Cardiac mapping instrument with shapeable electrode

• US 8,623,010 B2
• Filed: 06/09/2009
• Issued: 01/07/2014
• Est. Priority Date: 01/25/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ocel, Jon M., Briscoe, Roderick E., Francischelli, David E., Jahns, Scott E., Keogh, James R., Jolly, Katherine S., Bonner, Matthew D.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US12/480,926
• Publication Number:
  US 20090326527A1
• Time in Patent Office: 1,673 Days
• Field of Search: 606 32- 35, 606 38- 41, 607/6, 607/9, 607/119, 600/547
• US Class Current: 606/41
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems

Abstract

An instrument including an elongated shaft and a non-conductive handle is disclosed. The shaft defines a proximal section and a distal section. The distal section forms an electrically conductive tip. Further, the shaft is adapted to be transitionable from a straight state to a first bent state. The shaft is capable of independently maintaining the distinct shapes associated with the straight state and the first bent state. The handle is rigidly coupled to the proximal section of the shaft. The instrument is useful for epicardial pacing and/or mapping of the heart for temporary pacing on a beating heart, for optimizing the placement of ventricular leads for the treatment of patients with congestive heart failure and ventricular dysynchrony and/or for use in surgical ablation procedures.

Claims

1. A method of performing an ablation procedure, the method comprising:

providing a first instrument including an elongated shaft and a handle, the shaft defining a proximal section rigidly coupled to the handle, a distal section forming an electrically conductive tip;

positioning the tip of the first instrument through a patient'"'"'s chest;

applying ablation energy to the tip of the first instrument while contacting cardiac tissue;

creating an ablation lesion to isolate an area of cardiac tissue;

providing a second instrument including an elongated shaft and a handle, the shaft defining a proximal section rigidly coupled to the handle, a distal section forming an electrically conductive tip;

positioning the tip of the second instrument through a patient'"'"'s chest; and

applying stimulation energy to the tip of the second instrument while contacting the area of isolated cardiac tissue to assess transmurality of the ablation lesion.

2. The method of claim 1, wherein the first instrument further comprises an internal lumen extending from the proximal section of the shaft and in fluid communication with at least one passage formed in the distal section of the shaft.

3. The method of claim 2, further comprising:

dispensing conductive fluid from the internal lumen of the shaft via the at least one passage.

4. The method of claim 1, wherein the ablation energy is radiofrequency energy.

5. The method of claim 1, wherein the step of applying ablation energy to the tip of the first instrument includes dragging the tip of the first instrument along the cardiac tissue.

6. A method of performing an ablation procedure, the method comprising:

providing an instrument including an elongated shaft and a handle, the shaft defining a proximal section rigidly coupled to the handle, a distal section forming an electrically conductive tip;

positioning the tip through a patient'"'"'s chest;

applying ablation energy to the tip while contacting cardiac tissue;

creating an ablation lesion to isolate an area of cardiac tissue;

stopping the application of ablation energy to the tip;

repositioning the tip; and

applying stimulation energy to the tip while contacting the area of isolated cardiac tissue to assess transmurality of the ablation lesion.

7. The method of claim 6, wherein the instrument further comprises an internal lumen extending from the proximal section of the shaft and in fluid communication with at least one passage formed in the distal section of the shaft.

8. The method of claim 7, further comprising:

dispensing conductive fluid from the internal lumen of the shaft via the at least one passage while applying ablation energy to the tip.

9. The method of claim 6, wherein the ablation energy is radio frequency energy.

10. The method of claim 6, wherein the step of repositioning the tip includes contacting the tip against tissue entirely within the area of isolated tissue, and the step of applying stimulation energy to the tip occurs after the step of repositioning the tip.

11. A method of performing an ablation procedure, the method comprising:

providing an instrument including an elongated shaft and a handle, the shaft defining a proximal section rigidly coupled to the handle, a distal section forming an electrically conductive tip;

advancing the tip of the instrument through a patient'"'"'s chest and into the patient'"'"'s coronary sinus;

positioning the tip of the instrument in the patient'"'"'s coronary sinus between an existing lesion encircling at least a portion of the patient'"'"'s pulmonary veins and the annulus of the patient'"'"'s mitral valve;

applying ablation energy to the tip of the instrument while the tip is positioned in the coronary sinus; and

creating an ablation lesion in an area of cardiac tissue surrounding the tip.