Temporary atrial defibrillation catheter and method

• US 5,571,159 A
• Filed: 04/04/1994
• Issued: 11/05/1996
• Est. Priority Date: 04/04/1994
• Status: Expired due to Term

• Current Assignee: Eckhard Alt
• Original Assignee: Eckhard Alt
• Inventors: Alt, Eckhard
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US08/222,242
• Time in Patent Office: 946 Days
• Field of Search: 128/642, 607/119, 607/122, 607/123, 607/130
• US Class Current: 607/122
• CPC Class Codes: A61N 1/0563 specially adapted for defibrillation or cardioversion

Abstract

Atrial fibrillation disorders are treated by locating low impedance electrodes positioned on a single catheter body passing through the pulmonary artery valve to locate the electrodes respectively in the right atrium and the pulmonary artery. Thus an electrical energy impulse of the order of three joules is passed through a heart and tissue path establishing a field gradient for resetting atrially fibrillating cells to convert atrial fibrillation into sinus rhythm. A special non-implantable catheter for temporary use provided for this treatment method is characterized by an inflatable balloon on the distal tip end, two low impedance energy discharging electrodes spaced to reside respectively in the right atrium and the pulmonary artery and a flexible polymer catheter body sheath of a diameter of the order of two millimeters. Inflating and deflating of the distal balloon facilitates the positioning of the catheter and guarantees a stable position during the application of the electrical energy shock for conversion of atrial fibrillation.

Claims

1. A catheter adapted for temporary insertion in the body of a patient to treat atrial fibrillation, comprising:

a thin elongate flexible catheter body having a proximal end, a distal end, and a central portion between said proximal end and said distal end, said catheter body having a width, length, and flexibility to permit advancement thereof from said distal end along a path including right atrium, right ventricle, and pulmonary artery adjacent left atrium of the patient'"'"'s heart;

said central portion including first and second defibrillation electrodes of relatively low impedance structure spaced apart thereon and conforming in shape to said central portion to maintain a substantially smooth continuous surface therewith, the first electrode of said first and second electrodes being relatively more proximally located along said central portion and the second electrode thereof being relatively more distally located along said central portion, said first and second electrodes being spaced apart by a distance along said central portion such that when the distal end of the catheter body is advanced along said path into predetermined position in the pulmonary artery, said first electrode is located in the right atrium and said second electrode is located in the pulmonary artery adjacent the left atrium to establish an electric field with a vector through a substantial mass of the right and left atria when said first and second electrodes are energized by a defibrillating electrical shock;

said catheter body further including an electrical connector at the proximal end thereof and first and second electrical conductors carried therein and connected from said electrical connector to respective ones of said first and second electrodes for selective application of a defibrillating electrical shock thereto; and

deployable facilitating means at the distal end of the catheter body for selective deployment to aid maneuvering of the catheter body in advancement along said path and for temporarily and passively maintaining the distal end of the catheter body in said predetermined position in the pulmonary artery.

2. The catheter of claim 1, wherein said central portion of the catheter body further includes additional electrode means for use in pacing and sensing intracardiac activity of the patient'"'"'s heart.

3. The catheter of claim 1, further including lumen means in the catheter body to allow taking blood samples from the patient when the distal end of the catheter body is disposed in the pulmonary artery.

4. The catheter of claim 1, further including lumen means running the length of the catheter body to enable measuring pressure in the pulmonary artery when the distal end of the catheter body is disposed therein.

5. The catheter of claim 1, wherein said first and second defibrillation electrodes are spaced apart along the central portion of the catheter body by a distance of about 20 centimeters and sufficiently that neither of said first and second electrodes is disposed in the right ventricle when said distal end is in predetermined position in the pulmonary artery.

6. A catheter for temporary insertion in the body of a patient to treat atrial fibrillation, comprising:

a thin cylindrical, flexible, elongate catheter body having a proximal end and a distal end, first and second spaced apart, relatively low impedance defibrillation electrodes carried by the catheter body and conforming to the cylindrical shape thereof to provide a smooth catheter surface, the first electrode being located at or near the distal end of the catheter body and the second electrode being located toward the proximal end thereof and separated from the first electrode by a distance along said catheter body which is predetermined to position the second electrode in the right atrium of the patient'"'"'s heart when the first electrode is positioned in the patient'"'"'s pulmonary artery adjacent the left atrium by having advanced the distal end of the catheter body through a path including the right atrial and ventricular chambers and into the pulmonary artery of the heart, each of said first and second electrodes including a plurality of electrically interconnected, spaced apart, conductive rings of said cylindrical shape;

a balloon attached adjacent the distal end of the catheter body and coupled by a lumen in the catheter body to the proximal end thereof for selective inflation and deflation of the balloon, to facilitate advancing the distal end of the catheter body through a portion of said path in the direction of blood flow when the balloon is partially inflated, said balloon further adapted to anchor the distal end of the catheter body in place in the pulmonary artery when the balloon is substantially fully inflated while therein, to maintain the first and second electrodes in said positions in the pulmonary artery and right atrium, respectively, and to permit the catheter body to be released and withdrawn along said path from the patient'"'"'s body when the balloon is deflated;

first and second electrical conductor means carried by the catheter body from the proximal end thereof and connected to the first and second electrodes, respectively, for conducting electrical energy defibrillating shock impulses when applied to said conductor means at said proximal end of the catheter body to said first and second electrodes to establish an electrical field therebetween and through substantially the entire mass of the left and right atria for atrial defibrillation of the patient'"'"'s heart; and

further electrical means carried by said catheter body for use in sensing and pacing electrical activity of the patient'"'"'s heart.

7. A catheter for temporary insertion in the body of a patient to treat atrial fibrillation of the patient'"'"'s heart, comprising:

a flexible, elongate catheter body with distal and proximal ends and having a sufficiently small diameter and sufficient flexibility to be threaded through a path including right atrium, tricuspid valve, right ventricle, and pulmonary valve of the patient'"'"'s heart, to place the distal end of the catheter body in the pulmonary artery without substantially impeding blood flow;

first and second defibrillation electrodes on said catheter body having respective first and second poles spaced apart by a set distance therealong for placing said first pole in predetermined position in the right atrium when said second pole is placed in predetermined position in the pulmonary artery adjacent the left atrium of the patient'"'"'s heart by threading the catheter body through said path so that the distal end of the catheter body is in the pulmonary artery for temporary treatment of atrial fibrillation of the patient'"'"'s heart, and electrical conductors connected to said first and second electrodes and traversing said catheter body to the proximal end thereof to conduct a defibrillating electrical shock waveform applied at said proximal end to said conductors to said electrodes, whereby to establish an electric field between said poles and, by virtue of placement of the poles in said predetermined positions, with a vector of said electric field through substantially the entire mass of the left and right atria.

8. The catheter of claim 7, further including balloon means, disposed at the distal end of said catheter body and coupled by a lumen to the proximal end of the catheter body to allow the balloon means to be inflated and deflated through the lumen, for steering the catheter body through a portion of said path under influence of blood flow along said path when said balloon means is partially inflated, to aid placing the second pole in said predetermined position in the pulmonary artery and thereby placing the first pole in said predetermined position in the right atrium, and for retention of the distal end of the catheter body in said position when said balloon means is fully inflated, and for permitting withdrawal of said catheter body from the patient'"'"'s body along said path when said balloon means is deflated.