Diagnosis and treatment of atrial flutter in the right atrium

• US 5,846,223 A
• Filed: 05/24/1996
• Issued: 12/08/1998
• Est. Priority Date: 11/03/1993
• Status: Expired due to Term

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: Daig Corporation (Abbott Laboratories Incorporated)
• Inventors: Hassett, James A., Swartz, John F., Ockuly, John D.
• Primary Examiner(s): Bockelman, Mark
• Assistant Examiner(s): Sadula, Jennifer R.
• Application Number:
  US08/653,649
• Time in Patent Office: 928 Days
• Field of Search: 604/49, 604/53, 604/281, 604/284, 607/96, 607/101, 607/115, 607/119, 607/15, 128/645, 128/702, 128/705, 128/772, 600/15-17
• US Class Current: 604/510
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61M 25/0041 pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04

Abstract

A process for the treatment of atrial flutter and/or atrial fibrillation in the right atrium by use of an ablating and/or mapping catheters guided by a guiding introducer. Also disclosed is a predetermined shape for the guiding introducer for use in the treatment of atrial flutter and/or atrial fibrillation in the right atrium.

Claims

1. A procedure for the diagnosis or treatment of atrial flutter or atrial fibrillation in the right atrium of the heart comprising

(a) introducing into a specific location in the right atrium a guiding introducer with a predetermined shape containing a lumen running lengthwise therethrough, a proximal and a distal end,

(b) introducing into the lumen of the guiding introducer an ablating or mapping catheter containing a proximal and distal end, wherein said catheter has one or more electrodes located at or near the distal end of the catheter,

(c) guiding the catheter to a selected location within the right atrium by use of the guiding introducer, and

(d) mapping or ablating a selected location or track within the right atrium by use of the electrodes of the catheter to treat atrial flutter or atrial fibrillation.

2. The procedure of claim 1 wherein the ablating procedure utilizes one of the following sources of energy:

direct current, including high energy direct current, low energy direct current or fulgutronization procedures, microwave, ultrasound, laser, and radio frequency.

3. The procedure of claim 1 wherein the guiding introducer comprises a first, second and third section.

4. The procedure of claim 3 wherein the first section of the guiding introducer is an elongated, hollow, generally straight section of sufficient length for introduction into the patient and for manipulation from the point of insertion through to a desired location within the heart.

5. The procedure of claim 3 wherein the second section of the guiding introducer comprises a first, second and third portion.

6. The procedure of claim 5 wherein the first portion of the second section comprises a first curved segment, curving with an overall arc of about 30 to about 90 degrees followed by a second curved segment, curving generally in the opposite direction from the first curved segment curving with a an overall arc of about 30 to about 90 degrees.

7. The procedure of claim 5 wherein the second portion of the second section comprises a straight portion from about 0.1 to about 2.0 in. in length.

8. The procedure of claim 5 wherein the third portion of the second section comprises a first curved segment curving in an overall arc of about 30 to about 90 degrees followed by a second curved segment curving generally in the opposite direction from the first curved segment with an overall arc of about 30 to about 90 degrees.

9. The procedure of claim 7 wherein the distance from the straight portion of the second section to the first section is from about 0.5 to about 2.0 inches.

10. The procedure of claim 3 wherein the first and second sections are substantially coplanar.

11. The procedure of claim 3 wherein the overall lineal length of the second section if from about 2.0 to about 7.0 in.

12. The procedure of claim 3 wherein the second section of the guiding introducer comprises one or more straight portions and one or more curved portions.

13. The procedure of claim 3 wherein the third section comprises a first, second and third portion.

14. The procedure of claim 13 wherein the first portion of the third section comprises a straight segment from about 0.1 to about 3.0 in. in length and a curved segment, curving in an overall arc of about 20 to about 90 degrees.

15. The procedure of claim 13 wherein the first portion of the third section curves out of a plane formed by the first and second sections of the guiding introducer from about 20 to about 90 degrees.

16. The procedure of claim 13 wherein the second portion of the third section is a curved portion, curving from about 45 to about 135 degrees.

17. The procedure of claim 13 wherein the second portion of the third section curves out of a plane formed by the first and second sections of the guiding introducer from about 20 to about 90 degrees.

18. The procedure of claim 13 wherein the third portion of the third section is a generally straight portion from about 0.2 to about 2.0 inches ending in the distal tip of the guiding introducer.

19. The procedure of claim 3 wherein the third section comprises a first and second portions.

20. The procedure of claim 19 wherein the first portion of the third section comprises a straight segment from about 0.1 to about 3.0 in. in length, followed by a curved segment, curving in an overall arc of about 20 to about 90 degrees.

21. The procedure of claim 19 wherein the first portion of the third section curves out of a plane formed by the first and second sections of the guiding introducer from about 20 to about 90 degrees.

22. The procedure of claim 19 wherein the second portion of the third section is a curved portion, curving from about 45 to about 135 degrees.

23. The procedure of claim 19 wherein the second portion of the third section curves out of a plane formed by the first and second sections of the guiding introducer from about 20 to about 90 degrees.

24. The procedure of claim 3 wherein the third section of the guiding introducer comprises one or more straight sections and one or more curved sections.