Apparatus and method for diagnosis and therapy of electrophysiological disease

• US 8,721,636 B2
• Filed: 05/13/2005
• Issued: 05/13/2014
• Est. Priority Date: 10/22/1996
• Status: Expired due to Fees

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Inventors: Vaska, Matthias, Pless, Banjamin, Gallup, David A., Ulstad, Jack E. Jr., Anderson, Scott C., Richman, Roxanne L.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US11/129,056
• Publication Number:
  US 20060004352A1
• Time in Patent Office: 3,287 Days
• Field of Search: 606/41, 606 48- 50, 607/122
• US Class Current: 606/41
• 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 18/1402 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 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• 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 2018/00232 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 2018/142 : at least partly surrounding the target, e.g. concave, curved or in the form of a cave
• CPC Class Codes: A61B 2018/145 : wherein the effectors remain parallel during closing and opening
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• 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 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 1/06 : 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

The invention provides apparatus and methods for mapping conduction pathways and creating lesions in the heart wall for the treatment of atrial fibrillation. The apparatus may include at least one epicardial ablation probe having a plurality of electrodes for creating a lesion. The apparatus and method facilitate the formation of a lesion which electrically isolates the pulmonary veins from the surrounding myocardium.

Claims

1. A device for ablating epicardial cardiac tissue around a pulmonary vein of a subject, the device comprising

an ablating portion attached to an elongated body, the ablating portion and the elongated body having a working channel extending therethrough;

at least one ablating element coupled to the ablating portion;

a guide portion adapted to locate the ablating portion along the posterior location of the pulmonary veins in order to form one or more lesions selected from the group consisting of;

a transmural lesion on the superior side of the pulmonary veins and a transmural lesion along the inferior side of the pulmonary veins; and

a first electrode and a second electrode distinct from the at least one ablating element coupled to the ablating portion and disposed on opposite sides of the at least one ablating element, wherein the first electrode is configured to emit an electrical impulse and the second electrode is configured to receive the electrical impulse.

2. The device of claim 1, wherein the second electrode is configured to receive the electrical impulse emitted by the first electrode when the first and the second electrodes are located adjacent a discontinuity in a lesion.

3. The device of claim 1, wherein the at least one ablating element comprises one of:

a radiofrequency ablating element, a cryogenic ablating element, and an ultrasound ablating element.

4. The device of claim 1, wherein the at least one ablating element comprises a high intensity focused ultrasound ablating element.

5. The device of claim 1, wherein the ablating device further comprises an expandable element, and wherein the expandable element is adapted to move the at least one ablating element into improved contact with the epicardial tissue surface.

6. The device of claim 5, wherein the expandable element comprises an inflatable balloon.

7. The device of claim 6, wherein the inflatable balloon comprises one or more chambers, and wherein each chamber is coupled to an inflation lumen.

8. The device of claim 1, further comprising one or more steering wires extending through the working channel of the ablating portion and the elongated body.

9. The device of claim 1, wherein the guide portion comprises at least one expanding element.

10. The device of claim 9, wherein the at least one expanding element comprises a balloon.

11. An ablation device, the device comprising:

an ablating portion attached to an elongated body, the ablating portion and the elongated body having a working channel extending therethrough;

at least one ablating element coupled to the ablating portion;

a guide portion adapted to locate the ablating portion along tissue to be ablated; and

a first electrode and a second electrode distinct from the at least one ablating element coupled to the ablating portion and disposed on opposite sides of the at least one ablating element, wherein the first electrode is configured to emit an electrical impulse and the second electrode is configured to receive the electrical impulse.

12. The device of claim 11, wherein the second electrode is configured to receive the electrical impulse emitted by the first electrode when the first and the second electrodes are located adjacent a discontinuity in a lesion.

13. The device of claim 11, wherein the at least one ablating element comprises one of:

a radiofrequency ablating element, a cryogenic ablating element, and an ultrasound ablating element.

14. The device of claim 11, wherein the at least one ablating element comprises a high intensity focused ultrasound ablating element.

15. The device of claim 11, wherein the ablating device further comprises an expandable element, and wherein the expandable element is adapted to move the at least one ablating element into improved contact with the tissue to be ablated.

16. The device of claim 15, wherein the expandable element comprises an inflatable balloon.

17. The device of claim 16, wherein the inflatable balloon comprises one or more chambers, and wherein each chamber is coupled to an inflation lumen.

18. The device of claim 11, further comprising one or more steering wires extending through the working channel of the ablating portion and the elongated body.