CA2638963C - Coiled ablation catheter system - Google Patents

Coiled ablation catheter system

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Publication number
CA2638963C
CA2638963C CA 2638963 CA2638963A CA2638963C CA 2638963 C CA2638963 C CA 2638963C CA 2638963 CA2638963 CA 2638963 CA 2638963 A CA2638963 A CA 2638963A CA 2638963 C CA2638963 C CA 2638963C
Authority
CA
Grant status
Grant
Patent type
Prior art keywords
sheath
ablating element
system
shape
ablating
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CA 2638963
Other languages
French (fr)
Other versions
CA2638963A1 (en )
Inventor
David Keane
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
General Hospital Corp
Original Assignee
General Hospital Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Grant date

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/88Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements formed as helical or spiral coils
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00059Material properties
    • A61B2018/00071Electrical conductivity
    • A61B2018/00083Electrical conductivity low, i.e. electrically insulating
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00107Coatings on the energy applicator
    • A61B2018/00136Coatings on the energy applicator with polymer
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • A61B2018/00375Ostium, e.g. ostium of pulmonary vein or artery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1435Spiral
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1497Electrodes covering only part of the probe circumference
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2002/821Ostial stents

Abstract

A cardiac ablation catheter (100) includes a coil-like ablating element (102) this is deployed from an elongate, flexible sheath (104). The ablating element (102), while in the deployed position, has a shape with at least one revolution oriented in a plane that is orthogonal to a longitudinal axis (108) of the sheath. The catheter system (100) is well-situated to ablate a circumferential region of tissue about a pulmonary vein or the posterior wall of the left atrium proximate the pulmonary vein os. The treated tissue regional electrically isolates the atria from the pulmonary vein.

Description

COILED ABLATION CATHETER SYSTEM
RELATED APPLICATIONS
This application is a division of Canadian patent application serial No.

2,388,823 filed 11 September 2000, and which has been filed as the Canadian national phase application corresponding to International application No. PCT/US2000/024836 having an International filing date of 11 September 2000.

FIELD OF THE INVENTION
The present invention relates generally to catheter systems, and more particularly, to catheter systems for ablating and/or isolating foci that contribute to cardiac arrhythmia.
BACKGROUND OF THE INVENTION
Catheters are commonly used in surgical procedures to access certain areas of a patient's body without resorting to invasive surgical procedures. For example, catheters are widely used in the field of cardiology to conduct electrophysiological studies in which electrical potentials within the heart are mapped to determine the cause and location of arrhythmia. In many cases, certain undesired conductive pathways, known as foci, contribute to and cause the arrhythmia. Once the location of foci is identified, elements on or within the catheter can be utilized to ablate or isolate the foci, thus eliminating the arrhythmia.
One form of arrhythmia is atrial fibrillation, which is an uncoordinated contraction of the heart muscle within the atrium. Atrial fibrillation results from rapidly discharging foci and causes irregular heart beats, possibly leading to inefficient pumping of blood. In a significant number of patients, the foci that contribute to this condition are located within the pulmonary vein, adjacent to the atrium. These foci may be in the form of scattered groups of rapidly discharging cells. Treatment of this condition can sometimes be effective through the ablation of these foci.
However, identifying the location of these foci and effecting the ablative treatment of the foci can be time consuming and difficult.
A variety of cardiac mapping and ablation catheter systems are well known in the art.

For example, U.S. Patent No. 5,476,495 (Kordis et al.) discloses a steerable catheter system that is able to conduct cardiac mapping and ablation. U.S. Patent No.
5,507,743 (Edwards et al.) discloses a radio frequency (RF) treatment apparatus that includes a RF
electrode that assumes a helical orientation upon deployment. U.S. Patent No.
5,738,683 (Osypka) discloses a cardiac mapping/ablation catheter that includes an electrode that may be deployed in the shape of a loop. U.S. Patent No. 5,782,879 (Imran) discloses an endocardial mapping and ablation system in which the catheter includes a deployable distal extremity, in the form of a cage-like member that includes a plurality of electrodes.

Despite the existence of these references and existing ablation catheter systems, there exists a need to provide a system that is able to effectively treat atrial fibrillation conditions that are caused by foci present within the pulmonary vein.

SUMMARY OF THE INVENTION

The present invention provides a cardiac catheter system for ablating tissue to electrically isolate certain tissue from arrhythmia-inducing foci. Although the invention is primarily shown and described as a cardiac catheter system for ablating tissue with RF
energy, it is understood that the system has other applications and embodiments as well.
For example, other types of energy, such as microwave, laser, cryogenic, and ultrasonic energy, can be used without departing from the scope of the invention.

In one embodiment, a cardiac ablation catheter system includes an elongate, flexible sheath having an internal lumen and an open distal end. An ablating element is disposed within the sheath and is selectively deployable therefrom so as to project from the sheath in a substantially coil-like shape. In an exemplary embodiment, the deployed ablating element has a geometry forming at least one revolution for generating a circumferential lesion within a vessel, such as a pulmonary vein. In general, the ablating element is oriented in a plane that is substantially orthogonal to the longitudinal axis of the sheath in the deployed position to facilitate the formation of a lesion about the vein inner wall circumference.

The catheter system can include a variety of mechanisms for deploying the ablation member from the catheter. In one embodiment, the ablation member is released from a distal end of the catheter such that it assumes a predetermined shape. In another embodiment, the catheter includes a hatch or port from which the ablation member is selectively deployed. In a further embodiment, the elongate member includes a distal end affixed to a support member that is extendable from the catheter distal end.
By rotating and/or longitudinally displacing the support member, the ablation member can be deployed such it assumes a desired size.

To ablate or isolate the target foci tissue, the catheter is manipulated through the arterial network until the catheter is located proximate the desired treatment site. For example, the treatment site may be a location within the pulmonary vein or left atrium at or near the pulmonary vein os or in the right ventricular outflow tract, such as at the junction of the right atrium and superior vena cava. The ablating element is then deployed from the catheter such that the coil-like ablating element is generally oriented in a plane orthogonal to the longitudinal axis of the sheath. The deployed ablating element should be in contact with tissue about the circumference of the vein inner wall, such as at the os.
The ablation element is then energized to ablate the target tissue to electrically isolate the foci from healthy tissue on the opposite side of the formed lesion. The atria, for example, can be electrically isolated from a treated pulmonary vein by creating a circumferential lesion on the inner wall of the left atrium or in the pulmonary vein proximate the os.

Accordingly, in one aspect the present invention resides in an ablative stent device comprising: a self-expanding stent adapted to be implanted and deployed within a vessel to provide circumferential support of the vessel; said stent including a proximal portion having a first diameter and an ablation region along at least a portion of its length, the ablation region being adapted for surface contact with the vessel and the ablation region subtending at least a substantially complete circumferential band and being effective to ablate a signal-blocking path within the vessel upon application of energy to the stent, the stent further including a distal portion having a second diameter that is less than the first diameter and that is sufficient to enable the stent to seat within the vessel.

In another aspect, the present invention resides in a catheter for use in ablating a selected region of body tissue, comprising:

(a) the catheter comprising:

an elongate, flexible sheath having an internal lumen, an open distal end and a longitudinal axis;

an ablating element disposed within the sheath and selectively deployable therefrom so as to project from the sheath in a pulmonary vein with a substantially coil-like shape having at least one revolution, wherein the ablating element is positionable, in a deployed condition, is in a plane that is substantially orthogonal to the longitudinal axis of the sheath; and at least one exposed, conductive region disposed on at least a portion of the ablating element;

(b) the ablating element being distally advancable out of the sheath to allow the ablating element to form a substantially coil-like shape having at least one revolution;

(c) the ablating element having a conductive region sized for contact along a selected circumferential region of body tissue at the pulmonary vein; and wherein (d) the catheter is operable to transmit ablating energy to the ablating element while contacting the selected region of body tissue to form a circumferential lesion blocking arythmia signals originating in the pulmonary vein.

In a further aspect, the present invention resides in a catheter for use in ablating a selected region of body tissue, comprising the steps of:

(a) the catheter comprising:

an elongate, flexible sheath having an internal lumen, an open distal end and a longitudinal axis;

an ablating element disposed within the sheath and selectively deployable therefrom so as to project from the sheath in a substantially coil- like shape having at least one revolution, wherein the ablating element, in a deployed condition is oriented in a plane that is substantially orthogonal to the longitudinal axis of the sheath; and at least one exposed, conductive region disposed on at least a portion of the ablating element;

(b) the ablating element being advancable distally out of the sheath to allow the ablating element to form a substantially coil-like shape having at least one revolution and a conductive region which is contactable with a selected region of body tissue; and (c) wherein the catheter is operable to transmit ablating energy to the ablating element while contacting the selected region of body tissue.

In yet a further aspect the present invention provides a cardiac catheter system, comprising: an elongate, flexible sheath having an internal lumen, a distal end and a longitudinal axis; an ablating element disposed within the sheath and selectively deployable therefrom so as to project from the sheath to a pulmonary vein of a subject with a substantially coil-like shape having at least one revolution, wherein the ablating element, in a deployed condition, is oriented in a plane that is substantially orthogonal to the longitudinal axis of the sheath; the ablating element having a tissue contacting portion that is continuously conductive, the continuously conductive region being positioned on the ablating element such than when so deployed it ablates a circumferential blocking lesion in the region of said pulmonary vein; and a guide wire disposed within and selectively deployable from the sheath, wherein a leading end of the ablating element is secured to the guide wire.

In yet a further aspect the present invention provides a cardiac catheter system, comprising an elongate, flexible sheath having dimensions suitable for intravascular passage and a longitudinal axis; a guide wire disposed within the sheath and selectively deployable from a distal end of the sheath; an ablating element disposed within and selectively deployable from the distal end of the sheath in concert with the guide wire, the ablating element having a leading end secured to the guide wire and a trailing portion disposed within the sheath; and an ablating element deployment mechanism that is effective to advance at least a portion of the trailing portion of the ablating element out of the distal end of the sheath by a predetermined distance to cause the ablating element to assume a coil-like shape, with a tissue contacting portion that is continuously conductive and effective to ablate a circumferential blocking lesion in the region of a pulmonary vein.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:

FIG. 1 is a perspective new of an ablation catheter system in accordance with the present invention;

FIG. 2 is a side view of a portion of the catheter system of FIG. 1;
FIG. 3 is a front view of a portion of the catheter system of FIG 1;

FIG. 4 is a pictorial representation of the orientation of an ablating element in a deployed position and a catheter that forms a part of the catheter system of FIG. 1;

FIG. 5 is a perspective view of an alternative geometry for an ablating element;
FIG. 6 is a perspective view of a further embodiment of an ablation catheter system in accordance with the present invention;

FIG. 7 is a perspective view of another embodiment of an ablation catheter in accordance with the present invention;

FIG. 7A is a pictorial representation of an alternative embodiment of an ablation catheter in accordance with the present invention;

FIG. 8A is a pictorial representation of a further embodiment of an ablation -5a-catheter in accordance with the present invention shown in a first position;

FIG. 8B is a pictorial representation of the catheter of FIG. 8A shown in a second position;

FIG. 8C is a pictorial representation of the catheter system of FIG. 8A shown in 10 a a third position; and FIG. 9 is a perspective view of another embodiment of an ablation catheter system in accordance with the present invention.

DETAILED DESCRIPTION OF THE INVENTION

FIGS. 1-3 show an ablation catheter system 100 in accordance with the present invention having an ablation element 102 that is deployable from a flexible elongate catheter or sheath 104. The catheter sheath 104 should be semi-rigid and flexible so as to be readily steerable to a desired location in a patient's body, such as proximate the os of a pulmonary vein. Such catheter delivery systems are well known to those of ordinary skill in the art. In general, the deployed coil-like ablation element 102 has a shape that includes one or more revolutions substantially oriented in a transverse plane 106 (FIG.
4) that is orthogonal to a longitudinal axis 108 of the sheath 104. This geometry facilitates treating tissue about a circumference of a vessel, such as a pulmonary vein. The circumferential region of ablated tissue electrically isolates tissue on opposite sides of the ablated tissue.
Thus, the atria, for example, can be electrically isolated from any arrhythmia-inducing foci within the pulmonary vein.

In one embodiment, the catheter system 100 includes a tubular inner member 110 for housing the ablation member 102 in the non-deployed position. In general, it is preferred that the inner member 102 be formed from an insulative material to prevent unintended contact with tissue, for example. Exemplary materials for the insulative inner member 110 include Teflon and polyethylene.

The elongate ablation element 102 can have a variety of geometries that are effective to form a generally annular lesion about a circumference of a vessel wall.
Exemplary geometries include annular shapes having one or more revolutions, crenulated, corrugated, and combinations thereof. It is understood that the term "revolution" should be construed broadly to include configurations of somewhat less than three hundred and sixty degrees. It is further understood that the transverse plane 106 on which the revolutions of the elongate member are located provides a general frame of reference and that the elongate member can vary in distance from the plane as the elongate member forms a revolution.

In the exemplary embodiment of FIGS. 1-3, which shows the ablation member 102 in the deployed state, the ablation member 102 has a coil-like appearance that forms approximately one revolution generally oriented in the transverse plane 106 that is substantially orthogonal to a longitudinal axis 108 of the sheath. This configuration is well-suited for contacting a vessel inner wall about its circumference or for contacting the posterior wall of the left atrium to circumscribe the os of a pulmonary vein. The resultant circumferential lesion on the atrial or vessel wall can be effective to isolate electrical impulses from the offending foci from passing to healthy tissue on the opposite side of the lesion.

FIG. 5 shows the catheter system 100' including an ablation member 102' having an alternative, crenulated geometry. That is, the ablation member 102' undulates so as to intersect the transverse plane 106' at defined intervals along a revolution.
This configuration may inhibit or limit stenosis of the treated vessel proximate the circumferential lesion. The ablation member 102' can be partly surrounded by an insulative coating 112.

In one embodiment, the ablation member 102 is formed from a conductive elastic or superelastic shape memory material for ablating tissue with RF energy.
Exemplary shape memory materials include nickel-titanium alloys, such as Nitinol, and copper based alloys. It is understood that shape memory materials, in general, can be plastically deformed from a first shape at a relatively low temperature. Upon heating the material to some higher temperature, such as by resistive heating, the material will tend to return to the first shape. Such materials can have so-called one-way and two- way shape memories.

In further embodiments (not shown), the ablation member can be at least partly surrounded by an insulative coating. The insulative coating can be disposed on the ablation member so as to form a plurality of discrete electrodes for ablating tissue at selected locations along the vessel circumference.

The ablation element can be deployed from the sheath using a variety of mechanisms that are compatible with steerable catheter systems. Exemplary mechanisms include predetermined shapes for the elongate member, manual deployment mechanisms, and guide-wire based mechanisms.

FIG. 6 shows an ablation catheter system 200 having an ablation member 202 with a distal end 204 secured to a bulbous end 206 of a support member 208. The support member 208 is disposed within the sheath 210 and connected to an actuator (not shown) at a proximal end of the catheter. To deploy the ablation member 202, the support member 208 is longitudinally displaced with respect to the sheath such that the bulbous end 206 protrudes from the end 212 of the catheter. Upon exiting the sheath 210, the ablation member 202 assumes a predetermined shape that includes about one revolution in a transverse plane 214 orthogonal to the sheath longitudinal axis 216. The ablation member 202 can extend from a retractable support wire 218.

In one embodiment, the bulbous end 206 of the support member is radiopaque to facilitate determining the ablation member position on an external viewing system, such as an X-ray system.

Alternatively, the ablation member 202 can be wound on the support member 208 in the non-deployed state. The support member 208 can be rotated in a predetermined direction such that the ablation member 202 is unwound or released from the support member.
The support member 208 can be rotated until the ablation member extends from the support member a desired distance. After ablation, the ablation member 202 can be retracted to the non-deployed state by rotating the support member in the opposite direction.

FIG. 7 shows an ablation catheter system 300 including a guide wire 302 for manipulating a catheter 304 within the patient's body. It is understood that the guide wire 302 can be utilized in conjunction with mapping systems (which may be separate from or integral with the catheter system 300) to locate arrhythmic foci. The catheter 304 includes a hatch 306 from which an ablation member 308 can be deployed. Upon actuating the hatch 306 to the open position, the ablation member 308 discharges from the resultant opening 310 and assumes a predetermined configuration. It is understood that the predetermined annular shape will be effective to contact vessel walls having a circumference less than or equal to a predetermined value, which by way of example, may be in the range of about 0.4 centimeters to about 4.0 centimeters.

FIG. 7A shows an alternative embodiment of a catheter system 350 including an ablation member 352 having an exposed proximal portion 354 for ablating tissue and an insulated distal portion 356 for centering the catheter within a pulmonary vein 358.

The catheter system 350 is well suited for creating a circumferential lesion on the posterior left atrial wall 360 around the pulmonary vein os 362.

FIGS. 8A-C show a manually expandable ablation member 402 that forms a part of a cardiac ablation catheter system 400 in accordance with the present invention.
The system 400 includes a guide-wire based catheter 404 with an ablation member 406 that is manually deployable from the catheter. In one embodiment, the ablation member 406 is coupled to a semi-rigid support member 408 (FIG. 8C) that can be rotated and/or longitudinally displaced so as to deploy the ablation member 406. The size of the loop formed by the ablation member 406 can be selected by controlling the amount of rotation/displacement of the support member 408.
Alternatively, the leading end of the ablation element can be affixed to the guide wire. In one embodiment, the ablating element can be manipulated by rotating the guide wire.

FIG. 9 shows a further embodiment of a guide-wire based ablation catheter system 500 having a manually deployable ablation member 502. This system is similar to the system 200 shown in FIG 6 with the addition of a guide wire 504 that can provide additional stability during ablation. The catheter 506 is mounted on the guide wire 504 to facilitate advancement of the catheter into the pulmonary vein.

One skilled in the art will appreciate further features and advantages of the invention based on the above-described embodiments. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.

Claims (17)

1. A cardiac catheter system, comprising:
an elongate, flexible sheath having an internal lumen, a distal end and a longitudinal axis;
an ablating element disposed within the sheath and selectively deployable therefrom so as to project from the sheath to a pulmonary vein of a subject with a substantially coil-like shape having at least one revolution, wherein the ablating element, in a deployed condition, is oriented in a plane that is substantially orthogonal to the longitudinal axis of the sheath;
the ablating element having a tissue contacting portion that is continuously conductive, the continuously conductive region being positioned on the ablating element such than when so deployed it ablates a circumferential blocking lesion in the region of said pulmonary vein; and a guide wire disposed within and selectively deployable from the sheath, wherein a leading end of the ablating element is secured to the guide wire.
2. The system of claim 1, wherein the ablating element is self-expanding and assumes a predetermined shape upon deployment from the sheath.
3. The system of claim 2, wherein the ablating element is made from a shape-memory material.
4. The system of claim 3 wherein the shape-memory material is selected from the group consisting of nickel-titanium alloys and copper-based alloys.
5. The system of claim 3 wherein the shape-memory material is superelastic.
6. The system of claim 3, wherein the shape-memory material has a two-way shape memory.
7. The system of claim 1 wherein the ablating element further comprises a terminal which is connectable to an energy source selected from the group consisting of radio frequency energy, laser energy, microwave energy, ultrasonic energy, and cryogenic energy.
8. The system of claim 1, wherein the ablating element is manually and selectively expandable from the sheath.
9. The system of claim 1 wherein the coil-like shape has a radius which expands as the ablating element advances from the sheath.
10. The system of claim 1 wherein the guide wire extends along a longitudinal axis of the sheath, and the ablating element is expandable from the sheath by rotating the guide wire about the longitudinal axis of the sheath.
11. The system of claim 1, wherein the leading end of the ablating element is surrounded by an insulating material.
12. The system of claim 1, wherein a lagging end of the ablating element is uninsulated and forms the coil-like shape of the ablating element.
13. The system of claim 1, further comprising a non-conductive, insulating element disposed within the sheath and selectively deployable therefrom, wherein the ablating element is deployable from within the non-conducting, insulating element.
14. The system of claim 13 wherein the ablating element is retractable into the non-conductive, insulating element.
15. The system of claim 1, wherein the at least one exposed, conductive region further comprises a plurality of discrete electrodes.
16. The system of claim 1, wherein the coil-like shape of the ablating member has a crenulated circumferential region.
17. A cardiac catheter system, comprising an elongate, flexible sheath having dimensions suitable for intravascular passage and a longitudinal axis;
a guide wire disposed within the sheath and selectively deployable from a distal end of the sheath;

an ablating element disposed within and selectively deployable from the distal end of the sheath in concert with the guide wire, the ablating element having a leading end secured to the guide wire and a trailing portion disposed within the sheath; and an ablating element deployment mechanism that is effective to advance at least a portion of the trailing portion of the ablating element out of the distal end of the sheath by a predetermined distance to cause the ablating element to assume a coil-like shape, with a tissue contacting portion that is continuously conductive and effective to ablate a circumferential blocking lesion in the region of a pulmonary vein.
CA 2638963 1999-09-15 2000-09-11 Coiled ablation catheter system Active CA2638963C (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
US09396959 US6607520B2 (en) 1999-09-15 1999-09-15 Coiled ablation catheter system
US09/396,959 1999-09-15
US09/539,056 2000-03-30
US09539056 US6632223B1 (en) 2000-03-30 2000-03-30 Pulmonary vein ablation stent and method
CA 2388823 CA2388823C (en) 1999-09-15 2000-09-11 Coiled ablation catheter system

Publications (2)

Publication Number Publication Date
CA2638963A1 true CA2638963A1 (en) 2001-03-22
CA2638963C true CA2638963C (en) 2012-03-20

Family

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Family Applications (2)

Application Number Title Priority Date Filing Date
CA 2638963 Active CA2638963C (en) 1999-09-15 2000-09-11 Coiled ablation catheter system
CA 2388823 Active CA2388823C (en) 1999-09-15 2000-09-11 Coiled ablation catheter system

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Families Citing this family (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6890329B2 (en) 1999-06-15 2005-05-10 Cryocath Technologies Inc. Defined deflection structure
WO2003003948A1 (en) 2001-07-06 2003-01-16 Tricardia, L.L.C. Anti-arrhythmia devices and methods of use
DE10152066A1 (en) * 2001-10-25 2003-05-08 Curative Ag stent
US6656175B2 (en) * 2001-12-11 2003-12-02 Medtronic, Inc. Method and system for treatment of atrial tachyarrhythmias
US6814733B2 (en) 2002-01-31 2004-11-09 Biosense, Inc. Radio frequency pulmonary vein isolation
DE10218426A1 (en) * 2002-04-24 2003-11-06 Biotronik Mess & Therapieg Ablation of cardiac tissue, in particular for producing linear lesions between two vascular openings in the heart
US20040106952A1 (en) * 2002-12-03 2004-06-03 Lafontaine Daniel M. Treating arrhythmias by altering properties of tissue
EP1605866B1 (en) 2003-03-03 2016-07-06 Syntach AG Electrical conduction block implant device
EP1605875A3 (en) 2003-03-03 2005-12-28 Sinus Rhythm Technologies, Inc. Electrical block positioning devices and methods of use therefor
US9398967B2 (en) 2004-03-02 2016-07-26 Syntach Ag Electrical conduction block implant device
US7266414B2 (en) 2003-10-24 2007-09-04 Syntach, Ag Methods and devices for creating electrical block at specific sites in cardiac tissue with targeted tissue ablation
US20050222672A1 (en) * 2004-04-01 2005-10-06 Cappella, Inc. Ostial stent
US7993334B2 (en) 2005-12-29 2011-08-09 Boston Scientific Scimed, Inc. Low-profile, expanding single needle ablation probe
JP5827124B2 (en) * 2008-10-04 2015-12-02 ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. Loop structure supporting the diagnosis and / or treatment element contacts the tissue
US8712550B2 (en) 2008-12-30 2014-04-29 Biosense Webster, Inc. Catheter with multiple electrode assemblies for use at or near tubular regions of the heart
JP2012517306A (en) * 2009-02-12 2012-08-02 イューエムセー ユトレヒト ホールディング ベースローテン フェンノートシャップ The method for electrically insulating the ablation catheter and cardiac tissue
EP2747690A2 (en) * 2011-08-24 2014-07-02 Boston Scientific Scimed, Inc. Device and methods for nerve modulation
US9179974B2 (en) 2013-03-15 2015-11-10 Medtronic Ardian Luxembourg S.A.R.L. Helical push wire electrode
US9468407B2 (en) 2014-05-30 2016-10-18 Biosense Webster (Israel) Ltd. Catheter with distal section having side-by-side loops
EP3146924A1 (en) * 2015-09-24 2017-03-29 Medidata Sp. z o.o. Cryoapplicator for minimally invasive surgical cardiac ablation

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5156151A (en) * 1991-02-15 1992-10-20 Cardiac Pathways Corporation Endocardial mapping and ablation system and catheter probe
US5476495A (en) * 1993-03-16 1995-12-19 Ep Technologies, Inc. Cardiac mapping and ablation systems
US5582609A (en) * 1993-10-14 1996-12-10 Ep Technologies, Inc. Systems and methods for forming large lesions in body tissue using curvilinear electrode elements
US5507743A (en) * 1993-11-08 1996-04-16 Zomed International Coiled RF electrode treatment apparatus
US5573531A (en) * 1994-06-20 1996-11-12 Gregory; Kenton W. Fluid core laser angioscope
DE4425195C1 (en) * 1994-07-16 1995-11-16 Osypka Peter Heart catheter with multiple electrode device
US5593405A (en) * 1994-07-16 1997-01-14 Osypka; Peter Fiber optic endoscope
US5836940A (en) * 1994-10-25 1998-11-17 Latis, Inc. Photoacoustic drug delivery
US6012457A (en) * 1997-07-08 2000-01-11 The Regents Of The University Of California Device and method for forming a circumferential conduction block in a pulmonary vein

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EP1223876A4 (en) 2003-05-02 application
CA2388823A1 (en) 2001-03-22 application
EP1223876A1 (en) 2002-07-24 application
JP2003522561A (en) 2003-07-29 application
WO2001019269A1 (en) 2001-03-22 application
WO2001019270A1 (en) 2001-03-22 application
CA2638963A1 (en) 2001-03-22 application
CA2388823C (en) 2008-11-18 grant

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