Apparatus and method for diagnosis and therapy of electrophysiological disease

• US 6,311,692 B1
• Filed: 07/19/1999
• Issued: 11/06/2001
• Est. Priority Date: 10/22/1996
• Status: Expired due to Term

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: Epicor Inc. (Evoqua Water Technologies Corp.)
• Inventors: Vaska, Matthias, Richman, Roxanne L., Anderson, Scott C., Gallup, David A., Pless, Benjamin, Ulstad, Jack E. Jr.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US09/356,476
• Time in Patent Office: 841 Days
• Field of Search: 606/32-34, 606/41, 606/47, 600/374, 607/115, 607/116, 607/122, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• 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 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00232 having an irregular shape
• CPC Class Codes: A61B 2018/00261 arranged in a line
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00839 : Bioelectrical parameters, e.g. ECG, EEG
• 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: A61B 2018/145 : wherein the effectors remain parallel during closing and opening
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/3629 : in combination with non-electric therapy
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

The invention provides apparatus and methods for mapping conduction pathways and creating lesions in the heart wall for the treatment of atrial fibrillation. The apparatus may include at least one epicardial ablation probe having a plurality of electrodes for creating a lesion. The apparatus and method facilitate the formation of a lesion which electrically isolates the pulmonary veins from the surrounding myocardium.

Claims

1. A method of ablating tissue from an epicardial location, comprising the steps of:

providing an ablating device having an ablating element, the ablating device having a locking mechanism for locking a part of the ablating device to another part of the ablating device;

positioning the ablating device around a portion of a patient'"'"'s heart with the ablating element positioned against an epicardial location;

locking the locking mechanism so that the ablating device forms a closed loop around a portion of the patient'"'"'s heart with the ablating element positioned at the epicardial location and

ablating tissue with the ablating device.

2. The method of claim 1, wherein:

the providing step is carried out with the ablating device having a first ablating portion and a second ablating portion; and

the ablating step being carried out by ablating tissue with the first and second ablating portions, the ablating element being positioned along at least one of the first and second ablating portions.

3. The method of claim 2, wherein:

the ablating step is carried out with the first ablating portion extending adjacent to the pericardial reflection extending between the RS and LS pulmonary veins.

4. The method of claim 2, further comprising the step of:

the locking step is carried out so that the ablating device encircles at least one of the pulmonary veins.

5. The method of claim 1, wherein:

the providing step is carried out with the ablating element having an RF electrode.

6. The method of claim 1, wherein:

the providing step is carried out with the ablating element being an element selected from the group consisting of RF electrode, microwave transmitter, laser, ultrasound transducer, direct contact heating, or cryogenic element.

7. The method of claim 1, wherein:

the locking step is carried out so that the ablating device encircles all four pulmonary veins.

8. The method of claim 1, wherein:

the positioning step is carried out by wrapping the ablating device around the patient'"'"'s heart.

9. The method of claim 1, wherein:

the providing step is carried out with the ablating device having a plurality of ablating elements.

10. The method of claim 1, wherein:

the providing step is carried out with the ablating device having a width and a height, the width being larger than the height.

11. The method of claim 10, wherein:

the providing step is carried out with a width to height ratio being 2-5.