Method and devices for treating atrial fibrillation by mass ablation

• US 8,801,707 B2
• Filed: 08/14/2012
• Issued: 08/12/2014
• Est. Priority Date: 05/14/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Francischelli, David E., Stewart, Mark T., Skarda, James R.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): VAHDAT, KHADIJEH A
• Application Number:
  US13/584,932
• Publication Number:
  US 20120316488A1
• Time in Patent Office: 728 Days
• Field of Search: 606/27, 606/41, 606/45, 606/49, 606/50, 600/439
• US Class Current: 606/41
• 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 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 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/06 caused by chemical reaction , e.g. moxaburners
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00273 Anchoring means for temporary attachment of a device to tissue
• 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 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/0212 : using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/1405 : Electrodes having a specific shape
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61M 5/14 : Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

Apparatus and method for ablating target tissue including a non-linear area of tissue in the left atrium of a patient. The method can include selecting an ablation apparatus having an ablator with a tissue engagement section, penetrating a chest cavity of the patient, and identifying the target tissue. The method can also include positioning the ablation apparatus adjacent to the target tissue so that the tissue engagement section can transfer ablation energy to the target tissue. The method can further include energizing the tissue engagement section with ablation energy in order to create a footprint on the non-linear area of tissue in the left atrium and to reduce an overall mass of excitable tissue in the left atrium.

Claims

1. An ablation apparatus for ablating target tissue of a patient, the ablation apparatus comprising:

an insertion tool having a proximal end, a distal end, and a lumen;

an ablator including a conductor and a tissue engagement portion, the conductor having a source end extending from the proximal end of the insertion tool and a delivery end connected to the tissue engagement portion, the ablator removably inserted in the lumen, wherein the tissue engagement portion includes a skirt and the delivery end includes an adhesive tongue inside the skirt, the tongue moveable within the skirt to engage target tissue, and the skirt affixing the ablator to target tissue by a vacuum; and

an energy source connected to the conductor;

the insertion tool configured to be inserted into a patient so that the distal end is adjacent the target tissue;

wherein the ablation apparatus is configured such that;

the conductor is operable to urge the ablator out of the lumen to engage target tissue;

energy conducted from the energy source to the ablator is configured to create a footprint on target tissue to reduce an overall mass of excitable tissue.

2. The ablation apparatus of claim 1 and further comprising a sensor connected to the ablator to sense the target tissue.

3. The ablation apparatus of claim 1 and further comprising a mapping tool to visualize the tissue engagement portion of the ablator.

4. The ablation apparatus of claim 1 wherein the insertion tool includes a catheter.

5. The ablation apparatus of claim 1 the skirt is configured to receive fluid for conducting the energy to the target tissue.

6. The ablation apparatus of claim 5 wherein the fluid is electrically conductive.

7. The ablation apparatus of claim 5 wherein the fluid is caustic.

8. The ablation apparatus of claim 5 wherein the fluid is thermally conductive.

9. The ablation apparatus of claim 1 wherein the ablator includes a chemical delivery system.

10. The ablation apparatus of claim 9 wherein the chemical delivery system is configured to provide at least one of diffusion, iontophoresis, mechanical injection, needle-less injection, and controlled slow-release delivery.