Ablation methods and medical apparatus using same

• US 6,709,432 B2
• Filed: 04/26/2002
• Issued: 03/23/2004
• Est. Priority Date: 04/26/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ferek-Patric, Bozidar
• Primary Examiner(s): Gibson, Roy D.
• Assistant Examiner(s): VRETTAKOS, PETER J
• Application Number:
  US10/132,509
• Publication Number:
  US 20030204184A1
• Time in Patent Office: 697 Days
• Field of Search: 606/32-52
• 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 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/0088 Vibration

Abstract

Apparatus and methods of the present invention utilize sensed acoustical energy and may detect both instability of an ablation electrode during the ablation process and/or crater formation during tissue ablation.

Claims

1. A method for use in ablating tissue, comprising:

providing a catheter comprising an ablation electrode;

ablating tissue using the ablation electrode, wherein the ablation electrode directs electromagnetic energy to the tissue;

detecting at least acoustical energy resulting from the ablation of tissue; and

comparing the detected acoustical energy to at least a portion of an ECG waveform to determine stability of the catheter.

2. The method of claim 1, wherein comparing the detected acoustical energy to the at least a portion of an ECG waveform comprises:

detecting acoustical energy over a threshold; and

determining whether the detected acoustical energy is synchronized with the at least a portion of an ECG waveform.

3. The method of claim 1, wherein the method further comprises controlling the electromagnetic energy directed to the tissue based on the comparison.

4. The method of claim 1, wherein detecting at least acoustical energy further comprises detecting at least acoustical energy resulting from the ablation of tissue using a piezoelectric transducer element.

5. The method of claim 4, wherein the catheter further comprises a catheter body, and further wherein the piezoelectric transducer element is positioned proximate the ablation electrode of the catheter.

6. The method of claim of claim 1, wherein ablating tissue using the ablation electrode further comprises ablating cardiac tissue using the ablation electrode, wherein the ablation electrode directs electromagnetic energy to the cardiac tissue.

7. The method of claim 4, wherein the method further comprises:

detecting an ablation temperature using the piezoelectric transducer element; and

controlling the electromagnetic energy directed to the tissue based on the detected ablation temperature.

8. The method of claim 7, wherein the method further comprises simultaneously controlling the electromagnetic energy directed to the tissue based on the detected acoustical energy and the detected ablation temperature.

9. The method of claim 1, wherein the method further comprises:

analyzing the detected acoustical energy to detect at least one popping sound; and

reducing the electromagnetic energy directed to the tissue if at least one popping sound is detected.

10. A method for use in ablating tissue, comprising:

providing a catheter comprising an ablation electrode;

ablating tissue using the ablation electrode, wherein the ablation electrode directs electromagnetic energy to the tissue;

detecting acoustical energy and providing a transducer signal representative of the detected acoustical energy during ablation of tissue;

removing at least a cardiac generated acoustical energy component from the transducer signal; and

controlling the electromagnetic energy directed to the tissue based on the transducer signal having the at least a cardiac generated acoustical energy component removed therefrom.

11. The method of claim 10, wherein controlling the electromagnetic energy directed to the tissue based on the transducer signal having the at least a cardiac generated acoustical energy component removed therefrom comprises:

comparing the transducer signal having the at least a cardiac generated acoustical energy component removed therefrom to a predetermined popping sound spectrum to determine the presence of a popping sound; and

reducing the electromagnetic energy directed to the tissue if at least one popping sound is present.

12. The method of claim 10, wherein removing the at least a cardiac generated acoustical energy component from the transducer signal comprises:

detecting acoustical energy prior to ablating tissue and providing a pre-ablation transducer signal representative of at least cardiac generated acoustical energy; and

subtracting the pre-ablation acoustic signal from the transducer signal provided during tissue ablation.

13. The method of claim 10, wherein detecting acoustical energy further comprises detecting acoustical energy using a piezoelectric transducer element.

14. The method of claim 10, wherein the catheter comprises a catheter body, wherein the piezoelectric transducer is positioned proximate the ablation electrode of the catheter, and further wherein the method further comprises detecting an ablation temperature using the piezoelectric transducer element.

15. The method of claim 14, wherein detecting the ablation temperature using the piezoelectric transducer element comprises measuring a dielectric constant of the piezoelectric transducer.

16. The method of claim 14, wherein detecting the ablation temperature using the piezoelectric transducer element comprises measuring a dielectric loss tangent of the piezoelectric transducer.

17. The method of claim 10, wherein the method further comprises:

detecting an ablation temperature proximate the tissue being ablated; and

controlling the electromagnetic energy directed to the tissue based on the detected ablation temperature.

18. The method of claim 17, wherein the method further comprises simultaneously controlling the electromagnetic energy directed to the tissue based on the detected acoustical energy and the detected ablation temperature.

19. A method for use in ablating cardiac tissue, comprising:

providing a catheter comprising an ablation electrode and a piezoelectric transducer element operable for use in detecting acoustical energy;

ablating tissue using the ablation electrode, wherein the ablation electrode directs electromagnetic energy to the tissue;

detecting acoustical energy using the piezoelectric transducer element for detection of at least one popping sound;

if at least one popping sound is detected, reducing the electromagnetic energy directed to the tissue.

20. The method of claim 19, wherein detecting acoustical energy comprises:

detecting acoustical energy during ablation of tissue using the piezoelectric transducer element and providing a transducer signal representative of the detected acoustical energy;

removing at least a cardiac generated acoustical energy component from the transducer signal;

comparing the transducer signal having the at least a cardiac generated acoustical energy component removed therefrom to an acoustic profile representative of a popping sound; and

detecting at least one popping sound if the transducer signal having the at least a cardiac generated acoustical energy component removed therefrom matches the acoustic profile.

21. The method of claim 20, wherein removing the at least a cardiac generated acoustical energy component from the transducer signal comprises:

detecting acoustical energy prior to ablating tissue representative of at least cardiac generated acoustical energy and providing a pre-ablation transducer signal representative of the at least cardiac generated acoustical energy; and

subtracting the pre-ablation transducer signal from the transducer signal detected during ablation of tissue.

22. The method of claim 19, wherein the method further comprises detecting an ablation temperature proximate the tissue being ablated using the piezoelectric transducer element.

23. The method of claim 22, wherein the method further comprises reducing the electromagnetic energy directed to the tissue based on the ablation temperature.

24. A method for use in ablating tissue, comprising;

providing a catheter comprising an ablation electrode and a piezoelectric transducer element;

ablating cardiac tissue using the ablation electrode, wherein the ablation electrode directs electromagnetic energy to the cardiac tissue;

detecting acoustical energy during ablation of cardiac tissue using the piezoelectric transducer element and providing a transducer signal representative thereof, wherein the transducer signal is further representative of an ablation temperature proximate tissue being ablated; and

controlling the electromagnetic energy directed to the tissue based on the transducer signal.

25. The method of claim 24, wherein detecting acoustical energy further comprises simultaneously detecting acoustical energy and temperature using the piezoelectric transducer element.

26. The method of claim 24, wherein detecting acoustical energy using the piezoelectric transducer element further comprises:

removing at least a cardiac generated acoustical energy component from the transducer signal;

comparing the transducer signal having the at least a cardiac generated acoustical energy component removed therefrom to an acoustic profile representative of a popping sound; and

detecting at least one popping sound based on the transducer signal having the at least a cardiac generated acoustical energy component removed therefrom.

27. The method of claim 26, wherein removing the at least a cardiac generated acoustical energy component from the transducer signal comprises:

detecting acoustical energy prior to ablating tissue and providing a pre-ablation transducer signal representative of at least cardiac generated acoustical energy; and

subtracting the pre-ablation transducer signal from the transducer signal representative of acoustical energy during ablation of tissue.

28. The method of claim 26, wherein controlling the electromagnetic energy directed to the tissue based on the transducer signal further comprises reducing the electromagnetic energy directed to the tissue if at least one popping sound is detected.

29. The method of claim 24, wherein controlling the electromagnetic energy directed to the tissue based on the transducer signal further comprises reducing the electromagnetic energy directed to the tissue based on the ablation temperature.

30. A method for use in ablating tissue, comprising:

providing a catheter comprising an ablation electrode;

ablating tissue using the ablation electrode, wherein the ablation electrode directs electromagnetic energy to the tissue;

detecting acoustical energy and providing a transducer signal representative of the detected acoustical energy;

measuring a sound intensity of the detected acoustical energy;

comparing the measured sound intensity to a sound intensity threshold;

if the measured sound intensity is greater than the sound intensity threshold, then comparing the transducer signal to at least a portion of an ECG waveform; and

reducing the electromagnetic energy directed to the tissue if the transducer signal and the at least a portion of an ECG waveform are asynchronous.

31. The method of claim 30, wherein the method further comprises triggering an electrode stability alarm if the transducer signal and the at least a portion of an ECG waveform are synchronous.

32. A method for use in ablating cardiac tissue, comprising:

providing a catheter comprising an ablation electrode and a tensiometric element;

ablating tissue using the ablation electrode, wherein the ablation electrode directs electromagnetic energy to the cardiac tissue;

detecting a plurality of cardiac contractions using the tensiometric element and providing a tensiometric signal representative of the plurality of cardiac contractions;

detecting acoustical energy and providing a transducer signal representative of the detected acoustical energy;

comparing the tensiometric signal to the transducer signal; and

controlling the electromagnetic energy directed to the cardiac tissue based on the compared tensiometric signal and transducer signal.

33. The method of claim 32, wherein the detected acoustic energy comprises a plurality of sound events, wherein comparing the tensiometric signal to the transducer signal further comprises measuring a time interval between at least one sound event and at least one cardiac contraction.

34. The method of claim 33, wherein the method further comprises triggering an electrode stability alarm if the time interval is equal to a predetermined threshold delay interval.

35. The method of claim 33, wherein the method further comprises analyzing the transducer signal if the time interval is not equal to a predetermined threshold delay interval.

36. The method of claim 35, wherein analyzing the transducer signal further comprises:

removing at least a cardiac generated acoustical energy component from the transducer signal; and

comparing the transducer signal having the at least a cardiac generated acoustical energy component removed therefrom to an acoustic profile representative of a popping sound to detect at least one popping sound.

37. The method of claim 36, wherein removing the at least a cardiac generated acoustical energy component from the transducer signal comprises:

detecting acoustical energy prior to ablating tissue and providing a pre-ablation transducer signal representative of at least cardiac is generated acoustical energy; and

subtracting the pre-ablation transducer signal from the transducer signal representative of acoustical energy during ablation of tissue.

38. The method of claim 37, wherein controlling the electromagnetic energy directed to the cardiac tissue further comprises reducing the electromagnetic energy directed to the cardiac tissue if at least one popping sound is detected.