Systems and methods for assessing and treating tissue
First Claim
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1. A medical device, comprising:
- a first member having a proximal end configured to be electrically coupled to an energy source; and
a distal member disposed at a distal end of the first member, the distal member having a plurality of contact elements configured to deliver stimulating energy to tissue, detect electromyography (EMG) responses from the tissue to the stimulating energy, and deliver therapeutic energy to the tissue from only some of the plurality of contact elements based on the detected EMG responses from the tissue; and
a controller coupled to the distal member, the controller being configured to;
initiate delivery of stimulating energy from one or more of the contact elements to tissue proximate a target location;
receive electromyography (EMG) responses, from the distal member, of the tissue to the stimulating energy from one or more contact elements that are offset from the one or more of the contact elements used to deliver the stimulating energy;
determine one or more portions of the tissue for therapy based on the responses detected from the tissue to the stimulating energy;
initiate delivery of therapeutic energy from one or more of the contact elements to the one or more portions of tissue identified for therapy; and
initiate delivery of additional stimulating energy to a first location proximal to, and a second location distal to, the one or more portions of tissue to which the therapeutic energy was delivered after delivering the therapeutic energy, and initiate delivery of additional therapeutic energy to the one or more portions when stimulation at both the first location and the second location causes an EMG response greater than a threshold value.
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Abstract
A medical device including an elongate member having a proximal end configured to be electrically coupled to an energy source, and a distal member disposed at a distal end of the elongate member. The distal member may include a plurality of contact elements configured to deliver stimulating energy to innervated tissue, detect a response from the innervated tissue to the stimulating energy, and deliver therapeutic energy to the innervated tissue based on the response from the innervated tissue.
22 Citations
18 Claims
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1. A medical device, comprising:
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a first member having a proximal end configured to be electrically coupled to an energy source; and a distal member disposed at a distal end of the first member, the distal member having a plurality of contact elements configured to deliver stimulating energy to tissue, detect electromyography (EMG) responses from the tissue to the stimulating energy, and deliver therapeutic energy to the tissue from only some of the plurality of contact elements based on the detected EMG responses from the tissue; and a controller coupled to the distal member, the controller being configured to; initiate delivery of stimulating energy from one or more of the contact elements to tissue proximate a target location; receive electromyography (EMG) responses, from the distal member, of the tissue to the stimulating energy from one or more contact elements that are offset from the one or more of the contact elements used to deliver the stimulating energy; determine one or more portions of the tissue for therapy based on the responses detected from the tissue to the stimulating energy; initiate delivery of therapeutic energy from one or more of the contact elements to the one or more portions of tissue identified for therapy; and initiate delivery of additional stimulating energy to a first location proximal to, and a second location distal to, the one or more portions of tissue to which the therapeutic energy was delivered after delivering the therapeutic energy, and initiate delivery of additional therapeutic energy to the one or more portions when stimulation at both the first location and the second location causes an EMG response greater than a threshold value. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method of treating tissue comprising:
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positioning a medical device at a target location, the medical device having an expandable element and an array of contact elements; delivering stimulating energy from one or more of the contact elements to tissue proximate the target location; detecting electromyography (EMG) responses from the tissue to the stimulating energy from one or more contact elements that are offset from the one or more of the contact elements used to deliver the stimulating energy; determining one or more portions of the tissue for therapy based on the responses detected from the tissue to the stimulating energy; delivering therapeutic energy to the one or more portions of tissue identified for therapy; and delivering additional stimulating energy to a first location proximal to, and a second location distal to, the one or more portions of tissue to which the therapeutic energy was delivered after the step of delivering therapeutic energy, and applying additional therapeutic energy to the one or more portions when stimulation at both the first location and the second location causes an EMG response greater than a threshold value. - View Dependent Claims (9, 10, 11, 12, 13, 14, 15, 16)
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17. A method of treating lung tissue comprising:
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positioning a medical device at a target location within a first generation bronchus or a second generation bronchus of the lung, the medical device having an expandable element and an array of contact elements; delivering stimulating energy from one or more of the contact elements to innervated tissue proximate the target location; detecting electromyography (EMG) and electroneurography (ENG) responses from the innervated tissue to the stimulating energy from one or more contact elements that are circumferentially offset from the one or more of the contact elements used to deliver the stimulating energy; determining one or more portions of the innervated tissue for therapy based on the responses detected from the innervated tissue to the stimulating energy; delivering therapeutic energy to the one or more portions of innervated tissue identified for therapy from only some of the contact elements; delivering additional stimulating energy to a first location proximal to, and a second location distal to, the one or more portions of innervated tissue to which the therapeutic energy was delivered, after the step of delivering therapeutic energy; and applying additional therapeutic energy to the one or more portions when stimulation at both the first location and the second location causes an EMG or ENG response greater than a respective threshold value, wherein additional therapeutic energy is not delivered to the one or more portions of tissue when the additional stimulation at the first location causes an EMG or ENG response below the respective threshold value. - View Dependent Claims (18)
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Specification