Electrophysiology system and methods

• US 9,757,191 B2
• Filed: 09/26/2014
• Issued: 09/12/2017
• Est. Priority Date: 01/10/2012
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Avitall, Boaz, Koblish, Josef V.
• Primary Examiner(s): FOWLER, DANIEL WAYNE
• Application Number:
  US14/498,211
• Publication Number:
  US 20150011995A1
• Time in Patent Office: 1,082 Days
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/00904 Automatic detection of target tissue
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/4887 Locating particular structures in or on the body
• CPC Class Codes: A61B 5/6852 Catheters

Abstract

An electrophysiology system comprises an ablation catheter, a radiofrequency generator, and a mapping processor. The ablation catheter has a tissue ablation electrode and a plurality of microelectrodes distributed about the circumference of the tissue ablation electrode and electrically isolated therefrom. The plurality of microelectrodes define a plurality of bipolar microelectrode pairs. The mapping processor is configured to acquire output signals from the bipolar microelectrode pairs, compare the output signals, and generate an output to a display providing a visual indication of a characteristic of the microelectrodes and the tissue ablation electrode relative to myocardial tissue to be mapped and/or ablated.

Claims

1. An electrophysiology method comprising:

advancing a distal portion of an ablation catheter intravascularly to a location proximate myocardial tissue within a chamber of a heart, the distal portion of the ablation catheter including;

a tissue ablation electrode configured to apply ablation energy to the myocardial tissue;

a plurality of microelectrodes circumferentially distributed about the tissue ablation electrode and electrically isolated therefrom, the plurality of microelectrodes defining a plurality of bipolar microelectrode pairs, each bipolar microelectrode pair configured to generate an output signal based on a cardiac activation signal;

acquiring the output signals from each of the bipolar microelectrode pairs;

comparing an amplitude of the output signal from each of the bipolar microelectrode pairs to the amplitudes of the output signals from the other of the plurality of bipolar microelectrode pairs; and

displaying to a clinician a visual indication of a proximity of the tissue ablation electrode to the myocardial tissue, the visual indication including;

an indication that the tissue ablation electrode is in contact with the myocardial tissue if, based on the comparison between the amplitudes of the output signals, a difference between the amplitude of any one of the output signals and the amplitude of any one or more of the other output signals exceeds a predetermined threshold; and

an indication that the tissue ablation electrode is not in contact with the myocardial tissue if, based on the comparison between the amplitudes of the output signals, the difference between the amplitude of any one of the output signals and the amplitude of any one or more of the other output signals does not exceed a predetermined threshold.

2. The method of claim 1, wherein the acquiring and comparing steps are performed by a mapping processor operatively coupled to the microelectrodes.

3. The method of claim 1, wherein the plurality of microelectrodes include three microelectrodes defining first, second and third bipolar microelectrode pairs.

4. The method of claim 3, wherein the three microelectrodes are disposed at the same longitudinal position along the tissue ablation electrode.

5. The method of claim 4, further comprising displaying to the clinician a visual indication of an orientation of the tissue ablation electrode relative to the myocardial tissue based on the amplitudes of the output signals from the first, second and third bipolar microelectrode pairs.

6. The method of claim 5, wherein the ablation catheter further comprises a plurality of irrigation ports in the tissue ablation electrode fluidly and operatively coupled to an irrigation fluid reservoir and pump.

7. The method of claim 1, wherein the ablation catheter further includes a proximal handle having a control element for manipulation by a user, and wherein advancing the distal portion of the ablation catheter includes manipulating the control element to deflect the distal portion for positioning the tissue ablation electrode adjacent to the myocardial tissue.

8. An electrophysiology method comprising:

acquiring signals indicative of bioelectrical cardiac activity from bipolar pairs of microelectrodes of a plurality of microelectrodes, the plurality of microelectrodes circumferentially distributed around a tissue ablation electrode and electrically isolated therefrom, the tissue ablation electrode mounted on a catheter and configured to apply ablation energy to the myocardial tissue;

comparing an amplitude of the signal from each of the bipolar microelectrode pairs to the amplitudes of the signals from the other of the plurality of bipolar microelectrode pairs; and

displaying to a clinician a visual indication of a proximity of the tissue ablation electrode to the myocardial tissue, the visual indication including;

an indication that the tissue ablation electrode is in contact with the myocardial tissue if, based on the comparison between the amplitudes of the output signals, a difference between the amplitude of any one of the output signals and the amplitude of any one or more of the other output signals exceeds a predetermined threshold; and

an indication that the tissue ablation electrode is not in contact with the myocardial tissue if, based on the comparison between the amplitudes of the output signals, the difference between the amplitude of any one of the output signals and the amplitude of any one or more of the other output signals does not exceed a predetermined threshold.

9. The method of claim 8, wherein the acquiring and comparing steps are performed by a mapping processor operatively coupled to the microelectrodes.

10. The method of claim 8, wherein the plurality of microelectrodes include three microelectrodes defining first, second and third bipolar microelectrode pairs.

11. The method of claim 10, wherein the three microelectrodes are disposed at the same longitudinal position along the tissue ablation electrode.

12. The method of claim 11, further comprising displaying to the clinician a visual indication of an orientation of the tissue ablation electrode relative to the myocardial tissue based on the amplitudes of the output signals from the first, second and third bipolar microelectrode pairs.

13. The method of claim 8, wherein the ablation catheter further comprises a plurality of irrigation ports in the tissue ablation electrode fluidly and operatively coupled to an irrigation fluid reservoir and pump.