Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method

• US 5,324,284 A
• Filed: 06/05/1992
• Issued: 06/28/1994
• Est. Priority Date: 06/05/1992
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Cardiac Pathways Corp. (Boston Scientific Corporation)
• Inventors: Imran, Mir A.
• Primary Examiner(s): ASCHENBRENNER, PETER
• Application Number:
  US07/894,529
• Time in Patent Office: 753 Days
• Field of Search: 604/95, 606/33, 606/15, 128/692, 128/786, 128/784
• US Class Current: 606/15
• 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 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00505 Urinary tract
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0158 with magnetic or electrical means, e.g. by using piezo materials, electroactive polymers, magnetic materials or by heating of shape memory materials
• CPC Class Codes: C08L 2201/12 Shape memory

Abstract

Endocardial mapping and ablation system for introduction into a chamber of a heart formed by a wall and having a passage leading thereto. The system is comprised of a catheter probe having a distal extremity. A plurality of electrodes are carried by the distal extremity for mapping the wall of the chamber. An ablation catheter is provided having a distal extremity. The ablation catheter has control means whereby the distal extremity can be bent separately of movement of the catheter probe to come into close proximity to the wall of the heart. The distal extremity of the ablation catheter is provided with capabilities for ablating a portion of the wall of the heart to eliminate an arrhythmia in the heart.

Claims

1. In an endocardial mapping and ablation system for introduction into a chamber of a heart formed by a wall and having a passage leading thereto, a catheter probe having a distal extremity, a plurality of electrodes carried by the distal extremity of the catheter probe for mapping the wall of the chamber, an ablation catheter carried by the catheter probe and having a distal extremity movable into the chamber, said ablation catheter having control means whereby the distal extremity can be bent independently of movement of the catheter probe while the distal extremity of the catheter probe is in the chamber to come into close proximity to the wall of the heart and means carried by the distal extremity of the ablation catheter for ablating a portion of the wall of the heart.

2. A system as in claim 1 wherein said ablation catheter is provided with means for delivering RF energy for ablation.

3. A system as in claim 1 wherein said ablation catheter is provided with means for delivering laser energy for causing ablation.

4. A system as in claim 1 wherein said ablation catheter is provided with means for delivering a chemical for providing ablation.

5. A system as in claim 4 wherein said means for delivering a chemical includes a retractable cannula.

7. A system as in claim 1 wherein said ablation catheter has a longitudinal axis and wherein said control means includes means for steering the distal extremity of the ablation catheter through an angle of 360°

with respect to the longitudinal axis.

8. A system as in claim 1 together with a computer connected to the catheter probe and to the ablation catheter for automatically bringing the distal extremity of the ablation catheter into the vicinity of a selected electrode of the plurality of electrodes for performing an ablation.

6. In an endocardial mapping and ablation system for introduction into a chamber of a heart formed by a wall and having a passage leading thereto, a catheter probe having a distal extremity, a plurality of electrodes carried by the distal extremity of the catheter probe for mapping the wall of the chamber, an ablation catheter having a distal extremity movable into the chamber, said ablation catheter having control means whereby the distal extremity can be bent independently of movement of the catheter probe to come into close proximity to the wall of the heart and means carried by the distal extremity of the ablation catheter for ablating a portion of the wall of the heart, said catheter probe being provided with a lumen extending therethrough, said ablation catheter being slidably mounted in said lumen.

9. In an ablation catheter for introduction into a chamber of the heart, a flexible elongate member, said flexible elongate member having a centrally disposed lumen extending therethrough, said flexible elongate element having at least four additional lumens extending therethrough and generally surrounding the centrally disposed lumen, at least three of said additional lumens being spaced approximately 120°

apart, a flexible elongate element having a negative coefficient of expansion disposed in each of said three additional lumens, and a ground return conductor disposed in another of said additional lumens, means connecting the distal extremities of the flexible elongate elements formed of a material having a negative coefficient of expansion to the ground return conductor and means including conductors connected to said flexible elongate elements of a material having a negative coefficient of expansion for supplying electrical energy to the same to cause bending of the distal extremity with respect to the longitudinal axis.

10. A catheter as in claim 9 together with the electrode mounted on the distal extremity and connected to the ground return, and a conductor disposed in the central lumen and connected to the electrode for supplying radio frequency energy to the electrode.

11. A catheter as in claim 9 together with a fiber optic disposed in the central lumen and means for delivering laser energy to the fiber optic to cause ablation.

12. A catheter as in claim 9 together with a retractable cannula disposed within the central lumen and means for delivering a chemical to the distal extremity of the catheter through the central lumen.

13. In an endocardial mapping and ablation system for introduction into a chamber of the heart having blood therein and formed by a wall and having a passage leading thereto, a catheter probe having proximal and distal extremities and being comprised of a flexible elongate tubular member having at least one lumen extending therethrough extending the length thereof, a plurality of longitudinally and radially spaced apart electrodes, expandable means secured to the distal extremity of the flexible elongate tubular member and being movable between a contracted position and an expanded position, means mounting said electrodes on said expandable means whereby when the expandable means is moved to the expanded position in a chamber in the heart, the electrodes are moved into engagement with the wall forming the chamber of the heart in which the expandable means is disposed, means coupled to the expandable means for moving said expandable means between said contracted and expanded positions, leads in contact with the electrodes and extending into the flexible elongate tubular member, electrical means connected to said leads for performing electrical functions with respect to said electrodes, and an ablation catheter having proximal and distal extremities and slidably disposed in said lumen in said catheter probe, said ablation catheter comprising a flexible elongate member having proximal and distal extremities and a centrally disposed lumen extending therethrough, said flexible elongate member of said ablation catheter having at least three additional lumens spaced apart circumferentially about the centrally disposed lumen and extending into the distal extremity, an additional flexible elongate element having a negative coefficient of expansion disposed in each of said three additional lumens in said ablation catheter and having proximal and distal extremities, a common electrical return disposed in the ablation catheter, means interconnecting the distal extremities of the additional flexible elongate elements having a negative coefficient of expansion and said common electrical return, electrical means for supplying electrical energy to said flexible elongate elements having a negative coefficient of expansion to cause bending of the distal extremity of the ablation catheter and means carried by the distal extremity of the ablation catheter for causing ablation in the wall of the heart.

14. In a method for endocardial mapping and ablation of the wall of a heart forming a chamber in the heart and having a passage leading thereto by the utilization of a catheter probe having a plurality of electrodes and an ablation catheter, introducing the catheter probe into the chamber of the heart, performing mapping operations with the catheter probe to ascertain the focus of an arrhythmia in the heart, introducing the ablation catheter so that its distal extremity is disposed within the chamber of the heart while the catheter probe is in the chamber of the heart, manipulating the distal extremity of the ablation catheter while the catheter probe is in the chamber of the heart so that the distal extremity is brought into close proximity to the focus of the arrhythmia and utilizing the ablation catheter for delivering means for causing ablation in the tissue of the wall of the heart to terminate the arrhythmia.

15. A method as in claim 14 wherein radio frequency energy is delivered to cause the ablation.

16. A method as in claim 14 wherein laser energy is used to cause the ablation.

17. A method as in claim 14 wherein a chemical is used to cause the ablation.

18. A method as in claim 17 wherein a cut is placed into the wall before introduction of the chemical.

19. A method as in claim 14 by utilization of a computer, utilizing the computer to perform the mapping operation to select an electrode at the plurality of electrodes where an ablation is to be performed, and utilizing the computer to automatically position the distal extremity of the catheter probe in the vicinity of the selected electrode.

20. In an endocardial mapping and ablation system for introduction into a chamber of a heart formed by a wall and having a passage leading thereto, a catheter probe having a distal extremity, a plurality of electrodes, means carried by the distal extremity of the catheter probe for supporting said electrodes in spaced-apart positions so that blood in the chamber of the heart can flow therebetween, an ablation catheter carried by the catheter probe and having a distal extremity movable into the chamber and control means for moving the distal extremity of the ablation catheter independently of movement of the electrodes so that the distal extremity can be brought into close proximity to the wall of the heart between the electrodes and means carried by the distal extremity of the ablation catheter for ablating a portion of the wall of the heart while the distal extremity of the catheter probe is in the chamber of the heart.

21. In a method for endocardial mapping and ablation of the wall of the heart forming a chamber in the heart and having a passage leading thereto by utilization of a catheter probe having a plurality of electrodes and an ablation catheter, introducing the catheter probe into the chamber of the heart, performing mapping operations with the catheter probe by bringing the electrodes of the catheter probe into engagement with the wall of the heart in spaced-apart positions to ascertain the focus of an arrhythmia in the heart, introducing the ablation catheter so that its distal extremities disposed within the chamber of the heart while the catheter probe is in the chamber of the heart, manipulating the distal extremity of the ablation catheter while the catheter probe is in the chamber of the heart so that the distal extremity is brought into close proximity to the focus of the arrhythmia by moving the distal extremity of the ablation catheter between the electrodes and utilizing the ablation catheter for delivering means for causing ablation in the tissue of the wall to terminate the arrhythmia.