System and method for energy delivery to tissue while monitoring position, lesion depth, and wall motion

• US 9,033,885 B2
• Filed: 10/30/2009
• Issued: 05/19/2015
• Est. Priority Date: 10/30/2008
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: VytronUS, Inc. (Johnson & Johnson)
• Inventors: Thapliyal, Hira V., Gallup, David A., Arenson, James W.
• Primary Examiner(s): MEHTA, PARIKHA SOLANKI
• Application Number:
  US12/609,759
• Publication Number:
  US 20100113985A1
• Time in Patent Office: 2,027 Days
• Field of Search: 601/2, 600/407, 600/411, 600/427, 600/439, 600/508, 604/22, 606 27- 40, 607/2, 607 96-102, 607115-132
• US Class Current: 600/439
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00092 using thermocouples
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61N 2007/0052 using the same transducer for therapy and imaging
• CPC Class Codes: A61N 2007/0073 using multiple frequencies
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

Systems and methods for ablating tissue include an ablation device having an energy source and a sensor. The energy source provides a beam of energy directable to target tissue, and the sensor senses energy reflected back from the target tissue. The sensor collects various information from the target tissue in order to facilitate adjustment of ablation operating parameters, such as changing power or position of the energy beam. Gap distance between the energy source and target tissue, energy beam incident angle, tissue motion, tissue type, lesion depth, etc. are examples of some of the information that may be collected during the ablation process and used to help control ablation of the tissue.

Claims

1. A method of ablating tissue in a patient as a treatment for fibrillation, said method comprising:

providing an ablation device having only a single ultrasound transducer;

positioning the ablation device adjacent a target tissue;

moving the ablation device over a surface of the target tissue;

delivering a collimated beam of ultrasound energy to the target tissue with the single ultrasound transducer;

sensing energy reflected back from the target tissue with the single ultrasound transducer;

measuring a gap distance between the single ultrasound transducer and the surface of the target tissue, based on the sensed energy reflected back from the target tissue, while the ablation device moves over the surface of the target tissue, thereby generating a plurality of gap distances;

mapping the plurality of gap distances measured over the surface of the target tissue, thereby generating a map of the target tissue;

ablating the target tissue with the collimated beam of ultrasound energy;

maintaining a gap between the single ultrasound transducer and the target tissue so that there is no contact between the single ultrasound transducer and the target tissue while moving the ablation device, delivering the beam of energy, and sensing the energy reflected back from the target tissue; and

using the tissue map to plan one or more ablation paths and adjust energy delivery settings.

2. The method of claim 1, wherein the positioning of the ablation device comprises advancing the ablation device into a left atrium of the heart.

3. The method of claim 1, wherein moving the ablation device comprises moving the ablation device in a zig-zag pattern.

4. The method of claim 1, wherein moving the ablation device comprises moving the ablation device in a continuous path.

5. The method of claim 1, wherein the map is generated as part of a diagnostic sweep of the target tissue prior to the ablating step.

6. The method of claim 1, wherein the map comprise identification of anatomical structures in the target tissue.

7. The method of claim 6, wherein the anatomical structures comprise the pulmonary veins.

8. The method of claim 1, wherein the map indicates surface contours and angles of the target tissue.

9. The method of claim 1, wherein the map comprises a two dimensional representation of the target tissue.

10. The method of claim 1, wherein the map comprises a three dimensional representation of the target tissue.

11. The method of claim 1, wherein the ablating step creates a continuous lesion in the target tissue, the lesion blocking aberrant electrical pathways in the tissue so as to reduce or eliminate the fibrillation.

12. The method of claim 11, wherein the fibrillation comprises atrial fibrillation.

13. The method of claim 1, wherein using the tissue map to plan one or more ablation paths comprises creating a route with optimized gap distances through which the ablation device moves.

14. The method of claim 1, wherein the tissue map comprises angles of the beam of energy relative to the target tissue, and wherein using the tissue map to adjust energy deliver settings comprises adjusting one or more of a frequency, voltage, duty cycle, power, and dwell time of the beam of ultrasound energy based on the angles.

15. The method of claim 1, wherein an area sensed by the single ultrasound transducer is identical to an area ablated by the single ultrasound transducer.

16. The method of claim 1, further comprising removing a noise profile component from the collected data to determine the gap distance.