System and method for assessing transmurality of ablation lesions

• US 20010039415A1
• Filed: 04/26/2001
• Published: 11/08/2001
• Est. Priority Date: 04/27/2000
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Keogh, James R., Jahns, Scott E., Francischelli, David E.
• Granted Patent: US 6,584,360 B2
• Time in Patent Office: Days
• US Class Current: 606/27
• 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 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• 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 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00088 using thermistors
• CPC Class Codes: A61B 2017/00092 using thermocouples
• CPC Class Codes: A61B 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• CPC Class Codes: A61B 2017/00203 with speech control or speech recognition
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00738 : Depth, e.g. depth of ablation
• CPC Class Codes: A61B 2018/00761 : Duration
• CPC Class Codes: A61B 2018/00791 : Temperature
• 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 2018/0091 : Handpieces of the surgical instrument or device
• CPC Class Codes: A61B 2018/0262 : using a circulating cryogenic fluid
• CPC Class Codes: A61B 5/015 : By temperature mapping of body part
• CPC Class Codes: A61B 5/411 : Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance

Abstract

A device for monitoring temperature generated by an ablation apparatus on organic tissue is provided. The device comprises a temperature sensing pad; and an output device to receive and display a representation of a lesion found on the ablated organic tissue. Ablation systems incorporating the device and methods of using the device are also provided.

Claims

1. A sensing apparatus for monitoring temperature generated by an ablation apparatus on organic tissue, comprising:

a temperature-sensing pad; and

an output device in communication with the pad, the output device operatively adapted to receive and display a representation of a lesion found on the organic tissue.

2. The apparatus of

claim 1

wherein the pad comprises temperature-sensing elements incorporated therein.

3. The apparatus of

claim 2

wherein the temperature-sensing elements are arranged in a grid pattern.

4. The apparatus of

claim 3

wherein the output device displays a representation of the grid pattern.

5. The device of

claim 1

wherein the output device includes a processor for processing a signal received from the temperature-sensing pad.

6. The device of

claim 1

wherein the output device includes an amplifier for amplifying a signal received from the temperature-sensing pad.

7. The apparatus of

claim 2

wherein the temperature-sensing elements are thermocouples.

8. The apparatus of

claim 2

wherein the temperature-sensing elements are thermisters.

9. The apparatus of

claim 2

wherein the temperature-sensing elements are temperature-sensing liquid crystals.

10. The apparatus of

claim 2

wherein the temperature-sensing elements are temperature-sensing chemicals.

11. The apparatus of

claim 2

wherein the temperature-sensing elements are operatively adapted to be located within the tissue.

12. The apparatus of

claim 1

wherein the pad is mounted on a glove.

13. The apparatus of

claim 1

wherein the pad is formed as a portion of a glove.

14. The apparatus of

claim 1

wherein the pad is operatively adapted to be fitted over a finger.

15. The apparatus of

claim 1

wherein the pad further comprises a conductive element incorporated therein.

16. The apparatus of

claim 1

wherein the output device comprises a visual display on a monitor.

17. The apparatus of

claim 1

wherein the output device comprises a visual display on the pad.

18. A system for assessing transmurality of an ablation in a tissue comprising:

an ablation apparatus operatively adapted to ablate a first side of the tissue;

a temperature-sensing pad operatively adapted to sense temperature along a second side of the tissue; and

an output device in communication with the pad, the output device operatively adapted to indicate the temperature of the tissue.

19. The system of

claim 18

wherein the pad comprises temperature-sensing elements incorporated therein.

20. The system of

claim 18

wherein the temperature of the tissue indicated by the output device corresponds to transmurality of the lesion.

21. A method of ablating organic tissue comprising the steps of:

providing a temperature-sensing pad operatively adapted to sense a temperature of the tissue and an output device in communication with the pad, the output device operatively adapted to display a representation of a lesion found on a back side of the tissue;

positioning the pad against a back side of the tissue;

ablating the tissue with an ablation apparatus against a front side of the tissue;

sensing the temperature changes of the ablated tissue with the pad; and

ablating the tissue in accordance with the temperature changes.

22. The method of

claim 21

further comprising:

viewing the representation of the lesion; and

correlating the temperature changes of the ablated tissue with the representation of the lesion.

23. An apparatus for monitoring temperature generated by an ablation apparatus on organic tissue comprising:

a temperature sensing pad incorporating a plurality of temperature-sensing liquid crystals therein; and

an output device in communication with the pad, the output device operatively adapted to receive and display a representation of a lesion found on the organic tissue.

24. The apparatus of

claim 23

wherein the representation comprises a color scheme in which each color indicates a temperature.

25. An apparatus for monitoring temperature generated by an ablation apparatus on organic tissue comprising:

a finger pad comprising a plurality of temperature-sensing elements therein, the finger pad formed to conform to a finger; and

an output device in communication with the finger pad, the output device operatively adapted to receive and display a representation of a lesion found on the organic tissue.

26. The device of

claim 25

wherein the output device is the finger pad, the finger pad operatively adapted to receive and display a representation of a lesion found on the organic tissue.

27. A system for assessing transmurality of an ablation in a tissue comprising:

an ablation apparatus operatively adapted to ablate a first side of the tissue;

a temperature-sensing pad operatively adapted to sense temperature along a second side of the tissue;

a conductive element attached to the pad; and

an output device in communication with the pad, the output device operatively adapted to indicate the temperature of the tissue.

28. An ablation system for creating a tissue ablation site, the system comprising:

an energy source;

an ablation device operatively coupled to the energy source, the ablation device comprising one or more energy transfer elements positioned along a tissue contact surface of the ablation device; and

a sensor device operatively coupled to the energy source, the sensor device including a sensor adapted to sense a temperature parameter relating to the tissue ablation site, the sensor device having a tissue contact surface, one or more suction openings positioned along the tissue contact surface of the sensor device, and a suction conduit for providing suction from a suction source to the one or more suction openings, the suction conduit being operatively connected with the one or more suction openings.

29. The system of

claim 28

wherein the ablation device further comprises one or more suction openings positioned along the tissue contact surface and a suction conduit for providing suction from a suction source to the one or more suction openings, the suction conduit operatively connected with the one or more suction openings.

30. The system of

claim 28

wherein the ablation device further comprises an irrigation fluid conduit for providing irrigation fluid from an irrigation source to the tissue ablation site.

31. The system of

claim 30

wherein the irrigation fluid is an energy-conducting liquid.

32. The system of

claim 30

wherein the irrigation fluid comprises one or more diagnostic or therapeutic agents.

33. The system of

claim 30

wherein the sensor further comprises a means for varying irrigation fluid supplied to the irrigation conduit in response to the sensed temperature parameter.

34. The system of

claim 28

wherein the ablation device further comprises a maneuvering apparatus operatively connected with the tissue contact surface of the ablation device for maneuvering the energy transfer element.

35. The system of

claim 34

wherein the maneuvering apparatus includes at least one pull wire.

36. The system of

claim 34

wherein the maneuvering apparatus includes a handle.

37. The system of

claim 36

wherein the handle comprises one or more hinges or joints.

38. The system of

claim 37

wherein the one or more hinges or joints are actuated remotely.

39. The system of

claim 36

wherein the handle is shapeable.

40. The system of

claim 28

wherein the sensor device further comprises a maneuvering apparatus operatively connected with the tissue contact surface of the sensor device for maneuvering the sensor.

41. The system of

claim 40

wherein the maneuvering apparatus includes at least one pull wire.

42. The system of

claim 40

wherein the maneuvering apparatus includes a handle.

43. The system of

claim 42

wherein the handle comprises one or more hinges or joints.

44. The system of

claim 43

wherein the one or more hinges or joints are actuated remotely.

45. The system of

claim 42

wherein the handle is shapeable.

46. The system of

claim 28

wherein the sensor device further comprises an output device for alerting or informing a practitioner regarding the temperature parameter relating to the tissue ablation site sensed by the sensor device.

47. The system of

claim 28

further comprising a generator operatively connected to the energy source.

48. The system of

claim 47

wherein the generator includes a control unit or processor.

49. The system of

claim 28

wherein the energy source is an RF energy source.

50. The system of

claim 28

wherein the energy source is an electrical energy source.

51. The system of

claim 28

wherein the energy source is a laser energy source.

52. The system of

claim 28

wherein the energy source is a thermal energy source.

53. The system of

claim 28

wherein the energy source is a microwave energy source.

54. The system of

claim 28

wherein the energy source is an ultrasound energy source.

55. The system of

claim 28

further comprising a means for varying energy supplied by the energy source to the energy transfer elements in response to the sensed temperature parameter.