Method and apparatus for localized thermal ablation
First Claim
1. A thin, flexible catheter which can be advanced through a body vessel to an internal organ for microtransection or macrotransection of a desired portion of the internal organ, said catheter comprising:
- an elongated, thin flexible tube having a distal end and a proximal end;
a resistive heating element attached to said flexible tube;
coupling means for coupling said resistive heating element to a source of electrical energy in an ablation mode to cause resistive heating of said heating element, said heating element thereby producing localized thermal ablation of the desired portion of the organ when energized; and
a reference electrode attached to said flexible tube and proximally spaced from said heating element, said heating element and said reference electrode functioning in a sensing mode as sensing electrodes.
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Accused Products
Abstract
A thermal ablation catheter for microtransection or macrotransection of conduction paths within the heart includes a resistive heating element at its distal end for highly localized treatment. The heating element includes a resistive wire loop connected to an external power source and has a prescribed shape to insure that the wire loop is approximately perpendicular to the surface to be treated. A reference electrode spaced 8-10 inches from the distal end is used in conjunction with the wire loop (the sensing electrode) to sense potentials in the heart. The catheter is advanced through a blood vessel to the region of the A-V node and the His bundle, and the sensing mode is used to determine the desired location for treatment. The wire loop is then energized with d.c. current for a predetermined time on the order of 2-5 seconds to cause localized thermal ablation of the target area.
160 Citations
27 Claims
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1. A thin, flexible catheter which can be advanced through a body vessel to an internal organ for microtransection or macrotransection of a desired portion of the internal organ, said catheter comprising:
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an elongated, thin flexible tube having a distal end and a proximal end; a resistive heating element attached to said flexible tube; coupling means for coupling said resistive heating element to a source of electrical energy in an ablation mode to cause resistive heating of said heating element, said heating element thereby producing localized thermal ablation of the desired portion of the organ when energized; and a reference electrode attached to said flexible tube and proximally spaced from said heating element, said heating element and said reference electrode functioning in a sensing mode as sensing electrodes. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A thin, flexible catheter for passage through a blood vessel to the heart and for microtransection or macrotransection of a localized portion of the heart, said catheter comprising:
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an elongated, thin flexible tube having a distal end and a proximal end, a resistive heating element at the distal end of said flexible tube, said heating element including a prescribed length of resistive heating wire formed into a loop that is exposed for direct contact with the localized portion of the heart; mean for coupling said heating element to a source of electrical energy including a pair of electrical conductors connected to opposite ends of said heating wire and passing through said flexible tube to the proximal end of said flexible tube, said loop being raised to a sufficient temperature when energized by said source to effect localized thermal ablation of the localized portion of the heart, and a reference electrode attached to said flexible tube and proximally spaced from said heating element, and an electrical conductor connected to said reference electrode and passing through said flexible tube. - View Dependent Claims (13, 14, 15, 16, 17)
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18. Apparatus for microtransection of a desired portion of an internal body organ comprising:
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a thin, flexible catheter for passage through a body vessel to the internal organ including an elongated, thin flexible tube having a distal end and a proximal end; a resistive heating element at the distal end of said flexible tube, said heating element including a prescribed length of resistive heating wire, and a pair of electrical conductors connected to opposite ends of said heating wire and passing through said flexible tube; electrical power source means including means for supplying electrical power through said electrical conductors to said heating element for a predetermined time interval, said heating element causing localized thermal ablation of the desired portion of the organ when energized; and means for sensing electrical potentials within the heart to assist in determining a suitable location for thermal ablation and to evaluate the effect of thermal ablation, said sensing means including a reference electrode attached to said flexible tube and proximally spaced from said heating element, a third electrical conductor connected to said reference electrode and passing through said flexible tube, and means coupled to said third electrical conductor and at least one of said pair of conductors connected to said heating element for recording the potential between said heating element and said reference electrode. - View Dependent Claims (19, 20, 21)
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22. A method for microtransection or macrotransection of a conduction path in the heart comprising the steps of:
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providing a thin, flexible catheter having a resistive heating element at its distal end; advancing the flexible catheter through a blood vessel to the heart; placing the heating element in contact with the conduction path to be treated; and supplying electrical energy to said heating element for a predetermined time interval sufficient to cause localized thermal ablation of said conduction path. - View Dependent Claims (23, 24, 25)
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26. A thin, flexible catheter which can be advanced through a blood vessel to the heart for microtransection or macrotransection of a localized portion of the heart, said catheter comprising:
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an elongated, flexible catheter lead having a distal end and a proximal end; a resistive heating element at the distal end of said catheter lead; a reference electrode attached to said catheter lead and proximally spaced from said heating element; means for coupling said heating element to a source of electrical energy for thermal ablation of the localized portion of the heart in an ablation mode; and means for sensing an electrical potential between said heating element and said reference electrode in a sensing mode. - View Dependent Claims (27)
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Specification