Device and method for forming a circumferential conduction block in a pulmonary vein

• US 6,502,576 B1
• Filed: 08/17/2000
• Issued: 01/07/2003
• Est. Priority Date: 07/08/1997
• Status: Expired due to Term

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Lesh, Michael D.
• Primary Examiner(s): Nguyen, Dinh X.
• Application Number:
  US09/642,251
• Time in Patent Office: 873 Days
• Field of Search: 128/898 606/1,2,20,21,27,32,41 607/101,115,99,98,96,119,122 604/22 601/2
• US Class Current: 128/898
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/10 Power sources therefor
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00107 Coatings on the energy applicator
• CPC Class Codes: A61B 2018/00148 with metal
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00273 Anchoring means for temporary attachment of a device to tissue
• 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 2018/00369 Heart valves
• CPC Class Codes: A61B 2018/00375 : Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00815 : measured by a thermistor
• CPC Class Codes: A61B 2018/00821 : measured by a thermocouple
• CPC Class Codes: A61B 2018/00839 : Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00898 : Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/00994 : combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61M 2025/1075 : having a balloon composed of several layers, e.g. by coating or embedding
• CPC Class Codes: A61M 2210/125 : Heart
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

This invention is a method for treating a patient diagnosed with atrial arrhythmia by forming a circumferential conduction block along a circumferential path of tissue in a pulmonary vein wall that circumscribes the pulmonary vein lumen and transects the electrical conductivity of the pulmonary vein such that conduction is blocked along the longitudinal axis of the vein wall and into the left atrial wall. The method is performed to treat a patient with a focal arrythmogenic origin along the pulmonary vein wall by either ablating the focal origin or by isolating the focal origin from the atrial wall with the circumferential conduction block. The circumferential conduction block is also formed in a pulmonary vein in order to bridge the adjacent ends of two linear lesions, wherein each linear lesion is formed to extend between the pulmonary vein and another adjacent pulmonary vein in a less-invasive “maze”-type procedure. A circumferential ablation element in a circumferential ablation device assembly is used in a percutaneous translumenal catheter technique in order to form the circumferential conduction block in the pulmonary vein wall.

Claims

1. A method for treating atrial arrhythmia in a heart of a patient, wherein the patient includes a plurality of pulmonary veins and each pulmonary vein extends distally along a lumenal axis from a location in an atrium of the heart, the method comprising:

providing a medical device assembly having a distal end portion with an ablation element;

positioning the ablation element at one of the locations where one of the pulmonary veins extends from the atrium, wherein the one location is along either a funneling region of a pulmonary vein ostium of the one pulmonary vein or along a region of the one pulmonary vein comprising cardiac tissue upstream from the pulmonary vein ostium; and

using said ablation element to ablate a region of tissue that has a continuous circumferential pattern which extends about the lumenal axis of the one pulmonary vein without substantially repositioning the distal end portion.

2. A method as recited in claim 1, wherein ablating comprises contacting the region of tissue with an ablation element.

3. A method as recited in claim 1, wherein ablating comprises emitting energy from an ablation element.

4. A method as recited in claim 3, wherein ablating comprises emitting energy from at least on electrode ablation element.

5. A method as in claim 3, wherein ablating comprises emitting energy from at least one ultrasonic ablation element.

6. A method as recited in claim 3, wherein ablating comprises emitting energy from at least one light emitting ablation element.

7. A method as recited in claim 3, wherein ablating comprises emitting energy from at least one microwave ablation element.

8. A method as recited in claim 3, wherein ablating comprises emitting heat from at least one thermal ablation element.

9. A method as recited in claim 1, wherein ablating comprises ablatively coupling an ablative fluid to the tissue.

10. A method as recited in claim 9, wherein ablating comprises causing a conductive fluid to contact the region of tissue and passing electrical current through the conductive fluid so as to make the fluid ablative.

11. A method as recited in claim 1, wherein ablating comprises ablatively coupling a cryogenic ablation element to the tissue.

12. A method for treating atrial arrhythmia in a heart of a patient, wherein the patient includes a plurality of pulmonary veins and each pulmonary vein extends from a unique location in an atrium of the heart, the method comprising:

ablating a first ablation lesion that substantially circumscribes only one of the locations; and

ablating a second ablation lesion that substantially circumscribes only a different one of said locations.

13. The method of claim 12, further comprising forming a linear lesion between the first and second locations to connect the first and second ablation lesions.