Treatment adjustment based on temperatures from multiple temperature sensors

• US 9,522,037 B2
• Filed: 07/19/2016
• Issued: 12/20/2016
• Est. Priority Date: 11/19/2014
• Status: Active Grant

• Current Assignee: EPIX Therapeutics, Inc. (Medtronic Plc)
• Original Assignee: Advanced Cardiac Therapeutics, Inc. (Medtronic Plc)
• Inventors: Panescu, Dorin, Schultheis, Eric Andrew, Koblish, Josef Vincent, Johnson, Jessi E.
• Primary Examiner(s): FOWLER, DANIEL WAYNE
• Application Number:
  US15/214,376
• Publication Number:
  US 20160324575A1
• Time in Patent Office: 154 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00101 low, i.e. thermally insulating
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00672 lower
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00714 Temperature
• CPC Class Codes: A61B 2018/00761 Duration
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00815 measured by a thermistor
• CPC Class Codes: A61B 2018/00821 measured by a thermocouple
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/128 : generating two or more frequencies
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2562/046 : in a matrix array
• CPC Class Codes: A61B 5/01 : Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/068 : using impedance sensors
• CPC Class Codes: A61B 5/150954 : Means for the detection of operative contact with patient, e.g. by temperature sensitive sensor
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6852 : Catheters

Abstract

According to some embodiments, a medical instrument (for example, an ablation device) comprises an elongate body having a proximal end and a distal end, an energy delivery member positioned at the distal end of the elongate body, a first plurality of temperature-measurement devices carried by or positioned within the energy delivery member, the first plurality of temperature-measurement devices being thermally insulated from the energy delivery member, and a second plurality of temperature-measurement devices positioned proximal to a proximal end of the energy delivery member, the second plurality of temperature-measurement devices being thermally insulated from the energy delivery member.

Claims

1. A system for adjusting one or more treatment parameters of an ablation procedure based on temperature measurements received from a plurality of temperature sensors, the system comprising:

an ablation catheter comprising a distal electrode member positioned at a distal tip of the ablation catheter and a proximal electrode member spaced apart proximally from the distal electrode member by a gap,

a radiofrequency energy source configured to provide radiofrequency energy within an operating radiofrequency range for ablation to the ablation catheter through one or more conductors extending from the radiofrequency energy source to at least one of the distal electrode member and the proximal electrode member;

wherein the proximal electrode member is operatively coupled to the distal electrode member by a filtering element at frequencies within the operating radiofrequency range for ablation, such that the proximal electrode member and the distal electrode member function like a single electrode within the operating radiofrequency range for ablation, and wherein the proximal electrode member and the distal electrode member function as separate electrodes at high-resolution mapping frequencies outside the operating radiofrequency range for ablation;

a hardware processor configured to, upon execution of instructions stored on a computer-readable storage medium;

receive signals from a distal group of temperature sensors positioned along the distal electrode member of the ablation catheter;

receive signals from a proximal group of temperature sensors positioned along the proximal electrode member of the ablation catheter;

determine temperature measurements for each of the temperature sensors of the distal group based on the signals received from the distal group of temperature sensors;

determine temperature measurements for each of the temperature sensors of the proximal group based on the signals received from the proximal group of temperature sensors; and

adjust one or more treatment parameters of the ablation procedure based on the temperature measurements.

2. The system of claim 1,

wherein the one or more treatment parameters comprise one or more of:

duration of treatment, power level, target temperature, and maximum temperature,

wherein the processor is configured to adjust the one or more treatment parameters by sending control signals to the radiofrequency energy source, and

wherein the processor is configured to adjust the one or more treatment parameters based on peak temperature measurements.

3. The system of claim 1, wherein the gap has a width of between 0.1 mm and 1.0 mm.

4. The system of claim 1, wherein the radiofrequency energy source is configured to operate in a temperature control mode, wherein a target temperature of tissue is identified, and wherein the processor is configured to adjust the one or more treatment parameters to maintain a temperature of the tissue at the target temperature.

5. The system of claim 1, wherein the radiofrequency energy source is configured to operate in a power control mode in which a certain level of power is applied continuously and a maximum temperature is identified such that, when the maximum temperature is reached or exceeded as determined from the temperature measurements, the processor is configured to adjust the one or more treatment parameters.

6. The system of claim 1, wherein the processor is configured to adjust the one or more treatment parameters based on a predictive model or on peak temperature measurements.

7. The system of claim 1, wherein the operating radiofrequency range is between 200 kHz and 10 MHz.

8. The system of claim 1, wherein the proximal electrode member has a length that is longer than a length of the distal electrode member.

9. A system for adjusting one or more treatment parameters of an ablation procedure based on temperature measurements received from a plurality of temperature sensors, the system comprising:

a filtering element configured to operatively couple a distal electrode member and a proximal electrode member spaced apart by an electrically-insulating gap at an operating ablation frequency such that the proximal electrode member and the distal electrode member function like a single electrode at the operating ablation frequency to collectively ablate targeted tissue, and wherein the proximal electrode member and the distal electrode member function as separate electrodes at high-resolution mapping frequencies, thereby facilitating ablation and high-resolution mapping using a single electrode configuration;

a hardware processor configured to, upon execution of instructions stored on a computer-readable storage medium;

receive signals from a first plurality of temperature sensors positioned along the distal electrode member;

receive signals from a second plurality of temperature sensors positioned proximal to the first plurality of temperature sensors;

determine temperature measurements for each of the second plurality of temperature sensors based on the signals received from the second plurality of temperature sensors; and

adjust one or more treatment parameters of the ablation procedure based on the temperature measurements; and

an energy source configured to provide energy at the operating ablation.

10. The system of claim 9, wherein the one or more treatment parameters comprise one or more of:

duration of treatment, power level, target temperature, and maximum temperature.

11. The system of claim 9, wherein the processor is configured to adjust the one or more treatment parameters based on peak temperature measurements or on a predictive model.

12. The system of claim 9, wherein the energy source is configured to operate in a temperature control mode, wherein a target temperature of tissue is identified and the processor is configured to adjust the one or more treatment parameters to maintain a temperature of the tissue at the target temperature.

13. The system of claim 9, wherein the energy source is configured to operate in a power control mode in which a certain level of power is applied continuously and a maximum temperature is identified such that, when the maximum temperature is reached or exceeded as determined from the temperature measurements, the processor is configured to adjust the one or more treatment parameters.

14. The system of claim 9, wherein the operating ablation frequency is between 200 kHz and 10 MHz.

15. The system of claim 9, wherein the proximal electrode member is longer than the distal electrode member.

16. A method of adjusting treatment parameters of an ablation procedure based on temperature measurements received from a plurality of temperature sensors, the method comprising:

delivering energy having a frequency within an operating radiofrequency range to at least one of a proximal electrode member and a distal electrode member positioned at a distal end of an ablation device, wherein the proximal electrode member is spaced apart from the distal electrode member by a gap, wherein the proximal electrode member is operatively coupled to the distal electrode member using a filtering element at an operating ablation frequency such that the proximal electrode member and the distal electrode member function like a single electrode at the operating ablation frequency to collectively ablate targeted tissue, and wherein the proximal electrode member and the distal electrode member function as separate electrodes at high-resolution mapping frequencies;

receiving signals indicative of temperature from a first plurality of temperature sensors positioned along the distal electrode member;

receiving signals indicative of temperature from a second plurality of temperature sensors spaced apart axially from the first plurality of temperature sensors;

determining, upon execution of instructions stored on a non-transitory storage medium by a hardware processor, temperature measurements from the signals received from the first plurality of temperature sensors and the second plurality of temperature sensors; and

adjusting one or more treatment parameters of the ablation procedure based, at least in part, on said temperature measurements.

17. The method of claim 16, wherein said adjusting the one or more treatment parameters of the ablation procedure comprises automatically adjusting a power level.

18. The method of claim 16, wherein said operating radiofrequency range is between 200 kHz and 10 MHz.

19. The method of claim 16, further comprising calculating a peak temperature based on the determined temperature measurements.

20. The method of claim 16, wherein said adjusting the one or more treatment parameters of the ablation procedure is based, at least in part, on a predictive model or on peak temperature measurements.