Apparatus and method for ablation

• US 5,443,489 A
• Filed: 09/23/1994
• Issued: 08/22/1995
• Est. Priority Date: 07/20/1993
• Status: Expired due to Term

• Current Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Original Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Inventors: Ben-Haim, Shlomo
• Primary Examiner(s): MANUEL, GEORGE C
• Application Number:
  US08/311,596
• Time in Patent Office: 333 Days
• Field of Search: 128/642, 128/644, 128/660.03, 128/653.1, 128/772, 607/115, 607/116, 607/122, 606/13, 606/14, 606/39, 606/41, 606/46
• US Class Current: 607/115
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/14 Probes or electrodes 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00044 Sensing electrocardiography, i.e. ECG
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/6843 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/6885 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61N 1/06 for high-frequency therapy
• CPC Class Codes: A61N 1/3621 : for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3627 : for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia

Abstract

This invention concerns an apparatus and method for the treatment of cardiac arrhythmias. More particularly, this invention is directed to a method for ablating a portion of an organ or bodily structure of a patient, which comprises obtaining a perspective image of the organ or structure to be mapped; advancing one or more catheters having distal tips to sites adjacent to or within the organ or structure, at least one of the catheters having ablation ability; sensing the location of each catheter'"'"'s distal tip using a non-ionizing field; at the distal tip of one or more catheters, sensing local information of the organ or structure; processing the sensed information to create one or more data points; superimposing the one or more data points on the perspective image of the organ or structure; and ablating a portion of the organ or structure.

Claims

1. A method of ablating a portion of an organ or a bodily structure of a patient, which comprises the steps of:

(a) positioning the distal tip of each of one or more catheters at a site adjacent to or within an organ or bodily structure;

(b) sensing location information at the site;

(c) sensing local information at the site;

(d) processing sensed information from steps (b) and (c) to create one or more data points;

(e) repeating steps (a), (b), (c) and (d) one or more times to create sufficient data points for a map; and

(f) ablating a portion of an organ or a bodily structure of a patient.

2. The method of claim 1 which comprises an additional step before step (f) wherein said data points or said map is transmitted to receiving means.

3. The method of claim 2 which comprises a further step before step (f) wherein said data points or said map received by receiving means is projected onto an image receiving means.

4. The method of claim 3 which comprises a yet further step before step (f) wherein the location of a mapping/ablation catheter distal tip is superimposed on said projected data points or map on said image receiving means.

28. The method of claim 1, 5, 10, 14, 18 or 23, wherein sensing location information is achieved using a non-ionizing field.

5. A method for ablating a portion of an organ or a bodily structure of a patient, which comprises the steps of:

(a) obtaining a perspective image of the organ or bodily structure;

(b) positioning the distal tip of each of one or more catheters at a site adjacent to or within an organ or bodily structure;

(c) sensing location information at the site;

(d) sensing local information at the site;

(e) processing sensed information from steps (c) and (d) to create one or more data points; and

(f) repeating steps (b), (c), (d) and (e) one or more times to create sufficient data points for a map;

(g) superimposing said data points from steps (e) and (f) on the perspective image of the organ or bodily structure; and

(h) ablating a portion of an organ or a bodily

structure of a patient.

6. The method of claim 5 which comprises an additional step before step (h) wherein said data points or map and said perspective image are transmitted to receiving means.

7. The method of claim 6 which comprises a further step before step (h) wherein the location of a mapping/ablation catheter distal tip is superimposed on the perspective image of the organ or bodily structure.

8. The method of claim 6 which comprises a further step before step (h) wherein said data points or map and said perspective image received by receiving means are projected onto an image receiving means.

9. The method of claim 8 which comprises a yet further step before step (h) wherein the location of a mapping/ablation catheter distal tip is superimposed on said projected data points or map and said perspective image on said image receiving means.

10. A method of ablating a portion of an organ or a bodily structure of a patient, which comprises the steps of:

(a) positioning the distal tip of each of one or more reference catheters at a site adjacent to or within an organ or bodily structure;

(b) positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within an organ or bodily structure;

(c) sensing location information at each site;

(d) sensing local information at site with each mapping/ablation catheter distal tip;

(e) processing sensed information from steps (c) and (d) to create one or more data points;

(f) repeating steps (b), (c), (d) and (e) one or more times to create sufficient data points for a map; and

(g) ablating a portion of an organ or a bodily structure of a patient.

11. The method of claim 10 which comprises an additional step before step (g) wherein said data points or said map is transmitted to receiving means.

12. The method of claim 11 which comprises a further step before step (g) wherein said data points or said map received by receiving means is projected onto an image receiving means.

13. The method of claim 12 which comprises a yet further step before step (g) wherein the location of a mapping/ablation catheter distal tip is superimposed on said projected data points or map on said image receiving means.

14. A method for ablating a portion of an organ or a bodily structure of a patient, which comprises the steps of:

(a) positioning the distal tip of each of one or more reference catheters at a site adjacent to or within an organ or bodily structure;

(b) positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within an organ or bodily structure;

(c) sensing locating information at each site;

(d) determining relative location of each mapping/ablation distal tip relative to reference catheter distal tips;

(e) sensing local information at a site with each mapping/ablation catheter distal tip;

(f) processing sensed information from steps (d) and (e) to create one or more data points;

(g) repeating steps (b), (c), (d), (e) and (f) one or more times to create sufficient data points for a map; and

(h) ablating a portion of an organ or a bodily

structure of a patient.

15. The method of claim 14 which comprises an additional step before step (h) wherein said data points or said map is transmitted to receiving means.

16. The method of claim 15 which comprises a further step before step (h) wherein said data points or said map received by receiving means is projected onto an image receiving means.

17. The method of claim 16 which comprises a yet further step before step (h) wherein the location of a mapping/ablation catheter distal tip is superimposed on said projected data points or map on said image receiving means.

18. A method for ablating a portion of an organ or a bodily structure of a patient, which comprises the steps of:

(a) obtaining a perspective image of the organ or bodily structure;

(b) positioning the distal tip of each of one or more reference catheters at a site adjacent to or within an organ or bodily structure;

(c) positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within an organ or bodily structure;

(d) sensing location information at each site;

(e) sensing local information at a site with each mapping/ablation catheter distal tip;

(f) processing sensed information from steps (d) and (e) to create one or more data points;

(g) repeating steps (c), (d), (e) and (f) one or more times to create sufficient data points for a map;

(h) superimposing said data points or map from steps (f) and (g) on the perspective image of the organ or bodily structure; and

(i) ablating a portion of an organ or a bodily structure of a patient.

19. The method of claim 18 which comprises an additional step before step (i) wherein said data points or map and said perspective image are transmitted to receiving means.

20. The method of claim 19 which comprises a further step before step (i) wherein local information of a mapping/ablation catheter distal tip is superimposed on the perspective image of the organ or bodily structure.

21. The method of claim 18 which comprises a further step before step (i) wherein said data points or map and said perspective image received by receiving means are projected onto an image receiving means.

22. The method of claim 21 which comprises a yet further step before step (i) wherein the location of a mapping/ablation catheter distal tip is superimposed on said projected data points or map and said perspective image on said image receiving means.

23. A method for ablating a portion of an organ or a bodily structure of a patient, which comprises the steps of:

(a) obtaining a perspective image of the organ or bodily structure;

(b) positioning the distal tip of each of one or more reference catheters at a site adjacent to or within an organ or bodily structure;

(c) positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within an organ or bodily structure;

(d) sensing location information at each site;

(e) determining relative location of each mapping/ablation distal tip relative to reference catheter distal tips;

(f) sensing local information at a site with each mapping/ablation catheter distal tip;

(g) processing sensed information from steps (e) and

(f) to create one or more data points;

(h) repeating steps (c), (d), (e), (f) and (g) one or more times to create sufficient data points for a map;

(i) superimposing said data points or map from steps

(g) and (h) on the perspective image of the organ or bodily structure; and

(j) ablating a portion of an organ or a bodily structure of a patient.

24. The method of claim 23 which comprises an additional step before step (j) wherein said data points or map and said perspective image are transmitted to receiving means.

25. The method of claim 24 which comprises a further step before step (j) wherein the location of a mapping/ablation catheter distal tip is superimposed on the perspective image of the organ or bodily structure.

26. The method of claim 24 which comprises a further step before step (j) wherein said data points or map and said perspective image received by receiving means are projected onto an image receiving means.

27. The method of claim 26 which comprises a yet further step before step (j) wherein the location of a mapping/ablation catheter distal tip is superimposed on the said projected data points or map and said perspective image on said image receiving means.

29. An apparatus for ablating a portion of an organ or a bodily structure of a patient, which comprises:

(a) means for positioning the distal tip of each of one or more catheters at a site adjacent to or within an organ or bodily structure;

(b) means for sensing location information at the site;

(c) means for sensing local information at the site;

(d) means for processing sensed information from means (b) and (c) to create one or more data points;

(e) means for repeating the functions of means (a), (b), (c) and (d) one or more times to create sufficient data points for a map; and

(f) means for ablating a portion of an organ or a

bodily structure of a patient.

30. The apparatus of claim 29 which additionally comprises means for transmitting said data points or said map to receiving means.

31. The apparatus of claim 30 which further comprises means for projecting said data points or said map received by receiving means onto an image receiving means.

32. The apparatus of claim 31 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map on said image receiving means.

56. The apparatus of claim 29, 33, 38, 42, 46 or 51, wherein location information is sensed using a non-ionizing field.

33. An apparatus for ablating a portion of an organ or a bodily structure of a patient, which comprises:

(a) means for obtaining a perspective image of the organ or bodily structure;

(b) means for positioning the distal tip of each of one or more catheters at a site adjacent to or within an organ or bodily structure;

(c) means for sensing location information at the site;

(d) means for sensing local information at the site;

(e) means for processing sensed information from means (c) and (d) to create one or more data points;

(f) means for repeating the functions of means (b), (c), (d) and (e) one or more times to create sufficient data points for a map;

(g) means for superimposing said data points from means (e) and (f) on the perspective image of the organ or bodily structure; and

(h) means for ablating a portion of an organ or a bodily structure of a patient.

34. The apparatus of claim 33 which additionally comprises means for transmitting said data points or map and said perspective image to receiving means.

35. The apparatus of claim 33 which further comprises means for superimposing the location of a mapping/ablation catheter distal tip on the perspective image of the organ or bodily structure.

36. The apparatus of claim 34 which further comprises means for projecting said data points or map and said perspective image received by receiving means onto an image receiving means.

37. The apparatus of claim 36 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map and said perspective image on said image receiving means.

38. An apparatus for ablating a portion of an organ or a bodily structure of a patient, which comprises:

(a) means for positioning the distal tip of each of one or more reference catheters at a site adjacent to or within an organ or bodily structure;

(b) means for positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within an organ or bodily structure;

(c) means for sensing location information at each site;

(d) means for sensing local information at site with each mapping/ablation catheter distal tip;

(e) means for processing sensed information from means (c) and (d) to create one or more data points;

(f) means for repeating the functions of means (b), (c), (d) and (e) one or more times to create sufficient data points for a map; and

(g) means for ablating a portion of an organ or a bodily structure of a patient.

39. The apparatus of claim 38 which additionally comprises means for transmitting said data points or said map to receiving means.

40. The apparatus of claim 39 which further comprises means for projecting said data points or said map received by receiving means onto an image receiving means.

41. The apparatus of claim 40 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map on said image receiving means.

42. An apparatus for ablating a portion of an organ or a bodily structure of a patient, which comprises:

(a) means for positioning the distal tip of each of one or more reference catheters at a site adjacent to or within an organ or bodily structure;

(b) means for positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within an organ or bodily structure;

(c) means for sensing locating information at each site;

(d) means for determining relative location of each mapping/ablation distal tip relative to reference catheter distal tips;

(e) means sensing local information at a site with each mapping/ablation catheter distal tip;

(f) means for processing sensed information from means (d) and (e) to create one or more data points;

(g) means for repeating the functions of means (b), (c), (d), (e) and (f) one or more times to create sufficient data points for a map; and

(h) means for ablating a portion of an organ or a bodily structure of a patient.

43. The apparatus of claim 42 which additionally comprises means for transmitting said data points or said map to receiving means.

44. The apparatus of claim 43 which further comprises means for projecting said data points or said map received by receiving means onto an image receiving means.

45. The apparatus of claim 44 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map on said image receiving means.

46. An apparatus for ablating a portion of an organ or a bodily structure of a patient, which comprises:

(a) means for obtaining a perspective image of the organ or bodily structure;

(b) means for positioning the distal tip of each of one or more reference catheters at a site adjacent to or within an organ or bodily structure;

(c) means for positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within an organ or bodily structure;

(d) means for sensing location information at each site;

(e) means for sensing local information at a site with each mapping/ablation catheter distal tip;

(f) means for processing sensed information from means (d) and (e) to create one or more data points;

(g) means for repeating the functions of means (c), (d), (e) and (f) one or more times to create sufficient data points for a map;

(h) means for superimposing said data points or map from means (f) and (g) on the perspective image of the organ or bodily structure; and

(i) means for ablating a portion of an organ or a bodily structure of a patient.

47. The apparatus of claim 46 which additionally comprises means for transmitting said data points or map and said perspective image to receiving means.

48. The apparatus of claim 47 which further comprises means for superimposing local information of a mapping/ablation catheter distal tip on the perspective image of the organ or bodily structure.

49. The apparatus of claim 47 which further comprises means for projecting said data points or map and said perspective image received by receiving means onto an image receiving means.

50. The apparatus of claim 49 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on said projected data points or map and said perspective image on said image receiving means.

51. An apparatus for ablating a portion of an organ or a bodily structure of a patient, which comprises:

(a) means for obtaining a perspective image of the organ or bodily structure;

(b) means for positioning the distal tip of each of one or more reference catheters at a site adjacent to or within an organ or bodily structure;

(c) means for positioning the distal tip of each of one or more mapping/ablation catheters at a site adjacent to or within an organ or bodily structure;

(d) means for sensing location information at each site;

(e) means for determining relative location of each mapping/ablation distal tip relative to reference catheter distal tips;

(f) means for sensing local information at a site with each mapping/ablation catheter distal tip;

(g) means for processing sensed information from means (e) and (f) to create one or more data points;

(h) means for repeating the functions of means (c), (d), (e), (f) and (g) one or more times to create sufficient data points for a map;

(i) means for superimposing said data points or map from means (g) and (h) on the perspective image of the organ or bodily structure; and

(j) means for ablating a portion of an organ or a bodily structure of a patient.

52. The apparatus of claim 51 which additionally comprises means for transmitting said data points or map and said perspective image to receiving means.

53. The apparatus of claim 52 which further comprises means for superimposing the location of a mapping/ablation catheter distal tip on the perspective image of the organ or bodily structure.

54. The apparatus of claim 52 which further comprises means for projecting said data points or map and said perspective image received by receiving means onto an image receiving means.

55. The apparatus of claim 54 which yet further comprises means for superimposing the location of a mapping/ablation catheter distal tip on the said projected data points or map and said perspective image on said image receiving means.