Intravascular method and system for treating arrhythmia

• US 5,645,082 A
• Filed: 01/27/1994
• Issued: 07/08/1997
• Est. Priority Date: 01/29/1993
• Status: Expired due to Term

• Current Assignee: Sichuan Jinwangtong Electronic Science & Technology Company Limited
• Original Assignee: Cardima, Inc.
• Inventors: Samson, Gene, Sung, Ruey
• Primary Examiner(s): Sykes, Angela D.
• Assistant Examiner(s): Lacyk, John P.
• Application Number:
  US08/188,384
• Time in Patent Office: 1,258 Days
• Field of Search: 128/897-99, 128/634, 606/195, 606/200, 604/60
• US Class Current: 128/897
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/1214 Coils or wires
• CPC Class Codes: A61B 17/12145 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/1215 comprising additional materials, e.g. thrombogenic, having filaments, having fibers, being coated
• CPC Class Codes: A61B 17/12163 having a string of elements connected to each other
• CPC Class Codes: A61B 17/12168 having a mesh structure A61B17/1214 takes precedence
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61B 2017/12063 electrolytically detachable
• CPC Class Codes: A61B 2562/0215 Silver or silver chloride containing
• 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]

Abstract

A method and system for treating a patient'"'"'s heart exhibiting arrhythmia by first detecting electrical activity within the patient'"'"'s heart to determine the location of the arrhythmogenic site or conductive pathway causing the arrhythmia and then creating an infarct within the region of the patient'"'"'s heart where the arrhythmogenic site or the conductive pathway causing the arrhythmia is located by delivering an occluding element to a coronary artery which delivers oxygenated blood to said region of the patient'"'"'s heart. In one presently preferred embodiment the occluding element is a flaccid or limp coil which when disposed in a coronary arterial passageway forms a randomly shaped, intertwined mass which quickly forms thrombus within the coronary artery to block the passage of oxygenated blood therethrough. The flaccid coil may be delivered through an inner lumen of a catheter which has a distal portion extending within the coronary artery.

Claims

1. A method for locating and treating tissue of a patient'"'"'s heart exhibiting arrhythmia, comprising:

a) locating tissue within the patient'"'"'s heart which is causing or is involved with the arrhythmia by detecting electrical activity by means of at least one intravascular device disposed within a coronary artery or cardiac vein of the patient;

b) determining which coronary artery feeds oxygenated blood to the located tissue causing or involved with the arrhythmia; and

c) delivering an occluding element to the coronary artery to occlude the artery blocking blood flow to the located tissue causing or involved with the arrhythmia and to thereby terminate the arrhythmia.

2. The method of claim 1 wherein the artery is occluded at least in part by forming thrombus on the occluding element delivered therein.

3. The method of claim 1 wherein the occluding element permanently occludes the artery.

4. The method of claim 1 including the step of locating the tissue causing or involved with the arrhythmia by advancing an elongated intravascular device having a plurality of electrodes on a distal portion thereof into a coronary artery or a cardiac vein and detecting electrical activity from tissue causing or involved with the arrhythmia.

5. The method of claim 1 wherein the occluding element is a flaccid helically wound wire coil.

6. The method of claim 1 wherein the occluding element is releasably secured to a distal end of a guidewire, the guidewire is advanced through the patient'"'"'s coronary artery until the releasably secured occluding element is positioned at the desired location within the coronary artery and the occluding element is released to occlude the artery at the desired location.

7. The method of claim 1 wherein a catheter having proximal and distal ends and an inner lumen extending therein to a port in the distal end thereof is advanced within the patient'"'"'s vasculature until the distal end of the catheter is at the desired location in the coronary artery and the occluding element is advanced through the inner lumen of the catheter until it extends out the port in the distal end of the catheter into the coronary artery where the occluding member occludes the artery.

8. The method of claim 7 wherein the catheter has a plurality of sensing electrodes on a distal portion thereof and the tissue causing the arrhythmia is located by detecting electrical activity at a plurality of locations by means of the plurality of the sensing electrodes on a distal portion of the catheter.

9. The method of claim 8 wherein the electrical activity is detected in a bipolar mode.

10. A method for locating and treating tissue of a patient'"'"'s heart exhibiting arrhythmia, comprising:

a) locating tissue of the patient'"'"'s heart which causes or is involved with the arrhythmia by means of at least one intravascular device disposed within a coronary artery or cardiac vein of the patient;

b) determining which coronary artery or branch thereof feeds the tissue causing or involved with the arrhythmia;

c) providing an intravascular catheter having proximal and distal ends and an inner lumen extending therein to a discharge port in the distal end;

d) advancing the intravascular catheter into the patient'"'"'s coronary artery or branch thereof which feeds oxygenated blood to the tissue of the patient'"'"'s heart which causes or is involved with the arrhythmia; and

e) directing an occluding element through the inner lumen of the intravascular catheter and depositing it in the coronary artery or branch thereof to block blood flow to the tissue causing or involved with the arrhythmia and to thereby terminate the arrhythmia.

11. The method of claim 10 wherein the occluding element introduced into the arterial passageway is a flaccid coil which forms a randomly shaped, intertwined mass when introduced into the arterial passageway.

12. The method of claim 11 wherein the flaccid coil is hydraulically delivered through the inner lumen of the catheter into the arterial passageway.

13. The method of claim 11 wherein the helically wound wire coil is releaseably secured to a distal end of a guidewire which is advanced through the inner lumen of the catheter.

14. The method of claim 11 wherein thrombus forms on the flaccid coil which occludes the coronary artery.

15. The method of claim 11 wherein the region of the patient'"'"'s heart causing the arrhythmia is determined by advancing at least one intravascular sensing device having a plurality of sensing electrodes on a distal section thereof within a coronary artery or a cardiac vein of the patient'"'"'s heart and sensing electrical activity by means of sensing electrodes on the distal section of the intravascular sensing device from within the coronary artery or the cardiac vein.