Methods and devices for ablation

• US 8,114,069 B2
• Filed: 09/27/2005
• Issued: 02/14/2012
• 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: Sliwa, John W. Jr., Vaska, Matthias, Podmore, Jonathan L., Richman, Roxanne L., Anderson, Scott C., Champsaur, Gerard, Crowe, John E.
• Primary Examiner(s): Dvorak, Linda
• Assistant Examiner(s): DELLA, JAYMI E
• Application Number:
  US11/237,619
• Publication Number:
  US 20060135954A1
• Time in Patent Office: 2,331 Days
• Field of Search: 606 45- 46, 606/27, 607/122
• US Class Current: 606/27
• 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 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• 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 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 2017/00247 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 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• 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 2018/00214 : Expandable means emitting energy, e.g. by elements carried thereon
• 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 2018/00392 : 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 2018/00898 : Alarms or notifications created in response to an abnormal condition
• 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 2018/1213 : creating an arc
• 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 2018/147 : Electrodes transferring energy by capacitive coupling, i.e. with a dielectricum between electrode and target tissue
• 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: A61N 1/056 : Transvascular endocardial electrode systems
• 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. An ablating device for ablating epicardial cardiac tissue, the ablating device comprising

a body configured for deployment into a pericardial space to effect ablation of epicardial tissue of a heart;

and

at least two flexibly interconnected cells, the at least two flexibly interconnected cells defining an axis along a direction of their interconnection, wherein at least one cell of the at least two flexibly interconnected cells further comprises;

a housing having at least one open side;

an ablating element disposed within the housing and oriented such that an energy-emitting face of the ablating element faces the at least one open side of the housing; and

an inflatable membrane extending over at least part of the energy-emitting face of the ablating element, the inflatable membrane being spaced apart from the ablating element to form a fluid cavity having diverse configurations, wherein at least one of the diverse configurations has one region of the inflatable membrane spaced from the ablating element a different amount than a second region of the inflatable membrane, thereby locally tilting the axis defined by the at least two flexibly interconnected cells.

2. The ablating device of claim 1 further comprising a fluid inlet leading to the fluid cavity.

3. The ablating device of claim 1 further comprising a heat exchanger having an inlet adapted to receive a fluid and an outlet adapted to return the fluid to the fluid cavity.

4. The ablating device of claim 1, wherein the inflatable membrane is adapted to form a contact surface having a predetermined shape relative to the ablating element.

5. The ablating device of claim 4, wherein the inflatable membrane is adapted to form a curved contact surface relative to the ablating element when the fluid cavity contains a fluid.

6. The ablating device of claim 1, wherein the inflatable membrane comprises a plurality of apertures or holes thus permitting a fluid to pass therethrough to wet an adjacent volume of epicardial tissue.

7. An ablating device according to claim 1, wherein the ablating element comprises an acoustically-driven ablation element.

8. An ablating device according to claim 7, wherein the ablating element comprises an ultrasound ablation element.

9. An ablating device according to claim 1, wherein the ablating element comprises a radiofrequency-driven ablation element.

10. An ablating device according to claim 1, wherein the ablating element comprises a microwave-driven ablation element.

11. An ablating device according to claim 1, wherein the ablating element comprises a cryogenic ablation element.

12. An ablating device according to claim 2, further comprising a source of fluid coupled to the fluid inlet and wherein the ablating element comprises a high intensity focused ultrasound ablation element.

13. An ablating device according to claim 12, wherein the source of fluid comprises an acoustically transmissive gel substance.

14. An ablating device according to claim 12, wherein the source of fluid comprises a saline fluid.

15. An ablating device for ablating epicardial cardiac tissue, the ablating device comprising

a body configured for deployment into a pericardial space to effect ablation of epicardial tissue of a heart;

and

at least one cell, wherein the at least one cell further comprises;

a housing having at least one open side;

an ablating element disposed within the housing and oriented such that an energy-emitting face of the ablating element faces the at least one open side of the housing; and

an inflatable membrane extending over at least part of the energy-emitting face of the ablating element, the inflatable membrane being spaced apart from the ablating element to form a fluid cavity having at least a first configuration and a second configuration,

wherein an outer periphery of the inflatable membrane lies in a plane substantially parallel to the energy-emitting face of the ablating element in the first configuration, and

wherein the outer periphery of the inflatable membrane lies in a plane angled with respect to the energy-emitting face of the ablating element in the second configuration.