Deflectable catheter for ablating cardiac tissue

• US 6,083,222 A
• Filed: 10/18/1996
• Issued: 07/04/2000
• Est. Priority Date: 02/28/1995
• Status: Expired due to Term

• Current Assignee: George J. Klein
• Original Assignee: Boston Scientific Corporation
• Inventors: Koblish, Josef V., Coen, Thomas T., Klein, George J.
• Primary Examiner(s): Cohen, Lee S.
• Application Number:
  US08/730,896
• Time in Patent Office: 1,355 Days
• Field of Search: 606/41, 606/49, 606/51, 606/52, 607/99, 607/122, 607/126, 128/642
• US Class Current: 606/41
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2018/00279 deployable
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/162 located on the probe body
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems

Abstract

A deflectable catheter for ablating tissue in the heart of a patient comprising: an axially elongated catheter shaft sized and constructed to be advanced through the vasculature of a patient into the patient'"'"'s heart; a deflection wire; and an ablation electrode having first and second opposed electrically conductive surfaces exposable for contact with a selected area of tissue within the patient'"'"'s heart and movable with respect to each other to apply gripping force to the contacted area of heart tissue for stabilizing the position of the electrically conductive surfaces of the ablation electrode relative to the selected area of heart tissue. The ablation electrode has a first rigid surface exposed for contact with the vasculature of the patient during advancement of the catheter therethrough and has an electrically conductive second rigid surface exposable for contact with a selected area of tissue within the patient'"'"'s heart, wherein the axially transverse area circumscribed by the first surface of the ablation electrode is less than the tissue-contacting area exposable by the second rigid surface. Therapeutic treatments of the heart of a patient are also disclosed.

Claims

1. A deflectable catheter for ablating tissue in the heart of a patient comprising

an axially elongated catheter shaft having proximal and distal portions respectively terminating at proximal and distal ends, the catheter shaft being sized and constructed to be advanced through the vasculature of a patient into the patient'"'"'s heart,

a deflection wire coupled to the distal portion of the catheter shaft and extending within the catheter shaft to the proximal end thereof,

an ablation electrode coupled to the distal end of the catheter shaft and having first and second opposed electrically conductive surfaces exposable for contact with a selected area of tissue within the patient'"'"'s heart, and

an elongated electrode actuator extending through the catheter shaft and attached to the ablation electrode to effect movement of the first and second surfaces of the electrode with respect to each other to apply gripping force to the contacted area of heart tissue for stabilizing the position of the electrically conductive surfaces of the ablation electrode relative to the selected area of heart tissue.

2. The deflectable catheter of claim 1 wherein the ablation electrode is adjustable from a closed position in which the ablation electrode has an outer surface exposed for contact with the vasculature of the patient during advancement of the catheter therethrough to an open position in which the first and second electrically conductive surfaces are exposable for contact with tissue over an area larger than an axially transverse area circumscribed by the outer surface of the ablation electrode in the closed position.

3. The deflectable catheter of claim 1 wherein said electrode actuator is constructed and arranged to enable selective exposure of conductive surface of the ablation electrode to the selected area of heart tissue.

4. The deflectable catheter of claim 1 wherein the ablation electrode comprises two opposed gripping members that are movable relative to each other between an open position and a closed position, and said electrode actuator is coupled to the two gripping members and extending proximally therefrom to the proximal end of the catheter shaft for moving the gripping members.

5. The deflectable catheter of claim 4 further comprising a tracking member coupled to the deflection wire and constructed and arranged to track movement of the electrode actuator and to couple tension on the electrode actuator to the deflection wire to counteract force applied by the electrode actuator to the distal portion of the catheter shaft during movement of the gripping members.

6. The deflectable catheter of claim 4 wherein the opposed gripping members together form a generally dome-shaped outer surface.

7. The deflectable catheter of claim 4 wherein the opposed gripping members are formed of solid electrically conductive members that have opposed flat surfaces exposable for contact with the selected area of tissue, the opposed gripping members being pivotally hinged together about a pivot bearing.

8. The deflectable catheter of claim 1 wherein conductive surface of the ablation electrode that is exposable for contact with the selected area of heart tissue is characterized by mechanical rigidity and flatness over an extended area having transverse dimension of comparable size.

9. The deflectable catheter of claim 1 wherein conductive surface of the ablation electrode exposable for contact with the selected area of heart tissue comprises a plurality of teeth for engaging heart tissue.

10. The deflectable catheter of claim 1 further comprising a needle coupled to the distal end of the catheter shaft and constructed and arranged to penetrate heart tissue to a selected depth.

11. A deflectable catheter for ablating tissue in the heart of a patient comprising

an axially elongated catheter shaft having proximal and distal portions respectively terminating at proximal and distal ends, the catheter shaft being sized and constructed to be advanced through the vasculature of a patient into the patient'"'"'s heart,

a deflection wire coupled to the distal portion of the catheter shaft and extending within the catheter shaft to the proximal end thereof, and

an ablation electrode coupled to the distal end of the catheter shaft, the ablation electrode being adjustable from a closed position in which the ablation electrode has an outer surface exposed for contact with the vasculature of the patient during advancement of the catheter therethrough to an open position in which the ablation electrode is exposable for contact with a selected area of tissue within the patient'"'"'s heart over an area larger than an axially transverse area circumscribed by the outer surface of the ablation electrode in the closed position.

12. A method for the therapeutic treatment of the heart of a patient by ablation of a selected area of heart tissue comprising the steps of:

positioning an axially elongated catheter within the heart of a patient, the catheter having a distal ablation electrode with an exposable electrically conductive surface;

exposing the electrically conductive surface of the ablation electrode to a selected area of heart tissue;

gripping the selected area of heart tissue with the exposed electrically conductive surface of the ablation electrode to stabilize the position of the electrically conductive surface relative to the selected area of heart tissue; and

ablating the selected area of heart tissue by supplying to the electrically conductive surface of the ablation electrode energy sufficient to achieve tissue ablation.

13. The method of claim 12 further comprising the step of deflecting a distal portion of the catheter to increase pressure applied by the exposed conductive surface of the ablation electrode against the selected area of heart tissue.

14. The method of claim 12 further comprising the step of selecting the area of heart tissue to be ablated by measuring the electrical potentials within the patient'"'"'s heart using the catheter positioned within the heart.

15. A method for the therapeutic treatment of the heart of a patient by ablation of a selected area of heart tissue comprising the steps of:

providing an axially elongated catheter having a distal ablation electrode adjustable from a closed, low-profile position to an open position in which an electrically conductive rigid surface of the ablation electrode is exposable for contact with heart tissue over an area larger than an axially transverse area circumscribed by the rigid surface of the ablation electrode in the closed position;

advancing the catheter through the vasculature of a patient and into the patient'"'"'s heart with the ablation electrode in the closed position;

adjusting the ablation electrode into the open position to expose the electrically conductive rigid surface of the ablation electrode for contact with a selected area of heart tissue;

contacting the selected area of heart tissue with the electrically conductive rigid surface of the ablation electrode; and

ablating the selected area of heart tissue by supplying to the electrically conductive surface of the ablation electrode energy sufficient to achieve tissue ablation.

16. The method of claim 15 further comprising the step of deflecting a distal portion of the catheter to increase pressure applied by the exposed conductive surface of the ablation electrode against the selected area of heart tissue.

17. The method of claim 15 further comprising the step of selecting the area of heart tissue to be ablated by measuring the electrical potentials within the patient'"'"'s heart using the catheter positioned within the heart.