Atrial mapping and ablation catheter system

• US 5,487,385 A
• Filed: 12/03/1993
• Issued: 01/30/1996
• Est. Priority Date: 12/03/1993
• Status: Expired due to Term

• Current Assignee: Boaz Avitall
• Original Assignee: Boaz Avitall
• Inventors: Avitall, Boaz
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Casler, Brian L.
• Application Number:
  US08/161,920
• Time in Patent Office: 788 Days
• Field of Search: 128/642, 607/122, 607/125, 607/126, 607/98, 607/99
• US Class Current: 600/374
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00148 with metal
• 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 2018/00273 Anchoring means for temporary attachment of a device to tissue
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2562/043 in a linear array
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6855 with a distal curved tip
• CPC Class Codes: A61B 5/6856 : with a distal loop
• CPC Class Codes: A61B 5/6859 : with multiple distal splines
• CPC Class Codes: A61N 1/06 : for high-frequency therapy

Abstract

A recording and ablation catheter system for creating linear lesions in the right atrial chamber of a heart is disclosed which includes an array of readily controlled electroded arcuate distal working catheter shapes that are easily deployed to contact the inner wall surface of the right atrial cardiac chamber in a manner that enables easy recording and mapping of impulses and thereafter facilitates sustained contact so that linear lesions can be produced from an array of mapping and ablation electrode devices serially spaced along the working catheter shape.

Claims

1. A method of mapping and ablating surface tissue in the right atrial cardiac chamber comprising the steps of:

(a) navigating a main catheter or sheath carrying a deployable flexible distal working catheter section through the vascular system of a patient of interest;

(b) causing the distal end of the catheter to enter the right atrial chamber optionally through a vessel selected from the group consisting of the superior vena cava and the inferior vena cava;

(c) wherein said main catheter or sheath comprises;

(1) a vascular navigating guidewire disposed to protrude from a distal end of said main catheter or sheath;

(2) a single member flexible working catheter section having a proximal and a distal end and adapted to be deployed from said main catheter or sheath via a lumen therein for containing said working catheter section and a plurality of spaced separately connected serially situated electrodes on said single member working catheter section;

(3) means for causing said working catheter section to assume an arcuate shape of controlled curvature for contacting an internal surface of said chamber and assuming an adjustable posture enabling positioning for the production of substantially linear ablation lesions along a predetermined line of the chamber surface using said plurality of spaced electrodes;

(d) causing the distal area of the working catheter section to assume a controlled curvature in contact with a desired inner atrial surface such that a relatively linear ablation lesion can be formed by energizing a plurality of said spaced serial electrodes;

(e) adjusting and positioning said single member working catheter section to ablate desired areas of said inner atrial surface;

(f) ablating tissue to form linear lesions where indicated; and

(g) reversing steps (b) and (a).

2. The method of claim 1 further comprising the step of adjusting and positioning and using said working catheter to map electrical activity prior to ablation to determine correct ablation locations.

3. A recording and ablation catheter system for creating linear lesions in a heart chamber comprising:

(a) a hollow vascular catheter or sheath;

(b) a guide member for aiding the navigation of said catheter or sheath in the vascular system of a patient;

(c) a guide-mounted flexible inner catheter carried by and deployable from a lumen of said vascular catheter or sheath, said inner catheter having a working catheter section having spaced distal and proximal catheter riders having bores adapted to slidably thread over said guide member and being relatively adjustable to each other such that the working catheter section intermediate said distal and said proximal catheter riders is unattached and can be adjustably arcuately flexed according to the relative separation of said rider bores on said guide member to assume a desired shape to address an inner surface of a chamber; and

(d) a plurality of serial electrodes carried by said working catheter section.

4. The apparatus of claim 3 including means to adjust the electrodes of the adjustable working catheter section to assume a substantially linear contact pattern with respect to a contacted shaped chamber surface in a desired direction.

5. The apparatus of claim 3 wherein said working catheter section is rotatable with respect to the guide member.

6. The apparatus of claim 3 further comprising distal stop means for limiting travel of said distal catheter rider.

7. The apparatus of claim 6 wherein the location of said distal stop means and the length of said working catheter section are such that said working catheter section can access a right atrial chamber from either the inferior vena cava or the superior vena cava.

8. The apparatus of claim 3 wherein said catheter or sheath includes a deployment opening for deployment of said distal working catheter section.

9. The apparatus of claim 8 wherein said deployment opening is an elongated slot.

10. The apparatus of claim 8 wherein said deployment opening is at the distal end of said catheter or sheath.

11. The apparatus of claim 3 wherein said electrodes are separately connected thereby energizable in any combination.

12. The apparatus of claim 3 wherein the length of said working catheter section is from about 5 to about 15 cm.

13. The apparatus of claim 3 wherein said electrodes are about 4 mm in length.

14. The apparatus of claim 13 wherein an inter-electrode distance is about 4 mm.

15. A recording and ablation catheter system for a vascular cardiac catheter for creating linear lesions to produce segmentation in a heart chamber comprising:

(a) a hollow elongated vascular catheter or sheath having a lumen for containing in inner catheter;

(b) a vascular navigating guide member disposed to protrude from a distal end of said catheter or sheath;

(c) a single member flexible inner catheter having a distal working catheter section having a proximal and a distal end and adapted to be deployed from said elongated catheter or sheath, wherein the distal portion of said working catheter section further comprises guide member port through which the guide member and is slidably disposed and said guide member further comprises travel limiting means for limiting travel of the distal end of the working catheter section along the guide member so that further relative distal axial displacement of a more proximal portion of the distal working catheter section produces an arcuate protrusion thereof; and

(d) a plurality of spaced, separately connected, serially situated electrodes on said single member working catheter section.

16. The apparatus of claim 15 wherein the distal working catheter section forms a predetermined central loop shape upon deployment.

17. The apparatus of claim 16 wherein said loop shape is one selected from the group consisting of right and left handed loops.

18. The apparatus of claim 16 further comprising means to adjust the diameter of said loop.

19. The apparatus of claim 15 wherein said catheter or sheath further comprises a distal opening and wherein said distal working catheter section is adapted to be deployed by being advanced through said distal opening in said catheter or sheath.

20. The apparatus of claim 19 wherein the distal working catheter section forms a predetermined central loop shape upon deployment.

21. The apparatus of claim 19 wherein said loop shape is one selected from the group consisting of right and left handed loops.

22. The apparatus of claim 19 further comprising means to adjust the diameter of said loop.

23. The apparatus of claim 15 wherein the electrodes are arranged in spaced pairs having an intra-pair spacing and an inter-pair spacing and wherein said intra-pair spacing is less than said inter-pair spacing.

24. A recording and ablation catheter system for a vascular cardiac catheter for creating linear lesions to produce segmentation in the right atrial chamber comprising:

(a) a hollow elongated vascular catheter or sheath having a distal end and a lumen for containing an inner catheter;

(b) a vascular navigating guidewire having a proximal and a distal end wherein the distal end of the guidewire is disposed to protrude from the distal end of said catheter or sheath and the proximal end of the guidewire is mounted within the distal end of the catheter or sheath;

(c) an inner catheter comprising a single member flexible distal working catheter section having a proximal and a distal end and adapted to be deployed from said elongated catheter or sheath in a heart chamber, said distal working catheter section being contained at the proximal end and having a free, unattached distal end and a plurality of spaced separately connected, serially situated electrodes on said single member working catheter section; and

(d) wherein the distal end of said single member flexible distal working catheter section is of a predetermined generally arcuate shape assumed upon deployment.