CARDIAC ABLATION CATHETERS AND METHODS OF USE THEREOF

• US 20140357956A1
• Filed: 04/08/2014
• Published: 12/04/2014
• Est. Priority Date: 11/11/2008
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Amr Salahieh, Brian D. Brandt, Claudio Argento, Emma Leung, John P Claude, Jonah Lepak, Thilaka Sumanaweera
• Inventors: SALAHIEH, Amr, LEPAK, Jonah, LEUNG, Emma, BRANDT, Brian D., CLAUDE, John P., ARGENTO, Claudio, SUMANAWEERA, Thilaka, WEST, Zak
• Granted Patent: US 9,717,557 B2
• Time in Patent Office: Days
• US Class Current: 600/160
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00096 Optical elements
• CPC Class Codes: A61B 1/00181 for multiple fixed viewing angles A61B1/00193 takes precedence
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/051 Details of CCD assembly
• CPC Class Codes: A61B 1/06 with illuminating arrangements
• CPC Class Codes: A61B 1/0676 at distal tip of an endoscope
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/0016 : Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00214 : Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 : Balloons
• CPC Class Codes: A61B 2018/00232 : having an irregular shape
• CPC Class Codes: A61B 2018/00238 : porous
• CPC Class Codes: A61B 2018/00267 : having a basket shaped structure
• CPC Class Codes: A61B 2018/00285 : Balloons
• CPC Class Codes: A61B 2018/00291 : using suction
• CPC Class Codes: A61B 2018/00351 : Heart
• CPC Class Codes: A61B 2018/00357 : Endocardium
• CPC Class Codes: A61B 2018/00375 : Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00613 : Irreversible electroporation reversible electroporation A61N1/327
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00744 : Fluid flow
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00815 : measured by a thermistor
• CPC Class Codes: A61B 2018/00839 : Bioelectrical parameters, e.g. ECG, EEG
• 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 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1435 : Spiral
• CPC Class Codes: A61B 2018/1465 : Deformable electrodes
• CPC Class Codes: A61B 2034/2048 : using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2090/0454 : by reflection
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 : for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/309 : using white LEDs
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/364 : Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/371 : with simultaneous use of two cameras
• CPC Class Codes: A61B 2090/373 : using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/376 : using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3966 : Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2562/0215 : Silver or silver chloride containing
• CPC Class Codes: A61B 2562/0219 : Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 2562/125 : characterised by the manufacture of electrodes
• CPC Class Codes: A61B 2562/164 : the sensor is mounted in or on a conformable substrate or carrier
• CPC Class Codes: A61B 5/01 : Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/0538 : invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/067 : using accelerometers or gyroscopes
• CPC Class Codes: A61B 5/6852 : Catheters
• CPC Class Codes: A61B 5/6853 : with a balloon
• CPC Class Codes: A61B 5/6855 : with a distal curved tip
• CPC Class Codes: A61B 5/6858 : with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 90/30 : Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/92 : coded with colour
• CPC Class Codes: A61M 2025/0681 : Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• CPC Class Codes: A61M 25/0108 : using radio-opaque or ultrasound markers
• CPC Class Codes: A61M 25/0133 : Tip steering devices
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/04 : in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 25/1011 : Multiple balloon catheters
• CPC Class Codes: A61N 1/05 : for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/056 : Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/37247 : User interfaces, e.g. input or presentation means
• CPC Class Codes: C08L 2201/12 : Shape memory

Abstract

Cardiac ablation catheters and methods of use. In some embodiments the catheter includes at least one camera inside an expandable membrane for visualizing an ablation procedure.

Claims

1. An ablation catheter comprising:

an expandable membrane and a plurality of ablation electrodes secured to the exterior of the expandable membrane;

an imaging member disposed within the expandable membrane;

a diffuse reflector secured to at least a proximal portion of the expandable membrane; and

a light source disposed within the expandable member and positioned to direct light towards the diffuse reflector such that diffuse reflection of the light is directed towards a field of view of the imaging member.

2. The catheter of claim 1 wherein the imaging member is generally distally facing and the light source is generally proximally facing.

3. The catheter of claim 2 wherein the imaging member and the light source are secured to an inner catheter shaft.

4. The catheter of claim 3 wherein the imaging member is a plurality of cameras oriented to provide a 360 degree view around a longitudinal axis of the catheter.

5. The catheter of claim 2 wherein the imaging member is disposed distally relative the light source.

6. The catheter of claim 1 wherein the diffuse reflector does not extend to the distal end of the expandable membrane when in an expanded configuration.

7. The catheter of claim 6 wherein the diffuse reflector extends no further than about half-way along the distal length of the expandable membrane when in an expanded configuration.

8. The catheter of claim 1 wherein the diffuse reflector comprises first and second portions divided by a flex circuit secured to the exterior of the expandable membrane, the flex circuit comprising at least one conductive layer in electrical communication with at least one of the plurality of electrodes.

9. An inflatable assembly adapted to be positioned within a patient, comprising an expandable membrane;

an imaging member disposed within the expandable membrane;

a diffuse reflector secured to at least a proximal portion of the expandable membrane; and

a light source disposed within the expandable member and positioned to direct light towards the diffuse reflector such that diffuse reflection of the light is directed towards a field of view of the imaging member.

10-16. -16. (canceled)

17. An ablation catheter, comprising:

an expandable membrane and at least one ablation electrode secured to the exterior of the expandable membrane;

an imaging member disposed within the expandable membrane, the imaging member having a field of view;

a light source disposed within the expandable member adapted to deliver light towards the field of view of the imaging member; and

a reflection adjuster adapted to reduce specular reflection of light from at least one of the plurality of ablation electrodes into the field of view of the imaging member.

18. The catheter of claim 17 wherein the reflection adjuster is a light absorber.

19. The catheter of claim 17 wherein the reflection adjuster is adapted to scatter light away from the field of view of the imaging member.

20. The catheter of claim 17 wherein the reflection adjuster is an anti-reflective coating on at least one of an inside of balloon or the at least one electrode.

21. A video display process, comprising:

receiving a plurality of images from a camera in motion secured to a catheter;

calculating a mean rotation of a center of mass of an anatomical feature shown in the images relative to a feature whose position is fixed relative to the camera; and

communicating as output images in which the anatomical feature is fixed and the feature whose position is fixed relative to the camera is shown to be moving.

22. A method of stabilizing an image of cardiac tissue while moving a camera positioned within the heart;

comprising;

providing an ablation catheter within a left atrium, the ablation catheter including an expandable membrane, a plurality of electrodes secured to an exterior surface of the expandable membrane, at least one camera positioned within the expandable membrane with a field of view fixed relative to the position of the plurality of electrodes when the expandable membrane is in an expanded configuration, and a light source; and

in response to movement of the camera within the left atrium, and, while the camera is being moved, displaying a video of cardiac tissue in which the position of the cardiac tissue is fixed and the plurality of electrodes in the field of view are moving.

23. A method of superimposing an image of cardiac tissue with additional information, comprising:

positioning an ablation catheter within a left atrium, the ablation catheter including an expandable membrane, a plurality of electrodes secured to an exterior surface of the expandable membrane, at least one camera positioned within the expandable membrane, and a light source;

capturing an image with the at least one camera, wherein the image shows at least one of at least one of the plurality of electrodes and the cardiac tissue;

obtaining additional information indicative of at least one of a characteristic of the cardiac tissue and a characteristic of the ablation catheter; and

displaying the image that shows the at least one of at least one of the plurality of electrodes and the cardiac tissue with the with the additional information superimposed thereon.

24-29. -29. (canceled)

30. An ablation catheter comprising:

an expandable membrane and a plurality of ablation electrodes secured to the exterior of the expandable membrane;

at least one imaging member disposed within the expandable membrane, the at least one imaging member having a field of view that include the plurality of ablation electrodes; and

an electrode identifier associated with each of the plurality of electrodes and adapted to be visually identifiable in the field of view so that each of the plurality of electrodes can be visually identifiable.

31-34. -34. (canceled)