Systems and methods for forming large lesions in body tissue using curvilinear electrode elements

• US 5,582,609 A
• Filed: 08/08/1994
• Issued: 12/10/1996
• Est. Priority Date: 10/14/1993
• Status: Expired due to Term

• Current Assignee: EP Technologies Incorporated (Boston Scientific Corporation)
• Original Assignee: EP Technologies Incorporated (Boston Scientific Corporation)
• Inventors: Panescu, Dorin, Swanson, David K., Fleischman, Sidney D., Whayne, James G., Bourne, Thomas
• Primary Examiner(s): Sykes, Angela D.
• Assistant Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US08/287,310
• Time in Patent Office: 855 Days
• Field of Search: 606/28-33, 606/37-42, 606/45-50, 607/101, 607/102, 607/103, 607/115, 607/121, 607/122, 607/116, 128/642
• US Class Current: 606/39
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• 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 2017/00084 Temperature
• 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 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00107 Coatings on the energy applicator
• 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 2018/00214 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 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00869 Phase
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1435 : Spiral
• CPC Class Codes: A61B 2018/1497 : Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• 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 5/6857 : with a distal pigtail shape
• CPC Class Codes: A61B 5/6858 : with a distal basket, e.g. expandable basket
• CPC Class Codes: A61L 29/145 : Hydrogels or hydrocolloids
• CPC Class Codes: A61L 31/10 : Macromolecular materials
• CPC Class Codes: A61L 31/145 : Hydrogels or hydrocolloids
• CPC Class Codes: A61M 2025/09141 : made of shape memory alloys which take a particular shape at a certain temperature
• CPC Class Codes: A61M 25/0041 : pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61N 1/056 : Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/40 : Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia

Abstract

Systems and associated methods form larger and deeper lesion patterns by shaping a support body with multiple electrodes in ways that increase the density of the electrodes per given tissue area. The support body can carry either elongated, continuous electrodes or arrays of non-contiguous, segmented electrodes.

Claims

1. A system for ablating body tissue comprising

a catheter body having an elongated axis and including a region curved along the elongated axis in a radius of curvature and adapted to contact body tissue to at least partially encircle a body tissue area within the radius of curvature,

at least two electrodes supported by the catheter body in the region to transmit radio frequency energy into tissue, the at least two electrodes being spaced apart along the elongated axis on the region, the radius of curvature of the region further locating the at least two electrodes in a spaced apart relationship facing each other across the body tissue area, the body tissue area between the at least two electrodes being open and free of any electrode, each electrode having a diameter, the radius of curvature of the region being equal to or less than about 3.5 times the smaller of the diameters of the at least two electrodes, and

a source of radio frequency energy coupled to each of the at least two electrodes including a control element to convey radio frequency energy to the at least two electrodes for transmission simultaneously by each of the at least two electrodes,

whereby transmission of radio frequency energy simultaneously by the at least two electrodes forms a lesion that extends without interruption across the body tissue area between the at least two electrodes.

3. A system according to claim 1 or 2

wherein the radius of curvature is equal to or less than about 2.5 times the smaller of the diameters of the at least two electrodes.

4. A system according to claim 3

wherein the radius of curvature of the region is equal to or less than about 1.5 times the smaller of the diameters of the first and second zones.

12. A system according to claim 1 or 2 or 5 or 6 or 9 or 10

wherein at least one of the electrodes comprises metallic material attached to catheter body in the region.

13. A system according to claim 1 or 2 or 5 or 6 or 9 or 10

wherein at least one of the electrodes comprises a coating of material on the catheter body in the region.

14. A system according to claim 1 or 2 or 5 or 6 or 9 or 10

wherein the region of the catheter body is flexible and includes means for flexing the catheter body in the region along the radius of curvature.

15. A system according to claim 14

wherein the flexing means flexes the catheter body in the region from a generally straight configuration to form the region curved along the elongated axis in the radius of curvature.

16. A system according to claim 14

wherein the flexing means flexes the catheter body in the region from a generally straight configuration to selectively form the region curved along the elongated axis in the radius of curvature on opposite sides of the generally straight configuration.

17. A system according to claim 1 or 2 or 5 or 6 or 9 or 10

wherein the region forms a hook shape.

2. A system for ablating body tissue comprising

a catheter body having an elongated axis and including a region curved along the elongated axis in a radius of curvature and adapted to contact body tissue to at least partially encircle a body tissue area within the radius of curvature,

at least two electrodes supported by the catheter body in the region to transmit radio frequency energy into tissue, the at least two electrodes being spaced apart along the elongated axis on the region, the radius of curvature of the region further locating the at least two electrodes in a spaced apart relationship facing each other across the body tissue area, the body tissue area between the at least two electrodes being open and free of any electrode, each electrode having a diameter and a length, the length of each electrode being greater than about 5 times the diameter of the respective electrode, the radius of curvature of the region being equal to or less than about 3.5 times the smaller of the diameters of the at least two electrodes, and

a source of radio frequency energy coupled to each of the at least two electrodes including a control element to convey radio frequency energy to the at least two electrodes for transmission simultaneously by each of the at least two electrodes,

whereby transmission of radio frequency energy simultaneously by the at least two electrodes forms a lesion that extends without interruption across the body tissue area between the at least two electrodes.

5. A system for ablating body tissue comprising

a catheter body having an elongated axis and including a region curved along the elongated axis in a radius of curvature and adapted to contact body tissue to at least partially encircle a body tissue area within the radius of curvature,

at least two electrodes supported by the catheter body in the region to transmit radio frequency energy into tissue, the at least two electrodes being spaced apart along the elongated axis on the region, the radius of curvature of the region further locating the at least two electrodes in a spaced apart relationship facing each other at a facing distance across the body tissue area, the body tissue area between the at least two electrodes being open and free of any electrode, each electrode having a diameter, the facing distance being equal to or less than about 7 times the smaller of the diameters of the at least two electrodes, and

a source of radio frequency energy coupled to each of the at least two electrodes including a control element to convey radio frequency energy to the at least two electrodes for transmission simultaneously by each of the at least two electrodes,

whereby transmission of radio frequency energy simultaneously by the at least two electrodes forms a lesion that extends without interruption across the body tissue area between the at least two electrodes.

7. A system according to claim 5 or 6

wherein the facing distance is equal to or less than about 5 times the smaller of the diameters of the at least two electrodes.

8. A system according to claim 5 or 6

wherein the facing distance is equal to or less than about 3 times the smaller of the diameters of the at least two electrodes.

6. A system for ablating body tissue comprising

a catheter body having an elongated axis and including a region curved along the elongated axis in a radius of curvature and adapted to contact body tissue to at least partially encircle a body tissue area within the radius of curvature,

at least two electrodes supported by the catheter body in the region to transmit radio frequency energy into tissue, the at least two electrodes being spaced apart along the elongated axis on the region, the radius of curvature of the region further locating the at least two electrodes in a spaced apart relationship facing each other at a facing distance across the body tissue area, the body tissue area between the at least two electrodes being open and free of any electrode, each electrode having a length and a diameter, the length of each electrode being equal to or less than about 5 times the diameter of the respective electrode, the facing distance being equal to or less than about 7 times the smaller of the diameters of the at least two electrodes, and

a source of radio frequency energy coupled to each of the at least two electrodes including a control element to convey radio frequency energy to the at least two electrodes for transmission simultaneously by each of the at least two electrodes,

whereby transmission of radio frequency energy simultaneously by the at least two electrodes forms a lesion that extends without interruption across the body tissue area between the at least two electrodes.

9. A system for ablating body tissue comprising

a catheter body having an elongated axis and including a region curved along the elongated axis in a radius of curvature and adapted to contact body tissue to at least partially encircle a body tissue area within the radius of curvature,

at least two electrodes supported by the catheter body in the region to transmit radio frequency energy into tissue, the at least two electrodes being spaced apart along the elongated axis on the region, the radius of curvature of the region further locating the at least two electrodes in a spaced apart relationship facing each other at a facing distance across the body tissue area, the body tissue area between the at least two electrodes being open and free of any electrode, each electrode having a length, the facing distance being equal to or less than about 4 times the longer of the lengths of the at least two electrodes, and

a source of radio frequency energy coupled to each of the at least two electrodes including a control element to convey radio frequency energy to the at least two electrodes for transmission simultaneously by each of the at least two electrodes,

whereby transmission of radio frequency energy simultaneously by the at least two electrodes forms a lesion that extends without interruption across the body tissue area between the at least two electrodes.

10. A system for ablating body tissue comprising

a catheter body having an elongated axis and including a region curved along the elongated axis in a radius of curvature and adapted to contact body tissue to at least partially encircle a body tissue area within the radius of curvature,

at least two electrodes supported by the catheter body in the region to transmit radio frequency energy into tissue, the at least two electrodes being spaced apart along the elongated axis on the region, the radius of curvature of the region further locating the at least two electrodes in a spaced apart relationship facing each other at a facing distance across the body tissue area, the body tissue area between the at least two electrodes being open and free of any electrode, each electrode having a diameter and a length, the length of each electrode being equal to or less than about 5 times the diameter of the respective electrode, the facing distance being equal to or less than about 4 times the longer of the lengths of the at least two electrodes, and

a source of radio frequency energy coupled to each of the at least two electrodes including a control element to convey radio frequency energy to the at least two electrodes for transmission simultaneously by each of the at least two electrodes,

whereby transmission of radio frequency energy simultaneously by the at least two electrodes forms a lesion that extends without interruption across the body tissue area between the at least two electrodes.

11. A device according to claim 9 or 10

wherein the facing distance is less than about 3 times the longer of the lengths of the at least two electrodes.

18. A method for ablating body tissue comprising the steps of

providing a catheter body having an elongated axis and at least two electrodes supported by the catheter body to transmit radio frequency energy into tissue, the at least two electrodes being spaced apart along the elongated axis on the region,

positioning the catheter body in contact with body tissue while curved along the elongated axis in a radius of curvature to at least partially encircle a body tissue area within the radius of curvature, the radius of curvature of the region further locating the at least two electrodes in a spaced apart relationship facing each other across the body tissue area, the body tissue area between the at least two electrodes being open and free of any electrode, and

conveying radio frequency energy simultaneously to the at least two electrodes for transmission into body tissue to form a lesion that extends without interruption across the body tissue area between the at least two electrodes due to an additive heating effect.