Coaxial catheter instruments for ablation with radiant energy
First Claim
1. A cardiac ablation instrument comprising:
- a catheter body adapted for disposition within a heart having at least one lumen therein, which body can be deployed at a desired location within the heart; and
an energy emitter movable within a lumen of the catheter body such that it can be disposed at the desired location and deliver ablative energy to a target tissue site.
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Accused Products
Abstract
Ablation methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias and the like. Percutaneous ablation instruments in the form of coaxial catheter bodies are disclosed having at least one central lumen therein and having one or more balloon structures at the distal end region of the instrument. The instruments include an energy emitting element which is independently positionable within the lumen of the instrument and adapted to project radiant energy through a transmissive region of a projection balloon to a target tissue site. The instrument can optionally include at least one expandable anchor balloon disposed about, or incorporated into an inner catheter body designed to be slid over a guidewire. This anchor balloon can serve to position the device within a lumen, such as a pulmonary vein. A projection balloon structure is also disclosed that can be slid over the first (anchor balloon) catheter body and inflated within the heart, to define a staging from which to project radiant energy. An ablative fluid can also be employed outside of the instrument (e.g., between the balloon and the target region) to ensure efficient transmission of the radiant energy when the instrument is deployed. In another aspect of the invention, generally applicable to a wide range of cardiac ablation instruments, mechanisms are disclosed for determining whether the instrument has been properly seated within the heart, e.g., whether the device is in contact with a pulmonary vein and/or the atrial surface, in order to form a lesion by heating, cooling or projecting energy. This contact-sensing feature can be implemented by an illumination source situated within the instrument and an optical detector that monitors the level of reflected light. Measurements of the reflected light (or wavelengths of the reflected light) can thus be used to determine whether contact has been achieved and whether such contact is continuous over a desired ablation path.
332 Citations
78 Claims
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1. A cardiac ablation instrument comprising:
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a catheter body adapted for disposition within a heart having at least one lumen therein, which body can be deployed at a desired location within the heart; and
an energy emitter movable within a lumen of the catheter body such that it can be disposed at the desired location and deliver ablative energy to a target tissue site. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A cardiac ablation instrument comprising:
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a catheter body adapted for disposition within a heart having at least one lumen therein; and
a contact sensing element movable within a lumen of the catheter body such that it can be disposed at various locations to detect reflected radiant energy and, based on the reflected energy, select a desired location for forming a lesion. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40)
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41. A cardiac ablation instrument comprising:
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a first catheter body adapted for disposition within a heart having at least one lumen therein and comprising at least one anchorage element which can be deployed at the desired location to contact a cardiac structure and secure the device in place; and
a radiant energy emitter movable within a lumen of the first catheter body such that it can be disposed at the desired location and deliver radiant energy through a transmissive region of the instrument to a target tissue site. - View Dependent Claims (42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55)
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56. A method of ablating cardiac tissue, comprising:
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positioning a guide wire in proximity to a target region of cardiac tissue;
coupling a first catheter having at least one lumen to the positioned guide wire via the lumen such that the first catheter can be passed over the guide wire into a position within the heart;
removing the guide wire and replacing it with a radiant energy emitter slidable movable within a lumen of the first catheter such that it can be disposed at the desired location; and
activating the radiant energy emitter to deliver radiant energy through a transmissive region of the first catheter to the target tissue region to ablate tissue and form a conduction block. - View Dependent Claims (57, 58, 59, 60, 61, 62, 63, 64, 65, 66)
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67. A method of treating atrial fibrillation, comprising:
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positioning a distal portion of an ablation instrument in proximity to one or more pulmonary veins, the instrument having a hollow housing and an independently positionable energy emitter within the distal portion, the distal portion being transmissive to radiant energy; and
activating the energy emitter to transmit energy through the housing to form an annular lesion in proximity to the one or more pulmonary veins. - View Dependent Claims (68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78)
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Specification