Multipolar, multi-lumen, virtual-electrode catheter with at least one surface electrode and method for ablation
First Claim
1. A multipolar, multi-lumen, virtual-electrode catheter for treatment of tissue, the catheter comprising(a) a catheter body havingan outer surface;
- a first sidewall;
a second sidewall;
a first longitudinally-extending internal lumen, extending adjacent to said first sidewall and adapted to transport conductive fluid; and
a second longitudinally-extending internal lumen, extending adjacent to said second sidewall and adapted to transport conductive fluid;
(b) a first exit feature extending through said first sidewall of said catheter body, wherein said first exit feature thereby fluidly couples said first internal lumen to said outer surface of said catheter body;
(c) a second exit feature extending through said second sidewall of said catheter body, wherein said second exit feature thereby fluidly couples said second internal lumen to said outer surface of said catheter body;
(d) a first internal electrode residing within at least a distal portion of said first internal lumen and adapted to deliver treatment energy to the tissue via said conductive fluid and said first exit feature;
(e) a second internal electrode residing within at least a distal portion of said second internal lumen and adapted to deliver treatment energy to the tissue via said conductive fluid and said second exit feature; and
(f) at least one surface electrode mounted on said outer surface of said catheter body adjacent to said first and second exit features.
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Accused Products
Abstract
Multipolar, multi-lumen, virtual-electrode catheters having at least one surface electrode, and methods for treatment (e.g., treatment of cardiac arrhythmias) with such catheters are disclosed. The catheters have at least two internal lumens, and at least one internal, flexible electrode rides in each internal lumen. The flexible electrodes carry treatment energy (e.g., radiofrequency energy). The energy exits the catheters via at least one exit feature (e.g., slots, portholes, or micro-pores). The methods for treatment include operating the catheters in different modes depending upon location and type of treatment to be performed. The treatment energy delivered by one of the internal, flexible electrodes may be directed to the other internal, flexible electrode; or the energy delivered by one or both of the internal, flexible electrodes may be directed to one or more surface electrodes. The delivered energy establishes at least one electric field, and possibly one or more lesions, in the tissue.
233 Citations
37 Claims
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1. A multipolar, multi-lumen, virtual-electrode catheter for treatment of tissue, the catheter comprising
(a) a catheter body having an outer surface; -
a first sidewall; a second sidewall; a first longitudinally-extending internal lumen, extending adjacent to said first sidewall and adapted to transport conductive fluid; and a second longitudinally-extending internal lumen, extending adjacent to said second sidewall and adapted to transport conductive fluid; (b) a first exit feature extending through said first sidewall of said catheter body, wherein said first exit feature thereby fluidly couples said first internal lumen to said outer surface of said catheter body; (c) a second exit feature extending through said second sidewall of said catheter body, wherein said second exit feature thereby fluidly couples said second internal lumen to said outer surface of said catheter body; (d) a first internal electrode residing within at least a distal portion of said first internal lumen and adapted to deliver treatment energy to the tissue via said conductive fluid and said first exit feature; (e) a second internal electrode residing within at least a distal portion of said second internal lumen and adapted to deliver treatment energy to the tissue via said conductive fluid and said second exit feature; and (f) at least one surface electrode mounted on said outer surface of said catheter body adjacent to said first and second exit features. - 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)
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34. A multipolar, multi-lumen, virtual-electrode catheter for performing radiofrequency ablation of cardiac tissue, the catheter comprising
a catheter body defining an outer surface, a first internal lumen, and a second internal lumen, wherein said first and second internal lumens are adapted to carry conductive fluid; -
at least three metal electrodes positioned on said outer surface of said catheter body, wherein said at least three metal electrodes are adapted for placement against the cardiac tissue; a first metal conductor positioned within said first internal lumen and adapted to impart radiofrequency energy to the conductive fluid; a second metal conductor positioned within said second internal lumen and adapted to impart radiofrequency energy to the conductive fluid; a first opening on said outer surface of said catheter, said first opening adapted to create a flow path for the conductive fluid in said first internal lumen to flow out of the catheter and impinge upon the cardiac tissue as a virtual-electrode; a second opening on said outer surface of said catheter, said second opening adapted to create a flow path for the conductive fluid in said second internal lumen to flow out of the catheter and impinge upon the cardiac tissue as a virtual-electrode; and at least one temperature sensor on said outer surface of said catheter body in close juxtaposition to at least one of said at least three metal electrodes.
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35. A method for tissue ablation using a multipolar, multi-lumen, virtual-electrode catheter comprising
a catheter body with a sidewall and an outer surface; -
a first internal lumen extending within said catheter body and adapted to flowingly receive a conductive fluid; a second internal lumen extending within said catheter body and adapted to flowingly receive said conductive fluid; a first exit feature comprising a flow path from said first internal lumen through said catheter body sidewall to said catheter outer surface, said first exit feature being adapted to permit the conductive fluid to exit from said first internal lumen toward the tissue; a second exit feature comprising a flow path from said second internal lumen through said catheter body sidewall to said catheter outer surface, said second exit feature being adapted to permit the conductive fluid to exit from said second internal lumen toward the tissue; a first internal flexible conductor mounted within said first internal lumen adjacent to said first exit feature and to a first inner surface of said catheter body sidewall, wherein said first internal flexible conductor is adapted to deliver ablation energy to the tissue via the conductive fluid in said first internal lumen; a second internal flexible conductor mounted within said second internal lumen adjacent to said second exit feature and to a second inner surface of said catheter body sidewall, wherein said second internal flexible conductor is adapted to deliver ablation energy to the tissue via the conductive fluid in said second internal lumen; and at least one surface electrode mounted on said outer surface of said catheter body adjacent to at least one of said first and second exit features; the method comprising the steps of (a) flowing the conductive fluid within said first and second internal lumens and out of said first and second exit features; (b) delivering ablation energy to said first and second internal flexible conductors; (c) generating an electric field between at least one of said first and second internal flexible conductors and said at least one surface electrode; and (d) terminating delivery of said ablation energy upon creating of a lesion in the tissue.
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36. A method for tissue ablation using a multipolar, multi-lumen, virtual-electrode catheter, the method comprising the steps of
(a) placing against the tissue at least one of a first outboard dispersive surface electrode, a second outboard dispersive surface electrode, and an intermediate dispersive surface electrode, wherein said first outboard dispersive surface electrode, said second outboard dispersive surface electrode, and said intermediate dispersive surface electrode are each mounted on an outer surface of a catheter body of the virtual-electrode catheter; -
(b) flowing a conductive fluid through a first internal lumen and a second internal lumen, both said internal lumens extending within said catheter body toward at least one exit feature that is adjacent to at least one of said first outboard dispersive surface electrode, said second outboard dispersive surface electrode, and said intermediate dispersive surface electrode; (c) delivering ablation energy to at least one of a first active internal flexible conductor within said first internal lumen, and a second active internal flexible conductor within said second internal lumen; (d) generating at least one concentrated electric field between at least one of said first and second internal flexible conductors, and at least one of said first outboard dispersive surface electrode, said second outboard dispersive surface electrode, and said intermediate dispersive surface electrode; and (e) terminating delivery of said ablation energy after creation of a lesion in the tissue.
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37. A method for tissue ablation using a multipolar, multi-lumen, virtual-electrode catheter, the method comprising the steps of
setting up a first virtual electrode comprising an ablative energy source, a first internal electrode, a first exit feature, and conductive fluid flowing along said first internal electrode and through said first exit feature; -
setting up a second virtual electrode comprising said ablative energy source, a second internal electrode, a second exit feature, and conductive fluid flowing along said second internal electrode and through said second exit feature; placing each of a first outboard surface electrode, a second outboard surface electrode, and an intermediate surface electrode against tissue to be ablated; activating said first virtual electrode, thereby establishing a first electric field that extends between said first exit feature and said first outboard surface electrode, wherein said first electric field passes through the tissue; and establishing a second electric field that extends between said first exit feature and said intermediate surface electrode, wherein said second electric field passes through the tissue; activating said second virtual electrode, thereby establishing a third electric field that extends between said second exit feature and said intermediate surface electrode, wherein said third electric field passes through the tissue; and establishing a fourth electric field that extends between said second exit feature and said second outboard surface electrode, wherein said fourth electric field passes through the tissue; and maintaining at least one of said first, second, third, and fourth electric fields until a lesion is created in the tissue.
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Specification