Catheter with coronary sinus ostium anchor

• US 9,655,666 B2
• Filed: 10/29/2010
• Issued: 05/23/2017
• Est. Priority Date: 10/29/2010
• Status: Active Grant

• Current Assignee: Medtronic Ablation Frontiers LLC (Medtronic Plc)
• Original Assignee: Medtronic Ablation Frontiers LLC (Medtronic Plc)
• Inventors: Thompson-Nauman, Amy E., Markowitz, H. Toby
• Primary Examiner(s): Stoklosa, Joseph
• Assistant Examiner(s): KIM, EUN HWA
• Application Number:
  US12/915,327
• Publication Number:
  US 20120108953A1
• Time in Patent Office: 2,398 Days
• Field of Search: 606 41
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• 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 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00273 Anchoring means for temporary attachment of a device to tissue
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence

Abstract

A method of treating cardiac tissue is provided, including positioning a first chamber of a medical device adjacent an atrial wall; directing a cryogenic coolant into the first chamber; anchoring the first chamber to the atrial wall through cryoadhesion; directing a distal portion of the medical device into the coronary sinus; and positioning a cardiac lead through at least a portion of the coronary sinus with the distal portion. The method may include measuring a temperature of the first chamber; removing the first chamber from the atrial wall once a predetermined threshold temperature of the first chamber is reached; anchoring a second chamber of the medical device to a portion of the coronary sinus; and/or perfusing blood flow through at least a portion of the second chamber.

Claims

1. A method of operating a medical device in a patient, comprising:

positioning an inflatable first chamber of a medical device adjacent a first tissue region, the first tissue region including cardiac tissue, the inflatable first chamber including an expandable portion that is electrically conductive, the expandable portion being configured to be expanded to a maximum cross-sectional diameter of the inflatable chamber when the medical device is in use;

directing a cryogenic coolant through a first fluid flow path into the inflatable first chamber to expand the expandable portion of the inflatable first chamber;

positioning an inflatable second chamber of the medical device adjacent a second tissue region, the second tissue region including a portion of the coronary sinus, the inflatable second chamber including an expandable portion that is configured to be expanded to a maximum cross-sectional diameter of the inflatable second chamber when the medical device is in use;

directing a cryogenic coolant through a second fluid flow path into the inflatable second chamber to expand the expandable portion of the inflatable second chamber;

anchoring the expanded inflatable first chamber to the first tissue region through cryoadhesion and anchoring the expanded inflatable second chamber to the second tissue region through cryoadhesion;

positioning at least one of a diagnostic element and a therapeutic element of the medical device adjacent a third tissue region;

operating the at least one of a diagnostic element and therapeutic element proximate to the third tissue region; and

obtaining positional information from the expandable electrically conductive portion of the inflatable first chamber and transmitting the positional information from the electrically conductive portion of the inflatable first chamber to a position sensing system.

2. The method of claim 1, wherein the at least one of a diagnostic element and therapeutic element includes a thermal ablation element, and wherein operating the ablation element includes ablating at least a portion of the third tissue region.

3. The method of claim 1, wherein positioning the at least one of a diagnostic element and therapeutic element includes moving the at least one of a diagnostic element and therapeutic element with respect to the inflatable first chamber.

4. The method of claim 1, wherein the at least one of a diagnostic element and therapeutic element includes a cardiac lead.

5. The method of claim 1, further comprising measuring a temperature of the inflatable first chamber.

6. The method of claim 1, further comprising:

obtaining positional information from the at least one of a diagnostic element and a therapeutic element; and

storing the positional information.

7. The method of claim 6, wherein obtaining positional information from the at least one of a diagnostic element and a therapeutic element includes at least one of:

conducting a current through the at least one of a diagnostic element and a therapeutic element; and

measuring a voltage with the at least one of a diagnostic element and a therapeutic element.

8. The method of claim 7, wherein obtaining positional information from the at least one of a diagnostic element and a therapeutic element includes determining an impedance between i) the at least one of a diagnostic element and a therapeutic element and ii) a reference electrode positioned about the patient.

9. The method of claim 7, further comprising:

registering the obtained positional information to a historical positional information set.

10. The method of claim 1, wherein obtaining positional information from the inflatable first chamber includes at least one of:

conducting a current through at least a portion of the inflatable first chamber; and

measuring a voltage with at least a portion of the inflatable first chamber.

11. The method of claim 10, wherein obtaining positional information from the inflatable first chamber includes determining an impedance between the expandable portion of the inflatable first chamber and a reference electrode located proximate to the patient.

12. A method of treating a patient, comprising:

performing a first procedure, the first procedure including;

positioning a first chamber of a first medical device adjacent a first tissue region, the first chamber including an expandable portion that is electrically conductive;

expanding the expandable portion of the first chamber to a maximum diameter of the first chamber such that the expandable portion of the first chamber is in contact with the first tissue region;

positioning a second chamber of the first medical device adjacent a second tissue region, the second chamber including an expandable portion and one or more perfusion apertures;

expanding the expandable portion of the second chamber to a maximum cross-sectional diameter of the second chamber such that the expandable portion of the second chamber is in contact with the second tissue region;

anchoring the first chamber to the first tissue region through cryoadhesion and anchoring the second chamber to the second tissue region through cryoadhesion;

positioning at least one of a diagnostic element and a therapeutic element of the first medical device adjacent a third tissue region different from the first and second tissue regions;

operating the at least one of a diagnostic element and therapeutic element proximate to the third tissue region;

obtaining positional information from the expandable electrically conductive portion of the first chamber and the at least one of a diagnostic element and a therapeutic element;

generating a first map based on the positional information; and

performing a second procedure, the second procedure including;

positioning the first chamber of the first medical device adjacent a fourth tissue region, the second tissue region and the fourth tissue region being substantially co-located;

expanding the expandable portion of the first chamber to the maximum cross-sectional diameter of the first chamber such that the expandable portion of the first chamber is in contact with the fourth tissue region;

positioning the second chamber of the first medical device adjacent a fifth tissue region;

expanding the expandable portion of the second chamber to the maximum cross-sectional diameter of the second chamber such that the expandable portion of the second chamber is in contact with the fifth tissue region;

anchoring the first chamber to the fourth tissue region through cryoadhesion and anchoring the second chamber to the fifth tissue region through cryoadhesion;

positioning the at least one of a diagnostic element and a therapeutic element adjacent a sixth tissue region different from the fourth and fifth regions;

operating the at least one of a diagnostic element and therapeutic element proximate to the sixth tissue region;

obtaining positional information from the electrically conductive portion of the first chamber at the at least one of a diagnostic element and a therapeutic element;

generating a second map based on the positional information; and

registering the second map to the first map.

13. A method of treating cardiac tissue, comprising:

directing a distal portion of a medical device into a coronary sinus, the medical device including a first chamber and a second chamber;

positioning the first chamber of the medical device adjacent an atrial wall, the first chamber including an expandable portion that is electrically conductive and configured to be expanded to a maximum cross-sectional diameter of the first chamber when the device is in use;

directing a cryogenic coolant into the first chamber;

anchoring the first chamber to the atrial wall through cryoadhesion;

positioning the second chamber of the medical device adjacent a tissue region in the coronary sinus, the second chamber including an expandable portion that is configured to be expanded to a maximum cross-sectional diameter of the second chamber when the medical device is in use;

directing a cryogenic coolant into the second chamber;

anchoring the second chamber to the tissue region in the coronary sinus through cryoadhesion;

positioning an implantable cardiac lead through at least a portion of the coronary sinus with the distal portion of the medical device; and

transmitting positional data from the electrically conductive portion of the first chamber to a position sensing system.