Electromagnetic cardiac biostimulation

• US 6,443,974 B1
• Filed: 11/01/1999
• Issued: 09/03/2002
• Est. Priority Date: 07/28/1996
• Status: Expired due to Fees

• Current Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Original Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Inventors: Oron, Uri, Matcovitch, Avraham
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): VRETTAKOS, PETER J
• Application Number:
  US09/230,399
• Time in Patent Office: 1,037 Days
• Field of Search: 606/7, 606/15, 606/11, 606/88, 606/16, 606/2, 606/3, 606/13, 128/660, 128/633, 514/23, 607/123, 607/122, 607/88, 607/89
• US Class Current: 607/88
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/0056 the insertion parts being asymmetric, e.g. for unilateral bending mechanisms
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00243 cardiac
• 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 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/22002 preventing restenosis
• CPC Class Codes: A61B 2017/22008 used or promoted
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/2211 Plurality of fibres
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/374 : NMR or MRI
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/3954 : magnetic, e.g. NMR or MRI
• 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 5/06 : Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/061 : Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6885 : Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 8/0833 : involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 : for locating instruments
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61M 2025/0166 : Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61M 25/01 : Introducing, guiding, advancing, emplacing or holding catheters A61M25/10 takes precedence
• CPC Class Codes: A61M 25/0105 : Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61M 25/104 : used for angioplasty
• CPC Class Codes: A61N 1/05 : for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 2005/0659 : infrared
• CPC Class Codes: A61N 5/0601 : Apparatus for use inside the body
• CPC Class Codes: A61N 5/062 : Photodynamic therapy, i.e. excitation of an agent

Abstract

Methods and apparatus for biostimulation of a myocardial tissue, by irradiating the myocardial tissue with a source of electromagnetic radiation which causes biostimulation of the myocardial tissue. Preferably, the electromagnetic radiation is selected from the group consisting of infrared, visible light and ultraviolet radiation. Typically, the tissue is irradiated after the myocardial tissue develops an infarct of a given size, such that irradiating the myocardial tissue causes a reduction in the size of the infarct. The irradiation may also cause regeneration of cardiomyocytes in the infarct and help to preserve structure and activity of mitochondria in cardiomyocytes in the infarct.

Claims

1. A method for biostimulation of a myocardial tissue of a heart, said method comprising:

introducing a catheter having at least one position sensor into said heart;

tracking the location of said catheter within said heart using at least one position sensor;

positioning said catheter at said myocardial tissue of said heart;

irradiating said myocardial tissue without creating a channel in said myocardial tissue via a waveguide introduced by said catheter into said heart with a source of electromagnetic radiation having a power output in the range of 5 mW to 5 W and a wavelength in the range of 250 nm to 940 nm; and

inducing cells in said myocardial tissue to synthesize newly-formed contractile proteins as a result of said irradiation.

2. A method according to claim 1, wherein the electromagnetic radiation is selected from the group consisting of infrared, visible light and ultraviolet radiation.

3. A method according to claim 2, wherein irradiating the tissue comprises irradiating after the myocardial tissue develops an infarct of a given size, such that irradiating the myocardial tissue causes a reduction in the size of the infarct.

4. A method according to claim 2, wherein irradiating the tissue comprises irradiating after the myocardial tissue develops an infarct, such that irradiating the myocardial tissue causes regeneration of cardiomyocytes in the infarct.

5. A method according to claim 2, wherein irradiating the tissue comprises irradiating after the myocardial tissue develops an infarct, such that irradiating the myocardial tissue preserves structure and activity of mitochondria in cardiomyocytes in the infarct.

6. A method according to claim 2, wherein irradiating the tissue comprises irradiating after the myocardial tissue develops an infarct, such that irradiating the myocardial tissue preserves structure and activity of contractile proteins in cardiomyocytes in the infarct.

7. A method according to claim 2, wherein the source of electromagnetic radiation comprises a source of coherent light.

8. A method according to claim 7, wherein the source of coherent light comprises a diode laser.

9. A method according to claim 1, wherein irradiating the tissue comprises a plurality of irradiations of the myocardial tissue with the source of electromagnetic radiation.

10. A method according to claim 9, wherein irradiating the tissue comprises irradiating myocardial tissue with the source of electromagnetic radiation for a duration of 0.5-15 minutes.

11. A method according to claim 1, wherein the catheter is introduced through the aorta.

12. A method according to claim 1, and comprising administering a therapeutic chemical compound in conjunction with the irradiating.

13. A method according to claim 12, wherein administering the chemical compound comprises administering fructose-1,6-diphosphate (FDP).

14. A method according to claim 12, wherein administering the chemical compound comprises administering a seleno-organic free radicals scavenger.

15. A method according to claim 2, wherein irradiating the tissue and administering the chemical alleviates a post-reperfusion injury.

16. A method according to claim 1, and comprising performing a myocardial revascularization procedure in conjunction with the irradiating.

17. A method according to claim 6, wherein performing the myocardial revascularization procedure comprises performing a revascularization procedure simultaneously with the irradiating.

18. A method according to claim 1, and comprising receiving physiological signals from the tissue, wherein irradiating the tissue comprises irradiating heart tissue in response to the signals received therefrom.

19. A method according to claim 18, wherein the physiological signals comprise mechano-physiological signals.

20. A method according to claim 18, wherein the physiological signals comprise electrophysiological signals.

21. A method according to claim 1, wherein positioning the catheter comprises positioning the catheter responsive to a viability map, which indicates ischemic areas in the heart tissue.

22. A method according to claim 1, wherein positioning the catheter comprises positioning the catheter relative to a grid delineating a zone to be irradiated on a geometrical map of the heart wherein a plurality of points are indicated for irradiating.

23. A method according to claim 22, and comprising marking the points on the grid after irradiating.

24. A method according to claim 1, wherein irradiating the tissue comprises simultaneously irradiating an area of the heart wall substantially larger than a cross-sectional area of the waveguide.

25. A method according to claim 24, wherein the tissue is irradiated via the waveguide by expanding a radial dimension of the waveguide adjacent the tissue.

26. A method according to claim 1, wherein positioning the catheter comprises pressing a flexible distal portion of the catheter against the heart wall so that the portion conforms to the wall, and wherein irradiating the tissue comprises irradiating an area radially adjacent the distal portion.

27. A method according to claim 1, wherein the catheter is introduced into a coronary artery.

28. A method according to claim 1, wherein irradiating the heart tissue comprises irradiating the heart epicardially, in addition to irradiating via the waveguide introduced by the catheter.

29. A method according to claim 1, and comprising at least partially exposing non-myocardial tissues in a generally perpendicular direction to a lateral wall of the myocardial tissue, and wherein irradiating the tissue comprises placing an optical element coupled to the source of electromagnetic radiation onto the at least partially exposed non-myocardial tissues.

30. A method according to claim 29, wherein the non-myocardial tissues comprise chest muscles of a chest cavity and irradiating the tissue comprises placing the optical element into the chest cavity in a vicinity of the tissue.

31. A method according to claim 29, wherein placing the optical element comprises bringing the element into proximity with the pleural membrane.

32. A method according to claim 1, and wherein the source of electromagnetic radiation comprises a source of concentrated non-coherent light.

33. A method according to claim 32, wherein the source of concentrated non-coherent light comprises a xenon lamp.

34. A method according to claim 33 wherein the xenon lamp has an radiative power flux of 30-500 mW/cm².

35. A method for biostimulation of a myocardial tissue of a heart, said method comprising:

introducing a catheter into said heart;

positioning said catheter at said myocardial tissue of said heart;

receiving physiological signals from said myocardial tissue with said catheter;

irradiating said myocardial tissue without creating a channel in said myocardial tissue via a waveguide introduced by said catheter into said heart with a source of electromagnetic radiation having a power output in the range of 5 mW to 5 W and a wavelength in the range of 250 nm to 940 nm in response to the signals received therefrom; and

inducing cells in said myocardial tissue to synthesize newly-formed contractile proteins as a result of said irradiation.

36. A method according to claim 35, wherein the physiological signals comprise mechanophysiological signals.

37. A method according to claim 35, wherein the physiological signals comprise electrophysical signals.