Systems and methods for three-dimensional mapping of electrical activity

• US 7,255,695 B2
• Filed: 04/26/2002
• Issued: 08/14/2007
• Est. Priority Date: 04/27/2001
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: C.R. Bard, Inc. (Becton, Dickinson & Co)
• Inventors: Falwell, Gary S., MacAdam, David
• Primary Examiner(s): Peffley; Michael
• Application Number:
  US10/475,912
• Publication Number:
  US 20040181139A1
• Time in Patent Office: 1,936 Days
• Field of Search: 606/27, 606/28, 606/41, 606/42, 606 45- 50, 607/115, 607/116, 607/122, 600/374
• 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 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/1417 Ball
• CPC Class Codes: A61B 2562/0215 Silver or silver chloride containing
• CPC Class Codes: A61B 2562/043 in a linear array
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• 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 5/062 using magnetic field
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket

Abstract

An electrophysiology catheter and method of use for mapping and ablation procedures. The catheter includes a braided conductive member at its distal end that can be radially expanded.

Claims

1. A method for mapping electrical activity, comprising the steps of:

providing a catheter, the catheter having a braided conductive member at a distal end thereof, wherein the braided conductive member comprises at least first and second electrically independent conductive portions spaced lengthwise on the braided conductive member;

measuring electrical activity at respective locations of cardiovascular tissue in contact with the at least first and second electrically independent conductive portions; and

creating a three-dimensional map of electrical activity from the measured electrical activity.

2. The method of claim 1, further comprising the step of determining undesired conduction paths.

3. The method of claim 2, further comprising the step of ablating at least one of the undesired conduction paths.

4. The method of claim 1, further comprising the step of measuring electrical activity sensed by the at least first and second electrically independent conductive portions to check effectiveness of ablation.

5. A system comprising:

a catheter comprising;

a shaft having an axis that extends longitudinally along the length of the shaft; and

a braided conductive member connected to the shaft comprising a plurality of filaments and having proximal and distal ends, wherein the braided conductive member further comprises a first conductive portion located at a first longitudinal distance from the proximal end of the braided conductive member and a second conductive portion that is electrically independent from the first conductive portion and located at a second longitudinal distance from the proximal end of the braided conductive member;

an ablation energy generator for delivering ablation energy to the braided conductive member; and

software to generate a visual indication of a conduction pathway in the tissue based on electrical activity measured at respective locations of cardiovascular tissue in contact with the at least first and second conductive portions.

6. The system of claim 5, wherein the braided conductive member is constructed to assume a substantially cylindrical shape along at least a portion of the braided conductive member when deployed.

7. The system of claim 5, wherein the first and second conductive portions are located at approximately the same radial distance from the axis of the shaft.

8. The system of claim 5, wherein the braided conductive member further comprises a third conductive portion that is electrically independent from the first and second conductive portions and located at the second longitudinal distance from the proximal end of the braided conductive member.

9. The system of claim 5, further comprising means for independently sensing electrical activity at the first and second conductive portions.

10. The system of claim 5, further comprising means for independently applying ablation energy at the first and second conductive portions.

11. The system of claim 5, wherein the first longitudinal distance is approximately 5 mm greater than the second longitudinal distance.

12. The system of claim 5, wherein the first and second conductive portions are respectively located at first and second intersections of filaments.

13. The system of claim 5, wherein the filaments are partially insulated.

14. The system of claim 13, wherein the braided conductive member comprises two or more uninsulated circumferential bands.

15. A system, comprising:

a medical device comprising;

a shaft having an axis that extends longitudinally along a length of the shaft; and

first and second braided conductive members connected to a distal end of the shaft, the first and second braided conductive members each including a plurality of filaments;

wherein a diameter of an outermost portion of the first braided conductive member when fully deployed is substantially the same as the diameter of an outermost portion of the second braided conductive member when fully deployed; and

software to generate a visual indication of a conduction pathway based on electrical activity measured at respective locations of cardiovascular tissue in contact with at least the first and second braided conductive members.

16. The system of claim 15, wherein the first braided conductive member is electrically independent from the second braided conductive member.

17. The system of claim 16, further comprising means for independently sensing electrical activity at the first and second braided conductive members.

18. The system of claim 16, further comprising means for independently applying ablation energy at the first and second braided conductive members.

19. The system of claim 16, wherein the first braided conductive member comprises first and second conductive portions that are electrically independent from each other and the second braided conductive member comprises third and fourth conductive portions that are electrically independent from each other.

20. The system of claim 19, further comprising means for independently sensing electrical activity at the first, second, third, and fourth conductive portions.

21. The system of claim 19, further comprising means for independently applying ablation energy at the first, second, third, and fourth conductive portions.

22. The system of claim 19, wherein the first, second, third, and fourth conductive portions are respectively located at first, second, third, and fourth intersections of filaments.

23. The system of claim 15, wherein the filaments of the first and second braided conductive members are partially insulated.

24. The system of claim 23, wherein each of the first and second braided conductive members comprises an uninsulated circumferential band.

25. A method, comprising acts of:

introducing a braided conductive member of a catheter into a cardiovascular system, the braided conductive member comprising at least first and second electrically independent conductive portions spaced lengthwise on the braided conductive member;

deploying the braided conductive member such that it expands radially to contact tissue of the cardiovascular system;

measuring a first electrical signal at the first conductive portion while the first conductive portion is in contact with a first location of cardiovascular tissue and measuring a second electrical signal at the second conductive portion while the second conductive portion is in contact with a second location of cardiovascular tissue; and

based at least on said first and second electrical signals, determining a location of a conduction pathway in the tissue.

26. The method of claim 25, wherein the step of measuring includes simultaneously measuring the first and second electrical signals.

27. The method of claim 25, further comprising an act of forming a map of electrical signals each located at substantially the same radial distance from a longitudinal axis of the catheter.

28. The method of claim 25, further comprising an act of forming a substantially cylindrical map of conductive pathways in a blood vessel.

29. The method of claim 28, wherein the act of determining further comprises determining a direction of the conduction pathway in the tissue.

30. The method of claim 25, further comprising an act of applying a pacing signal at a third conductive portion on the braided conductive member.

31. The method of claim 25, further comprising an act of applying ablation energy at a conductive portion of the braided conductive member where a conduction pathway is detected.

32. The method of claim 29, further comprising an act of measuring a third electrical signal at the first conductive portion and measuring a fourth electrical signal at the second conductive portion to assess whether the conduction pathway has been interrupted by the act of applying ablation energy.

33. A system for mapping electrical activity in cardiovascular tissue, comprising:

a catheter having a braided conductive member at a distal end thereof, wherein the braided conductive member comprises at least first and second electrically independent conductive portions spaced lengthwise on the braided conductive member;

an ablation energy generator for delivering ablation energy to the braided conductive member; and

means for creating a three-dimensional map of electrical activity within the cardiovascular tissue from electrical activity sensed at locations of the cardiovascular tissue in contact with the at least first and second electrically independent conductive portions.