Ablation catheter and method for isolating a pulmonary vein

• US 6,325,797 B1
• Filed: 04/05/1999
• Issued: 12/04/2001
• Est. Priority Date: 04/05/1999
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Min, Xiaoyi, Mehra, Rahul, Francischelli, David E., Flickinger, William J., Stewart, Mark T.
• Primary Examiner(s): COHEN, LEE S
• Application Number:
  US09/286,048
• Time in Patent Office: 974 Days
• Field of Search: 606/41, 606/49, 607/99, 607/113, 607/122
• 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 2017/00044 Sensing electrocardiography, i.e. ECG
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/1435 Spiral

Abstract

A catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The catheter assembly includes a catheter body and at least one electrode. The catheter body includes a proximal portion, an intermediate portion and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a substantially closed loop transverse to the longitudinal axis. The at least one electrode is disposed along the loop. With this configuration, the loop is axially directed into contact with the chamber wall about the vessel ostium. Upon energization, the electrode ablates a continuous lesion pattern about the vessel ostium, thereby electrically isolating the vessel from the chamber.

Claims

1. A method for forming an ablation pattern to electrically isolate a vessel having an ostium from a chamber formed within a patient for treatment of cardiac arrhythmia, the method including:

selecting a catheter assembly comprising a catheter body defining a longitudinal axis and having a proximal portion and a distal portion, the distal portion forming a substantially closed loop transverse to the longitudinal axis, the loop defining a loop axis that is aligned with the longitudinal axis, and at least one electrode displayed along the distal portion;

guiding the distal portion into the chamber;

directing the distal portion to a position spaced from the vessel ostium, whereby the loop axis is substantially aligned with a center of the vessel ostium;

advancing the distal portion in a direction parallel with the loop axis such that the loop contacts the chamber wall about the vessel ostium; and

energizing the electrode to ablate a continuous, closed lesion pattern about the vessel ostium to electrically isolate the vessel from the chamber.

2. The method of claim 1, wherein the chamber is a left atrium and the vessel is a pulmonary vein.

3. The method of claim 1, wherein selecting a catheter assembly includes providing a substantially circular loop.

4. The method of claim 1, wherein selecting a catheter assembly includes providing a loop sized to define a diameter greater than a diameter of the vessel ostium.

5. The method of claim 1, wherein selecting a catheter assembly includes providing the distal portion with a loop segment of at least one revolution for forming the loop.

6. The method of claim 5, wherein selecting a catheter assembly includes providing the distal portion with a lateral segment extending laterally from an intermediate portion, the loop segment extending from the lateral segment.

7. The method of claim 1, wherein the loop axis is substantially parallel with the longitudinal axis.

8. The method of claim 1, wherein selecting a catheter assembly includes the catheter body having an intermediate portion between the proximal portion and the distal portion, the intermediate portion including a proximal section and a distal section adjacent the distal portion, the distal section configured to be more flexible than the proximal section for allowing deflection of the distal portion relative to the proximal section.

9. The method of claim 1, wherein selecting a catheter assembly includes selecting a catheter assembly further comprising:

an elongated guide body having a central lumen and defining a proximal end and a distal end, the catheter body being slidably maintained within the central lumen such that in a deployed position, the distal portion of the catheter body extends distally from the distal end of the guide body, and in a retracted position, the distal portion is proximal the distal end;

wherein the distal portion is substantially straight in the retracted position.

10. The method of claim 9, further comprising:

deploying the distal portion of the catheter body from the distal end of the guide body prior to the loop contacting the chamber wall.

11. The method of claim 9, wherein the distal portion is made of a shape memory material such that the distal portion forms the loop in the deployed position.

12. The method of claim 1, further comprising:

straightening the distal portion with a stylet slidably disposed within a central lumen formed by the catheter body prior to guiding the distal portion into the chamber.

13. The method of claim 1, wherein selecting a catheter assembly further includes selecting a catheter assembly with the loop defining a proximal end and a distal end, wherein the at least one electrode includes a first section positioned at the proximal end and a second section positioned at the distal end, the loop being configured such that when axially compressed, the first section is immediately adjacent the second section.

14. The method of claim 13, wherein the first section includes an electrode apart from an electrode of the second section.

15. A method of electrically isolating a vessel from a chamber formed within a patient, the vessel defining an ostium in a wall of the chamber, for treatment of cardiac arrhythmia, the method comprising:

providing a catheter assembly comprising a catheter body having a distal portion forming a closed loop maintaining a plurality of electrodes; and

ablating a continuous, closed lesion pattern in the chamber wall about the vessel ostium by substantially simultaneously energizing the plurality of electrodes, the lesion pattern electrically isolating the vessel from the chamber.

16. A method of electrically isolating a vessel from a chamber formed within a patient, the vessel defining an ostium in a wall of the chamber, for treatment of cardiac arrhythmia, the method comprising:

providing a catheter assembly including a catheter body defining a longitudinal axis and having a proximal portion and a distal portion, the distal portion forming a substantially closed loop transverse to the longitudinal axis, the loop defining a loop axis and maintaining at least one electrode;

positioning the loop about the vessel ostium; and

ablating a continuous, closed lesion pattern in the chamber wall about the vessel ostium, the lesion pattern electrically isolating the vessel from the chamber.

17. The method of claim 16, wherein positioning the loop includes:

directing the distal portion into the chamber such that the loop axis is substantially aligned with a center of the vessel ostium; and

advancing the distal portion in a direction substantially parallel with the loop axis such that the loop contacts the chamber wall about the vessel ostium.

18. The method of claim 16, wherein the loop maintains a plurality of electrodes, the method further including:

determining which of the plurality of electrodes are in contact with chamber wall before ablating the continuous, closed lesion pattern.

19. A method of electrically isolating a vessel from a chamber formed within a patient, the vessel defining an ostium in a wall of the chamber, for treatment of cardiac arrhythmia, the method comprising:

ablating only a continuous, closed lesion pattern in the chamber wall about the vessel ostium, the lesion pattern electrically isolating the vessel from the chamber.

20. The method of claim 19, wherein the vessel is a pulmonary vein, and further wherein the lesion pattern defines an internal area at least slightly larger than an area of the pulmonary vein ostium.

21. The method of claim 19, wherein the continuous, closed lesion pattern is formed with a single catheter assembly.

22. The method of claim 19, wherein a catheter assembly comprising a catheter body having a distal portion forming a closed loop maintaining a plurality of electrodes is provided, and wherein ablating a continuous, closed lesion pattern includes:

substantially simultaneously energizing the plurality of electrodes.

23. The method of claim 19, wherein a catheter assembly is provided and includes a catheter body defining a longitudinal axis and having a proximal portion and a distal portion, the distal portion forming a substantially closed loop transverse to the longitudinal axis, the loop defining a loop axis and maintaining at least one electrode, the method further including:

positioning the loop about the vessel ostium prior to ablating the continuous, closed lesion pattern.

24. The method of claim 23, wherein positioning the loop includes:

directing the distal portion into the chamber such that the loop axis is substantially aligned with a center of the vessel ostium; and

advancing the distal portion in a direction substantially parallel with the loop axis such that the loop contacts the chamber wall about the vessel ostium.

25. The method of claim 23, wherein the loop maintains a plurality of electrodes, the method further including:

determining which of plurality of electrodes are in contact with the chamber wall before ablating the continuous, closed lesion pattern.