Mapping and/or ablation catheter with coilable distal extremity and method for using same

• US 5,680,860 A
• Filed: 10/31/1995
• Issued: 10/28/1997
• Est. Priority Date: 07/07/1994
• Status: Expired due to Fees

• Current Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pathways Corp. (Boston Scientific Corporation)
• Inventors: Imran, Mir A.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US08/550,778
• Time in Patent Office: 728 Days
• Field of Search: 128/642, 607/98, 607/99, 607/101, 607/102, 607/104, 607/105, 607/115, 607/116, 607/119, 607/122, 607/123, 607/125-128, 606/41, 606/47
• US Class Current: 600/374
• 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 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2018/00148 with metal
• 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 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/1435 Spiral
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket

Abstract

A mapping and/or ablation catheter for introduction into a chamber having a wall accessible by a passage leading to the chamber. The catheter includes a flexible elongate member extending along a longitudinal axis and having a distal extremity. An elongate flexible element is provided and has one end secured to the distal extremity of the flexible elongate member and an opposite free end. The elongate flexible element is movable between a first position in which it is adaptable to conform generally to the contour of the passage and a second position in which it has a coil-like configuration. The elongate flexible element serves to form at least one electrode. The elongate flexible element is passed through the passage into the chamber when in the first position and the at least one electrode is moved into engagement with the wall for mapping and/or ablating of the wall when the elongate flexible element is in the second position.

Claims

1. A mapping and/or ablation catheter for introduction into a chamber formed by a wall of a heart of a human body comprising a flexible elongate tubular member having proximal and distal extremities and extending along a longitudinal axis, the flexible elongate tubular member provided with a lumen extending between the proximal and distal extremities and having a length so that when the distal extremity is disposed in the chamber of the heart the proximal extremity is outside of the body, a flexible elongate member slidably carried within the lumen and having a distal end portion with a free end, means carried by the proximal extremity of the flexible elongate tubular member for moving the distal end portion between a first position disposed in the lumen in the flexible elongate tubular member and a second position extending distally of the flexible elongate tubular member, the distal end portion including an element of a shape memory alloy having a predetermined coil-like configuration in which the distal end portion extends substantially in a plane at an angle to the longitudinal axis when in the second position, the distal extremity of the flexible elongate tubular member serving as means for moving the distal end portion to a substantially straightened configuration when the distal end portion is disposed in the lumen and a plurality of longitudinally spaced-apart electrodes carried by the distal end portion for permitting high density mapping and/or ablating of a portion of the wall inside the chamber of the heart.

2. A catheter as in claim 1 wherein the coil-like configuration extends at a substantially right angle to the longitudinal axis.

3. A catheter as in claim 1 wherein the coil-like configuration has a plurality of loops which are generally circular in shape.

4. A catheter as in claim 1 wherein the coil-like configuration has a plurality of loops which are asymmetrical in shape.

5. A catheter as in claim 1 wherein the coil-like configuration has an external diameter of at least 0.5 centimeter.

6. A catheter as in claim 1 wherein the coil-like configuration has a plurality of turns which curve radially inwardly.

7. A catheter as in claim 6 wherein the free end of the distal extremity extends generally at a right angle to the coil-like configuration for engaging the wall of the chamber and for retaining the coil-like configuration on the wall of the chamber.

8. A catheter as in claim 1 wherein the coil-like configuration has a plurality of turns which curve radially outwardly.

9. A catheter as in claim 1 wherein the plurality of electrodes includes a plurality of at least three ablation electrodes in substantial linear alignment across the coil-like configuration for forming a continuous lesion on the wall of the heart.

10. A catheter as in claim 1 wherein the coil-like configuration has a plurality of loops, the plurality of electrodes including at least one ablation electrode extending around at least one of the loops.

11. A catheter as in claim 1 wherein the element is made from a superelastic shape memory alloy.

12. A catheter as in claim 1 wherein the coil-like configuration extends in a plane at a substantially right angle to the longitudinal axis.

13. A mapping and/or ablation catheter for introduction into a chamber of a heart having a wall accessible by a passage leading to the chamber comprising a flexible elongate member extending along a longitudinal axis and having a distal extremity with a free end, the distal extremity having a first shape in which the distal extremity is substantially straight to permit the distal extremity to pass through the passage, means coupled to the flexible elongate member for applying electrical energy to the flexible elongate member to change the distal extremity to a second shape in which the distal extremity has a coil-like configuration extending in a plane at an angle to the longitudinal axis, at least one electrode carried by the distal extremity and being included within means for mapping and/or ablating the wall inside the chamber of the heart whereby the flexible elongate member is passed through the passage into the chamber when having the first shape and the at least one electrode is moved into engagement with the wall for mapping and/or ablating of the wall when the flexible elongate member has the second shape.

14. A mapping and/or ablation catheter for introduction into a chamber of a heart having a wall accessible by a passage leading to the chamber comprising a flexible elongate member extending along a longitudinal axis and having a distal extremity formed in a coil-like configuration with a plurality of turns, at least one electrode carried by the coil-like configuration and being included within means for mapping and/or ablating the wall of the chamber of the heart, the coil-like configuration being provided with a plurality of longitudinally spaced-apart ports and at least one lumen in communication with the ports for supplying a liquid to the ports for delivery between the turns of the coil-like configuration the at least one lumen and ports serving as means for inhibiting the formation of thrombus on the coil-like configuration.

15. A method of mapping a wall of a chamber of a heart having a surface utilizing a flexible elongate tubular member having proximal and distal extremities and a lumen extending between the proximal and distal extremities and a flexible elongate member having a distal end portion with a free end, the distal end portion including an element of a shape memory alloy and having a predetermined coil-like configuration extending in a plane, a plurality of longitudinally spaced-apart electrodes mounted on the distal end portion, comprising the steps of inserting the distal end portion of the flexible elongate member into the lumen so as to cause the distal end portion to become substantially straight, introducing the distal extremity into the chamber of the heart, causing relative longitudinal movement between the flexible elongate tubular member and the distal end portion so as to cause the distal end portion to slide out of the lumen and assume the coil-like configuration, engaging the wall of the heart with the coil-like configuration and mapping the wall of the heart with the plurality of electrodes to locate the origin of an arrhythmia.

16. A method as in claim 15 wherein the inserting step includes restraining the distal end portion in a substantially straightened shape with the flexible elongate tubular member.

17. A method as in claim 15 together with the step of ablating the wall of the heart.

18. A method of mapping a surface of a wall of a left atrium of a heart having a right atrium with a flexible elongate member having proximal and distal extremities, a handle secured to the proximal extremity, the distal extremity carrying a plurality of longitudinally spaced-apart electrodes and having a free end, comprising utilizing the handle to introduce the distal extremity with the free end into the right atrium, extending the distal extremity through the septum into the left atrium of the heart, causing the distal extremity with the free end to assume a coil-like configuration, engaging the wall of the left atrium with the coil-like configuration and mapping the wall of the atrium with the electrodes carried on the distal extremity with the free end.

19. A mapping and/or ablation catheter for introduction into a chamber formed by a wall of a heart of a human body and accessible by a passage leading to the chamber comprising a flexible elongate tubular member having proximal and distal extremities and extending along a longitudinal axis, the flexible elongate tubular member provided with a lumen extending between the proximal and distal extremities and having a length so that when the distal extremity is in the heart the proximal extremity is outside of the body, a flexible elongate member slidably carried within the lumen and having a distal end portion with a free end, means carried by the proximal extremity of the flexible elongate tubular member for moving the distal end portion between a first position disposed in the lumen in the flexible elongate tubular member and a second position outside of the flexible elongate tubular member, the distal end portion including an element of a shape memory alloy having a predetermined spiral configuration substantially centered on the longitudinal axis when in the second position, the distal extremity of the flexible elongate tubular member serving as means for moving the distal end portion to a substantially straightened configuration when the distal end portion is disposed in the lumen and a plurality of longitudinally spaced-apart electrodes carried by the distal end portion for mapping and/or ablating the wall inside the chamber of the heart.

20. A catheter as in claim 19 wherein the spiral configuration tapers as it extends distally from the flexible elongate tubular member.

21. An endocardial mapping device for introduction into a chamber formed by a wall of a heart of a human body and accessible by a passage leading to the chamber comprising a flexible elongate tubular member extending along a longitudinal axis and having proximal and distal extremities and a lumen extending between the proximal and distal extremities, the flexible elongate tubular member having a length so that when the distal extremity is in the chamber the proximal extremity is outside of the body, a plurality of electrodes, means carried by the distal extremity for supporting the plurality of electrodes in spaced-apart positions lying substantially in a plane, said means including at least one flexible elongate member having a free end and having at least certain of said electrodes mounted thereon in longitudinally spaced-apart positions, the free end of said flexible elongate member including an element of a shape memory alloy having a predetermined conformation so that the electrodes mounted thereon lie in a predetermined pattern, the distal extremity of the flexible elongate tubular member serving as means for moving said flexible elongate member to a substantially straightened conformation when said flexible elongate member is disposed in the lumen said flexible elongate member being slidably movable in the lumen between a first position and a second position so that in the first position the free end of said flexible elongate member is disposed within the lumen and in the second position the free end is disposed distal of the distal extremity of the flexible elongate tubular member whereby the plurality of electrodes engage a portion of the wall when said flexible elongate member is in the second position for permitting high density mapping of the portion of the wall.

22. A device as in claim 21 wherein the element is formed from a superelastic shape memory alloy.

23. A device as in claim 21 wherein said flexible elongate member has a plurality of loops when in the predetermined conformation.

25. A device as in claim 21 wherein the plane is disposed at a substantially right angle to the longitudinal axis.

24. A catheter for introduction into a chamber formed by a wall of a heart of a human body in which aberrant electrical signals are traveling in the wall of the heart comprising a flexible elongate member having proximal and distal extremities and extending along a longitudinal axis, the flexible elongate member having a length so that when the distal extremity is disposed in the chamber the proximal extremity is outside of the body, the distal extremity having a coil-like configuration formed from a plurality of turns, a plurality of at least three longitudinally spaced-apart electrodes mounted on separate turns in substantial linear alignment across the coil-like configuration, of the distal extremity lead means connected to the plurality of electrodes and extending to the proximal extremity of the flexible elongate member, means for supplying electrical energy to the plurality of electrodes, the plurality of electrodes being spaced apart so that when electrical energy is supplied to the electrodes a substantially linear lesion is formed in the wall of the heart to interrupt the path of aberrant electrical signals.

26. A catheter as in claim 24 wherein the distal extremity of the flexible elongate member includes an element of a superelastic shape memory alloy.

27. A catheter as in claim 24 wherein each of the plurality of electrodes is a ring electrode.