Structures and methods for deploying electrode elements

• US 6,214,002 B1
• Filed: 03/13/2000
• Issued: 04/10/2001
• Est. Priority Date: 10/07/1994
• Status: Expired due to Term

• Current Assignee: EP Technology (Boston Scientific Corporation)
• Original Assignee: EP Technology (Boston Scientific Corporation)
• Inventors: Swanson, David K., Fleischman, Sidney D., Whayne, James G.
• Primary Examiner(s): COHEN, LEE S
• Application Number:
  US09/524,080
• Time in Patent Office: 393 Days
• Field of Search: 600/374, 606/41, 606/45, 606/47, 606/49, 607/122, 607/126, 607/99
• US Class Current: 606/41
• 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 2017/2911 rings
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00148 with metal
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/00946 slidable
• CPC Class Codes: A61B 2018/00952 rotatable
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/142 at least partly surrounding the target, e.g. concave, curved or in the form of a cave
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems

Abstract

An electrode support structure comprises a guide body having at its distal end a flexible spline leg. The spline leg is flexed to define an arcuate shape to facilitate intimate contact against tissue. An electrode element is carried by the spline leg for movement along its axis. The structure includes a control element coupled to the electrode element. The control element remotely imparts force to move the electrode element along the axis of the spline leg. Therefore, in use, the physician can cause the electrode element to travel along a path that the spline leg defines, without otherwise changing the location of the guide body.

Claims

1. An apparatus for forming a lesion within the heart, comprising:

a carrier; and

a device associated with the carrier including a circumferential lesion formation structure adapted to engage a circumferential target tissue area that encircles a pulmonary vein and a support structure adapted to engage tissue adjacent to the target tissue area to fix the position of the circumferential lesion formation structure.

2. An apparatus as claimed in claim 1, wherein the carrier comprises a catheter.

3. An apparatus as claimed in claim 1, wherein the circumferential lesion formation structure is substantially annular.

4. An apparatus as claimed in claim 1, wherein the circumferential lesion formation structure is substantially circular.

5. An apparatus as claimed in claim 1, wherein the circumferential lesion formation structure comprises at least one electrode.

6. An apparatus as claimed in claim 1, wherein the circumferential lesion formation structure comprises an energy emitting structure.

7. An apparatus as claimed in claim 1, wherein the circumferential lesion formation structure is flexible.

8. An apparatus as claimed in claim 1, wherein the device comprises a collapsible/expandable device.

9. An apparatus for forming a lesion in a circumferential target tissue area within the heart, comprising:

a carrier; and

a device including a plurality of flexible splines associated with the carrier and including a circumferential lesion formation structure adapted to engage the circumferential target tissue area and a support structure adapted to engage tissue adjacent to the target tissue area to fix the position of the circumferential lesion formation structure.

10. An apparatus for forming a lesion in a circumferential target tissue area within the heart, comprising:

a carrier; and

a device associated with the carrier including a circumferential lesion formation structure adapted to engage the circumferential target tissue area and a support structure adapted to engage tissue adjacent to the target tissue area to fix the position of the circumferential lesion formation structure the circumferential lesion formation structure including a first loop structure defining a first loop structure plane and the support structure including a second loop structure defining a second loop structure plane substantially perpendicular to the first loop structure plane.

11. An apparatus as claimed in claim 10, wherein the first loop structure comprises a unitary spline structure.

12. An apparatus as claimed in claim 10, wherein the first loop structure comprises a plurality of splines.

13. A treatment method, comprising the steps of:

introducing an expandable device formed from a plurality of resilient splines and including a circumferential lesion formation structure and a support structure associated with the circumferential lesion formation structure, into the heart;

expanding the expandable device;

engaging a circumferential region of tissue with the circumferential lesion formation structure;

engaging tissue other than the circumferential region of tissue engaged by the circumferential lesion formation structure with the support structure; and

forming a circumferential lesion in the circumferential region of tissue.

14. A treatment method as claimed in claim 13, wherein the step of introducing an expandable device into the heart comprises the steps of:

directing a vascular introducer into the heart;

collapsing the expandable device; and

passing the collapsed expandable device through the vascular introducer.

15. A method as claimed in claim 14, wherein the step of expanding the expandable device comprises the step of advancing the expandable device out of the introducer.

16. A method as claimed in claim 13, further comprising the step of:

urging the circumferential lesion formation structure against the circumferential region of tissue with the support structure.

17. A method as claimed in claim 13, wherein the step of forming a circumferential lesion comprises the step of supplying energy to the circumferential region of tissue.

18. A method of treating arrhythmia, comprising the steps of:

introducing an expandable device, including a lesion formation structure and a support structure associated with the lesion formation structure, into the left atrium of the heart;

expanding the expandable device;

engaging an annular region of tissue associated with a pulmonary vein with the lesion formation structure;

engaging tissue other than the engaged annular region of tissue with the support structure; and

forming an annular lesion in the annular region of tissue associated with the pulmonary vein.

19. A method as claimed in claim 18, wherein the step of introducing an expandable device into the heart comprises the step of introducing a device including a plurality of resilient splines into the heart.

20. A method as claimed in claim 18, wherein the step of introducing an expandable device into the heart comprises the steps of:

directing a vascular introducer into the left atrium;

collapsing the expandable device; and

passing the collapsed expandable device through the vascular introducer.

21. A method as claimed in claim 20, wherein the step of expanding the expandable device comprises the step of advancing the expandable device out of the introducer.

22. A method as claimed in claim 18, further comprising the step of:

urging the lesion formation structure against the annular region of tissue associated with the pulmonary vein with the support structure.

23. A method as claimed in claim 18, wherein the step of forming a lesion comprises the step of supplying energy to the annular region of tissue associated with the pulmonary vein.

24. A method as claimed in claim 18, wherein the step of engaging an annular region of tissue associated with a pulmonary vein comprises the step of engaging a region of tissue that encircles the pulmonary vein.

25. A method of making electrical contact with an annular region of tissue associated with pulmonary vein, comprising the steps of:

introducing an expandable device, including an annular electrode structure and a support structure associated with the annular electrode structure, into the heart;

expanding the expandable device;

engaging the annular region of tissue with the annular electrode structure; and

engaging tissue other than the annular region of tissue with the support structure.

26. A method as claimed in claim 25, wherein the step of engaging the annular region of tissue comprises the step of engaging a region of tissue that encircles the pulmonary vein.

27. An apparatus for forming a lesion in an annular tissue area associated with a pulmonary vein within heart, comprising:

a carrier; and

an expandable device associated with the carrier including an annular energy transmission structure adapted to engage the annular tissue area and a support structure associated with the annular energy transmission device adapted to engage tissue other than the annular tissue area to fix the position of the annular energy transmission structure.

28. An apparatus as claimed in claim 27, wherein the carrier comprises a catheter.

29. An apparatus as claimed in claim 27, wherein the annular energy transmission structure comprises at least one electrode.

30. An apparatus as claimed in claim 27, wherein the expandable device comprises a plurality of splines.