Conduction block verification probe and method of use

• US 7,957,820 B2
• Filed: 11/25/2008
• Issued: 06/07/2011
• Est. Priority Date: 12/04/2001
• Status: Expired due to Fees

• Current Assignee: Atricure, Inc.
• Original Assignee: Endoscopic Technologies Incorporated (Atricure, Inc.)
• Inventors: Williams, Mathew, Geyster, Steve, Bertolero, Arthur A., Ibrahim, Tamer
• Primary Examiner(s): MANUEL, GEORGE C
• Application Number:
  US12/323,374
• Publication Number:
  US 20090076503A1
• Time in Patent Office: 924 Days
• Field of Search: 607/129
• US Class Current: 607/129
• CPC Class Codes: A61B 1/12 with cooling or rinsing arrangements
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/2945 Curved jaws
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00345 Vascular system
• 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 2018/00404 : Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/0225 : using an instrument for clamping tissue, e.g. forceps
• CPC Class Codes: A61B 2018/0262 : using a circulating cryogenic fluid
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/1432 : curved
• CPC Class Codes: A61B 2090/373 : using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 5/0536 : Impedance imaging, e.g. by tomography
• CPC Class Codes: A61B 5/6852 : Catheters
• CPC Class Codes: A61N 1/05 : for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0587 : Epicardial electrode systems; Endocardial electrodes piercing the pericardium

Abstract

Devices and methods provide for ablation of cardiac tissue for treating cardiac arrhythmias such as atrial fibrillation. Although the devices and methods are often be used to ablate epicardial tissue in the vicinity of at least one pulmonary vein, various embodiments may be used to ablate other cardiac tissues in other locations on a heart. Devices generally include at least one tissue contacting member for contacting epicardial tissue and securing the ablation device to the epicardial tissue, and at least one ablation member for ablating the tissue. Various embodiments include features, such as suction apertures, which enable the device to attach to the epicardial surface with sufficient strength to allow the tissue to be stabilized via the device. For example, some embodiments may be used to stabilize a beating heart to enable a beating heart ablation procedure. Many of the devices may be introduced into a patient via minimally invasive introducer devices and the like. Although devices and methods of the invention may be used to ablate epicardial tissue to treat atrial fibrillation, they may also be used in veterinary or research contexts, to treat various heart conditions other than atrial fibrillation and/or to ablate cardiac tissue other than the epicardium.

Claims

1. A method of verifying a conduction block in heart tissue of a patient, comprising:

placing a bipolar conduction block verification probe in contact with an epicardial surface of the patient'"'"'s heart, the conduction block verification probe having an elongate probe shaft having a proximal end and a distal end, a first pacing electrode and a second pacing electrode exposed on a distal-facing surface at the distal end of the elongate probe shaft;

a first wire connected to the first pacing electrode and extending through the elongate probe shaft to a first electrical connector and a second wire connected to the second pacing electrode and extending through the elongate probe shaft to a second electrical connector;

connecting the first and second electrical connectors to an external bipolar pacing pulse generator;

generating pacing pulses with the external bipolar pacing pulse generator at a rate higher than the intrinsic pulse rate of the patient'"'"'s heart and conducting the pacing pulses to the epicardial surface through the first and second pacing electrodes; and

determining the pacing threshold of the heart.

2. The method of claim 1, wherein the elongate probe shaft includes a malleable member and the method comprises bending the malleable member to a desired curvature for placing the bipolar conduction block verification probe in contact with the epicardial surface of the patient'"'"'s heart.

3. The method of claim 1, wherein the bipolar conduction block verification probe is placed in contact with an epicardial surface of the patient'"'"'s heart inside of an encircling lesion and determining the pacing threshold of the heart.

4. The method of claim 3, wherein the bipolar conduction block verification probe is placed in contact with an epicardial surface of the patient'"'"'s heart outside of the encircling lesion and determining the pacing threshold of the heart.

5. The method of claim 4, further comprising comparing the pacing thresholds measure from inside and outside the encircling lesion.

6. The method of claim 1, further comprising determining the pacing threshold of the heart before and after a therapeutic ablation procedure and comparing the pacing thresholds measured.

7. The method of claim 1, further comprising performing a therapeutic ablation procedure after determining an initial pacing threshold of the heart, determining a subsequent pacing threshold of the heart after the therapeutic ablation procedure and comparing the pacing thresholds measured.

8. The method of claim 7, further comprising revising the therapeutic ablation procedure based on the comparison of the pacing thresholds measured.