JP7394766B2 - フォーカルアブレーションのためのシステム、デバイス、および方法 - Google Patents

フォーカルアブレーションのためのシステム、デバイス、および方法 Download PDF

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JP7394766B2
JP7394766B2 JP2020537624A JP2020537624A JP7394766B2 JP 7394766 B2 JP7394766 B2 JP 7394766B2 JP 2020537624 A JP2020537624 A JP 2020537624A JP 2020537624 A JP2020537624 A JP 2020537624A JP 7394766 B2 JP7394766 B2 JP 7394766B2
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electrodes
splines
spline
distal
electrode
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JP2021511103A (ja
JP2021511103A5 (enExample
Inventor
ヴィスワナータン，ラジュ
ジンゲラー，アラン
ロング，ゲイリー
パギアード，ジャン－リュック
ハッチー，ブリトニー
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ファラパルス，インコーポレイテッド
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Priority claimed from US15/874,721 external-priority patent/US10130423B1/en
Priority claimed from PCT/US2018/029938 external-priority patent/WO2018201037A1/en
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Priority to JP2023200526A priority Critical patent/JP7817228B2/ja
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A61B18/14—Probes or electrodes therefor
    • A61B18/16—Indifferent or passive electrodes for grounding
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022—Balloons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022—Balloons
    • A61B2018/0025—Multiple balloons
    • A61B2018/00261—Multiple balloons arranged in a line
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/00267—Expandable means emitting energy, e.g. by elements carried thereon having a basket shaped structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00357—Endocardium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00375—Ostium, e.g. ostium of pulmonary vein or artery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00613—Irreversible electroporation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3966—Radiopaque markers visible in an X-ray image
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/327—Applying electric currents by contact electrodes alternating or intermittent currents for enhancing the absorption properties of tissue, e.g. by electroporation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Cardiology (AREA)
  • Plasma & Fusion (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Otolaryngology (AREA)
  • Surgical Instruments (AREA)
JP2020537624A 2018-01-18 2019-01-18 フォーカルアブレーションのためのシステム、デバイス、および方法 Active JP7394766B2 (ja)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2023200526A JP7817228B2 (ja) 2018-01-18 2023-11-28 フォーカルアブレーションのためのシステム、デバイス、および方法

Applications Claiming Priority (9)

Application Number Priority Date Filing Date Title
US15/874,721 US10130423B1 (en) 2017-07-06 2018-01-18 Systems, devices, and methods for focal ablation
US15/874,721 2018-01-18
USPCT/US2018/029938 2018-04-27
PCT/US2018/029938 WO2018201037A1 (en) 2017-04-28 2018-04-27 Systems, devices, and methods for delivery of pulsed electric field ablative energy to endocardial tissue
US201862744495P 2018-10-11 2018-10-11
US62/744,495 2018-10-11
US201862769407P 2018-11-19 2018-11-19
US62/769,407 2018-11-19
PCT/US2019/014226 WO2019143960A1 (en) 2018-01-18 2019-01-18 Systems, devices, and methods for focal ablation

Related Child Applications (1)

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JP2023200526A Division JP7817228B2 (ja) 2018-01-18 2023-11-28 フォーカルアブレーションのためのシステム、デバイス、および方法

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JP2021511103A5 JP2021511103A5 (enExample) 2022-01-26
JP7394766B2 true JP7394766B2 (ja) 2023-12-08

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EP (1) EP3740148A1 (enExample)
JP (2) JP7394766B2 (enExample)
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US12263014B2 (en) 2020-08-18 2025-04-01 St. Jude Medical, Cardiology Division, Inc. High-density electrode catheters with magnetic position tracking
US12376901B2 (en) 2018-05-21 2025-08-05 St. Jude Medical, Cardiology Division, Inc. Radio-frequency ablation and direct current electroporation catheters
US12551658B2 (en) 2022-03-25 2026-02-17 St. Jude Medical, Cardiology Division, Inc. Steerable introducer with slide block divider
US12575877B2 (en) 2018-04-05 2026-03-17 St. Jude Medical, Cardiology Division, Inc. High density electrode mapping catheter
US12588851B2 (en) 2018-03-13 2026-03-31 St. Jude Medical, Cardiology Division, Inc. Variable density mapping catheter
US12653607B2 (en) 2018-09-28 2026-06-16 St. Jude Medical, Cardiology Division, Inc. Intravascular catheter tip electrode assemblies
US12672828B2 (en) 2022-09-28 2026-07-07 St. Jude Medical, Cardiology Division, Inc. High density paddle catheter with distal coupler and distal electrode

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US10905329B2 (en) 2016-06-09 2021-02-02 Biosense Webster (Israel) Ltd. Multi-function conducting elements for a catheter
US12029545B2 (en) 2017-05-30 2024-07-09 Biosense Webster (Israel) Ltd. Catheter splines as location sensors
US20190314083A1 (en) 2018-04-11 2019-10-17 Biosense Webster (Israel) Ltd. Flexible Multi-Arm Catheter with Diametrically Opposed Sensing Electrodes
US11045628B2 (en) 2018-12-11 2021-06-29 Biosense Webster (Israel) Ltd. Balloon catheter with high articulation
US11207016B2 (en) 2018-12-28 2021-12-28 Biosense Webster (Israel) Ltd. Mapping ECG signals using a multipole electrode assembly
US11850051B2 (en) 2019-04-30 2023-12-26 Biosense Webster (Israel) Ltd. Mapping grid with high density electrode array
US11712172B2 (en) 2019-07-18 2023-08-01 Biosense Webster (Israel) Ltd. Visual guidance for positioning a distal end of a medical probe
US11759150B2 (en) 2019-08-27 2023-09-19 Biosense Webster (Israel) Ltd. Accurate basket catheter tracking
US10625080B1 (en) 2019-09-17 2020-04-21 Farapulse, Inc. Systems, apparatuses, and methods for detecting ectopic electrocardiogram signals during pulsed electric field ablation
EP4054460A4 (en) 2019-11-05 2022-12-07 Sirona Medical Technologies, Inc. Multi-modal catheter for improved electrical mapping and ablation
US11065047B2 (en) 2019-11-20 2021-07-20 Farapulse, Inc. Systems, apparatuses, and methods for protecting electronic components from high power noise induced by high voltage pulses
US11950930B2 (en) 2019-12-12 2024-04-09 Biosense Webster (Israel) Ltd. Multi-dimensional acquisition of bipolar signals from a catheter
US11517218B2 (en) 2019-12-20 2022-12-06 Biosense Webster (Israel) Ltd. Selective graphical presentation of electrophysiological parameters
US20210369132A1 (en) 2020-05-29 2021-12-02 Biosense Webster (Israel) Ltd. Intraluminal reference electrode for cardiovascular treatment apparatus
US11987017B2 (en) 2020-06-08 2024-05-21 Biosense Webster (Israel) Ltd. Features to assist in assembly and testing of devices
CN116137804A (zh) * 2020-07-16 2023-05-19 波士顿科学医学有限公司 通过不可逆电穿孔进行局灶性心脏消融的导管和方法
US12310652B2 (en) 2020-07-24 2025-05-27 Boston Scientific Scimed, Inc. Hybrid electroporation ablation catheter
US12268437B2 (en) 2020-07-24 2025-04-08 Boston Scientific Scimed, Inc. Electric field application for single shot cardiac ablation by irreversible electroporation
JP7901579B2 (ja) * 2020-07-24 2026-08-06 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 電気穿孔法アブレーションカテーテル
US12048479B2 (en) 2020-09-10 2024-07-30 Biosense Webster (Israel) Ltd. Surface mounted electrode catheter
US11950841B2 (en) 2020-09-22 2024-04-09 Biosense Webster (Israel) Ltd. Basket catheter having insulated ablation electrodes and diagnostic electrodes
US11950840B2 (en) 2020-09-22 2024-04-09 Biosense Webster (Israel) Ltd. Basket catheter having insulated ablation electrodes
US12082875B2 (en) 2020-09-24 2024-09-10 Biosense Webster (Israel) Ltd Balloon catheter having a coil for sensing tissue temperature and position of the balloon
US11974803B2 (en) 2020-10-12 2024-05-07 Biosense Webster (Israel) Ltd. Basket catheter with balloon
US12290306B2 (en) * 2020-10-19 2025-05-06 Biosense Webster (Israel) Ltd. Using unipolar configuration for irreversible-electroporation (IRE)
US12201786B2 (en) 2020-12-17 2025-01-21 Biosense Webster (Israel) Ltd. Measurement of distal end dimension of catheters using magnetic fields
US11918383B2 (en) 2020-12-21 2024-03-05 Biosense Webster (Israel) Ltd. Visualizing performance of catheter electrodes
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CR20230475A (es) 2021-04-07 2024-01-19 Btl Medical Dev A S Dispositivo y método de ablación de campo pulsado
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WO2023276080A1 (ja) * 2021-06-30 2023-01-05 日本ライフライン株式会社 カテーテル
JP7669536B2 (ja) 2021-07-02 2025-04-28 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 折り畳み可能要素を備えた局所アブレーションデバイス、ならびにそのシステムおよび方法
PL4366637T3 (pl) 2021-07-06 2025-11-03 Btl Medical Development A.S. Urządzenie do ablacji pulsacyjnym polem elektrycznym
US12364426B2 (en) 2021-08-12 2025-07-22 Biosense Webster (Israel) Ltd. Electro-anatomical mapping and annotation presented in electrophysiological procedures
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US12419683B2 (en) 2021-12-22 2025-09-23 Biosense Webster (Israel) Ltd. Irreversible electroporation with shorted electrodes
US12629201B2 (en) 2021-12-30 2026-05-19 Biosense Webster (Israel) Ltd. Multi-form catheter
US12661737B2 (en) 2022-01-20 2026-06-23 Biosense Webster (Israel) Ltd. Intravascular device including high voltage coaxial conductor wiring
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US12484961B2 (en) 2022-01-20 2025-12-02 Biosense Webster (Israel) Ltd. Mechanical retainer systems for electrodes of a basket catheter, and methods of the same
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WO2023158283A1 (ko) * 2022-02-21 2023-08-24 가톨릭대학교 산학협력단 전기적 자극을 이용하는 절제용 수술 도구
US12629203B2 (en) 2022-03-25 2026-05-19 Biosense Webster (Israel) Ltd. Elongated trapezoidal electrodes of a basket catheter and methods of making the same
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