Method and apparatus for R-F ablation

• US 6,016,809 A
• Filed: 10/09/1997
• Issued: 01/25/2000
• Est. Priority Date: 08/27/1993
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Hoey, Michael F, Mulier, Peter M. J.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US08/946,942
• Time in Patent Office: 838 Days
• Field of Search: 606/41, 606/42, 606/45-50, 607/100-105, 607/115, 607/116, 607/122, 604/20-22, 604/114, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 2017/00097 one of the thermometric elements being an electrode or the heating element
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00065 porous
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00452 Skin
• CPC Class Codes: A61B 2018/00476 Hair follicles
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00821 measured by a thermocouple
• CPC Class Codes: A61B 2018/1253 monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/1435 : Spiral
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3925 : ultrasonic
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61M 2025/0089 : Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
• CPC Class Codes: A61M 2230/08 : Other bio-electrical signals
• CPC Class Codes: A61M 25/0084 : being one or more injection needles

Abstract

An ablation catheter and a method of performing cardiac ablation. The catheter is provided with a hollow, helical electrode, which is screwed into cardiac tissue at a desired ablation site and connected to a source of R-F electrical energy to ablate the tissue adjacent the electrode. Prior to ablation, a conductive fluid may be injected through the hollow needle, both to provide for cooling of the tissue adjacent the needle and to increase the conductivity of the tissue in the area of the electrode.

Claims

1. A method of catheter ablation comprising:

advancing a catheter having a proximal end, a distal end, an internal longitudinal lumen, an electrical conductor, a hollow needle mounted to said catheter body, an exterior surface of said hollow needle comprising an electrode surface, said hollow needle coupled to the internal lumen of said catheter and to said electrical conductor, to a desired site within a patient'"'"'s body;

inserting said needle into tissue at said desired site;

delivering a saline solution through the internal lumen of said catheter and said needle into said tissue;

coupling said electrical conductor to a source of electrical energy; and

only after initiation of delivery of said saline solution into said tissue, initiating delivery of electrical energy to said electrode surface to ablate said tissue, while said saline solution remains present in said tissue.

2. A method according to claim 1 further comprising the step of delivering said saline solution through the internal lumen of said catheter and said needle into said tissue during delivery of electrical energy to said desired site.

3. A method according to claim 1 or claim 2 wherein said step of delivering saline solution to said tissue prior to initiation of delivery of electrical energy to said desired site comprises delivering said saline solution for at least two minutes prior to initiation of delivery of electrical energy to said site.

11. A method according to claims 1, 4, 6 or 8 wherein said step of delivering electrical energy comprises delivering R-F energy.

4. A method of catheter ablation, comprising:

advancing a catheter having a proximal end, a distal end, an internal longitudinal lumen, an electrical conductor, a hollow needle mounted to said catheter body, an exterior surface of said hollow needle comprising an electrode surface, said hollow needle coupled to the internal lumen of said catheter and to said electrical conductor, to a desired site within a patient'"'"'s body;

inserting said needle into said tissue at said desired site;

delivering a conductive fluid through the internal lumen of said catheter and said needle and into said tissue;

coupling said electrical conductor to a source of electrical energy; and

delivering electrical energy to said electrode surface to ablate said tissue while said conductive fluid is present in said tissue, delivery of said electrical energy initiated only after initiation of delivery of said conductive fluid and continuing during delivery of said conductive fluid.

5. A method according to claim 4, wherein said fluid delivering step comprises delivering said conductive fluid for at least two minutes prior to initiation of said delivery of said electrical energy.

6. A method of catheter ablation, comprising:

advancing a catheter having a proximal end, a distal end, an internal longitudinal lumen, an electrical conductor, an electrode surface coupled to said conductor and a hollow needle mounted to said catheter body coupled to the internal lumen of said catheter, to a desired site within a patient'"'"'s body;

inserting said needle into tissue at said desired site;

applying a conductive fluid through the internal lumen of said catheter and said needle into said tissue;

coupling said electrical conductor to a source of electrical energy; and

only after initiation of application of said conductive fluid into said tissue, initiating delivery of electrical energy to said desired site by means of said electrode surface to ablate said tissue and continuing delivery of electrical energy to said desired site while said conductive fluid is being applied to said tissue.

7. A method according to claim 6 wherein said fluid delivering step comprises delivering said conductive fluid for at least two minutes prior to initiation of delivery of electrical energy.

8. A method of catheter ablation comprising:

advancing a catheter having a proximal end, a distal end, an internal longitudinal lumen, an electrical conductor, an electrode surface coupled to said conductor and a hollow needle mounted to said catheter body coupled to the internal lumen of said catheter, to a desired site within a patient'"'"'s body;

inserting said needle into tissue at said desired site;

applying a saline solution through the internal lumen of said catheter and said needle into said tissue;

coupling said electrical conductor to a source of electrical energy; and

only after initiation of delivery of said saline solution into said tissue, initiating delivery of electrical energy to said desired site by means of said electrode surface to ablate said tissue, while said saline solution is present in said tissue.

9. A method according to claim 8 wherein said step of delivering electrical energy further comprises delivering electrical energy during delivery of said saline solution into said tissue.

10. A method according to either claim 8 or 9 wherein said saline solution delivery step comprises delivering said saline solution for at least two minutes prior to initiation of delivery of said electrical energy.

12. A method of catheter ablation, comprising:

advancing a catheter having a proximal end, a distal end, an internal longitudinal lumen, an electrical conductor, an electrode surface coupled to said conductor and a hollow helical needle mounted to said catheter body, coupled to the internal lumen of said catheter, to a desired site within a patient'"'"'s body;

screwing said hollow helical needle into said tissue at said desired site;

coupling said electrical conductor to a source of electrical energy; and

only after initiation of delivery of said saline solution into said tissue, initiating delivery of electrical energy to said desired site by means of said electrode surface to ablate said tissue, while said saline solution is present in said tissue.

13. A method according to claim 12 wherein said step of delivering electrical energy further comprises delivering electrical energy during delivery of said saline solution into said tissue.

14. A method according to claim 12 or claim 13 wherein said saline solution delivery step comprises delivering said saline solution for at least two minutes prior to initiation of delivery of said electrical energy.

15. A method according to claim 12 wherein said step of delivering electrical energy comprises delivering RF energy.