Endocardial mapping apparatus

• US 5,730,128 A
• Filed: 09/24/1996
• Issued: 03/24/1998
• Est. Priority Date: 10/12/1993
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Cardiac Pathways Corp. (Boston Scientific Corporation)
• Inventors: Gingell, Patsy A., Imran, Mir A., Pomeranz, Mark L.
• Primary Examiner(s): Cohen, Lee S.
• Application Number:
  US08/718,780
• Time in Patent Office: 546 Days
• Field of Search: 128/642, 607/122, 607/125, 607/126, 606/41
• US Class Current: 600/374
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 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 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• 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
• CPC Class Codes: A61N 1/06 for high-frequency therapy

Abstract

An endocardial mapping apparatus for mapping the wall of a chamber of the heart having blood therein. The apparatus includes a flexible elongate tubular member having proximal and distal extremities and at least one lumen extending therethrough. A basket assembly is carried by the distal extremity of the flexible elongate tubular member and is movable between contracted and expanded positions. The basket assembly has a plurality of elongate flexible circumferentially spaced-apart arms with joined proximal and distal extremities and a plurality of longitudinally spaced-apart electrodes carried by each arm for engaging the wall of the heart. The arms have spaces therebetween when the basket assembly is in an expanded position. An elongate flexible rotatable member is rotatably coupled to the joined distal extremities and is disposed within the basket assembly. At least one electrode is carried by the rotatable member for engaging the wall of the heart. A torque knob is coupled to the rotatable member for rotating the member within the basket assembly and for bowing it radially outwardly into a space between the arms so as to engage the wall of the heart along a portion of the length thereof for mapping and/or ablating.

Claims

1. An apparatus for mapping a wall of a chamber of a heart having blood therein comprising a first flexible elongate member extending along a longitudinal axis and having proximal and distal extremities, a plurality of at least three second flexible elongate members carried by the distal extremity of the first flexible elongate member, the second flexible elongate members having proximal and distal extremities, the proximal extremities of the second flexible elongate members extending along the longitudinal axis from the distal extremity of the first flexible elongate member, means for joining together the distal extremities of the second flexible elongate members, the second flexible elongate members having portions proximal of the joined together distal extremities which are bowable outwardly relative to the longitudinal axis to an expanded position to engage a portion of the wall of the heart, each of the second flexible elongate members having a plurality of longitudinally spaced-apart electrodes mounted thereon, the second flexible elongate members being asymmetrically disposed about the longitudinal axis when in the expanded position for forming a mapping assembly to perform fine resolution mapping of the wall of the heart.

2. The apparatus of claim 1 wherein the first flexible elongate member has at least one lumen extending therethrough, the proximal extremity of at least one of the second flexible elongate members slidably disposed within said lumen, means carried by the proximal extremity of the first flexible elongate member to move the proximal extremity of said second flexible elongate member longitudinally within said lumen so as to move the distal extremity of said second flexible elongate member to the expanded position.

3. The apparatus of claim 2 wherein the second flexible elongate members have an outwardly bowed shaped memory.

4. An apparatus for mapping the wall of a chamber of a heart having blood therein comprising a first flexible elongate member having proximal and distal extremities, a plurality of at least four second flexible elongate members carried by the distal extremity of the first flexible elongate member, the second flexible elongate members having proximal and distal extremities, the proximal extremities of the second flexible elongate members extending from the distal extremity of the first flexible elongate member, means joining together the distal extremities of the second flexible elongate members, said second flexible elongate members having portions proximal of the joined together distal extremities of the second flexible elongate members that are bowable outwardly relative to the joined together distal extremities to engage a portion of the wall of the heart, each of the second flexible elongate members having a plurality of longitudinally spaced-apart electrodes, the second flexible elongate members subtending an angle of approximately 90°

about the longitudinal axis when bowed outwardly so as to perform fine resolution mapping of the wall of the heart.

5. The apparatus of claim 4 wherein the second flexible elongate members have an outwardly bowed shaped memory.

6. An apparatus for mapping a wall forming a chamber of a heart having blood therein comprising a flexible elongate tubular member extending along a longitudinal axis and having proximal and distal extremities, the flexible elongate tubular member being provided with at least one lumen extending between the proximal and distal extremities, a mapping assembly carried by the distal extremity of the flexible elongate tubular member and having a plurality of elongate flexible spaced-apart arms with interconnected proximal extremities and interconnected distal extremities, the arms of the mapping assembly being movable between a contracted position and an expanded position in which the arms bow outwardly relative to the longitudinal axis to engage the wall of the heart, a plurality of spaced-apart electrodes carried by the mapping assembly for engaging the wall of the heart, an elongate flexible member having a proximal portion slidably disposed within the lumen and a distal portion coupled to said interconnected distal extremities, at least two longitudinally spaced-apart electrodes carried by the distal portion of the elongate flexible member for engaging the wall of the heart and means coupled to the elongate flexible member for moving the proximal portion of said member longitudinally within the lumen so as to bow the distal portion of said member outwardly to engage the wall of the heart.

7. The apparatus of claim 6 wherein the arms each have an outwardly bowed shaped memory.

8. The apparatus of claim 6 wherein the arms are circumferentially spaced apart.

9. An apparatus for mapping the wall of a chamber of a heart having blood therein comprising a flexible elongate tubular member having proximal and distal extremities and at least one lumen extending between the proximal and distal extremities, a basket assembly carried by the distal extremity of the flexible elongate tubular member and being movable between contracted and expanded positions, the basket assembly having a plurality of elongate flexible circumferentially spaced-apart arms with proximal extremities and interconnected distal extremities, a plurality of spaced-apart electrodes carried by the basket assembly for engaging the wall of the heart, said arms having circumferential spaces therebetween when the basket assembly is in an expanded position, an elongate flexible member having a proximal portion slidably disposed within the lumen and a distal portion disposed within the basket assembly, at least two longitudinally spaced-apart electrodes carried by the distal portion of the elongate flexible member for engaging the wall of the heart and means coupled to the elongate flexible member for moving the proximal portion of the elongate flexible member longitudinally within the lumen so as to bow the distal portion of the elongate flexible member into a space between the arms so that the at least two electrodes engage the wall of the heart for mapping and/or ablating.

10. The apparatus of claim 9 together with means for interconnecting the proximal extremities of the arms.

11. The apparatus of claim 9 wherein the arms move to a bowed position when the basket assembly moves to the expanded position, the arms each having an outwardly bowed shaped memory.

12. The apparatus of claim 9 wherein the arms are circumferentially spaced-apart at approximately equal distances.

13. An apparatus for mapping the wall of a chamber of a heart having blood therein comprising a flexible elongate tubular member having proximal and distal extremities and at least one lumen extending therethrough, a basket assembly carried by the distal extremity of the flexible elongate tubular member and being movable between contracted and expanded positions, the basket assembly having a plurality of elongate flexible spaced-apart arms with interconnected distal extremities, a plurality of spaced-apart electrodes carried by the basket assembly for engaging the wall of the heart, said arms being circumferentially spaced apart when the basket assembly is in an expanded position to provide circumferential spaces, an elongate flexible member independent of the arms having a proximal portion slidably disposed within the lumen and a distal portion disposed within the arms and coupled to said interconnected distal extremities and means coupled to the elongate flexible member for moving the proximal portion of said member longitudinally within the lumen so as to bow the distal portion of said member proximal of the joined distal extremities radially outwardly into one of the circumferential spaces between the arms to engage the wall of the heart and a plurality of spaced-apart electrodes carried by the distal portion of said member for mapping the wall of the heart between the arms to provide an increased capability for more precisely locating an anomaly in the wall of the heart.

14. The apparatus of claim 13 wherein the arms have proximal extremities, means for interconnecting the proximal extremities of the arms.