Method and apparatus for monitoring and controlling tissue temperature and lesion formation in radio-frequency ablation procedures

• US 6,423,057 B1
• Filed: 01/21/2000
• Issued: 07/23/2002
• Est. Priority Date: 01/25/1999
• Status: Expired due to Term

• Current Assignee: Arizona Board of Regents (University of Arizona)
• Original Assignee: Arizona Board of Regents (University of Arizona)
• Inventors: Bosnos, Michael, He, Ding Sheng, Marcus, Frank
• Primary Examiner(s): GIBSON, ROY DEAN
• Application Number:
  US09/488,878
• Time in Patent Office: 914 Days
• Field of Search: 606/34, 606/37-43, 606/45, 606/48-50, 607/100, 607/101, 607/99, 607/105, 607/98, 607/102
• US Class Current: 606/34
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance

Abstract

Impedance and capacitance-related parameters are monitored in the electrical circuit of a tissue-ablation apparatus wherein RF electrical power is administered at predetermined frequencies. Tissue temperature has been found to correlate well with low-frequency impedance, or with the resistive component of impedance at any frequency. Therefore, one or both of these parameters are calculated and tracked during the ablation procedure to estimate tissue temperature. Similarly, tissue lesion formation has been found to correlate well with changes in the capacitive component of tissue impedance. Thus, this parameter can be used to track tissue lesion formation during the ablation procedure. The ratio of tissue-to-blood interface with the ablation electrode is estimated by measuring impedance at a very low frequency and a very high frequency. The difference between these two values divided by the high-frequency value is taken to be a measure of such ratio. Alternatively, other electrical parameters indicative of changes in the capacitive component of the system may be measured and the ratio is calculated as a function of these changes with respect to a baseline value.

Claims

1. A method of monitoring tissue lesion formation during a tissue-ablation surgical procedure, comprising the following steps:

administering electrical power at predetermined voltages and corresponding currents to a tissue in contact with an ablation device;

measuring an electrical parameter related to a capacitive component of the tissue; and

tracking said tissue lesion formation on the basis of a known correlation between said electrical parameter and tissue lesion formation for said tissue;

wherein said tissue is cardiac tissue.

2. The method of claim 1, wherein said electrical parameter is a phase angle between said voltages and corresponding currents, and said known correlation is between a capacitive parameter related to phase angle and tissue lesion formation for said tissue.

3. The method of claim 1, wherein said electrical parameter is a capacitive component of tissue impedance, and said known correlation is between changes of said capacitive component and tissue lesion formation for said tissue.

4. The method of claim 3, wherein said capacitive component is calculated from said voltages and corresponding currents measured during the procedure.

5. The method of claim 1, wherein said ablation device is an electrode and said surgical procedure is carried out with radio-frequency electrical energy.

6. The method of claim 1, further comprising the step of terminating said surgical procedure when said tissue lesion formation is estimated to reach a predetermined amount.

7. In a tissue-ablation surgical procedure wherein an ablating energy is administered to a tissue in contact with an ablation device immersed in a liquid, a method of estimating a ratio of tissue-to-liquid interface area with the device comprising the following steps:

(a) administering electrical power at predetermined voltages and corresponding currents to the tissue in contact with said ablation device;

(b) measuring an electrical parameter related to a capacitive component of the tissue;

(c) calculating said capacitive component of the tissue; and

(d) estimating said ratio on the basis of a change in said capacitive component.

8. The method of claim 7, wherein said electrical parameter is phase angle.

9. The method of claim 7, wherein said electrical parameter is impedance and steps (c)-(d) are accomplished by the following steps:

measuring said voltages and corresponding currents at a first frequency of operation and calculating corresponding first values of tissue admittance;

measuring said voltages and corresponding currents at a second frequency of operation and calculating corresponding second values of tissue admittance; and

estimating said ratio on the basis of a difference between said first and second values of tissue admittance.

10. The method of claim 7, wherein said tissue is cardiac tissue.

11. The method of claim 7, wherein said liquid is blood.

12. The method of claim 7, wherein said ablating energy is radio-frequency electrical energy and said ablation device is an electrode.

13. In a tissue-ablation surgical procedure wherein an ablating energy is administered to a tissue in contact with an ablation device, a method for concurrently monitoring tissue temperature and tissue-lesion formation during the surgical procedure, comprising the following steps:

(a) administering ablating electrical power to the tissue in contact with said ablation device at a predetermined ablating frequency;

(b) concurrently with step (a), administering a low-frequency electrical power to the tissue in contact with said ablation device at a predetermined low-frequency voltage and a corresponding low-frequency current, wherein said low-frequency electrical power is administered at a low frequency below said ablating frequency;

(c) concurrently with steps (a) and (b), administering a high-frequency electrical power to the tissue in contact with said ablation device at a predetermined high-frequency voltage and a corresponding high-frequency current, wherein said high-frequency electrical power is administered at a high frequency above said ablating frequency;

(d) measuring said low-frequency voltage and corresponding low-frequency current and said high-frequency voltage and corresponding high-frequency current;

(e) calculating a low-frequency impedance, a low-frequency admittance, and a high-frequency admittance based on data collected in step (d);

(f) tracking said tissue temperature on the basis of a known correlation between temperature and said low-frequency impedance in the tissue; and

(g) tracking said tissue-lesion formation on the basis of a known correlation between lesion formation in said tissue and a difference between said high-frequency admittance and low-frequency admittance in the tissue.

14. The method of claim 13, wherein said tissue is cardiac tissue.

15. The method of claim 13, wherein said ablating energy is radio-frequency electrical energy and said ablation device is an electrode.

16. The method of claim 13, wherein said ablating frequency is about 250-500 kHz, said low frequency is about 5 KHz, and said high frequency is about 1 MHz.

17. The method of claim 13, further comprising the step of terminating said surgical procedure when the tissue temperature is estimated to reach about 95°

C.

18. The method of claim 13, further comprising the step of terminating said surgical procedure when said tissue-lesion formation is estimated to reach a predetermined amount.

19. A radio-frequency electrical apparatus for performing an ablation operation on a tissue, comprising:

an electrode adapted for placement against said tissue;

an ablation radio-frequency generator capable of energizing said electrode at a predetermined ablation frequency to produce ablation of the tissue;

a low-frequency generator capable of administering a low-frequency electrical power to the tissue in contact with said electrode at a predetermined low-frequency voltage and a corresponding low-frequency current, said low-frequency electrical power being administered at a low frequency below said ablating frequency;

a high-frequency generator capable of administering a high-frequency electrical power to the tissue in contact with said electrode at a predetermined high-frequency voltage and a corresponding high-frequency current, said high-frequency electrical power being administered at a high frequency above said ablating frequency;

means for measuring said low-frequency voltage and corresponding low-frequency current and said high-frequency voltage and corresponding high-frequency current;

means for calculating a low-frequency impedance, a low-frequency admittance, and a high-frequency admittance based on data collected by said measuring means;

means for tracking a temperature of said tissue on the basis of a known correlation between tissue temperature and said low-frequency impedance; and

means for tracking a tissue-lesion formation on the basis of a known correlation between lesion formation in said tissue and a difference between said high-frequency admittance and low-frequency admittance.

20. The radio-frequency electrical apparatus of claim 19, wherein said tissue is cardiac tissue, said ablating frequency is about 250-500 kHz, said low frequency is about 5 KHz, and said high frequency is about 1 MHz.

21. The radio-frequency electrical apparatus of claim 19 further comprising means for terminating said ablating operation when said tissue-lesion formation is estimated to reach a predetermined amount.

22. The radio-frequency electrical apparatus of claim 21, wherein said means for terminating said ablating operation includes means for controlling an output of said ablation radio-frequency generator in response to a signal related to at least one of said low-frequency impedance and said difference between the high-frequency admittance and the low-frequency admittance.