Ablation system

• US 7,367,972 B2
• Filed: 09/09/2003
• Issued: 05/06/2008
• Est. Priority Date: 04/26/2001
• Status: Expired due to Fees

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Mehra, Rahul, Francischelli, David E., Stewart, Mark T., Skarda, James R.
• Primary Examiner(s): Gibson; Roy D.
• Assistant Examiner(s): VRETTAKOS, PETER J
• Application Number:
  US10/657,987
• Publication Number:
  US 20040049179A1
• Time in Patent Office: 1,701 Days
• Field of Search: 606 27- 52, 606/34
• US Class Current: 606/34
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00761 Duration
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00886 Duration
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

A system for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the impedance of the tissue to be ablated. Rather than attempting to detect a desired drop or a desired increase impedance, completeness of a lesion is detected in response to the measured impedance remaining at a stable level for a desired period of time, referred to as an impedance plateau. The mechanism for determining transmurality of lesions adjacent individual electrodes or pairs may be used to deactivate individual electrodes or electrode pairs, when the lesions in tissue adjacent these individual electrodes or electrode pairs are complete, to create an essentially uniform lesion along the line of electrodes or electrode pairs, regardless of differences in tissue thickness adjacent the individual electrodes or electrode pairs.

Claims

1. An ablation system, comprising:

generating means for generating ablation energy;

an ablation device comprising first ablation means connectable to the generating means and locatable adjacent a first tissue site to be ablated, for applying the generated ablation energy to the first tissue site;

a first impedance measuring electrode mounted to the ablation device so that the first impedance measuring electrode is adjacent the first tissue site when the first ablating means is adjacent the first tissue site;

impedance measurement circuitry connectable to the first impedance measuring electrode to measure impedance at the first tissue site, using the first impedance measuring electrode; and

control circuitry operably coupled to the generating means to initiate and terminate the application of ablating energy to the first ablating means, wherein the control circuitry is coupled to the impedance measurement circuit and terminates application of ablation energy to the first ablating means responsive to occurrence of an impedance plateau measured by the impedance measuring circuitry using the first impedance measuring electrode, following initiation of application of ablating energy to the first ablating means, wherein the impedance plateau is defined as a maximum acceptable rate of change of impedance measurements over a defined period of time.

2. A system as in claim 1 wherein the first ablating means is a first ablation electrode and wherein the generating means comprises an R-F generator.

3. A system as in claim 2 wherein the first ablation electrode is an irrigated ablation electrode.

4. A system as in claim 2 wherein the first ablation electrode is employed as the first impedance measuring electrode.

5. A system as in any of claims 1-4, further comprising:

second ablation means and connectable to the generating means and mounted to the ablation device so that the second ablation means is locatable adjacent a second tissue site to be ablated while the first ablation means is located adjacent the first tissue site, for applying the generated ablation energy to the second tissue site;

a second impedance measuring electrode mounted to the ablation device so that the second impedance measuring electrode is adjacent the second tissue site when the second ablating means is adjacent the second tissue site; and

wherein the impedance measurement circuitry is connectable to the first impedance measuring electrode to measure impedance at the second tissue site, using the second impedance measuring electrode; and

control circuitry operably coupled to the generating means to initiate and terminate the application of ablating energy to the second ablating means, wherein the control circuitry is coupled to the impedance measurement circuitry and terminates application of ablation energy to the second ablating means responsive to occurrence of the impedance plateau measured by the impedance measuring circuitry using the second impedance measuring electrode, following initiation of application of ablating energy to the second ablating means.

6. A system as in claim 5 wherein the second ablating means is a second ablation electrode.

7. A system as in claim 6 wherein the second ablation electrode is an irrigated ablation electrode.

8. A system as in claim 6 wherein the second ablation electrode is employed as the second impedance measuring electrode.

9. A system as in claim 5 wherein the first and second ablating means are simultaneously connectable to generating means wherein the control means is operable to simultaneously initiate application of ablating energy to the first and second ablating means.

10. A system as in claim 5 wherein the first and second ablating means are successively connectable to generating means wherein the control means is operable to initiate application of ablating energy to the second ablating means following termination of application of ablating energy to the first ablating means.

11. An ablation system according to claim 1 where the defined period of time is about 8 out of 12 impedance measurements.

12. An ablation system according to claim 1 where the defined period of time is at least 6 out of 6 impedance measurements.

13. An ablation system, comprising:

a generator for generating ablation energy;

an ablation device comprising an ablation element connectable to the generator and locatable adjacent a tissue site to be ablated, for applying the generated ablation energy to the tissue site;

an impedance measurement electrode mounted to the ablation device so that the impedance measurement electrode is adjacent the tissue site when the ablation element is adjacent the tissue site;

impedance measurement circuitry connectable to the impedance measurement electrode to measure impedance at the tissue site, using the impedance measurement electrode; and

control circuitry operably coupled to the generator to initiate and terminate the application of ablating energy to the ablation element, wherein the control circuitry is coupled to the impedance measurement circuit and terminates application of ablation energy to the ablation element responsive to occurrence of an impedance plateau measured by the impedance measurement circuitry using the impedance measurement electrode, following initiation of application of ablating energy to the ablation element, wherein the impedance plateau is defined as a maximum acceptable rate of change of impedance measurements over a defined period of time.

14. A system as in claim 13 wherein the ablation element is an ablation electrode and wherein the generator is an R-F generator.

15. A system as in claim 14 wherein the ablation electrode is an irrigated ablation electrode.

16. A system as in claim 14 wherein the ablation electrode is employed as the impedance measurement electrode.