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

• US 9,833,641 B2
• Filed: 11/20/2015
• Issued: 12/05/2017
• 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): KISH, JAMES M
• Application Number:
  US14/947,294
• Publication Number:
  US 20160074679A1
• Time in Patent Office: 746 Days
• Field of Search: None
• 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 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart
• 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: A61B 8/5223 for extracting a diagnostic or physiological parameter from medical diagnostic data for algorithms to analyse biomedical images G06T7/0012
• CPC Class Codes: A61B 8/58 Testing, adjusting or calibrating the diagnostic device
• 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 7/022 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 for ablating tissue, said method comprising:

providing an elongate shaft having an ultrasound transducer adjacent a distal portion thereof;

positioning the ultrasound transducer adjacent a target tissue;

moving the ultrasound transducer over a surface of the target tissue;

sensing the target tissue with the ultrasound transducer;

calculating a motion of the target tissue relative to the ultrasound transducer;

measuring a distance between the ultrasound transducer and the surface of the target tissue;

generating a map of the surface of the target tissue based on the measured distance;

ablating the target tissue with a beam of ultrasound energy; and

adjusting the ablation based on the calculated motion and measured distance to form a continuous lesion in the target tissue.

2. The method of claim 1, wherein the beam of ultrasound energy is collimated.

3. The method of claim 1, wherein positioning the ultrasound transducer comprises advancing the elongate shaft into a left atrium of a heart.

4. The method of claim 1, wherein sensing the target tissue comprises sensing a portion of the beam of ultrasound energy which is reflected back from the target tissue.

5. The method of claim 1, wherein generating the map comprises running a diagnostic sweep of the target tissue prior to ablating the target tissue.

6. The method of claim 1, wherein adjusting the ablation comprises varying a speed of movement of the ultrasound transducer relative to the target tissue.

7. The method of claim 1, wherein adjusting the ablation comprises varying a dwell time of the beam of ultrasound energy in contact with the target tissue.

8. The method of claim 1, wherein adjusting the ablation comprises varying a power of the beam of ultrasound energy.

9. The method of claim 1, wherein moving the ultrasound transducer comprises rotating or translating the elongate shaft.

10. The method of claim 1, further comprising calculating an angle of incidence between the ultrasound transducer and the target tissue using at least three consecutive or closely-spaced distance measurements.

11. The method of claim 10, wherein the map indicates surface contours and angles of the target tissue.

12. The method of claim 10, further comprising adjusting the ablation based on the calculated angle of incidence.

13. The method of claim 1, wherein calculating the motion comprises repeatedly scanning a portion of the target tissue over a short time duration.

14. The method of claim 1, wherein adjusting the ablation comprises repositioning the ultrasound transducer relative to the target tissue.

15. The method of claim 1, wherein measuring the distance comprises removing a noise profile component from a sensed portion of the beam of ultrasound energy which is reflected back from the target tissue.

16. The method of claim 1, wherein sensing the target tissue comprises determining a thickness of the target tissue and further comprising adjusting the ablation based on the determined thickness.

17. The method of claim 1, wherein sensing the target tissue comprises determining properties of the target tissue after ablation thereof.

18. The method of claim 1, wherein the continuous lesion is tear-shaped such that a first diameter of the lesion at the tissue surface is smaller than a second diameter of the lesion deeper within the target tissue.

19. The method of claim 1, wherein the continuous lesion comprises a transmural lesion, and wherein adjusting the ablation comprises forming the transmural lesion without extending the lesion beyond an outer wall of the target tissue.

20. The method of claim 1, further comprising blocking aberrant electrical pathways in the tissue with the continuous lesion so as to reduce or eliminate fibrillation.