Methods and devices for ablation

• US 7,824,403 B2
• Filed: 04/11/2006
• Issued: 11/02/2010
• Est. Priority Date: 10/22/1996
• Status: Expired due to Fees

• Current Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Original Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc. (Abbott Laboratories)
• Inventors: Vaska, Matthias, Tansey, Casey, Hoffman, Drew, Crowe, John E., Miller, Gary Henry, Podmore, Jonathan L., Champsaur, Gerard
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US11/401,357
• Publication Number:
  US 20060184167A1
• Time in Patent Office: 1,666 Days
• Field of Search: 606/41, 606 48- 50, 600/37, 600/587, 335/11, 335/12, 623/2.11, 607/122
• US Class Current: 606/41
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• CPC Class Codes: A61B 17/2202 the ultrasound transducer being inside patient's body at the distal end of the catheter
• CPC Class Codes: A61B 17/2251 characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/2253 using a coupling gel or liquid
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00232 having an irregular shape
• CPC Class Codes: A61B 2018/00261 arranged in a line
• CPC Class Codes: A61B 2018/00285 : Balloons
• CPC Class Codes: A61B 2018/00291 : using suction
• CPC Class Codes: A61B 2018/00351 : Heart
• CPC Class Codes: A61B 2018/00363 : Epicardium
• CPC Class Codes: A61B 2018/00375 : Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00654 : with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00839 : Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/142 : at least partly surrounding the target, e.g. concave, curved or in the form of a cave
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2090/395 : with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61M 2025/0293 : Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube
• CPC Class Codes: A61M 2025/1072 : having balloons with two or more compartments
• CPC Class Codes: A61M 25/0041 : pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0084 : being one or more injection needles
• CPC Class Codes: A61M 25/04 : in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 25/1011 : Multiple balloon catheters
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/3629 : in combination with non-electric therapy
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

An ablating device has a cover which holds an interface material such as a gel. The cover contains the interface material during initial placement of the device. The ablating device may also have a removable tip or a membrane filled with fluid. In still another aspect, the ablating device may be submerged in liquid during operation.

Claims

1. A sizing device for sizing an area around pulmonary veins along an epicardial surface, the sizing device comprising

an elongate body having a substantially straight proximal portion and a distal portion preshaped into a partial loop when not subjected to any deforming force;

and

a plurality of sizing indicators along a length of the elongate body,

wherein the plurality of sizing indicators is used to measure a length of a perimeter of the epicardial surface when the sizing device is placed around the pulmonary veins along an epicardial surface.

2. The sizing device of claim 1, wherein the distal portion terminates in a tip, and wherein the tip is offset with respect to the elongated elongate body.

3. The sizing device of claim 1, further comprising a connector at a proximal end of the body for connecting the sizing device to an ablation device.

4. The sizing device of claim 3, wherein the connector is a snap-fit connector.

5. The sizing device of claim 1, wherein a cross section of the elongate body at a proximal end thereof is larger than a cross section of the elongate body at a distal end thereof.

6. A sizing device for sizing an area around pulmonary veins along an epicardial surface, the sizing device comprising an elongate body having a distal end and a proximal end, the elongate body being preshaped into a partial loop when in a resting, unbiased state;

a connector at the proximal end for connecting the sizing device to an ablation device having at least one ablating element; and

a plurality of sizing indicators along a length of the elongate body, wherein the plurality of sizing indicators is used to identify an ablation device that is sized to fit around the pulmonary veins along an epicardial surface.

7. The sizing device of claim 6, wherein the connector is a snap-fit connector.

8. The sizing device of claim 6, wherein the distal end further comprises a tip, and wherein the tip is offset with respect to the elongate body.

9. The sizing device of claim 6, wherein a cross section of the elongate body at the proximal end is larger than a cross section of the elongate body at the distal end.

10. A system for ablating cardiac tissue, the system comprising a sizing device having an elongate body with a distal end and a proximal end, the elongate body being configured to form a partial loop when in a resting, unbiased shape;

a connector at the proximal end; and

a plurality of sizing indicators along a length of the elongate body; and

a plurality of ablating devices, each having a different length, the plurality of ablating devices corresponding to the plurality of sizing indicators,

wherein the plurality of sizing indicators is used to select one of the plurality of ablating devices such that the selected ablating device is sized to fit around pulmonary veins along an epicardial surface.

11. The system of claim 10, wherein the ablating devices further comprise an opening for receiving the connector at the proximal end of the sizing device.

12. The system of claim 10, wherein the connector is a snap-fit connector.

13. A system for ablating cardiac tissue, the system comprising

a sizing device having an elongate body with a distal end and a proximal end, the elongate body being configured to form a partial loop when in a resting, unbiased shape;

a connector at the proximal end; and

a plurality of sizing indicators along a length of the elongate body; and

an ablating device having a flexible body having a semi-circular shape and a first end and a second end;

a number of ablating elements arranged along the length of the flexible body;

elongate elements attached to the first end and second end of the flexible body for locking the ends of the ablating device in a closed loop position; and

an opening at the first end for receiving the connector of the sizing device,

wherein the ablating device is coupled to the connector at the proximal end of the sizing device.

14. The system of claim 13, wherein the ablating device comprises between 8 and 20 ablating elements.

15. The system of claim 13, wherein the ablating elements are ultrasonic ablation elements configured to emit focused ultrasound energy in at least one direction.

16. The system of claim 13, wherein the elongate elements are sutures.

17. The system of claim 13, wherein a deformable membrane extends over each of the ablating elements forming a passageway for a flowable material.

18. A system for ablating cardiac tissue, the system comprising

a sizing device having an elongate body with a distal end and a proximal end, the elongate body being configured to form a partial loop when in a resting, unbiased shape;

a connector at the proximal end; and

a plurality of sizing indicators along a length of the elongate body;

an ablating device having a flexible body having a semi-circular shape and a first end and a second end;

a number of ablating elements arranged along the length of the flexible body;

elongate elements attached to the first end and to the second end of the flexible body for locking the ends of the ablating device in a closed loop position; and

an opening at the first end for receiving the connector of the sizing device, wherein the ablating device is coupled to the connector at the proximal end of the sizing device; and

at least one tourniquet device having an elongate metal rod having a first end and a second end, wherein the elongate metal rod is configured to form a hook at the first end and a loop at the second end; and

an elongate hollow tube extending over a portion of the metal rod;

wherein the at least one tourniquet device is used to tension the elongate elements attached to the first end and second end of the flexible body of the ablating device for locking the ablating device in a closed loop position.