Atrial ablation catheter adapted for treatment of septal wall arrhythmogenic foci and method of use

• US 9,005,194 B2
• Filed: 07/18/2008
• Issued: 04/14/2015
• Est. Priority Date: 11/24/2004
• Status: Active Grant

• Current Assignee: Medtronic Ablation Frontiers Technologies, LLC
• Original Assignee: Medtronic Ablation Frontiers LLC (Medtronic Plc)
• Inventors: Oral, Hakan, Werneth, Randell L., Castellano, Thomas M., Kunis, Christopher G.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US12/176,115
• Publication Number:
  US 20080275443A1
• Time in Patent Office: 2,461 Days
• Field of Search: 606/41, 606 45- 50, 607/101, 607/102, 607/122
• US Class Current: 606/41
• 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 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing

Abstract

An atrial ablation catheter with an electrode array particularly adapted to locate and ablate foci of arrhythmia which are required for sustained atrial fibrillation is provided. The array is easily deployed and retracted from the catheter, and presents a proximally oriented electrode array that can be pulled against the septal wall of the left atrium to engage the septal wall.

Claims

1. An ablation catheter configured to ablate septal wall tissue, comprising:

an elongate delivery tube defining a major axis and having a distal end adapted for insertion into the heart of a patient;

at least one resilient arm with a delivery configuration and an expanded configuration, wherein the at least one resilient arm comprises a distal arm section, a proximal arm section, and a bend section disposed between the distal arm section and the proximal arm section, the proximal arm section of the at least one resilient arm defining a shape selected from the group consisting of cordate, hastate, and sagittate when the at least one resilient arm is in the expanded configuration; and

a plurality of electrodes disposed on the proximal arm section of the at least one resilient arm, wherein the distal arm section defines a substantially linear configuration substantially orthogonal to the major axis when the at least one resilient arm is in the expanded configuration.

2. The ablation catheter of claim 1 wherein the at least one resilient arm is adapted to bend at the bend section when it is expanded from the delivery configuration to the expanded configuration.

3. The ablation catheter of claim 1 wherein the proximal arm section forms an acute angle with the distal arm section at the bend section when the at least one resilient arm is in the expanded configuration.

4. The ablation catheter of claim 1 further comprising a pin extending into the elongate delivery tube, the pin being longitudinally slidable relative to the elongate delivery tube.

5. The ablation catheter of claim 4 wherein the proximal arm section is attached to the elongate delivery tube and the distal arm section is attached to the pin.

6. The ablation catheter of claim 1 further adapted to map septal wall tissue.

7. The ablation catheter of claim 1 wherein the proximal arm section extends generally along a longitudinal axis of the elongate delivery tube when the at least one resilient arm is in the delivery configuration.

8. The ablation catheter of claim 1 wherein the distal arm section extends generally along a longitudinal axis of the elongate delivery tube when the at least one resilient arm is in the delivery configuration.

9. The ablation catheter of claim 1 wherein the proximal arm section is arcuate when the at least one resilient arm is in the expanded configuration.

10. An ablation catheter configured to ablate septal wall tissue, comprising:

an elongate delivery tube having a distal end adapted for insertion into the heart of a patient;

at least one resilient arm with a delivery configuration and an expanded configuration, wherein the at least one resilient arm comprises a distal arm section, a proximal arm section, and a bend section disposed between the distal arm section and the proximal arm section, the proximal arm section of the at least one resilient arm defining a shape selected from the group consisting of cordate, hastate, and sagittate when the at least one resilient arm is in the expanded configuration; and

a plurality of electrodes disposed on the proximal arm section of the at least one resilient arm, wherein the bend section is pre-formed in the at least one resilient arm and forms an acute angle with the distal arm section.

11. The ablation catheter of claim 10 wherein the at least one resilient arm is adapted to bend at the bend section when it is expanded from the delivery configuration to the expanded configuration.

12. The ablation catheter of claim 10 further comprising a pin extending into the elongate delivery tube, the pin being longitudinally slidable relative to the elongate delivery tube.

13. The ablation catheter of claim 12 wherein the proximal arm section is attached to the elongate delivery tube and the distal arm section is attached to the pin.

14. The ablation catheter of claim 10 further adapted to map septal wall tissue.

15. The ablation catheter of claim 10 wherein the proximal arm section extends generally along a lateral axis of the elongate delivery tube when the at least one resilient arm is in the expanded configuration.

16. The ablation catheter of claim 10 wherein the distal arm section extends generally along a lateral axis of the elongate delivery tube when the at least one resilient arm is in the expanded configuration.

17. The ablation catheter of claim 10 wherein the proximal arm section extends generally along a longitudinal axis of the elongate delivery tube when the at least one resilient arm is in the delivery configuration.

18. The ablation catheter of claim 10 wherein the distal arm section extends generally along a longitudinal axis of the elongate delivery tube when the at least one resilient arm is in the delivery configuration.

19. The ablation catheter of claim 10 wherein the proximal arm section is arcuate when the at least one resilient arm is in the expanded configuration.

20. An ablation catheter configured to ablate septal wall tissue, comprising:

an outer catheter tube defining a major axis and having a distal end adapted for insertion into the heart of a patient;

an inner catheter tube slidably disposed within the outer catheter tube;

a pin slidably disposed within the inner catheter tube;

at least one resilient arm with a delivery configuration and an expanded configuration, wherein the at least one resilient arm comprises a distal arm section attached to the pin, a proximal arm section attached to the inner catheter tube, and a bend section disposed between the distal arm section and the proximal arm section,

wherein the distal arm section defines a substantially linear configuration substantially orthogonal to the major axis when the at least one resilient arm is in the expanded configuration, and proximal arm section of the at least one resilient arm defines a shape selected from the group consisting of cordate, hastate, and sagittate when the at least one resilient arm is in the expanded configuration; and

a plurality of electrodes disposed on the proximal arm section of the at least one resilient arm.

21. The ablation catheter of claim 20 wherein the at least one resilient arm is adapted to bend at the bend section when it is expanded from the delivery configuration to the expanded configuration.

22. The ablation catheter of claim 20 further adapted to map the septal wall.

23. The ablation catheter of claim 20 wherein the proximal arm section is positioned outside of the outer catheter tube when the at least one resilient arm is in the expanded configuration.

24. The ablation catheter of claim 20 wherein the distal arm section is positioned outside of the outer catheter tube when the at least one resilient arm is in the expanded configuration.

25. The ablation catheter of claim 20 wherein the proximal arm section is positioned inside of the outer catheter tube when the at least one resilient arm is in the delivery configuration.

26. The ablation catheter of claim 20 wherein the distal arm section is positioned inside of the outer catheter tube when the at least one resilient arm is in the delivery configuration.

27. A method of treating atrial fibrillation comprising:

inserting an ablation catheter defining a major axis into the left atrium of the heart of a patient;

expanding a resilient arm of the ablation catheter by bending the resilient arm at a bend section in the resilient arm, wherein the resilient arm comprises proximal and distal arm sections extending from the bend section, the distal arm section defining a substantially linear configuration substantially orthogonal to the major axis when the resilient arm is substantially expanded, and the proximal arm section of the at least one resilient arm defining shape selected from the group consisting of cordate, hastate, and sagittate when the resilient arm is substantially expanded;

pulling the proximal arm section of the resilient arm into contact with septal wall tissue; and

passing energy through at least one electrode disposed on the proximal arm section to ablate the septal wall tissue.

28. The method of claim 27 further comprising sensing electrical signals of the septal wall tissue through the at least one electrode disposed on the proximal arm section.

29. The method of claim 28 further comprising repeating the passing energy and sensing steps on another area of septal wall tissue.

30. The method of claim 28 further comprising determining if the proximal arm section is disposed over an arrhythmogenic focus in the left atrium.

31. The method of claim 27 wherein the step of expanding the resilient arm further comprises bending the resilient arm until the proximal arm section extends generally along a lateral axis of the ablation catheter.

32. The method of claim 27 wherein the step of expanding the resilient arm further comprises bending the resilient arm until the distal arm section extends generally along a lateral axis of the ablation catheter.

33. The method of claim 27 further comprising removing an outer catheter tube from the resilient arm before expanding the resilient arm.

34. The method of claim 27 wherein the expanding step further comprises sliding a pin relative to a longitudinal axis of the ablation catheter.