Biplanar deflectable catheter for arrhythmogenic tissue ablation
First Claim
1. A catheter comprising:
- (a) a flexible, tubular distal catheter section extending a main catheter tube and describing a distal catheter lumen and having a working distal tip area to be precisely controlled and including a distal tip;
(b) a single multi-function manipulation control means for manipulative control of the distal tip area and having a distal end anchored at or near the distal tip of the distal catheter section and operable in a manner such that the application of controlled longitudinal tension to the multi-function manipulation control means produces a corresponding controlled longitudinal bending of the distal tip area and the controlled application of rotational torque to the multi-function deflection control means produces a corresponding controlled radial deflection of the distal tip area in a plane substantially parallel to a direction of the applied rotational torque; and
(c) wherein the combined application of longitudinal tension and rotational torque to the control element provides three-dimensional manipulative control of the working distal tip section.
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Accused Products
Abstract
A vascular catheter has a highly flexible distal section. A biplanar control system is provided for enabling and controlling the movement of the distal catheter section and tip in any direction in a manner such that the distal tip is capable of accessing any point on the wall of the chamber entered. Dual-wire biplanar control system embodiments include a vertical deflection control wire operable to deflect the distal tip of the catheter in a controlled manner in a vertical plane substantially parallel to the longitudinal axis of the tubular catheter and a lateral deflection control wire operable to deflect the distal tip of the catheter in a controlled manner in a lateral plane substantially perpendicular to the longitudinal axis of the tubular catheter. A one-wire system for both vertical and lateral control is also described.
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Citations
32 Claims
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1. A catheter comprising:
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(a) a flexible, tubular distal catheter section extending a main catheter tube and describing a distal catheter lumen and having a working distal tip area to be precisely controlled and including a distal tip; (b) a single multi-function manipulation control means for manipulative control of the distal tip area and having a distal end anchored at or near the distal tip of the distal catheter section and operable in a manner such that the application of controlled longitudinal tension to the multi-function manipulation control means produces a corresponding controlled longitudinal bending of the distal tip area and the controlled application of rotational torque to the multi-function deflection control means produces a corresponding controlled radial deflection of the distal tip area in a plane substantially parallel to a direction of the applied rotational torque; and (c) wherein the combined application of longitudinal tension and rotational torque to the control element provides three-dimensional manipulative control of the working distal tip section. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A single element manipulation control system for a catheter comprising:
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(a) a main catheter tube describing a lumen therein; (b) a flexible, tubular distal catheter section extending the main catheter tube, having an external surface and describing a distal catheter lumen and having a working distal tip area to be precisely controlled and including a distal tip; (c) electrode means for establishing electrical connection with adjacent tissue surfaces comprising at least one electrode carried by the working distal tip area in communication with the external surface of the distal catheter section; (d) a control system for controlling said working distal tip area comprising an independent multi-function manipulation control element threaded loosely within the main catheter tube and the distal catheter lumen and having a distal end anchored at or near the distal tip of the distal catheter section and operable in a manner such that the application of tension to the control element axially displaces the control element and produces a corresponding controlled axial deflection or bending of the distal tip and the application of rotational torque to the control element produces a corresponding controlled radial deflection of the distal tip in a plane substantially parallel to a direction of the applied rotational torque; (e) wherein the application of a combination of axial tension and rotational torque to the control element provides three-dimensional manipulative control of the working distal tip section; and (f) control means for applying said axial tension and rotational torque to the multi-function manipulation control element comprising; (1) a control handle means for manipulating the distal tip area containing a cylindrical recess, a reciprocal piston means for operating the control means with the control handle means disposed in and reciprocally operable in the cylindrical recess and attached to the control means such that reciprocal motion of the piston causes a corresponding axial displacement of the multi-function manipulation control element and thereby controls the axial deflection of the distal tip; and (2) wherein the piston means is retained in hand-rotatable relation to the handle means such that the rotation of the piston means with respect to the handle means applies said rotational torque to the multi-function manipulation control element which the control element transmits to the distal tip thereby causing the distal tip to deflect radially correspondingly as desired. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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26. A method of mapping the electrical cardiac depolarization potentials and ablating tissue comprising the steps of:
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(a) introducing a deflectable cardiac mapping and ablation catheter system into a vascular system of a patient, the catheter system comprising; (1) a catheter having a flexible, tubular distal catheter section describing a distal catheter lumen and having a distal tip sought to be precisely controlled; (2) a single element control means for axial and radial deflection control disposed and extending within the distal catheter lumen and having a distal end anchored at a point at or near the distal end of the flexible distal catheter section and operable in a manner such that the reciprocal movement of the control means deflects or bends the distal tip of the catheter in a plane substantially parallel a direction of movement of the control means and such that the application of rotational torque to the control means when the tip is bent produces a corresponding deflection of the distal tip of the catheter in a radial plane substantially parallel to the direction of the applied rotational torque; (3) means for reciprocally displacing the single element control means along the flexible distal catheter lumen; and (4) means for applying rotational torque to the single element control means; (5) tip electrode means comprising at least one electrode carried by an electrode segment of the distal catheter section connected through the catheter system and in communication with an external surface of the distal catheter section; (b) adjusting the combined tension and torsion in the single element control means to deflect and steer the electrode means to access the tissue surface of the chamber as required; (c) using the tip electrode means to detect and map cardiac depolarization potentials; and (d) operating said tip electrode means to ablate early activation sites as indicated. - View Dependent Claims (27)
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28. A system for controlling manipulation of a catheter tip area in three-dimensional space comprising:
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(a) a catheter device having a proximal and a distal end an axis and a distal catheter tip area to be controlled at or proximate the distal end thereof; (b) independent manipulation means associated with said catheter device, the manipulation means further comprising a control element for the controlled bending of said catheter tip area, in a plane substantially parallel to the axis thereof, responsive to the application or relaxation of axial tension, and for the controlled radial manipulation of the catheter tip area, by the application of rotational torque, such that a combined application of axial tension and rotational torque to the control element produces three-dimensional manipulative control of the catheter tip; and (c) control means associated with said manipulation means for applying or relaxing axial tension and rotational torque thereto. - View Dependent Claims (29, 30)
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31. A dual-element catheter tip control system comprising:
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(a) a catheter having a highly flexible, tubular distal catheter section having a distal end and describing a distal catheter lumen and having a distal tip sought to be precisely controlled; (b) a first deflection control element threaded within the distal catheter lumen and having a distal end anchored at a point at or near the distal end of the flexible distal catheter section in a manner such that the axial displacement thereof deflects the distal tip of the catheter axially in a plane substantially parallel a direction of element movement; (c) means for axially displacing the first deflection control element further comprising; (1) a hand-operated control handle having an axially displaceable section attached to the first deflection control element, the axial motion of which causes a corresponding axial displacement of the first deflection control element and thereby controls the axial deflection of the distal tip; (d) a second deflection control element threaded within the distal catheter lumen and having a distal end anchored at or near the distal end of the flexible distal catheter section in a manner such that the application of rotational torque to the second deflection control element produces a corresponding radial deflection of the distal tip of the catheter in a plane substantially parallel to the direction of the applied rotational torque; and (e) means for applying said rotational torque to the second deflection control element further comprising; (1) a self-locking, hand-rotatable radial adjustment control knob mounted from the control handle and attached to the second deflection control element in a manner such that rotation of the knob left or right applies a corresponding rotational torque to the second deflection control element which transmits it to the distal tip thereby causing the distal tip to deflect radially as desired.
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32. A dual-element catheter tip control system comprising:
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(a) a catheter having a highly flexible, tubular distal catheter section having a distal end and describing a distal catheter lumen and having a distal tip sought to be precisely controlled; (b) a first deflection control element threaded within the distal catheter lumen and having a distal end anchored at a point at or near the distal end of the flexible distal catheter section in a manner such that the movement of the first deflection control element axially along in the distal catheter lumen deflects the distal tip of the catheter in a plane substantially parallel a direction of element movement; (c) means for axially displacing the first deflection control element along the flexible distal catheter lumen comprising; (1) a hand-operated control handle having a longitudinally displaceable section attached to the first deflection control element, the longitudinal motion of which causes a corresponding longitudinal displacement of the first deflection control element and thereby controls the axial deflection of the distal tip; (d) a second deflection control element threaded within the distal catheter lumen and having a distal end anchored at or near the distal end of the flexible distal catheter section in a manner such that the application of rotational torque to the second deflection control element produces a corresponding radial deflection of the distal tip of the catheter in a plane substantially parallel to the direction of the applied rotational torque; and (e) means for applying said rotational torque to the second deflection control element further comprising; (1) a rotatable ring gear means associated with an internal pinion gear connected to the second deflection control wire in a manner such that rotation of the ring gear causes a corresponding opposite rotation of the pinion gear, rotation of the pinion gear applying a corresponding amount of rotational torque to the second deflection control element which, in turn, transmits the torque to the distal tip and translating the torque into control to cause the distal tip to deflect radially as desired.
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Specification