claim 8, wherein the cardiac electrical activity is near-field activity.

10. The apparatus according to claim 8, wherein there is a phase shift of 90°

between an E field and an H field of the cardiac electrical activity.

11. The apparatus according to claim 8, further comprising configuration circuitry for configuring the first and second ablation electrodes to function in a bipolar mode of operation wherein the first and second ablation electrodes function as bipolar electrodes and in a unipolar mode of operation wherein at least one of the first and second ablation electrodes functions as a unipolar electrode.

12. The apparatus according to claim 11, wherein the monitor is operative for tagging the map to indicate first and second portions of the ablation path associated with the bipolar mode of operation and the unipolar mode of operation, respectively.

13. The apparatus according to claim 8, wherein the sensing electrode comprises at least two sensing electrodes disposed between the first and second ablation electrodes.