Guided cardiac ablation catheters
First Claim
1. A cardiac ablation instrument for treatment of atrial fibrillation comprising:
- a catheter adapted for disposition within a heart;
an expandable balloon member coupled to the catheter and adapted for positioning proximate to a pulmonary vein;
an ablation element within the balloon member for creating at least one lesion in the vicinity of the pulmonary vein; and
a reflectance sensor for positioning the ablation element relative to the pulmonary vein,wherein the instrument further comprises at least one orientation marker detectable by the reflectance sensor, the orientation marker being configured to determine the angular position of the instrument relative to the pulmonary vein.
12 Assignments
0 Petitions
Accused Products
Abstract
Guided ablation instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias, including atrial fibrillation. In one aspect of the invention, a percutaneous catheter is disclosed with an endoscope positionable in the instrument'"'"'s distal end region to obtain an image. The image allows the clinician to determine whether contact has been achieved (or blood has been cleared from an ablative energy transmission path) before ablation begins or while ablation is occurring. In one embodiment, percutaneous ablation catheters are disclosed having at least one central lumen and one or more balloon structures at the distal end region of the instrument. Also disposed in the distal end region are an illuminating light source and an endoscope capable of collecting sufficient light to relay an image to the user. The instruments can further include an ablation element. The ablation element can be a contact ablation element, or a radiant energy emitter, which is preferably independently positionable within the lumen of the instrument and adapted to project ablative energy through a transmissive region of the instrument body (and/or balloon) to a target tissue site proximate to the pulmonary veins. The energy can delivered without the need for contact between the energy emitter and the target tissue so long as a clear transmission pathway is established. The endoscope element of the instrument allows the clinician to determine the position of the instrument and, if radiant energy is to be employed, see if such a pathway is clear. Moreover, because the position of the radiant energy emitter can be varied, endoscopic guidance permits the clinician to select a desired location and dose for the lesion.
-
Citations
29 Claims
-
1. A cardiac ablation instrument for treatment of atrial fibrillation comprising:
-
a catheter adapted for disposition within a heart; an expandable balloon member coupled to the catheter and adapted for positioning proximate to a pulmonary vein; an ablation element within the balloon member for creating at least one lesion in the vicinity of the pulmonary vein; and a reflectance sensor for positioning the ablation element relative to the pulmonary vein, wherein the instrument further comprises at least one orientation marker detectable by the reflectance sensor, the orientation marker being configured to determine the angular position of the instrument relative to the pulmonary vein. - View Dependent Claims (2, 3, 4, 5, 6, 7, 10, 11, 12, 13, 14, 15, 16, 17)
-
-
8. A cardiac ablation instrument for treatment of atrial fibrillation comprising:
-
a catheter adapted for disposition within a heart; an expandable balloon member coupled to the catheter and adapted for positioning proximate to a pulmonary vein, the expandable balloon having a tear-drop shape; an ablation element within the balloon member for creating at least one lesion in the vicinity of the pulmonary vein; and a reflectance sensor for positioning the ablation element relative to the pulmonary vein, wherein the reflectance sensor is capable of sensing contact between at least a portion of the instrument and cardiac tissue.
-
-
9. A cardiac ablation instrument for treatment of atrial fibrillation comprising:
-
a catheter adapted for disposition within a heart; an expandable balloon member coupled to the catheter and adapted for positioning proximate to a pulmonary vein; an ablation element within the balloon member for creating at least one lesion in the vicinity of the pulmonary vein; and a reflectance sensor for positioning the ablation element, wherein the longitudinal position of the ablation element is adjustable relative to the balloon to create a lesion of variable size such that the ablation element can be configured to form a wide circumferential lesion by positioning the element at a rear location of the balloon member and the ablation element can be configured to form a smaller diameter circumferential lesion by positioning the ablation element closer to a front portion of the balloon.
-
-
18. A cardiac ablation instrument for treatment of atrial fibrillation comprising:
-
a catheter adapted for disposition within a heart; an expandable balloon member coupled to the catheter and adapted for positioning proximate to a pulmonary vein; an ablation element within the balloon member for creating at least one lesion in the vicinity of the pulmonary vein; and a reflectance sensor for positioning the ablation element relative to the pulmonary vein, wherein the ablation element further comprises beam forming optics for projecting an annular beam of light, such that the ablation element projects at least a partial ring of ablative energy of variable diameter based on its axial position within the catheter body.
-
-
19. A cardiac ablation instrument for treatment of atrial fibrillation comprising:
-
a catheter adapted for disposition within a heart; an expandable balloon member coupled to the catheter and adapted for positioning proximate to a pulmonary vein; an ablation element within the balloon member for creating at least one lesion in the vicinity of the pulmonary vein; and a reflectance sensor for positioning the ablation element relative to the pulmonary vein, wherein the instrument further comprises an aiming beam generator to project a pattern of visible light coincident with a desired ablation location. - View Dependent Claims (20)
-
-
21. A cardiac ablation instrument for treatment of atrial fibrillation comprising:
-
a catheter adapted for disposition within a heart; an expandable balloon member coupled to the catheter and adapted for positioning proximate to a pulmonary vein; an ablation element within the balloon member for creating at least one lesion in the vicinity of the pulmonary vein; and a reflectance sensor for positioning the ablation element relative to the pulmonary vein, wherein movement of the ablation element causes a change in size or fluence of an ablative energy beam incident on a target tissue.
-
-
22. A cardiac ablation instrument for treatment of atrial fibrillation comprising:
-
a catheter adapted for disposition within a heart; an expandable balloon member coupled to the catheter and having a tear drop shape such that it is adapted for positioning proximate to a pulmonary vein; an ablation element within the balloon member for creating at least one lesion in the vicinity of the pulmonary vein; and a reflectance sensor for positioning the ablation element within the heart, wherein the ablation element is capable of movement within the tear-drop shaped balloon and movement of the ablation element causes a change in size or fluence of an ablative energy beam incident on a target tissue. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29)
-
Specification