Circumferential ablation device assembly

• US 7,993,337 B2
• Filed: 05/12/2009
• Issued: 08/09/2011
• Est. Priority Date: 05/09/1997
• Status: Expired due to Fees

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Lesh, Michael D.
• Primary Examiner(s): GIBSON, ROY DEAN
• Application Number:
  US12/464,473
• Publication Number:
  US 20090221996A1
• Time in Patent Office: 819 Days
• Field of Search: 606/41, 606 45- 47, 606/49
• US Class Current: 606/41
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00273 Anchoring means for temporary attachment of a device to tissue
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00369 Heart valves
• CPC Class Codes: A61B 2018/00375 Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00815 measured by a thermistor
• CPC Class Codes: A61B 2018/00821 measured by a thermocouple
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/00994 : combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A circumferential ablation device assembly which is adapted to forming a circumferential conduction block in a pulmonary vein is described. The assembly includes a circumferential oblation clement which is adapted to ablate a circumferential region of tissue along a pulmonary vein wall which circumscribes the pulmonary vein lumen, thereby transecting the electrical conductivity of the pulmonary vein against conduction along its longitudinal axis and into the left atrium. The circumferential ablation element includes an expandable member with a working length that is adjustable from a radially collapsed position to a radially expanded position. An equatorial band circumscribes the outer surface of the working length and is adapted to ablate tissue adjacent thereto when actuated by an ablation actuator. A pattern of insulators may be included over an ablation element which otherwise spans the working length in order to form the equatorial band described.

Claims

1. A method for treating atrial arrhythmia by forming a lesion at a location where a pulmonary vein extends from an atrium in a patient, comprising:

delivering a treatment device to the location, the treatment device comprising an expandable contact member and an ablation element;

adjusting the expandable contact member to a radially expanded position in the atrium;

forcing the expanded contact member retrogradedly against the pulmonary vein ostium to engage the pulmonary vein ostium of the pulmonary vein along the posterior atrial wall such that a circumferential area of the expandable contact member is positioned along a circumferential region of tissue near the pulmonary vein ostium; and

actuating the ablation element to ablate at least a portion of the circumferential region of tissue to form said lesion.

2. A method as recited in claim 1, wherein the expandable contact member comprises an inflatable balloon located along a distal end portion of the treatment device;

and

wherein adjusting the expandable contact member comprises inflating the balloon to have expanded outer diameter that is sufficient to engage the circumferential region of tissue.

3. A method as recited in claim 2, wherein the ablation element is coupled to the inflatable balloon such that when the inflatable balloon is expanded and forced to engage the substantially circumferential area of tissue, the ablation element is simultaneously positioned at the location.

4. A method as recited in claim 1, wherein the step of adjusting the expandable contact member to a radially expanded position occurs prior to the step of forcing the expanded contact member retrogradedly against the pulmonary vein ostium to engage the pulmonary vein ostium.

5. A method as recited in claim 1, further comprising:

monitoring the pulmonary vein prior to ablation to confirm that the vein contains an arrhythmogenic origin for atrial arrhythmia.

6. A method as recited in claim 5, wherein monitoring the pulmonary vein comprises positioning a sensing element at the location;

and

sensing electrical signals along the pulmonary vein.

7. A method as recited in claim 6, further comprising:

determining the location of arrhythmogenic origin for atrial arrhythmia; and

positioning a treatment device at the location.

8. A method as recited in claim 6, further comprising:

monitoring the pulmonary vein after ablating said tissue to confirm treatment of said arrhythmia.

9. A method as recited in claim 8, wherein monitoring the pulmonary vein comprises sensing electrical conduction signals along the pulmonary vein wall.

10. A method as recited in claim 9, wherein sensing electrical conduction signals comprises determining the presence or absence of arrhythmogenic firing at said location.

11. A method as recited in claim 8, further comprising:

providing a test electrode on said treatment device;

positioning the treatment device so that the test electrode is upstream from the circumferential lesion; and

firing a test signal into the tissue surrounding the test electrode to simulate a focal arrhythmia.

12. The method of claim 1, wherein actuating the ablation element discharges an electrical current.

13. The method of claim 12 further comprising providing a conductive media between the ablation element and the circumferential region of tissue.

14. The method of claim 1, wherein actuating the ablation element discharges thermal energy.

15. The method of claim 1, wherein actuating the ablation element absorbs thermal energy.

16. The method of claim 1, wherein actuating the ablation element discharges ultrasound energy.

17. The method of claim 1, wherein actuating the ablation element discharges microwave energy.

18. The method of claim 1, wherein actuating the ablation element discharges light energy.