Method for ablating body tissue

• US 8,146,603 B2
• Filed: 04/22/2011
• Issued: 04/03/2012
• Est. Priority Date: 05/12/2006
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: VytronUS, Inc. (Johnson & Johnson)
• Inventors: Thapliyal, Hira V., Gallup, David A., Arenson, James W.
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US13/092,747
• Publication Number:
  US 20110230798A1
• Time in Patent Office: 347 Days
• Field of Search: 128/898, 601/2, 601/3, 606/27, 606/28, 606 41- 49
• US Class Current: 128/898
• 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 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• 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 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/22024 with a part reflecting mechanical vibrations, e.g. for focusing
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

A tissue ablation system for treating fibrillation in a patient comprises a steerable interventional catheter having an energy source that emits a beam of energy to ablate tissue thereby creating a conduction block for aberrant electrical pathways. The system also includes a handle disposed near a proximal end of the interventional catheter and has an actuation mechanism for steering the interventional catheter. A console allows the system to be controlled and provides power to the system, and a display pod is electrically coupled with the console. The display pod has a display panel to display system information to a user and allows the user to control the system. A catheter pod is releasably coupled with the handle electrically and mechanically, and also electrically coupled with the display pod.

Claims

1. A method for ablating cardiac tissue, said method comprising:

advancing a treatment catheter through a patient'"'"'s vasculature into an atrium of a heart, the treatment catheter comprising an ultrasound emitter disposed near a distal end thereof;

positioning the ultrasound emitter to face heart tissue within the left atrium and outside of a pulmonary vein;

ablating the heart tissue with ultrasound energy from the ultrasound emitter to form a first lesion outside of a pulmonary vein while rotating the ultrasound emitter about a first rotation axis, wherein the first lesion encircles the ostia of the pulmonary vein,

wherein the first lesion is formed without direct contact between the ultrasound emitter and the heart tissue, and wherein the ablating step is performed with the ultrasound energy being directed distally from a distally facing surface of the ultrasound emitter, and

wherein the ultrasound energy is initially directed at an inner wall of the heart;

sensing a gap distance with a sensor coupled to the treatment catheter, the gap distance extending between the ultrasound emitter and the heart tissue;

based on the sensed gap distance, controlling re-positioning of the ultrasound emitter position by adjusting the gap distance between the ultrasound emitter and the heart tissue while maintaining the gap therebetween within an ablation window length, wherein adjusting comprises proximal or distal axial movement of the ultrasound emitter relative to the heart tissue;

cooling the ultrasound emitter with fluid wherein the fluid flows past the ultrasound emitter and exits the treatment catheter; and

providing a separation between the ultrasound emitter and blood in the atrium to prevent the blood from coagulating on the ultrasound emitter, wherein the separation comprises the fluid.

2. The method of claim 1, wherein the ultrasound energy from the ultrasound emitter comprises a collimated beam.

3. The method of claim 1, wherein the ultrasound emitter comprises an ultrasound transducer, and wherein the sensor comprises the ultrasound transducer.

4. The method of claim 1, wherein the positioning comprises bending a distal portion of the treatment catheter.

5. The method of claim 1, further comprising anchoring the treatment catheter.

6. The method of claim 5, wherein anchoring the treatment catheter comprises placing an anchor against a wall of the atrium.

7. The method of claim 5, wherein anchoring the treatment catheter comprises placing an anchor within a pulmonary vein.

8. The method of claim 5, wherein anchoring the treatment catheter comprises expanding an anchor.

9. The method of claim 1, wherein positioning comprises rotating the treatment catheter.

10. The method of claim 1, further comprising sensing depth of ablation in the heart tissue and adjusting the ultrasound energy.

11. The method of claim 10, wherein the ultrasound emitter comprises an ultrasound transducer and sensing the depth of ablation comprises sensing the depth of ablation with the ultrasound transducer.

12. The method of claim 1, further comprising:

ablating the heart tissue with ultrasound energy from the ultrasound emitter to form a second lesion outside of a second pulmonary vein while rotating the ultrasound emitter about a second rotation axis, wherein the second lesion encircles the ostia of the second pulmonary vein,

wherein the second lesion is formed without direct contact between the ultrasound emitter and the heart tissue, and wherein ablating the second pulmonary vein is performed with the ultrasound energy being directed distally from a distally facing surface of the ultrasound emitter, and

wherein the ultrasound energy is initially directed at an inner wall of the heart.

13. The method of claim 12, further comprising ablating the heart tissue with the ultrasound energy to form a connecting lesion while moving the ultrasound emitter between the first lesion and the second lesion, wherein the connecting lesion crosses the first and the second lesions.

14. The method of claim 13, further comprising ablating the heart tissue with the ultrasound energy to form a transverse lesion while moving the ultrasound emitter between the connecting lesion and the mitral valve, wherein the transverse lesion crosses the connecting lesion and extends toward the mitral valve.

15. The method of claim 1, further comprising controlling lesion depth by adjusting distance between the ultrasound emitter and the heart tissue with proximal or distal axial movement of the ultrasound emitter relative to the heart tissue.

16. The method of claim 1, further comprising controlling lesion depth by adjusting the ultrasound energy.

17. The method of claim 1, further comprising sensing heart tissue thickness and controlling depth of the first lesion by adjusting distance between the ultrasound emitter and the heart tissue with proximal or distal axial movement of the ultrasound emitter relative to the heart tissue.

18. The method of claim 1, further comprising sensing thickness of the heart tissue and controlling depth of the first lesion by adjusting the ultrasound energy.