SYSTEMS AND METHODS OF PHOTODYNAMIC-BASED CARDIAC ABLATION VIA THE ESOPHAGUS

• US 20090171331A1
• Filed: 12/29/2008
• Published: 07/02/2009
• Est. Priority Date: 12/31/2007
• Status: Active Grant

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Inventors: Byrd, Isreal A., Paul, Saurav
• Granted Patent: US 7,996,078 B2
• Time in Patent Office: Days
• US Class Current: 606/14
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61N 5/0601 Apparatus for use inside the body
• CPC Class Codes: A61N 5/062 Photodynamic therapy, i.e. excitation of an agent

Abstract

Systems and methods for photodynamic ablation of cardiac tissue via an esophagus are disclosed. An exemplary system includes an ablation catheter having an expandable distal end for securing the ablation catheter in the esophagus. The distal end of the ablation catheter contains at least one light source operable to activate a photodynamic substance delivered to the target area of the cardiac tissue to be ablated and form a lesion. The system also includes at least one feedback device contained in the distal end of the ablation catheter. The at least one feedback device provides feedback for at least one of: positioning a distal end of an ablation catheter in a desired position in the esophagus adjacent a target area of the cardiac tissue to be ablated, forming an adequate lesion, and assessing lesion formation.

Claims

1. A system for photodynamic ablation of cardiac tissue via an esophagus, comprising:

an ablation catheter having an expandable distal end for securing the ablation catheter in the esophagus, the distal end containing at least one light source operable to activate a photodynamic substance delivered to the target area of the cardiac tissue to be ablated and form a lesion;

at least one feedback device contained in the distal end of the ablation catheter, the at least one feedback device providing feedback for at least one of;

positioning a distal end of an ablation catheter in a desired position in the esophagus adjacent a target area of the cardiac tissue to be ablated, assessing tissue contact, forming an adequate lesion, and assessing lesion formation.

2. The system of claim 1, wherein the feedback for positioning the ablation catheter in the esophagus includes tissue sensing data.

3. The system of claim 2, wherein the tissue sensing data includes output from surface electrodes at the distal end of the ablation catheter.

4. The system of claim 2, wherein the tissue sensing data includes output from piezoelectric sensors at the distal end of the ablation catheter.

5. The system of claim 2, wherein the tissue sensing data includes pressure data from a fluid used to expand the distal end of the ablation catheter.

6. The system of claim 1, further comprising a control unit configured to automatically expand the distal end of the ablation catheter to secure the ablation catheter in the esophagus;

and

7. The system of claim 6, wherein the control unit is further configured to automatically stop expanding the distal end of the ablation catheter when the distal end of the ablation catheter is sufficiently secured in the esophagus.

8. The system of claim 1, wherein the feedback for forming an adequate lesion includes concentration of the photodynamic substance sensed at the distal end of the ablation catheter.

9. The system of claim 8, wherein the concentration of the photodynamic substance corresponds to magnetic markers sensed at the distal end of the ablation catheter.

10. The system of claim 1, wherein the feedback for assessing lesion formation is from thermocouples on the distal end of the ablation catheter.

11. The system of claim 1, wherein the feedback for assessing lesion formation is from movement of radiopaque markers sensed at the distal end of the ablation catheter.

12. A system for photodynamic ablation of cardiac tissue via an esophagus, comprising:

means for securing an ablation catheter in the esophagus;

means for providing feedback for positioning a distal end of the ablation catheter in a desired position in the esophagus adjacent a target area of the cardiac tissue to be ablated;

means for providing feedback for forming an adequate lesion means for activating a photodynamic substance from the ablation catheter and delivered to the target area of the cardiac tissue to be ablated to form a lesion; and

means for providing feedback for assessing lesion formation.

13. The system of claim 12, further comprising:

means for automatically expanding the distal end of the ablation catheter to secure the ablation catheter in the esophagus; and

means for automatically stopping the expanding based on the feedback for positioning to reduce or eliminate damage to the esophagus.

14. A method for photodynamic ablation of cardiac tissue via an esophagus, comprising:

providing feedback for positioning a distal end of an ablation catheter in a desired position in the esophagus adjacent a target area of the cardiac tissue to be ablated; and

securing the distal end of the ablation catheter in the esophagus in the desired position in the esophagus, and then actuating a light source in the ablation catheter to activate a photodynamic substance delivered to the target area of the cardiac tissue to be ablated.

15. The method of claim 14, wherein the feedback for positioning the ablation catheter in the esophagus includes tissue sensing data.

16. The method of claim 15, wherein the tissue sensing data includes output from surface electrodes at the distal end of the ablation catheter.

17. The method of claim 15, wherein the tissue sensing data includes output from piezoelectric sensors at the distal end of the ablation catheter.

18. The method of claim 15, wherein the tissue sensing data includes pressure data from a fluid used to expand the distal end of the ablation catheter.

19. The method of claim 14, further comprising:

automatically expanding the distal end of the ablation catheter to secure the ablation catheter in the esophagus, and

automatically stopping the expanding based on the feedback for positioning to reduce or eliminate damage to the esophagus.

20. The method of claim 14, further comprising providing feedback for forming an adequate lesion.

21. The method of claim 20, wherein the feedback for forming an adequate lesion includes concentration of the photodynamic substance sensed at the distal end of the ablation catheter.

22. The method of claim 21, wherein the concentration of the photodynamic substance corresponds to markers sensed at the distal end of the ablation catheter.

23. The method of claim 22, wherein the markers are magnetic particles.

24. The method of claim 14, further comprising providing feedback for assessing lesion formation.

25. The method of claim 24, wherein the feedback for assessing lesion formation is from thermocouples on the distal end of the ablation catheter.

26. The method of claim 24, wherein the feedback for assessing lesion formation is from movement of markers sensed at the distal end of the ablation catheter.

27. The method of claim 26, wherein the markers are radiopaque particles.