Ablation catheter having shape-changing balloon
First Claim
1. A circumferential ablation catheter comprising:
- an elongated tubular catheter body having an outer wall, proximal and distal ends, and a lumen extending therethrough;
a generally tubular inner support member having proximal and distal ends and a lumen extending therethrough, wherein a proximal portion of the inner support member extends into the lumen of the catheter body and a distal portion of the inner support member extends outside the catheter body;
a circumferential ablation element mounted on the distal portion of the inner support member outside the catheter body;
a moveable tube extending through the lumen of the inner support member and through the catheter body, the moveable tube being longitudinally moveable relative to the inner support member and catheter body and having a distal end extending beyond the distal end of the inner support member; and
an inflatable balloon provided generally in surrounding relation to the circumferential ablation element, the inflatable balloon having a proximal end attached to the distal end of the catheter body and a distal end attached to a portion of the moveable tube that extends beyond the distal end of the inner support member;
wherein longitudinal movement of the moveable tube relative to the catheter body and inner support member causes movement of the distal end of the balloon relative to the proximal end of the balloon to thereby change the length of the balloon.
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Accused Products
Abstract
A circumferential ablation catheter is provided that is particularly useful for ablating a circumferential region of tissue in a tubular region of or near the heart, such as a pulmonary vein. The catheter comprises an elongated tubular catheter body having an outer wall, proximal and distal ends, and a lumen extending therethrough. The catheter also comprises a generally tubular inner support member having proximal and distal ends and a lumen extending therethrough. A proximal portion of the inner support member extends into the lumen of the catheter body, and a distal portion of the inner support member extends outside the catheter body. A circumferential ablation element, such as an ultrasound transducer, is mounted on the distal portion of the inner support member outside the catheter body. A moveable tube extends through the lumen of the inner support member and through the catheter body. The moveable tube is longitudinally moveable relative to the inner support member and catheter body and has a distal end that extends beyond the distal end of the inner support member. An inflatable balloon is provided generally in surrounding relation to the circumferential ablation element. The inflatable balloon has a proximal end attached, directly or indirectly, to the distal end of the catheter body and a distal end attached, directly or indirectly, to a portion of the moveable tube that extends beyond the distal end of the inner support member. Longitudinal movement of the moveable tube relative to the catheter body and inner support member causes movement of the distal end of the balloon relative to the proximal end of the balloon to thereby change the length and shape of the expanded balloon.
326 Citations
39 Claims
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1. A circumferential ablation catheter comprising:
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an elongated tubular catheter body having an outer wall, proximal and distal ends, and a lumen extending therethrough;
a generally tubular inner support member having proximal and distal ends and a lumen extending therethrough, wherein a proximal portion of the inner support member extends into the lumen of the catheter body and a distal portion of the inner support member extends outside the catheter body;
a circumferential ablation element mounted on the distal portion of the inner support member outside the catheter body;
a moveable tube extending through the lumen of the inner support member and through the catheter body, the moveable tube being longitudinally moveable relative to the inner support member and catheter body and having a distal end extending beyond the distal end of the inner support member; and
an inflatable balloon provided generally in surrounding relation to the circumferential ablation element, the inflatable balloon having a proximal end attached to the distal end of the catheter body and a distal end attached to a portion of the moveable tube that extends beyond the distal end of the inner support member;
wherein longitudinal movement of the moveable tube relative to the catheter body and inner support member causes movement of the distal end of the balloon relative to the proximal end of the balloon to thereby change the length of the balloon. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39)
a puller wire extending through a lumen of the catheter body, said puller wire being fixedly attached at its distal end at or near the location of deflection; and
a control handle for moving the puller wire longitudinally relative to the catheter body to thereby cause deflection.
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25. A method for treating atrial arrhythmia by ablating a substantial portion of a circumferential region of tissue in a tubular region of or near the heart of a patient, comprising:
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introducing into a patient a catheter according to claim 1, wherein the circumferential ablation element comprises an ultrasound ablation element coupled to an acoustic energy driver;
contacting a substantial portion of the circumferential region of tissue with at least a portion of the inflatable balloon, such that the ultrasound ablation element is positioned to deliver a substantially circumferential pattern of ultrasound energy through the inflatable balloon to the substantial portion of the circumferential region of tissue; and
actuating the acoustic energy driver to ablatively couple the ultrasound ablation element to the substantial portion of the circumferential region of tissue via the inflatable balloon.
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26. A method according to claim 25, wherein contacting at least the substantial portion of the circumferential region of tissue comprises expanding the inflatable balloon to radially engage the substantial portion of the circumferential region of tissue.
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27. A method according to claim 26, wherein expanding the inflatable balloon comprises introducing an ultrasonically transparent inflation fluid to an inner region of the inflatable balloon.
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28. A method according to claim 27, wherein the ultrasonically transparent inflation fluid comprises a radiopaque dye.
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29. A method according to claim 26, further comprising longitudinally moving moveable tube relative to the catheter body to move the distal end of the balloon distally relative to the proximal end of the balloon.
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30. A method according to claim 29, wherein the moveable tube is moved longitudinally after the balloon is expanded.
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31. A method according to claim 25, wherein the moveable tube has a lumen extending therethrough, wherein the lumen is open at the distal end of the moveable tube, and further wherein the catheter is introduced over a guidewire that extends through the lumen of the moveable tube.
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32. A method according to claim 25, wherein the catheter further comprises a distal tubing mounted on the distal end of the moveable tube and having a proximal end to which the distal end of the balloon is attached, wherein one or more electrodes are mounted on the distal tubing.
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33. A method according to claim 32, further comprising mapping electrical activity in the tubular region of or near the heart using the one or more electrodes.
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34. A catheter according to claim 25, wherein the inner support member is longitudinally moveable relative to the catheter body and moveable tube, the method further comprising longitudinally moving the inner support member relative to the catheter body and moveable tube to affect longitudinal movement of the circumferential ablation element relative to the catheter body and moveable tube.
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35. A method according to claim 25, further comprising ablatively coupling the ultrasound ablation element to the substantial portion of the circumferential region of tissue at a location where cardiac tissue extends along the pulmonary vein.
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36. A method according to claim 25, further comprising ablatively coupling the ultrasound ablation element to the substantial portion of the circumferential region of tissue at a location where cardiac tissue extends along an ostium of the pulmonary vein.
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37. A method according to claim 25, further comprising ablatively coupling the ultrasound ablation element to the substantial portion of the circumferential region of tissue at a location along the atrial wall and surrounding an ostium of the pulmonary vein.
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38. A method according to claim 25, further comprising actuating the ultrasound ablation element to emit the substantially circumferential pattern of ultrasound energy at a frequency ranging from about 5 MHz to about 20 MHz.
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39. A method according to claim 25, wherein the entire circumferential region of tissue is ablatively coupled to the ultrasound ablation element.
Specification