CLOSURE AND ABLATION OF BODY VISCERA AND CONDUITS

• US 20170281193A1
• Filed: 08/26/2015
• Published: 10/05/2017
• Est. Priority Date: 08/26/2014
• Status: Abandoned Application

• Current Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Original Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Inventors: Asirvatham, Samuel J., Holmes, Jr., David R.
• Application Number:
  US15/505,982
• Publication Number:
  US 20170281193A1
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/12177 comprising additional materials, e.g. thrombogenic, having filaments, having fibers or being coated
• 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 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00273 Anchoring means for temporary attachment of a device to tissue
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• 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 2018/00791 Temperature
• 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 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1495 Electrodes being detachable from a support structure
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter

Abstract

Devices and methods can be used to treat heart conditions. Some such devices include endocardial occlusion and ablation devices. For example, such devices can be used for closing and ablating the left atrial appendage to treat atrial fibrillation and to reduce the potential for embolic stroke. In addition, this document provides devices and methods for closing and ablating other body viscera, conduits, valves, and the like.

Claims

1. An implantable medical device comprising:

a frame comprising multiple elongate elements, the frame being reconfigurable between a low-profile delivery configuration and an expanded configuration;

a covering, attached to the frame, the covering comprising a skirt that restricts blood flow through at least a portion of the frame;

a plurality of electrode pairs fixedly disposed around an outer periphery of the medical device, the electrode pairs configured to deliver ablation energy; and

at least one pair of distally-located electrodes attached to the frame.

2. The implantable medical device of claim 1, further comprising one or more anchor features extending outward from the outer periphery of the medical device.

3. The implantable medical device of claim 1, wherein the skirt is selectively deployable such that at least a portion of the skirt is extendable outward from the outer periphery of the medical device.

4. The implantable medical device of claim 3, wherein the covering is pleated or elastic to facilitate deployment of the selectively deployable skirt.

5. The implantable medical device of claim 1, wherein the at least one pair of distally-located electrodes are configured for pacing or electrographic detection.

6. The implantable medical device of claim 1, wherein the plurality of electrode pairs include two or more different sizes of electrode pairs.

7. An implantable medical device comprising:

a frame comprising one or more elongate elements, the frame being reconfigurable between a low-profile delivery configuration and an expanded configuration; and

a covering, attached to the frame, the covering comprising a skirt, wherein the skirt is selectively deployable such that at least a portion of the skirt is extendable outward from an outer periphery of the medical device.

8. The implantable medical device of claim 7, wherein the medical device is selected from a group consisting of:

an occluder, a prosthetic valve, a stent, and a filter.

9. An implantable medical device system comprising:

a deployment system including a catheter and a sheath defining a lumen, wherein the catheter is slidably disposed within the lumen;

a frame comprising multiple elongate elements, the frame being reconfigurable between a low-profile delivery configuration and an expanded configuration, wherein the frame is in the low-profile deliver configuration when the frame is confined within the lumen and wherein the frame is in the expanded configuration when the frame is not confined in the lumen;

a covering, attached to the frame, the covering comprising a skirt that restricts blood flow through at least a portion of the frame;

a plurality of electrode pairs fixedly disposed around an outer periphery of the medical device, the electrode pairs configured to deliver ablation energy; and

at least one pair of distally-located electrodes attached to the frame.

10. The implantable medical device system of claim 9, further comprising an ablation energy source and controller that runs an algorithm for controlling ablation energy delivered to the plurality of electrode pairs.

11. A method for treating a human heart of a patient, the method comprising:

deploying an implantable medical device within a left atrial appendage of the heart, wherein the implantable medical device comprises;

a frame comprising multiple elongate elements, the frame being reconfigurable between a low-profile delivery configuration and an expanded configuration;

a covering, attached to the frame, the covering comprising a skirt that restricts blood flow through at least a portion of the frame;

a plurality of electrode pairs fixedly disposed around an outer periphery of the medical device, the electrode pairs configured to deliver ablation energy; and

at least one pair of distally-located electrodes attached to the frame;

delivering ablation energy from the plurality of electrode pairs to the left atrial appendage; and

detecting, using the pair of distally-located electrodes, the presence or absence of an electrogram on the left atrial appendage.

12. The method of claim 11, further comprising individually modulating ablation energy delivered to individual pairs of the plurality of electrode pairs.

13. The method of claim 11, wherein the delivering ablation energy at least partially continues until one or more gaps between the implantable medical device and the left atrial appendage are determined to be sealed by formation of scar tissue.

14. The method of claim 11, wherein the skirt is selectively deployable such that at least a portion of the skirt is extendable outward from the outer periphery of the medical device.

15. The method of claim 14, further comprising deploying one or more portions of the selectively deployable skirt.

16. The method of claim 15, wherein the deploying comprises delivering an energy from outside of the patient that is received by the implantable medical device.

17. The method of claim 16, wherein the energy is RF.