Endocardial mapping and/or ablation catheter probe

• US 5,722,401 A
• Filed: 11/13/1995
• Issued: 03/03/1998
• Est. Priority Date: 10/19/1994
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Cardiac Pathways Corp. (Boston Scientific Corporation)
• Inventors: Lerohl, Andrew L., Imran, Mir A., Heitzmann, Harold A., Pietroski, Susan M.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US08/555,927
• Time in Patent Office: 841 Days
• Field of Search: 128/642, 128/DIG. 22, 607/119-122, 607/126, 607/127, 607/130, 606/41
• 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 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00107 Coatings on the energy applicator
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• 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 2018/00351 Heart
• CPC Class Codes: A61B 2018/00869 Phase
• 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 2018/1435 Spiral
• CPC Class Codes: A61B 2018/1465 Deformable electrodes
• 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 5/6858 with a distal basket, e.g. expandable basket

Abstract

A catheter probe comprising a flexible elongate tubular member having proximal and distal extremities. An expandable assembly capable of moving from a contracted position to an expanded position is secured to the distal extremity of the flexible elongate tubular member and is formed from at least two elongate members movable between contracted and expanded positions. The elongate members have extremities which are joined so that the elongate members extend at an angle relative to each other to form a vee therebetween. A plurality of longitudinally and radially spaced-apart electrodes are carried by the expandable assembly so that they can be moved into engagement with the wall of the heart when the expandable assembly is expanded into the expanded position. Electrical conductors extend through the elongate tubular member and are connected to the electrodes for performing electrical functions with respect to the electrodes. An elastomeric material is adhered to the joined extremities of the elongate members and is disposed within the vee for inhibiting the formation of thrombus on the elongate members while the expandable assembly is disposed within the blood of the heart.

Claims

1. A mapping probe for introduction through a lumen into a chamber of a heart having blood therein and formed by a wall comprising a flexible elongate tubular member having proximal and distal extremities, expandable means movable from a contracted position to an expanded position secured to the distal extremity of the flexible elongate tubular member and formed from at least two elongate members, each of the elongate members having an extremity, means for joining together the extremities so that the elongate members extend at an angle relative to each other to form a vee therebetween when the expandable means is in the expanded position, a plurality of spaced-apart electrodes carried by the expandable means for engaging the wall of the heart when the expandable means is in the expanded position, electrical means extending through the flexible elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes and web-like means made of an elastomeric material adhered to the extremities of the elongate members and extending between the extremities within the vee for inhibiting the formation of thrombus in the vee when the expandable means is disposed within the blood of the heart.

2. A probe as in claim 1 wherein the web-like means is substantially planar in conformation.

3. A probe as in claim 1 wherein the elastomeric material is polyurethane.

4. A probe as in claim 1 wherein the elongate members are arms and wherein the extremities are the distal extremities of the arms.

5. A probe as in claim 4 wherein the arms extend at an acute angle relative to each other.

6. A probe as in claim 1 wherein the expandable means is a basket-like assembly having a plurality of longitudinally-extending spaced-apart elongate arms having joined proximal and distal extremities, the joined distal extremities of an adjacent pair of arms forming the vee.

7. A probe as in claim 6 wherein the elongate arms include a group of arms which are spaced relatively closely together and at least one support arm aligned generally opposite the group of arms, the plurality of electrodes being carried in longitudinally spaced-apart positions on the group of arms and the at least one support arm serving to urge the group of arms against the wall of the heart so as to permit high density mapping of the wall from electrical signals sensed by the electrodes.

8. A probe as in claim 1 together with an antithrombogenic agent disposed on the expandable means for inhibiting the formation of thrombus on the expandable means when the expandable means is disposed within the blood of the heart.

9. A mapping probe for introduction through a lumen into a chamber of a heart having blood therein and formed by a wall comprising a flexible elongate tubular member having proximal and distal extremities and at least one lumen extending therethrough, a basket assembly movable between contracted and expanded positions, the basket assembly having a plurality of longitudinally-extending circumferentially spaced-apart arms with proximal and distal extremities, means for joining the proximal extremities of the arms to the distal extremity of the flexible elongate tubular member, means for joining together the distal extremities of the arms so that the distal extremities of adjacent arms extend at an angle relative to each other to form a vee therebetween when the basket assembly is in the expanded position, a plurality of longitudinally spaced-apart electrodes carried by each arm for engaging the wall of the heart when the basket assembly is in the expanded position, electrical means extending through the flexible elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes and web-like means made of an elastomeric material extending within the vees between the distal extremities of the arms for inhibiting the formation of thrombus in the vees when the basket assembly is disposed within the blood of the heart.

10. A probe as in claim 9 wherein the means for joining the proximal extremities of the arms to the distal extremity of the flexible elongate tubular member includes means for joining together the proximal extremities of the arms so that the proximal extremities of adjacent arms extend at an angle relative to each other to form a vee therebetween when the basket assembly is in the expanded position, additional web-like means made from an elastomeric material extending within the vees between the proximal extremities of adjacent arms for inhibiting the formation of thrombus in said vees when the basket assembly is disposed within the blood of the heart.

11. A probe as in claim 10 together with an antithrombogenic agent disposed on the basket assembly.

12. A probe as in claim 9 wherein the web-like means is bendable to permit the distal extremities of the arms to move close together when the basket assembly moves to the contracted position.

13. A mapping probe for introduction through a lumen into a chamber of a heart having blood therein and formed by a wall comprising a flexible elongate tubular member having proximal and distal extremities, a sector-shaped basket movable between contracted and expanded positions, the sector-shaped basket having a plurality in excess of three longitudinally-extending spaced-apart arms lying within an angle of 180°

or less about the longitudinal axis, the arms of the sector-shaped basket having proximal and distal extremities and a plurality of longitudinally spaced-apart electrodes, at least one additional arm extending along the longitudinal axis and having proximal and distal extremities, means for securing the proximal extremities of the arms to the distal extremity of the flexible elongate tubular member, means for joining together the distal extremities of the arms and electrical means extending through the flexible elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes, the at least one additional arm serving to urge the electrodes of the sector-shaped basket against the wall of the heart when the sector-shaped basket assembly is in the expanded position to permit high density mapping of the wall of the heart.

14. A probe as in claim 13 wherein the arms of the sector-shaped basket range between five and six in number.

15. A probe as in claim 13 wherein the arms of the sector-shaped basket lie within an angle of approximately 90°

about the longitudinal axis.

16. A probe as in claim 13 wherein the arms of the sector-shaped basket lie with an angle of approximately 120°

about the longitudinal axis.

17. A probe as in claim 13 wherein the sector-shaped basket has a longitudinal dimension which approximates the longitudinal dimension of the chamber of the heart.

18. A probe as in claim 13 wherein the electrodes include a pattern of closely-spaced electrodes for permitting high density mapping of a region of the wall.

19. A probe as in claim 18 wherein the sector-shaped basket has a longitudinal dimension significantly less than the longitudinal dimension of the chamber of the heart so as to permit the closely-spaced electrodes to be moved longitudinally within the chamber.

20. A probe as in claim 13 together with web-like means made of an elastomeric material disposed between the joined distal extremities of the arms the sector-shaped basket for inhibiting the formation of thrombus on the sector-shaped basket while the sector-shaped basket is disposed within the blood of the heart.

21. A probe as in claim 13 wherein the electrodes on adjacent arms are longitudinally offset relative to each other.

22. A mapping probe for introduction through a lumen into a chamber of a heart having blood therein and formed by a wall comprising a flexible elongate tubular member having proximal and distal extremities, a sector-shaped basket carried by the distal extremity of the flexible elongate tubular member and extending along a longitudinal axis, the sector-shaped basket having a plurality in excess of three longitudinally-extending spaced-apart arms with interconnected proximal extremities and interconnected distal extremities, the arms lying within an angle of approximately 180°

or less about the longitudinal axis, a plurality of longitudinally spaced-apart electrodes carried by each of the arms and electrical means extending through the flexible elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes, the sector-shaped basket being movable between a contracted position for introduction through the lumen into the chamber and an expanded position for causing the electrodes to engage a portion of the wall of the heart to perform high density mapping of said portion of the wall of the heart.

23. A probe as in claim 22 wherein the arms lie within an angle of approximately 90°

or less about the longitudinal axis.

24. A probe as in claim 23 wherein the arms range between five and six in number.

25. A probe as in claim 22 together with an elongate member having a proximal extremity carried by the distal extremity of the flexible elongate tubular member and a distal extremity, means for securing the distal extremity of the elongate member to the distal extremities of the arms, the elongate member serving to urge the sector-shaped basket against said portion of the wall of the heart.

26. A probe as in claim 25 wherein the elongate member consists of an additional arm which is disposed generally opposite the arms of the sector-shaped basket and is movable between a contracted position and an expanded position in which the additional arm bows outwardly from the longitudinal axis for engaging the wall of the heart generally opposite said portion.

27. A probe as in claim 22 wherein the arms each include a spring-like member which extends along the arm and has a predetermined shape for urging the sector-shaped basket to the expanded position.

28. A catheter for introduction through a lumen into a chamber of a heart having blood therein and formed by a wall comprising a flexible elongate tubular member having proximal and distal extremities and extending along a longitudinal axis, a sector-shaped basket carried by the distal extremity of the flexible elongate tubular member, the sector-shaped basket having a plurality of arms extending along the longitudinal axis, each of the arms having a plurality of longitudinally spaced-apart outwardly facing electrodes, all of the arms of the sector-shaped basket lying exclusively in a sector extending at right angles to the longitudinal axis within an angle of 180°

or less whereby the electrodes carried by the arms can be urged against a portion of the wall of the heart by the sector-shaped basket for performing high density mapping of said portion of the wall.

29. A catheter as in claim 28 wherein each of the arms includes a shape memory alloy element.

30. A catheter as in claim 28 together with means for moving the sector-shaped basket from a collapsed position to an expanded position.

31. A catheter as in claim 28 together with means for yieldably urging the electrodes into engagement with the wall of the heart.

32. A catheter as in claim 31 wherein the means for yieldably urging includes an additional arm free of electrodes extending along the longitudinal axis generally opposite the sector-shaped basket.

33. A catheter as in claim 28 wherein the arms each have proximal and distal extremities, means interconnecting the proximal extremities of the arms and means interconnecting the distal extremities of the arms.

34. An apparatus for mapping a wall of a chamber of a heart comprising a flexible elongate member having proximal and distal extremities, expandable means carried by the distal extremity of the flexible elongate member, the expandable means movable between contracted and expanded positions and having a plurality of elongate flexible spaced-apart arms with distal extremities and means for joining together the distal extremities of the arms, a plurality of spaced-apart electrodes carried by the expandable means for engaging the wall of the heart when the expandable means is in its expanded position, the means for joining together the distal extremities of the arms including a distal tip formed from elastomeric material with a rounded distal end free of ridges for inhibiting the formation of trauma in the wall of the heart upon engagement of the tip with said wall.

35. An apparatus as in claim 34 wherein the an tip has a curved surface for providing a smooth transition between the tip and the arms to inhibit the formation of thrombus.

36. An apparatus as in claim 34 wherein the elastomeric material is silicone.

37. An apparatus as in claim 34 wherein the expandable means is a basket assembly having a plurality of spaced:

apart arms, a plurality of longitudinally spaced-apart electrodes carried by each of the arms for mapping the wall of the heart.

38. An apparatus as in claim 37 wherein the plurality of arms are circumferentially spaced apart.

39. An apparatus as in claim 37 wherein the plurality of arms are spaced relatively close together for permitting high density mapping of a portion of the wall of the heart.

40. A catheter for introduction into a body comprising a flexible elongate tubular member having proximal and distal extremities and extending along a longitudinal axis, first and second pluralities of arms extending along the longitudinal axis, each of the arms having a proximal extremity, means for attaching the proximal extremities of the arms to the distal extremity of the flexible elongate tubular member, said means including a first tubular member secured to the distal extremity of tile flexible elongate tubular member, the proximal extremities of the first plurality of arms circumferentially disposed about the first tubular member, a second tubular member concentrically mounted about the first tubular member for clamping the proximal extremities of the first plurality of arms between the first and second tubular members, the proximal extremities of the second plurality of arms circumferentially disposed about the second tubular member and a third tubular member concentrically mounted about the second tubular member for clamping the proximal extremities of the second plurality of arms between the second and third tubular members.

41. A catheter as in claim 40 wherein the proximal extremities of the first plurality of arms are circumferentially offset from the proximal extremities of the second plurality of arms.

42. A catheter as in claim 40 wherein the tubular members are each made from stainless steel.

43. A catheter as in claim 40 wherein each of the arms has a distal extremity, means for securing together the distal extremities of the arms.

44. A catheter as in claim 40 wherein the proximal extremities of the arms are circumferentially spaced-apart at equal intervals.

45. A catheter as in claim 40 wherein each of the arms has a plurality of longitudinally spaced-apart electrodes for engaging a wall of a heart.