Electrode catheter for ablation purposes and related method thereof

• US 9,211,405 B2
• Filed: 03/20/2008
• Issued: 12/15/2015
• Est. Priority Date: 03/22/2007
• Status: Active Grant

• Current Assignee: University of Virginia
• Original Assignee: University of Virginia Patent Foundation (University of Virginia)
• Inventors: Mahapatra, Srijoy, Gillies, George T.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US12/532,233
• Publication Number:
  US 20100211064A1
• Time in Patent Office: 2,826 Days
• Field of Search: 606 32- 34, 606/41, 606 48- 50, 607/101, 607/102, 607/116, 607/122
• US Class Current: 1/1
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00035 with return means
• CPC Class Codes: A61B 2018/00279 deployable
• 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 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61N 1/06 for high-frequency therapy

Abstract

An electrode catheter for use with an endocardial ablation catheter, wherein the electrode catheter receives the transmitted energy for ablating a portion of the heart. The electrode catheter comprises a proximal portion, a distal portion, and a longitudinal structure there between; and an electrode in communication with said electrode catheter, wherein said electrode receives the transmitted energy from the endocardial ablation catheter, or alternatively an epicardial ablation catheter.

Claims

1. A device, comprising:

an energy source;

an endocardial ablation catheter electrically connected to the energy source and configured to be disposed in a heart and to transmit energy received from the energy source for ablating a portion of the heart;

an electrode catheter configured to be disposed in the middle mediastinum of the thorax of a subject and configured for use with the endocardial ablation catheter, said electrode catheter comprising;

a proximal portion, a distal portion, and a longitudinal structure there between;

at least one distal fluid aperture adapted for passage of a fluid; and

an electrode in communication with said electrode catheter,

wherein said electrode is configured to receive the transmitted energy from the endocardial ablation catheter, and

wherein said electrode catheter is configured to be placed outside of the heart, and to receive the transmitted energy from the endocardial ablation catheter via said electrode while the endocardial ablation catheter is disposed inside of the heart.

2. The device of claim 1, wherein the electrode catheter is configured to be disposed in the pericardial space.

3. The device of claim 1, wherein the electrode catheter is configured to be disposed in outside the pericardium.

4. The device of claim 1, wherein the electrode catheter is configured to be disposed inside the pericardium.

5. The device of claim 1, wherein said at least one distal fluid aperture is in communication with a fluid lumen extending longitudinally through said longitudinal structure toward said proximal end.

6. The device of claim 5, wherein said distal fluid aperture is configured to emit a fluid.

7. The device of claim 5, wherein said distal fluid aperture is configured to extract a fluid.

8. The device of claim 5, wherein said distal fluid aperture is configured to emit and extract a fluid.

9. The device of claim 5, further comprising:

at least one proximal fluid aperture at said proximal portion, wherein said at least one proximal fluid aperture is in communication with said fluid lumen, and wherein said at least one proximal fluid aperture is adapted for passage of fluid.

10. The device of claim 9, wherein said proximal fluid aperture is configured to emit a fluid.

11. The device of claim 9, wherein said proximal fluid aperture is configured to extract a fluid.

12. The device of claim 9, wherein said proximal fluid aperture is configured to emit and extract a fluid.

13. The device of claim 9, further comprising a fluid control means configured for controlling passage of the fluid.

14. The device of claim 13, wherein said control means comprises a control handle in communication with said electrode catheter.

15. The device of claim 13, wherein said control means is in communication with an external fluid source.

16. The device of claim 9, wherein the device is configured such that the fluid may be used to cool said electrode.

17. The device of claim 9, wherein the device is configured such that the fluid may be used to distend proximate anatomical structures.

18. The device of claim 1, further comprising a stabilization means configured for stabilizing said electrode catheter.

19. The device of claim 18, wherein said stabilization means comprises at least one deployable member.

20. The device of claim 18, wherein said stabilization means comprises one or more protrusions for engaging proximal anatomical structures.

21. The device of claim 18, wherein said stabilization means comprises a non-conducting material.

22. The device of claim 18, further comprising a control means configured for controlling or adjusting said stabilization means.

23. The device of claim 22, wherein said control means comprises a control handle in communication with said electrode catheter.

24. The device of claim 1, further comprising a steering means configured for positioning said electrode catheter.

25. The device of claim 24, further comprising a second steering means configured for steering said electrode catheter.

26. The device of claim 24, wherein said steering means is configured to orient said electrode catheter about one center of curvature.

27. The device of claim 24, wherein said steering means is configured to adjust a curvature of said electrode catheter about two or more preconfigured centers of curvature.

28. The device of claim 24, wherein said steering means comprises at least one of the following:

guide wire, pull string, positional adjustment device, tensioning line, or digitating distal tip.

29. The device of claim 24, further comprising a control means configured for controlling said steering means.

30. The device of claim 29, wherein said control means comprises a control handle in communication with said electrode catheter.

31. The device of claim 1, further comprising an electrical lead in communication with said electrode configured for supplying energy to said electrode.

32. The device of claim 31, further comprising a control handle in communication with said electrode catheter, wherein said control handle is controllably connected to said electrical lead.

33. The device of claim 1, wherein said electrode is made of a conducting material.

34. The device of claim 33, wherein said conducting material comprises at least one of the following:

platinum, gold, silver, iridium or any other type of conducting material, alloy or metal.

35. The device of claim 1, wherein said electrode is contoured for the receiving of said transmitted energy.

36. The device of claim 1, wherein said electrode is contoured to be compatible with proximate anatomical structures.

37. The device of claim 1 wherein said electrode is semi-cylindrical in shape.

38. The device of claim 1, wherein said electrode is disposed on said distal portion of said electrode catheter.

39. The device of claim 1, wherein said electrode has a longitudinal length of between about 20 mm and about 50 mm.

40. The device of claim 1, wherein said electrode catheter has a total length of less than about 200 cm.

41. The device of claim 1, wherein said electrode catheter has a total length of less than about 100 cm.

42. The device of claim 1, wherein said electrode catheter has a total length of less than about 50 cm.

43. The device of claim 1, wherein said electrode catheter has a total length of less than about 25 cm.

44. The device of claim 1, wherein said electrode catheter has a total length of less than about 20 cm.

45. The device of claim 1, wherein said electrode catheter is configured to be used simultaneously in conjunction with the endocardial ablation catheter for the purpose of achieving localized burning of heart tissues.

46. The device of claim 45, wherein said device is configured to provide a roughly triangular shaped pattern of current density.

47. The device of claim 1, which when used in conjunction with the endocardial ablation catheter, is configured to provide a roughly triangular shaped pattern of current density.

48. The device of claim 1, wherein the device is configured to be navigated through a puncture of the thorax.

49. The device of claim 48, wherein the device is configured to puncture the sub-xiphoid.

50. The device of claim 48, further comprising a pressure probe needle configured to be used in navigating said electrode catheter.

51. The device of claim 50, wherein said pressure probe needle comprises an access needle.

52. The device of claim 50, wherein said pressure probe needle comprises a sensor configured for sensing pressure in the thorax.

53. The device of claim 48, further comprising an access needle, said access needle adapted to be inserted into the thorax.

54. The device of claim 53, further comprising a guidewire, wherein said guidewire is adapted to be inserted into said access needle.

55. A method using an endocardial ablation catheter, which transmits energy for ablating a portion of a heart, and an electrode catheter including an electrode and at least one aperture, said method comprising:

disposing the endocardial ablation catheter in the heart;

disposing the electrode in the middle mediastinum of the thorax of a subject;

at least one of providing a fluid or extracting a fluid via the aperture of the electrode catheter; and

receiving the transmitted energy with the electrode from the endocardial ablation catheter.

56. The method of claim 55, wherein navigation of the electrode is carried out through a sub-xiphoid puncture.

57. The method of claim 55, wherein the electrode is disposed in the pericardial space.

58. The method of claim 55, wherein the electrode is disposed outside the pericardium.

59. The method of claim 55, wherein the electrode is disposed inside the pericardium.

60. The method of claim 55, wherein the electrode is disposed in a first ventricle of the heart.

61. The method of claim 60, wherein the endocardial ablation catheter is positioned in a second ventricle of the heart.

62. The method of claim 61, wherein said first ventricle is the right ventricle of the heart and said second ventricle is the left ventricle of the heart.

63. The method of claim 61, wherein said first ventricle is the left ventricle of the heart and said second ventricle is the right ventricle of the heart.

64. The method of claim 55, wherein the electrode is made from a conducting material.

65. The method of claim 55, wherein the electrode is contoured for said receiving of the transmitted energy.

66. The method of claim 55, wherein the electrode is contoured to be compatible with proximate anatomical structures.

67. The method of claim 55, wherein the electrode is between 20 mm and 50 mm.

68. The method of claim 55, further comprising disposing the electrode on the electrode catheter.

69. The method of claim 68, wherein said disposing comprises the catheter being inserted into the middle mediastinum of the thorax by inserting the catheter into an access needle.

70. The method of claim 69, further comprising providing a guidewire, wherein the guidewire is adapted to be inserted into the access needle.

71. The method of claim 68, wherein the electrode is disposed on a distal portion of the catheter.

72. The method of claim 68, wherein the catheter further comprises a means for the passage of fluid through the catheter.

73. The method of claim 72, further comprising using the fluid to cool the electrode.

74. The method of claim 72, further comprising using the fluid to distend proximal anatomical structures.

75. The method of claim 68, further comprising using a stabilization means of the catheter for holding the electrode in a position facing the endocardial ablation catheter.

76. The method of claim 55, wherein electrode catheter further comprises at least one steering means for positioning the electrode, the method further comprising adjusting a curvature of the electrode catheter about two or more preconfigured centers of curvature via the at least one steering means.