Systems and methods for epicardial navigation
First Claim
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1. A system for use with a vacuum source for ablating a tissue of a heart, comprising:
- an engagement catheter comprising a proximal end, a distal end, and first and second lumens extending between the proximal end and the distal end;
an external catheter comprising a distal end, an ablation contact positioned at or near the distal end of the external catheter, and a first magnet positioned at or near the distal end of the external catheter, wherein the external catheter is configured such that the external catheter is capable of at least partial insertion into the second lumen of the engagement catheter;
an internal catheter comprising a distal end and a first magnet positioned at or near the distal end of the internal catheter, the internal catheter devoid of an ablation contact; and
a vacuum port located at the proximal end of the engagement catheter, the vacuum port being operatively connected to the first lumen of the engagement catheter and capable of operative connection to the vacuum source;
wherein the first lumen of the engagement catheter includes a suction port located at or near the distal end of the engagement catheter, the suction port being configured to removably attach to a targeted tissue on the interior of a wall of the heart, such that the suction port is capable of forming a reversible seal with the targeted tissue when the vacuum source is operatively attached to the vacuum port,wherein the internal catheter is configured for engaging the external catheter when a portion of the external catheter is positioned on or adjacent to an epicardial surface of the heart and a portion of the internal catheter is positioned on or adjacent to an endocardial surface of the heart, such that manipulation of the internal catheter is capable of directing the external catheter, andwherein the system is capable of enlarging a pericardial space between the targeted tissue and a pericardial sac that surrounds the heart by retracting the targeted tissue away from the pericardial sac; and
wherein the internal catheter is configured for engaging the external catheter when a portion of the external catheter is positioned on or adjacent to the epicardial surface of the heart and a portion of the internal catheter is positioned on or adjacent the endocardial surface of the heart, such that manipulation of the internal catheter is capable of directing the external catheter so that the external catheter is operable to remove or destroy tissue at the first surface of the tissue at a location directed by the internal catheter; and
wherein the external catheter is further operable to remove or destroy tissue at the epicardial surface at a second location directed by the internal catheter and along the epicardial surface between the first location and the second location without moving the internal catheter.
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Abstract
Systems and methods for navigating a catheter along the epieardial surface of the heart are disclosed. At least some of the embodiments disclosed herein are useful for epieardial ablation, Various embodiments permit ablation of the epieardial surface of the heart using an external ablation catheter in the pericardial space and an internal guide catheter within the heart. Such a configuration allows the clinician to precisely target for ablation specific locations on the cardiac tissue.
42 Citations
38 Claims
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1. A system for use with a vacuum source for ablating a tissue of a heart, comprising:
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an engagement catheter comprising a proximal end, a distal end, and first and second lumens extending between the proximal end and the distal end; an external catheter comprising a distal end, an ablation contact positioned at or near the distal end of the external catheter, and a first magnet positioned at or near the distal end of the external catheter, wherein the external catheter is configured such that the external catheter is capable of at least partial insertion into the second lumen of the engagement catheter; an internal catheter comprising a distal end and a first magnet positioned at or near the distal end of the internal catheter, the internal catheter devoid of an ablation contact; and a vacuum port located at the proximal end of the engagement catheter, the vacuum port being operatively connected to the first lumen of the engagement catheter and capable of operative connection to the vacuum source; wherein the first lumen of the engagement catheter includes a suction port located at or near the distal end of the engagement catheter, the suction port being configured to removably attach to a targeted tissue on the interior of a wall of the heart, such that the suction port is capable of forming a reversible seal with the targeted tissue when the vacuum source is operatively attached to the vacuum port, wherein the internal catheter is configured for engaging the external catheter when a portion of the external catheter is positioned on or adjacent to an epicardial surface of the heart and a portion of the internal catheter is positioned on or adjacent to an endocardial surface of the heart, such that manipulation of the internal catheter is capable of directing the external catheter, and wherein the system is capable of enlarging a pericardial space between the targeted tissue and a pericardial sac that surrounds the heart by retracting the targeted tissue away from the pericardial sac; and wherein the internal catheter is configured for engaging the external catheter when a portion of the external catheter is positioned on or adjacent to the epicardial surface of the heart and a portion of the internal catheter is positioned on or adjacent the endocardial surface of the heart, such that manipulation of the internal catheter is capable of directing the external catheter so that the external catheter is operable to remove or destroy tissue at the first surface of the tissue at a location directed by the internal catheter; and wherein the external catheter is further operable to remove or destroy tissue at the epicardial surface at a second location directed by the internal catheter and along the epicardial surface between the first location and the second location without moving the internal catheter. - View Dependent Claims (2, 3, 4, 5, 6, 14, 15)
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7. A system for navigating a catheter on a surface of a tissue, the system comprising:
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an external catheter comprising a distal end, a first magnet positioned at or near the distal end of the external catheter, and an ablation contact positioned at or near the distal end of the external catheter, the ablation contact being configured to remove or destroy tissue; and an internal catheter comprising a distal end and a first magnet positioned at or near the distal end of the internal catheter, the internal catheter devoid of an ablation contact; wherein the internal catheter is configured for engaging the external catheter when a portion of the external catheter is positioned on or adjacent to a first surface of the tissue and a portion of the internal catheter is positioned on or adjacent to an opposing surface of the tissue, such that manipulation of the internal catheter is capable of directing the external catheter so that the external catheter is operable to remove or destroy tissue at the first surface of the tissue at a location directed by the internal catheter, and wherein the external catheter is further operable to remove or destroy tissue at the first surface at a second location directed by the internal catheter and along the first surface between the first location and the second location without moving the internal catheter. - View Dependent Claims (8, 9, 10, 11, 12, 13, 16, 17, 18)
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19. A method of ablating a targeted tissue on an epicardial surface of a heart, comprising:
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providing an external catheter comprising a distal end, a first magnet positioned at the distal end of the external catheter, and an ablation contact positioned at the distal end of the external catheter, wherein the ablation contact is configured to remove or destroy tissue; providing an internal catheter comprising a distal end, a first electrode positioned at or near the distal end of the internal catheter, and a second electrode positioned at or near the distal end of the internal catheter, the internal catheter devoid of an ablation contact; placing the distal end of the internal catheter within the heart, such that the first and second electrodes are positioned within the heart at a desired ablation location and in a desired ablation pattern; activating the first electrode of the internal catheter such that the ablation contact of the external catheter is directed to the targeted tissue at a first location; activating the ablation contact to ablate the targeted tissue using the external catheter at a location directed by the internal catheter; deactivating the first electrode of the internal catheter; and activating the second electrode of the internal catheter such that the ablation contact of the external catheter is directed to the targeted tissue at a second location; wherein the targeted tissue is ablated by the ablation contact between the first location and the second location without relocating the internal catheter. - View Dependent Claims (20, 21, 22)
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23. A method of ablating a tissue, the method comprising:
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providing an external catheter comprising a distal end, a first magnet positioned at or near the distal end of the external catheter, and an ablation contact positioned at or near the distal end of the external catheter, the ablation contact being configured to remove or destroy tissue; providing an internal catheter comprising a distal end and a first magnet positioned at or near the distal end of the internal catheter, the internal catheter being configured for engaging the external catheter, the internal catheter devoid of an ablation contact; placing the distal end of the external catheter adjacent to a first surface of the tissue; placing the distal end of the internal catheter adjacent to an opposing surface of the tissue; manipulating the internal catheter to direct the ablation contact of the external catheter to contact a first targeted location on the first surface of the tissue; ablating the first targeted location on the first surface of the tissue using the external catheter at a location directed by the internal catheter; and ablating a second targeted location on the first surface of the tissue and along the first surface between the first location and the second location without moving the internal catheter. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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Specification