Multi-fiber laser catheter
First Claim
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1. A laser catheter, for use in providing therapeutic laser energy to human heart tissue at a pre-selected tissue site, the catheter comprising:
- a) a catheter body having a proximal end and a distal end and an inner wall defining a lumen extending generally along a longitudinal axis of said catheter;
b) a multi-fiber optic cable having a proximal end and a distal end located within said catheter body and having a plurality of individual optical fibers to provide laser energy to the tissue site by a laser source;
c) a fixation element, having a proximal end and a distal end and operably carried through said lumen extending past said distal end of said catheter body, constructed to selectively penetrate the tissue to a predetermined depth at said pre-selected tissue site and to fix said distal end of said catheter body to said tissue; and
d) a plurality of temperature sensors, fixedly attached at spaced intervals along the length of said fixation element within the tissue to sense the temperature of said tissue at a plurality of tissue depths corresponding to said spaced intervals while said laser catheter is providing laser energy to said pre-selected tissue site, wherein said plurality of temperature sensors provide temperature readings correlated to the tissue depth at which each temperature sensor is located to create a temperature depth profile of the tissue.
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Abstract
Laser catheters according to the invention include multiple optical fibers for delivery of laser energy to a pre-determined treatment site in the therapeutic treatment of cardiac tissue. A fixation device fixes the distal end of the catheter to the treatment site. Temperature sensing devices disposed on the fixation device provide a temperature depth profile of the tissue treatment site, which can be used to control the treatment. Multi-piece, single-piece and porous tip catheters are disclosed.
271 Citations
43 Claims
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1. A laser catheter, for use in providing therapeutic laser energy to human heart tissue at a pre-selected tissue site, the catheter comprising:
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a) a catheter body having a proximal end and a distal end and an inner wall defining a lumen extending generally along a longitudinal axis of said catheter; b) a multi-fiber optic cable having a proximal end and a distal end located within said catheter body and having a plurality of individual optical fibers to provide laser energy to the tissue site by a laser source; c) a fixation element, having a proximal end and a distal end and operably carried through said lumen extending past said distal end of said catheter body, constructed to selectively penetrate the tissue to a predetermined depth at said pre-selected tissue site and to fix said distal end of said catheter body to said tissue; and d) a plurality of temperature sensors, fixedly attached at spaced intervals along the length of said fixation element within the tissue to sense the temperature of said tissue at a plurality of tissue depths corresponding to said spaced intervals while said laser catheter is providing laser energy to said pre-selected tissue site, wherein said plurality of temperature sensors provide temperature readings correlated to the tissue depth at which each temperature sensor is located to create a temperature depth profile of the tissue. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A laser catheter for use in a multi-piece catheter system, the laser catheter providing controlled laser energy effective to therapeutically denature human heart tissue at a pre-selected cardiac tissue site, the catheter comprising:
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a) a catheter body having a proximal end and a distal end, and an inner wall defining a first lumen extending generally along a longitudinal axis of the catheter; b) a multi-fiber optic cable having a proximal end and a distal end located within the catheter body and having a plurality of individual optical fibers to provide laser energy to the tissue site by a laser source; c) substantially helically-shaped fixation means, aligned co-axially with and contained within the catheter body, for penetrating a controlled depth into cardiac tissue at the pre-selected tissue site and fixing the catheter to the site, the fixation means having a proximal end and a distal end and a length sufficient to extend beyond the distal end of the catheter body; and d) a plurality of temperature sensing means, fixedly attached to the fixation means at spaced intervals from the distal end of the fixation means and operably connected to the laser source, for sensing a plurality of temperatures, at depths within the cardiac tissue corresponding to the spaced intervals, while the laser catheter is providing radiant energy to the tissue site, wherein the plurality of temperature sensing means provide temperature signals which correlate to the tissue temperature at the location of each temperature sensing means, and wherein the temperature signals are used to control irradiation of the tissue site. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A one-piece laser catheter system, providing controlled laser energy effective to therapeutically denature human heart tissue within a patient'"'"'s heart without ablating that tissue, the catheter system comprising:
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a) a catheter body having a proximal end and a distal end, and an inner wall defining a first lumen extending generally along a longitudinal axis of the catheter; b) a multi-fiber optic cable having a proximal end and a distal end located within the catheter body and having a plurality of individual optical fibers to provide laser energy to a pre-selected treatment site by a laser source; c) a metal tip operably coupled to the distal end of the catheter body, the plurality of optical fibers passing through the metal tip, distal ends of the optical fibers being held in an orientation divergent from the longitudinal axis of the catheter body by the metal tip; d) fixation means, aligned coaxially with and contained within the catheter body, for penetrating a controlled depth into cardiac tissue at the pre-selected treatment site and fixing the catheter to the site, the fixation means having a proximal end and a distal end and a length sufficient to extend beyond the distal end of the catheter body; e) a plurality of temperature sensing means, fixedly attached to the fixation means at spaced intervals along the fixation means within the cardiac tissue, for sensing a plurality of temperatures at depths within the cardiac tissue corresponding to the spaced intervals while laser energy is being provided to the tissue site, wherein the plurality of temperature sensing means provide temperature signals which correlate to the tissue temperature at the location of each temperature sensing means, and wherein the temperature signals are used to control irradiation of the tissue site and to create a temperature depth profile of the cardiac tissue; f) electrophysiological sensing means, located on the external surface of the catheter body, for sensing the electrophysiological characteristics of cardiac tissue proximate to the sensing means; and g) steering means for guiding the catheter system through anatomical structures within the patient'"'"'s body to the interior of the heart, the steering means being operatively coupled to an externally accessible steering control device for controlling steering of the catheter through the anatomical structures. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33)
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34. A method for the controlled laser irridation of cardiac tissue at a pre-selected tissue site to therapeutically denature cardiac tissue at the site, the method comprising:
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(a) introducing a distal end of a laser catheter proximate to the pre-selected cardiac tissue site; (b) denaturing cardiac tissue at the pre-selected tissue site by irradiating the cardiac tissue with laser energy provided via the catheter by a laser source; (c) fixing the distal end of the catheter to the pre-selected tissue site by penetrating cardiac tissue at the pre-selected tissue site with a fixation element extending from the distal end of the catheter; (d) flushing the pre-selected tissue site with a fluid flushing medium introduced to the pre-selected tissue site through the catheter; and (e) monitoring, during step (d), the temperature of the cardiac tissue at the pre-selected tissue site with at least one temperature sensor at the fixation element. - View Dependent Claims (35, 36, 37, 38, 39)
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40. A method of providing both laser energy and radio frequency energy to denature cardiac tissue at a pre-selected tissue site by a catheter, the method comprising:
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(a) introducing a distal end of a catheter proximate to the pre-selected cardiac tissue site; (b) irradiating the cardiac tissue with laser energy provided via the catheter by a laser source; (c) irradiating the cardiac tissue with radio frequency energy provided via the catheter by a radio frequency energy source; (d) flushing the pre-selected tissue site with a fluid flushing medium introduced to the pre-selected tissue site through a porous tip of the catheter; (e) fixing the distal end of the catheter to the pre-selected tissue site by penetrating cardiac tissue at the pre-selected tissue site with a fixation element extending from the distal end of the catheter; and (f) monitoring the temperature of the cardiac tissue at the pre-selected tissue site with at least one temperature sensor at the fixation element. - View Dependent Claims (41)
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42. A one-piece laser catheter system, providing controlled laser energy effective to therapeutically denature human heart tissue within a patient'"'"'s heart without ablating that tissue, the catheter system comprising:
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a) a catheter body having a proximal end and a distal end, and an inner wall defining a first lumen extending generally along a longitudinal axis of the catheter; b) a multi-fiber optic cable having a proximal end and a distal end located within the catheter body and having a plurality of individual optical fibers to provide laser energy to a pre-selected treatment site by a laser source; c) a porous metal tip operably coupled to the distal end of the catheter body, the plurality of optical fibers passing through the metal tip, the distal ends of the optical fibers being held in an orientation divergent from the longitudinal axis of the catheter body by the metal tip; d) fixation means, aligned coaxially with and contained within the catheter body, for penetrating a controlled depth into cardiac tissue at the pre-selected treatment site and fixing the catheter to the site, the fixation means having a proximal end and a distal end and a length sufficient to extend beyond the distal end of the catheter body; e) a plurality of temperature sensing means, fixedly attached to the fixation means at spaced intervals from the distal end of the fixation means, for sensing a plurality of temperatures at depths within the cardiac tissue corresponding to the spaced intervals while the laser is providing radiant energy to the tissue site, wherein the plurality of temperature sensing means provide temperature signals which correlate to the tissue temperature at the location of each temperature sensing means, and wherein the temperature signals are used to control irradiation of the tissue site; f) electrophysiological sensing means, located on the external surface of the catheter body, for sensing the electrophysiological characteristics of cardiac tissue proximate to the sensing means; and g) steering means for guiding the catheter system through anatomical structures within the patient'"'"'s body to the interior of the heart, the steering means being operatively coupled to an externally accessible steering control device for controlling steering of the catheter through the anatomical structures.
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43. A one-piece laser catheter system, providing controlled laser energy effective to therapeutically denature human heart tissue within a patient'"'"'s heart without ablating that tissue, the catheter system comprising:
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a) a catheter body having a proximal end and a distal end, and an inner wall defining a first lumen extending generally along a longitudinal axis of the catheter; b) a multi-fiber optic cable having a proximal end and a distal end located within the catheter body and having a plurality of individual optical fibers to provide laser energy to a pre-selected treatment site by a laser source; c) a metal tip operably coupled to the distal end of the catheter body, the plurality of optical fibers passing through the metal tip, the distal ends of the optical fibers being held in an orientation divergent from the longitudinal axis of the catheter body by the metal tip; d) fixation means, aligned coaxially with and contained within the catheter body, for penetrating a controlled depth into cardiac tissue at the pre-selected treatment site and fixing the catheter to the site, the fixation means having a proximal end and a helically-shaped distal end and a length sufficient to extend beyond the distal end of the catheter body; e) a plurality of temperature sensing means, fixedly attached to the fixation means at spaced intervals from the distal end of the fixation means, for sensing a plurality of temperatures at depths within the cardiac tissue corresponding to the spaced intervals while the laser is providing radiant energy to the tissue site, wherein the plurality of temperature sensing means provide temperature signals which correlate to the tissue temperature at the location of each temperature sensing means, and wherein the temperature signals are used to control irradiation of the tissue site; f) electrophysiological sensing means, located on the external surface of the catheter body, for sensing the electrophysiological characteristics of cardiac tissue proximate to the sensing means; and g) steering means for guiding the catheter system through anatomical structures within the patient'"'"'s body to the interior of the heart, the steering means being operatively coupled to an externally accessible steering control device for controlling steering of the catheter through the anatomical structures.
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Specification