System and method for adaptive RF ablation

• US 9,532,828 B2
• Filed: 04/28/2011
• Issued: 01/03/2017
• Est. Priority Date: 11/29/2010
• Status: Active Grant

• Current Assignee: Medtronic Ablation Frontiers LLC (Medtronic Plc)
• Original Assignee: Medtronic Ablation Frontiers LLC (Medtronic Plc)
• Inventors: Condie, Catherine R., Sherman, Marshall L., Kasischke, Kathryn E., Corvi, Timothy J., Strunk, Aaron R.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): Ekrami, Yasamin
• Application Number:
  US13/096,236
• Publication Number:
  US 20120136348A1
• Time in Patent Office: 2,077 Days
• Field of Search: 606/20, 606/22, 606/23, 606/33, 606/39, 606/40, 606/41, 606/45
• US Class Current: 1/1
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/14 Probes or electrodes 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 2018/0016 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 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• 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 2018/00726 Duty cycle
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure

Abstract

A medical method, device, and system are provided, including advancing an ablation element of a medical device into contact with tissue to be treated, selecting a power level of energy to ablate the tissue, delivering energy at the selected power level to the ablation element, determining whether the ablation element is in continuous contact with the tissue, and reducing the selected power level when the ablation element ceases to be in continuous contact with the tissue.

Claims

1. A medical method, comprising:

advancing an ablation element of a medical device into contact with tissue to be treated;

supplying power from a power source to the ablation element to ablate the tissue;

monitoring a temperature of the ablation element;

then determining a state of contact between the ablation element and the tissue based on the temperature of the ablation element;

then, after a determination that the state of contact is that continuous tissue contact has been lost, initiating a reduction in the power supplied by the power source; and

when the ablation element regains continuous tissue contact; and

the state of regained continuous tissue contact has continued for at least three seconds, then initiating an increase in the power supplied by the power source.

2. The medical method of claim 1, wherein the tissue to be treated is cardiac tissue.

3. The medical method of claim 1, further comprising:

selecting a desired temperature of the ablation element; and

reducing the power to the ablation element when the monitored temperature exceeds the desired temperature.

4. The medical method of claim 1, further comprising:

selecting a maximum limit for the supplied power to the ablation element;

measuring the supplied power to the ablation element;

calculating the average power supplied to the ablation element; and

limiting the average power to the maximum threshold.

5. The medical method of claim 4, further comprising setting a maximum duty cycle equal to the current duty cycle value when the supplied power is at least equal to the maximum limit, and thereafter limiting the duty cycle value to the maximum duty cycle.

6. A medical method, comprising:

advancing an electrode of a medical device into contact with tissue to be treated;

delivering energy from an energy source to the electrode;

monitoring an instantaneous temperature of the electrode;

selecting a desired temperature and a threshold variation;

calculating an average temperature of the electrode during the energy delivery to the electrode;

calculating a difference between the instantaneous electrode temperature and the average electrode temperature;

calculating a continuity value by subtracting the difference from the desired temperature;

determining a state of contact between the electrode and the tissue and assigning a contact status, the contact status based on the continuity value and the threshold variation, a contact status of continuous contact being assigned when the continuity value is less than the threshold variation and a contact status of one of intermittent contact and no contact being assigned when the continuity value is greater than the threshold variation;

initiating a reduction in the energy delivered by the energy source when the contact status is one of intermittent contact and no contact;

then re-evaluating contact between the electrode and the tissue and re-assigning the contact status;

determining whether the contact status is continuous contact; and

when the contact status is continuous contact and has been continuous contact for at least three seconds, then initiating an increase in the energy delivered by the energy source.

7. The medical method of claim 6, wherein the threshold variation is substantially equal to 5 degrees.

8. The medical method of claim 6, further comprising selecting an increment, and calculating a reduction value by multiplying the continuity value by the increment, wherein reducing the desired temperature is performed by subtracting the reduction value from the desired temperature.

9. The medical method of claim 8, wherein the increment is substantially equal to 1 degree.

10. The medical method of claim 7, wherein the medical device has a plurality of electrodes, and wherein monitoring, delivering, calculating, and reducing are performed individually with respect to each electrode.

11. A medical method, comprising:

advancing an electrode of a medical device into contact with tissue to be treated;

monitoring a temperature of the electrode;

selecting a desired temperature and a threshold value;

delivering energy from an energy source at a duty cycle value to the electrode;

setting a duty cycle limit equal to an initial duty cycle value;

limiting the energy to a maximum of the duty cycle limit when the threshold value exceeds the temperature; and

after the temperature has exceeded the threshold value continuously for at least three seconds, then increasing the duty cycle limit.

12. The medical method of claim 11, wherein the threshold value is substantially equal to 50 degrees.