US20030195501A1 - RF ablation system and method having automatic temperature control - Google Patents

RF ablation system and method having automatic temperature control Download PDF

Info

Publication number
US20030195501A1
US20030195501A1 US10/400,770 US40077003A US2003195501A1 US 20030195501 A1 US20030195501 A1 US 20030195501A1 US 40077003 A US40077003 A US 40077003A US 2003195501 A1 US2003195501 A1 US 2003195501A1
Authority
US
United States
Prior art keywords
electrode
power
temperature
electrodes
tissue
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.)
Abandoned
Application number
US10/400,770
Inventor
Marshall Sherman
Kathryn Lockwood
Thomas Castellano
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.)
Individual
Original Assignee
Individual
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
Priority claimed from US09/073,392 external-priority patent/US6059778A/en
Application filed by Individual filed Critical Individual
Priority to US10/400,770 priority Critical patent/US20030195501A1/en
Publication of US20030195501A1 publication Critical patent/US20030195501A1/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • 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
    • A61B18/1206Generators therefor
    • 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
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/0016Energy applicators arranged in a two- or three dimensional array
    • 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
    • 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
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00642Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A61B2018/00654Sensing and controlling the application of energy with feedback, i.e. closed loop control with individual control of each of a plurality of energy emitting elements
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00702Power or energy
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00714Temperature
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00726Duty cycle
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00738Depth, e.g. depth of 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/0075Phase
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00755Resistance or impedance
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00797Temperature measured by multiple temperature sensors
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00821Temperature measured by a thermocouple
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00875Resistance or impedance
    • 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
    • A61B18/1206Generators therefor
    • A61B2018/124Generators therefor switching the output to different electrodes, e.g. sequentially
    • 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
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/126Generators therefor characterised by the output polarity bipolar
    • 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
    • A61B18/1206Generators therefor
    • A61B2018/1273Generators therefor including multiple generators in one device
    • 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
    • A61B2018/1467Probes or electrodes therefor using more than two electrodes on a single probe

Definitions

  • the invention relates generally to an electrophysiological (“EP”) apparatus and method for providing energy to biological tissue, and more particularly, to a radio frequency (“RF”) ablation apparatus for controlling the flow of current through, and the temperature of, a biological site so that the volume of ablation lesions may be controlled.
  • EP electrophysiological
  • RF radio frequency
  • the heart beat in a healthy human is controlled by the sinoatrial node (“S-A node”) located in the wall of the right atrium.
  • the S-A node generates electrical signal potentials that are transmitted through pathways of conductive heart tissue in the atrium to the atrioventricular node (“A-V node”) which in turn transmits the electrical signals throughout the ventricle by means of the His and Purkinje conductive tissues.
  • A-V node atrioventricular node
  • Improper growth of, or damage to, the conductive tissue in the heart can interfere with the passage of regular electrical signals from the S-A and A-V nodes. Electrical signal irregularities resulting from such interference can disturb the normal rhythm of the heart and cause an abnormal rhythmic condition referred to as “cardiac arrhythmia.”
  • ablation of the damaged tissue can restore the correct operation of the heart.
  • ablation can be performed by percutaneous ablation, a procedure in which a catheter is percutaneously introduced into the patient and directed through an artery to the atrium or ventricle of the heart to perform single or multiple diagnostic, therapeutic, and/or surgical procedures.
  • an ablation procedure is used to destroy the tissue causing the arrhythmia in an attempt to remove the electrical signal irregularities or create a conductive tissue block to restore normal heart beat or at least an improved heart beat.
  • Successful ablation of the conductive tissue at the arrhythmia initiation site usually terminates the arrhythmia or at least moderates the heart rhythm to acceptable levels.
  • a widely accepted treatment for arrhythmia involves the application of RF energy to the conductive tissue.
  • AF atrial fibrillation
  • Maze procedure a procedure published by Cox et al. and known as the “Maze procedure” involves continuous atrial incisions to prevent atrial reentry and to allow sinus impulses to activate the entire myocardium. While this procedure has been found to be successful, it involves an intensely invasive approach. It is more desirable to accomplish the same result as the Maze procedure by use of a less invasive approach, such as through the use of an appropriate EP catheter system.
  • RF energy there are two general methods of applying RF energy to cardiac tissue, unipolar and bipolar.
  • a large surface area electrode e.g., a backplate
  • the backplate completes an electrical circuit with one or more electrodes that are introduced into the heart, usually via a catheter, and placed in intimate contact with the aberrant conductive tissue.
  • electrodes introduced into the heart have different potentials and complete an electrical circuit between themselves.
  • the flux traveling between the two electrodes of the catheter enters the tissue to cause ablation.
  • the electrodes are placed in intimate contact with the target endocardial tissue.
  • RF energy is applied to the electrodes to raise the temperature of the target tissue to a non-viable state.
  • the temperature boundary between viable and non-viable tissue is approximately 48° Centigrade.
  • Tissue heated to a temperature above 48° C. becomes non-viable and defines the ablation volume.
  • the objective is to elevate the tissue temperature, which is generally at 37° C., fairly uniformly to an ablation temperature above 48° C., while keeping both the temperature at the tissue surface and the temperature of the electrode below 100° C.
  • a basic configuration of an ablation catheter for applying RF energy includes a distal tip which is fitted with an electrode device.
  • the electrode device is the source of an electrical signal that causes heating of the contacting and neighboring tissue.
  • the electrode device may include a single electrode used for emitting RF energy. This single electrode acts as one electrical pole. The other electrical pole is formed by the backplate in contact with a patient's external body part.
  • a RF source is applied to the electrode.
  • the RF source is typically in the 500 kHz region and produces a sinusoidal voltage. When this is delivered between the distal tip of a standard electrode catheter and a backplate, it produces a localized RF heating effect and produces a well defined, deep acute lesion slightly larger than the tip electrode.
  • a lesion having a larger surface area than that produced by a single electrode in a unipolar arrangement may be required.
  • numerous ablation catheters have been designed.
  • an electrode device having four peripheral electrodes which extend from a retracted mode is used. See U.S. Pat. No. 5,500,011 to Desai.
  • the four peripheral electrodes and the central electrode form an electrode array that covers a larger surface area of the tissue than a single electrode.
  • the five electrodes When used with a conventional RF power source, and in conjunction with a backplate, the five electrodes produce five lesion spots distributed over the area spanned by the electrode array.
  • the lesions produced are discontinuous in relation to each other and there are areas between the electrodes that remain unablated.
  • This device must be manipulated so that when expanded, all electrodes are in contact with the endocardium.
  • An “end on” approach is required such that the end of the catheter, on which all five electrodes are mounted, is in intimate contact with the target tissue.
  • an electrode device having a central electrode and a number of peripheral electrodes which also fan out from a retracted mode is used.
  • a backplate is not used; instead the central electrode functions as the reference while the peripheral electrodes have multi-phase RF power applied to them.
  • This arrangement also requires the same manipulation of the catheter such that an end-on contact is made by the expanded electrodes, as discussed above.
  • the mechanical configuration of both of the above-described techniques comprises an expanding approach.
  • an electrode device When used for ablation, an electrode device is typically part of a catheter system. Accordingly, it is desirable to minimize the diameter of the electrode device during introduction to and withdrawal from the patient to lessen trauma to the patient. Therefore, electrode devices having peripheral expandable electrodes must be configured so that the peripheral electrodes are expandable to a large size yet are retractable to as small a size as practical. Such requirements pose design and manufacturing difficulties due to the movement of mechanical parts required for proper operation. Further considerations are the undesirable complexity and increased manufacturing cost associated with an expandable a catheter.
  • the invention is directed to an apparatus and a method for controlling the application of energy to, and the temperature of, a biological site during ablation.
  • the invention relates to an apparatus for delivering energy to biological tissue while maintaining the temperature of the biological tissue near a target temperature.
  • the apparatus includes a plurality of electrodes positionable proximal the biological tissue and at least one temperature sensing device located on at least one of the electrodes.
  • the temperature sensing device provides a temperature signal indicative of the temperature at the interface between the at least one electrode and the tissue.
  • the apparatus also includes a generator that operates under the control of a processor to apply power to each of the electrodes.
  • the power has an associated phase angle and, within a time duration, a plurality of alternating on periods and off periods, one set of adjacent on and off periods defining a duty cycle.
  • the processor is adapted to, during the on period of each duty cycle, set the phase angles of the power provided to each electrode such that at least two of the electrodes are provided power with different phase angles.
  • the processor is further adapted to, in response to the temperature signal, determine the temperature at the at least one electrode/tissue interface; compare the interface temperature to the target temperature and adjust the duty cycle of the power provided to the at least one electrode in response to the comparison.
  • the processor is adapted to increase or decrease the duty cycle of the power to the at least one electrode when the at least one electrode/tissue interface temperature is less than or greater than the target temperature.
  • the processor is adapted to set the power to the at least one electrode to zero when the at least one electrode/tissue interface temperature is a specified first number of degrees greater than the target temperature to thereby allow the electrode to cool off.
  • the processor is further adapted to incrementally increase the power to the electrode until the interface temperature is near the target temperature.
  • the apparatus further includes a power interruption device connected to the processor. The processor is adapted to control the power interruption device to interrupt power to the at least one electrode when the at least one electrode/tissue interface temperature is a specified second number of degrees greater than the target temperature.
  • the invention in another facet, relates to an apparatus for delivering energy to biological tissue while maintaining the temperature of the biological tissue near a target temperature.
  • the apparatus includes a catheter having a plurality of electrodes at its distal end. The distal end may be positioned so that the electrodes are located proximal the biological tissue.
  • the apparatus also includes a plurality of temperature sensing devices. At least one temperature sensing device is located on a select number of the electrodes. These devices provide a temperature signal indicative of the temperature at the interface between the electrode and the tissue.
  • the apparatus also includes a generator operating under the control of a processor to apply power to each of the electrodes. The power has an associated phase angle and, within a time duration, a plurality of alternating on periods and off periods.
  • One set of adjacent on and off periods define a duty cycle.
  • the processor is adapted to, in response to each of the temperature signals, determine the temperature at the electrode/tissue interface and regulate the temperature of a plurality of temperature zones. Each zone includes at least one combination electrode/temperature sensing device. The temperature is regulated by controlling the power to at least one electrode in the zone.
  • the processor is further adapted to regulate the power to a plurality of phase groups. Each group includes at least one electrode. The power is regulated by controlling the phase of the power to each electrode in the group such that during the on portion of a duty cycle the phase in one group is different then the phase in another group.
  • the invention in another aspect, relates to a method for delivering energy to biological tissue while maintaining the temperature of the biological tissue near a target temperature.
  • the method comprises positioning a plurality of electrodes proximal the biological tissue. At least one of the electrodes carries a temperature sensing device for providing a temperature signal indicative of the temperature at the interface between the electrode and the tissue.
  • the method also includes providing power to each of the electrodes. The power has, within a time duration, a plurality of alternating on periods and off periods, wherein one set of adjacent on and off periods defines a duty cycle.
  • Also included in the method is, during the on period of each duty cycle, providing power with different phase angles to at least two of the electrodes; determining the temperature at the at least one electrode/tissue interface in response to the temperature signal; comparing the at least one electrode/tissue interface temperature to the target temperature; and adjusting the duty cycle of the power provided to the at least one electrode in response to the comparison.
  • the invention in another aspect, relates to a method for delivering energy to biological tissue while maintaining the temperature of the biological tissue near a target temperature.
  • the method comprises positioning a catheter having a plurality of electrodes at its distal end so that the electrodes are located proximal the biological tissue.
  • a select number of the electrodes carry at least one temperature sensing device.
  • the device provides a temperature signal indicative of the temperature at the interface between the electrode and the tissue.
  • the method also includes providing power having an associated phase and, within a time duration, a plurality of alternating on periods and off periods, one set of adjacent on and off periods defining a duty cycle.
  • the method further includes, in response to the temperature signals, determining the temperature at the electrode/tissue interface; individually regulating the temperature of a plurality of temperature zones, wherein each zone comprises at least one combination electrode/temperature sensing device.
  • the temperature is regulated by controlling the power to at least one electrode in the zone.
  • the method further includes regulating the power to a plurality of phase groups, wherein each group comprises at least one electrode.
  • the power is regulated by controlling the phase of the power to each electrode in the group such that during the on portion of a duty cycle the phase in one group is different then the phase in another group.
  • FIG. 1 is a schematic diagram of an ablation apparatus including a power control system, electrode device and backplate;
  • FIGS. 2 - 1 and 2 - 2 form a block diagram presenting more detail of a power control system in accordance with aspects of the invention, showing phase angle control, duty cycle control, and impedance and temperature monitoring;
  • FIG. 3 is a diagram of a multi-channel ablation apparatus in accordance with aspects of the invention wherein a single microprocessor controls the phase angle and duty cycle of each channel individually;
  • FIG. 4 depicts a first power waveform having a first phase angle and alternating instances of peak power and very low power
  • FIG. 5 depicts a second power waveform having a second phase angle different from the first phase angle and alternating instances of peak power and very low power;
  • FIG. 6 presents a time frame (TF) diagram showing a fifty-percent duty cycle
  • FIG. 7A depicts the phase relationship and voltage potential between the first and second power waveforms having first and second phase angles respectively, as a function of time;
  • FIG. 7B depicts the phase relationship and voltage potential between the first and second power waveforms having second and first phase angles respectively, as a function of time;
  • FIGS. 8A, 8B, 8 C, 8 D, and 8 E are schematic diagrams of an embodiment of a power control system in accordance with aspects of the invention with FIG. 8A showing how FIGS. 8B, 8C, 8 D and 8 E are related;
  • FIG. 9A is a three dimensional representation of an ablation apparatus having a linear array of band electrodes in contact with a biological site with a backplate at the opposite side of the biological site, in which the phase angle difference between adjacent electrodes of the linear array is zero degrees;
  • FIGS. 9B through 9D depict, along the x, y, and z axes shown, the depth of the lesions formed by the ablation apparatus of FIG. 9A showing that the apparatus acts as a unipolar device with multiple electrodes and the resulting lesions are discontinuous;
  • FIG. 10A is a three dimensional representation of an ablation apparatus having a linear array of band electrodes in contact with a biological site with a backplate at the opposite side of the biological site, in which the phase angle difference between adjacent electrodes is 180 degrees;
  • FIGS. 10B through 10D depict, along the x, y, and z axes shown, the continuity and depth of a lesion formed by the ablation apparatus of FIG. 10A showing that the apparatus acts as a bipolar device with no significant amount of current flowing to the backplate;
  • FIG. 11A is a three dimensional representation of an ablation apparatus having a linear array of band electrodes in contact with a biological site with a backplate at the opposite side of the biological site, in which the phase difference between adjacent electrodes is approximately 90 degrees;
  • FIGS. 11B through 11D depict, along the x, y, and z axes shown, the continuity and depth of a lesion formed by the ablation apparatus of FIG. 11A showing the greater depth of lesion resulting from the phase angle difference.
  • FIG. 12 presents a block diagram of the current flow among electrodes and the backplate through the biological site for adjacent electrodes having different phase angles
  • FIG. 13 presents the same block diagram as FIG. 12 with the phase angles between adjacent electrodes reversed.
  • FIGS. 14A through 14D present, along the x, y, and z axes shown, the increased continuity, depth, and uniformity of a lesion formed by the alternating phase apparatus and method shown in previous figures.
  • FIG. 1 there is shown an ablation apparatus 10 in accordance with aspects of the present invention.
  • the apparatus 10 includes a power control system 12 that provides power or drive 14 to an electrode device 16 .
  • the power control system 12 comprises a power generator 18 that may have any number of output channels through which it provides the power 14 .
  • the operation of the power generator 18 is controlled by a controller 20 which outputs control signals 21 to the power generator 18 .
  • the controller 20 monitors the power 14 provided by the power generator 18 .
  • the controller 20 also receives temperature signals 22 from the electrode device 16 . Based on the power 14 and temperature signals 22 the controller 20 adjusts the operation of the power generator 18 .
  • a backplate 24 is located proximal to the biological site 26 opposite the site from the electrode device 16 , and is connected by a backplate wire 28 to the power generator 18 .
  • the backplate 24 is set at the reference level to the power provided to the electrodes, as discussed in detail below.
  • the electrode device 16 is typically part of a steerable EP catheter 30 capable of being percutaneously introduced into a biological site 26 , e.g., the atrium or ventricle of the heart.
  • the electrode device 16 is shown in schematic form with the components drawn to more clearly illustrate the relationship between the components and the relationship between the components and the power control system 12 .
  • the catheter 30 comprises a distal segment 34 and a handle 31 located outside the patient.
  • a preferred embodiment of the electrode device 16 includes twelve band electrodes 32 arranged in a substantially linear array along the distal segment 34 of the catheter 30 .
  • the electrode device 16 may include a tip electrode 36 .
  • band electrodes 32 are arranged so that there is space 38 between adjacent electrodes.
  • the width of the band electrodes 32 is 3 mm and the space 38 between the electrodes is 4 mm.
  • the total length of the electrode device 16 is approximately 8 cm.
  • the arrangement of the band electrodes 32 is not limited to a linear array and may take the form of other patterns.
  • a substantially linear array is preferred for certain therapeutic procedures, such as treatment of atrial fibrillation, in which linear lesions of typically 4 to 8 cm in length are desired.
  • a linear array is more easily carried by the catheter 30 and also lessens the size of the catheter.
  • the band electrodes 32 are formed of a material having a significantly higher thermal conductivity than that of the biological tissue 26 . Possible materials include silver, copper, gold, chromium, aluminum, molybdenum, tungsten, nickel, platinum, and platinum/10% iridium. Because of the difference in thermal conductivity between the electrodes 32 and the tissue 26 , the electrodes 32 cool off more rapidly in the flowing fluids at the biological site. The power supplied to the electrodes 32 may be adjusted during ablation to allow for the cooling of the electrodes while at the same time allowing for the temperature of the tissue to build up so that ablation results.
  • the electrodes 32 are sized so that the surface area available for contact with fluid in the heart, e.g., blood, is sufficient to allow for efficient heat dissipation from the electrodes to the surrounding blood.
  • the electrodes 32 are 7 French (2.3 mm in diameter) with a length of 3 mm.
  • the thickness of the band electrodes 32 also affects the ability of the electrode to draw thermal energy away from the tissue it contacts.
  • the electrodes 32 are kept substantially thin so that the electrodes effectively draw energy away from the tissue without having to unduly increase the outer diameter of the electrode.
  • the thickness of the band electrodes is 0.05 to 0.13 mm (0.002 to 0.005 inches).
  • each band electrode 32 has a temperature sensor 40 mounted to it.
  • Each temperature sensor 40 provides a temperature signal 22 to the controller 20 which is indicative of the temperature of the respective band electrode 32 at that sensor.
  • a temperature sensor 40 is mounted on every other band electrode 32 .
  • every other electrode has two temperature sensors 40 .
  • FIG. 1 which shows an embodiment having one temperature sensor for each electrode, there is shown a single power lead 15 for each electrode 32 to provide power to each electrode for ablation purposes and two temperature leads 23 for each temperature sensor 40 to establish the thermocouple effect.
  • the drive wire may comprise one of the thermocouple wires or may comprise a common wire for a plurality of thermocouples mounted on the same electrode.
  • the inventors hereby incorporates by reference U.S. Pat. Nos. 6,049,737 and 6,045,550 both of which are assigned to the assignee of the present invention.
  • FIGS. 2 - 1 and 2 - 2 a block diagram of an ablation apparatus 10 and method in accordance with aspects of the invention is presented.
  • a single channel of the power control system 12 is depicted. This channel controls the application of power to a single electrode 32 .
  • a channel may control a plurality or group of electrodes.
  • a microprocessor 42 which is part of the controller 20 (FIG. 1), provides a duty cycle control signal 44 to a duty cycle generator (“DCG”) 45 .
  • DCG duty cycle generator
  • the duty cycle generator 45 receives the control signal 44 by an 8-bit latch 46 .
  • the latch 46 provides an 8-bit signal 47 to a duty cycle comparator 48 .
  • the comparator 48 compares the 8-bit signal 47 to a count from an 8-bit duty cycle counter 50 and if the count is the same, provides a duty cycle off signal 49 to the duty cycle gate 52 .
  • the gate 52 is connected to a frequency source (“FS”) 54 , such as an oscillator that produces 500 kHz.
  • FS frequency source
  • an 8-bit control has a period or time frame of 0.5 msec.
  • the electrode is in the off period only 0.25 msec.
  • the period or time frame 78 (FIG. 6) is lengthened by use of a prescalar 56 interposed between the frequency source 54 and the counter 50 .
  • the prescalar 56 lengthens the period to 4 msec thus allowing for a 2 msec off period during a fifty-percent duty cycle. This results in a sufficient cooling time for the very thin band electrodes discussed above. Other lengths of the period may be used depending on the circumstances.
  • a terminal count detector 58 detects the last count of the period and sends a terminal count signal 59 to the gate 52 which resets the gate for continued output of the frequency source signal. This then begins the on period of the duty cycle and the counter 50 begins its count again.
  • the duty cycle is set at fifty percent and the 8-bit latch is accordingly set to 128. In another embodiment, the duty cycle is set at ten percent.
  • a programmable logic array (“PLA”) 60 receives phase control signals 61 from the microprocessor 42 and controls the phase of the frequency source 54 accordingly.
  • the PLA 60 receives the terminal count signal 59 from the terminal count detector 58 and only permits phase changes after receiving that terminal count signal.
  • the output signal from the gate 52 during the on period of the duty cycle is provided to a binary power amplifier (“BPA”) 62 that increases the signal to a higher level, in this case, 24 volts.
  • BPA binary power amplifier
  • the amplified signals are then filtered with a band pass filter (“BPF”) 64 to convert the somewhat square wave to a sine wave.
  • the band pass filter 64 in one embodiment is centered at 500 kHz.
  • IOT isolated output transformer
  • This signal is then sent to a relay interconnect (“RI”) 67 before it is provided as a power output signal OUTn 14 to an electrode 32 at the biological site to cause ablation.
  • the power output signal 14 from the isolated output transformer 66 is monitored in one embodiment to determine the impedance at the electrode 32 .
  • a voltage and current monitor (“VCM”) 68 is used.
  • the monitor signal 69 is converted to digital form by an A-to-D converter (“ADC”) 70 and provided to the microprocessor 42 .
  • ADC A-to-D converter
  • some or all of the electrodes 32 may include a temperature sensor 40 (FIG. 1) that provides temperature signals 22 (FIG. 2- 2 ) which are used to determine the temperature at the electrode 32 .
  • the power 14 in conjunction with the temperature signals 22 , are used to determine the temperature at the electrode 32 .
  • Both the temperature signals 22 and the power 14 pass through a temperature filter (“FL”) 73 before being sent to the microprocessor 42 .
  • the temperature filter 73 is contained in a printed circuit board separate from the controller 20 and contains its own processor. In either case, the filter 73 filters out any RF noise present in the power 14 so that the signal may be used for temperature monitoring purposes.
  • the microprocessor monitors the power 14 and temperature signals 22 only during the off periods of the power 14 duty cycle. Accordingly, negligible RF noise is present in the power line and filtration is not necessary.
  • the microprocessor 42 may alter the duty cycle of the power 14 in response to either or both of the impedance or temperature signals.
  • the temperature sensed and/or the determined impedance may be displayed to an operator.
  • the operator in response may then manually control the duty cycle or other power parameters such as by rotating a knob mounted on a front panel of an instrument.
  • a knob mounted on a front panel of an instrument In the case of a multiple channel instrument and catheter, as discussed below, multiple knobs may be provided in this manual arrangement for control over each channel.
  • FIG. 3 a multiple channel ablation apparatus is shown. Although only three complete channels are shown, the apparatus comprises many more as indicated by the successive dots. Those channels are not shown in FIG. 3 to preserve clarity of illustration.
  • By providing different voltage levels between two electrodes 32 in an array current flows between those electrodes in a bipolar electrode approach.
  • By setting the backplate 24 (FIG. 1) at a voltage level different from at least one of those electrodes 32 , current flows between that electrode and the backplate.
  • the current flow through the biological site 26 can be more precisely controlled.
  • One technique for setting different voltage levels between the electrodes 32 is to maintain a phase difference between them in an AC approach. By setting the backplate 24 at the reference level, current flows between the electrodes 32 and the backplate.
  • the single microprocessor 42 which again is part of the controller 20 (FIG. 1), controls the duty cycle and the phase of each channel individually in this embodiment.
  • Each channel shown comprises the same elements and each channel produces its own power output signal 14 (OUT 1 , OUT 2 , through OUTn where “n” is the total number of channels) on respective electrode leads (LEAD 1 , LEAD 2 , through LEAD n where “n” is the total number of leads) to the electrodes 32 .
  • This multi-channel approach permits more individual control over each electrode.
  • the duty cycle of the power applied to each electrode can be individually controlled.
  • One electrode may have a ten percent duty cycle while another has a thirty percent duty cycle.
  • the signals as shown in FIGS. 4, 5, and 6 , have alternating instances of peak power i.e., “on” periods 74 , and very low power 76 , i.e., “off” periods.
  • the output power 14 is a 500 kHz sine wave.
  • the number of cycles of the sine wave contained within one on period 74 has been substantially reduced in the drawing to emphasize the phase difference between the first and second output signals OUT 1 , OUT 2 .
  • the voltage of each power signal 14 during an off period 76 is substantially zero and during an on period 74 is approximately 350 volts peak-to-peak.
  • the power OUT 1 and OUT 2 also have a variable duty cycle for controlling the length of the on period 74 and the off-period 76 within a time frame 78 (see FIG. 6).
  • the duty cycle is the ratio of the length of the on period 74 to the length of the entire time frame 78 .
  • the effective power is the peak power times the duty cycle. Thus, a signal having a peak power of 100 watts and a 50% duty cycle has an effective power of 50 watts.
  • the two power signals OUT 1 , OUT 2 are phased differently from each other.
  • the phase angle of each power signal is set and controlled by the processor 42 and PLA 60 .
  • Each power signal OUT 1 and OUT 2 has a respective phase angle and those phase angles differ between the two of them.
  • the phase angle difference between the power OUT 1 and OUT 2 produces a voltage potential between the band electrodes 32 (FIG. 1) that receive the power. This voltage potential, in turn, induces current flow between the band electrodes 32 .
  • FIGS. 7A and 7B The phase angle relationship of the power and the voltage potential produced as a function of time is shown in FIGS. 7A and 7B.
  • V e-e 2 ⁇ V ⁇ ⁇ sin ⁇ ( ⁇ ⁇ ⁇ ⁇ 2 ) ⁇ sin ⁇ ( 2 ⁇ ⁇ ⁇ ⁇ ⁇ f ⁇ ⁇ t ) (Eq. 1)
  • V voltage amplitude of power
  • FIG. 7A shows first and second power OUT 1 and OUT 2 provided to first and second electrodes respectively having a phase angle difference ⁇ with OUT 1 leading OUT 2 by 132 degrees.
  • FIG. 7B shows the same power OUT 1 and OUT 2 but with the phase angles reversed where OUT 2 is now leading OUT 1 by 132 degrees.
  • FIGS. 8A through 8E schematic diagrams of an embodiment of the ablation apparatus 10 of FIGS. 2 - 1 and 2 - 2 are presented in FIGS. 8B through 8E while FIG. 8A shows how FIGS. 8B through 8E should be oriented in relation to each other.
  • the frequency source 54 provides a signal 80 , typically at 500 kHz with a phase angle controlled by the microprocessor 42 through the PLA 60 , to the duty cycle generator 45 .
  • the duty cycle generator 45 modulates the frequency source signal 80 to produce the selected duty cycle in accordance with the duty cycle control signal 44 as previously described.
  • the duty cycle generator 45 outputs two signals 82 and 84 to the binary power amplifier 62 .
  • a dual MOSFET driver U 2 receives the signals, converts their 5V level to a 12V level, and sends each to a transformer T 2 which transforms the signals into 24 V peak-to-peak power.
  • the 24V power is then sent to a multi-state driver 86 which includes a configuration of FETs Q 2 , Q 3 , Q 4 , and Q 5 .
  • a conducting state of the driver 86 which is typically the on period 74 of the power, these FETs Q 2 through Q 5 conduct and forward the power to a bandpass filter 64 comprising a series LC network.
  • a high-impedance state of the driver 86 which is typically during the off period 76 of the power, the FETs Q 2 through Q 5 are nonconducting and no power is sent to the bandpass filter 64 . Instead the FETs Q 2 through Q 5 present a high impedance load to any signals received through the electrode 32 .
  • the load impedance on the FETs Q 2 through Q 5 presented by the circuit following the FETs, the electrode, and the tissue is approximately 150 ⁇ but transformed through the output transformer T 3 , it presents a load impedance to the FETs Q 2 -Q 5 of approximately 0.5 to 1 ⁇ .
  • the FETs In the off state, the FETs present an impedance of approximately 250 ⁇ which is large in comparison to the transformed load impedance of approximately 0.5 to 1 ⁇ . Therefore, very little power flows when the FETs are in the off state.
  • the bandpass filter 64 operates to shape the output signal provided by the binary amplifier 62 from a square wave to a sinusoidal wave.
  • the filtered signal 85 then passes to the isolated output section 66 where it is step-up transformed to 350 volt peak-to-peak sinusoidal power at T 3 .
  • the power is then split into two identical power signals OUT 1 A, OUT 1 B and provided to two or more respective band electrodes 32 on the output lines LEAD 1 A, LEAD 1 B.
  • the isolated output section 66 also includes relays 88 that may be individually opened to remove the power signals OUT 1 A, OUT 1 B from the electrode leads LEAD 1 A, LEAD 1 B when an alert condition is detected, such as high temperature or high impedance at the respective electrode 32 . As previously mentioned these conditions are determined by the microprocessor 42 which receives signals indicative of the temperature and impedance at each of the band electrodes 32 .
  • the power from the isolated output section 66 is monitored and representative signals are supplied to an RF voltage and current monitor 68 where in this case, the voltage and current of each output signal are measured to determine the impedance of the particular channel.
  • the measured signals are sent to an A-to-D converter 70 (FIG. 2- 2 ) before being sent to the microprocessor 42 for impedance monitoring. If the impedance is above a threshold level indicative of blood clotting or boiling, the microprocessor 42 sends a signal to the duty cycle generator 45 to reduce or discontinue the duty cycle of the power OUT 1 A, OUT 1 B and thus lower the effective power delivered to the band electrodes 32 .
  • the temperature at the electrodes 32 is determined by monitoring the power 14 and temperature signals 22 and measuring the voltage difference between the signals. As previously mentioned, in one embodiment of the invention, these signals pass through a filter 73 (FIG. 2- 2 ) before being sent to the microprocessor 42 . The voltage value is converted to a temperature and if the temperature is above a threshold level the duty cycle of the power 14 is reduced. In the case where a single lead is used to provide a signal which is used to determine the temperature as well as provide power to the electrode 32 , the signal from the lead is received on temperature leads 87 , 89 connected at the output side of the relays 88 .
  • the duty cycle of each electrode 32 may be individually controlled by the microprocessor 42 .
  • the duty cycle of the output signal may be adjusted. For example, one electrode 32 may have a temperature requiring a duty cycle of ten percent, while another electrode may have a temperature which allows for a fifty percent duty cycle.
  • every other electrode 32 has a temperature sensor 40 , the electrodes are grouped in pairs with each electrode in the pair having the same duty cycle.
  • the electrode device 16 and the backplate 24 are positioned proximal the biological site 26 undergoing ablation such that the biological site is interposed between the electrode device and the backplate.
  • the band electrodes 32 (only one of which is indicated by a numeral 32 for clarity of illustration) of the electrode device 16 each receives power OUT 1 , OUT 2 , OUT 3 , OUT 4 having a phase angle on LEAD 1 through LEAD 4 .
  • every other electrode 32 receives the same phase angle. Therefore, the phase angle of electrode A equals the phase angle of electrode C and the phase angle of electrode B equals the phase angle of electrode D.
  • the electrodes 32 are formed into a linear array as shown.
  • a thermocouple temperature sensor 40 is located at each of the electrodes A, B, C, and D and uses the electrode power lead LEADS 1 through 4 as one of the sensor leads. The sensors 40 provide temperature sensor signals 22 for receipt by the power control system 12 .
  • alternate electrodes 32 may be grouped together and each may receive the same power having the same phase angle and duty cycle. Another group or groups of electrodes 32 may be interspaced with the first group such that the electrodes of one group alternate with the electrodes of the other group or groups. Each electrode 32 in a particular group of electrodes has the same phase angle and duty cycle. For example, electrodes A and C may be connected to the same power while interspaced electrodes B and D may be connected to a different power output signal.
  • the use of individual power signals also provides the ability to disable any combination of electrodes 32 and thereby effectively change the length of the electrode device 16 .
  • an electrode device 16 with twelve electrodes 32 receives twelve power signals from a twelve channel power control system 12 .
  • the electrodes 32 are 3 mm in length and are 4 mm apart. Accordingly, by disabling various electrodes, a virtual electrode of any length from 3 mm to 8 cm may be produced by the electrode device 16 .
  • the backplate 24 is maintained at the reference voltage level in regard to the voltage level of the power OUT 1 through OUTn.
  • phase angle difference is established between adjacent band electrodes.
  • This phase angle difference may be adjusted to control the voltage potential between adjacent band electrodes 32 and thus to control the flow of current through the biological site 26 .
  • V voltage amplitude of power
  • I e-b V ⁇ ⁇ sin ⁇ ⁇ ( 2 ⁇ ⁇ ⁇ ⁇ ⁇ f ⁇ ⁇ t ) Z e - b (Eq. 3)
  • V voltage amplitude of power
  • FIGS. 9A through 11D illustrate various current flow patterns within a biological site.
  • the depths and widths of the lesions depicted in FIGS. 9 through 11 are not necessarily to scale or in scalar proportion to each other but are provided for clarity in discerning the differences between the various power application techniques.
  • the phase difference between adjacent electrodes 32 is zero degrees, no current flows between the electrodes in accordance with Eq. 2 above, and the apparatus operates in a unipolar fashion with the current flowing to the backplate 24 as shown in FIGS. 9A through 9D.
  • the lesions are discrete.
  • the lesions 90 are discontinuous in regard to each other.
  • the phase difference between adjacent electrodes 32 is set within the range of a value greater than zero to less than 180 degrees, the current flow varies from a deep, discontinuous unipolar pattern to a more continuous, shallow bipolar pattern.
  • the current flows as shown in FIG. 11A.
  • FIGS. 11B through 11D The continuity and depth of the lesion 94 is illustrated in FIGS. 11B through 11D.
  • adjacent electrodes alternated in phase but were provided with power in groups. Electrodes A and C were provided with power at a first phase angle and electrodes B and D were provided with power at a second phase angle, different from the first.
  • the phase angle of the power may be adjusted in order to produce a lesion having different depth and continuity characteristics.
  • other elements of the electrode device 16 are considered.
  • the width of the band electrodes 32 and the spacing between the electrodes are factors in selecting an optimum phase angle.
  • the width of the band electrodes is 3 mm
  • the spacing between the electrodes is 4 mm
  • the electrodes receive power which establish a phase difference of 132 degrees between adjacent electrodes.
  • energy is applied to the biological tissue 26 during the on period of the duty cycle in an alternating unipolar-bipolar manner.
  • a voltage potential is established between the electrodes 32 and the backplate 24 .
  • current flows through the tissue 26 between the electrodes 32 and the backplate 24 .
  • a voltage potential is established between at least two of the electrodes 32 rather than between the electrodes and the backplate 24 .
  • current flows through the tissue 26 between the electrodes 32 .
  • the voltage difference between the electrodes 32 may be established by providing power with different phase angles to the electrodes as previously mentioned.
  • some of the electrodes 32 may be connected to a reference potential while others are maintained at a different voltage level.
  • the continuity and depth of the lesion produced may be controlled. For example, operating in the unipolar mode for one-fourth of the on period and in the bipolar mode for three-fourths of the on period produces a lesion having a continuity and depth similar to the lesion 94 illustrated in FIGS. 11B through 11D.
  • FIGS. 8 B through and 8 E the following devices are shown: Device Part No. Manufacturer U1 GAL6002B Lattice U2 SN75372 numerous Q1 1RFZ34N numerous Q2, Q3, Q4, Q5 1RFZ44N numerous Q7, Q8, Q9 MPF6601 numerous R3, R5 1 ⁇ numerous T1, T4 CMI-4810 Corona Magnetics, Inc. T2 GFS97-0131-1 GFS Manufacturing T5 CMI-4809 Corona Magnetics, Inc.
  • the transformer denoted by “T 3 ” is a 1:12 turns ratio, single turn primary, step up transformer wound on a TDK core PC50EER23Z.
  • FIG. 12 presents a block diagram of the current flow among electrodes 32 and the backplate 24 through the biological site 26 for adjacent electrodes having different phase angles where the phase angles of the A and C electrodes lead the phase angles of the B and D electrodes. It has been noted that with the approach shown in FIG. 12, the vector sum of the currents flowing through the site 26 is such that more current flows at one or more electrodes than at others. This is shown figuratively with shorter arrows leading to the backplate from the B and D electrodes. Although the ablation volume is greater than in the prior techniques, the ablation volume appears irregular or nonuniform as shown in FIG. 11D. It is desirable to have a more uniform ablation volume, especially as to depth, so that irregular electrical signals do not pass under the ablation volume at a point having less depth and require a repeat of the ablation procedure.
  • FIG. 13 presents the same block diagram as FIG. 12 with the phase angles between adjacent electrodes reversed.
  • the phase angles of the power at the B and D electrodes 32 now lead the phase angles of the power at the A and C electrodes 32 .
  • the change in current flow due to this opposite phasing is represented figuratively with shorter arrows now at the A and C electrodes thus balancing the current flow pattern of FIG. 12. It has been found that by alternating the phase angles such as shown in FIGS. 12 and 13, a much more uniform current flow and much more uniform ablation volume result.
  • a cumulative effect of the current flow causes the tissue between all the band electrodes 32 and the backplate 24 to become ablated, depth-wise through the biological site 26 , at a substantially even rate and thus a lesion having substantially uniform depth is produced.
  • FIGS. 14A through 14D where an ablation volume 96 is shown, which has much greater uniformity in shape.
  • the ablation lesion 96 has a uniform depth and gives rise to a high level of confidence that the ablation volume created with the ablation apparatus in accordance with the invention will successfully destroy the tissue causing the arrhythmia.
  • the phase between the electrodes was alternated as shown in FIGS. 12 and 13 only during the off period of the duty cycle. That is, and with reference to FIG. 6, during the entire on period 74 of the duty cycle of one time frame 78 , the phase angles of the power at the A and C electrodes 32 led the phase angles of the power at the B and D electrodes 32 by 132 degrees. During the following off period 76 of the same time frame 78 , the phase angles of the power to be supplied was changed to be opposite those phase angles used during the on period 74 , in preparation for the next on period.
  • phase angles of the power provided to electrodes B and D led the phase angles of the power provided to the A and C electrodes by 132 degrees during that entire on period. During the immediately subsequent off period, the phase angles were again changed so that electrodes A and C would lead electrodes B and D.
  • the processor 42 monitors the temperatures at the electrodes/tissue interface and automatically makes power adjustments in view of these temperatures.
  • the tissue temperature may range from 50° C. to 65° C.
  • the temperature of each electrode/tissue interface is monitored and the power applied to each electrode 32 is individually adjusted to maintain the electrode/tissue interface temperature at or near the target temperature.
  • An interface temperature within 5° C. degrees of the target temperature is considered to be “near” the target temperature.
  • Adjustments to the power are made by changing the duty cycle of the power being applied to the electrode 32 . When the electrode/tissue interface temperature is less than the target temperature, the duty cycle is increased. Conversely, when the interface temperature is greater than the target temperature, the duty cycle is decreased.
  • the processor 42 may institute a “soft cutoff.” During a soft cutoff the processor temporarily sets the power to an electrode 32 to zero by setting the duty cycle of the power such that there is no on portion of the duty cycle. During this continuous off period, the electrode/tissue interface is able to cool off to a temperature less than the temperature that caused the cutoff and usually to a temperature less than the target temperature. Once the interface cools off, the processor 42 incrementally increases the power to the electrode 32 until the interface temperature settles to a temperature near the target temperature. The incremental increase in power may be achieved by programming the processor, using well known proportional integral derivative (PID) algorithms, to increase the duty cycle in either a step like or smooth, continuous manner.
  • PID proportional integral derivative
  • Conditions which necessitate a soft cutoff may be programmed into the processor 42 .
  • Such condition may include an interface temperature that is greater than the target temperature by a first specified number of degrees. For example, if the target temperature is 65° C. and the measured interface temperature is at least 5 degrees greater than 65° C., then the electrode may be subject to a soft cutoff.
  • the processor 42 may institute a “hard cutoff.” During a hard cutoff, power to an electrode 32 may be interrupted by opening the relay 88 (FIG. 80) associated with the power output providing the power to the electrode 32 . Conditions which necessitate a hard cutoff may be programmed into the processor 42 . Such conditions may include an interface temperature that is greater than the target temperature by a second specified number of degrees that is greater than the specified number of degrees associated with a soft cutoff. For example, if the target temperature is 65° C. and the measured interface temperature is at least 10 degrees greater than 65° C., then the power to the electrode may be interrupted.
  • the electrodes 32 are grouped into electrode zones, with each zone including one or more electrodes.
  • the electrodes within a zone are adjacent each other.
  • At least one of the electrodes 32 within each zone includes a temperature sensor 40 .
  • the processor 42 monitors the interface temperatures of each electrode 32 having a temperature sensor 40 and adjusts the power to each of the electrodes within an electrode zone based on the maximum interface temperature in that zone. Accordingly, if the electrode 32 having the maximum interface temperature provides an interface temperature sufficient to warrant a duty cycle increase, duty cycle decrease, soft cutoff or hard cutoff, each electrode 32 within the zone is subject to the same adjustment.
  • controller 20 is shown in FIG. 1 as forming a part of the power control system 12 .
  • it may take other forms such as an external processor in a separate computer for example.
  • duty cycle control and phase control may be performed by circuits other than those shown here. Accordingly, it is not intended that the invention be limited, except as by the appended claims.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Otolaryngology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Surgical Instruments (AREA)

Abstract

A plurality of electrodes are positioned at the distal end of a catheter such that the electrodes may be positioned proximal biological tissue. A select number of the electrodes have a temperature sensing device associated with them for providing a temperature signal indicative of the temperature at the interface between the electrode and the tissue. A generator operates under the control of a processor to apply power to each of the electrodes. The power has an associated phase angle and, within a time duration, a plurality of alternating on periods and off periods, one set of adjacent on and off periods defining a duty cycle. The processor is programmed to determine the temperature at the electrode/tissue interface based on the temperature signals, compare the temperature to a target temperature and to adjust the power to the electrode accordingly. Such adjustments may comprise an increase or decrease in the duty cycle, a setting of the duty cycle to zero followed by an incremental increase in the duty cycle or a power interrupt.

Description

    RELATED APPLICATIONS
  • This is a continuation of application Ser. No. 09/738,032, filed Dec. 13, 2000 which is a continuation-in-part of application Ser. No. 09/501,472, filed Feb. 9, 2000, now U.S. Pat. No. 6,200,314, which is a division of application Ser. No. 09/073,392, filed May, 5, 1998, now U.S. Pat. No. 6,059,778.[0001]
  • BACKGROUND OF THE INVENTION
  • The invention relates generally to an electrophysiological (“EP”) apparatus and method for providing energy to biological tissue, and more particularly, to a radio frequency (“RF”) ablation apparatus for controlling the flow of current through, and the temperature of, a biological site so that the volume of ablation lesions may be controlled. [0002]
  • The heart beat in a healthy human is controlled by the sinoatrial node (“S-A node”) located in the wall of the right atrium. The S-A node generates electrical signal potentials that are transmitted through pathways of conductive heart tissue in the atrium to the atrioventricular node (“A-V node”) which in turn transmits the electrical signals throughout the ventricle by means of the His and Purkinje conductive tissues. Improper growth of, or damage to, the conductive tissue in the heart can interfere with the passage of regular electrical signals from the S-A and A-V nodes. Electrical signal irregularities resulting from such interference can disturb the normal rhythm of the heart and cause an abnormal rhythmic condition referred to as “cardiac arrhythmia.”[0003]
  • While there are different treatments for cardiac arrhythmia, including the application of anti-arrhythmia drugs, in many cases ablation of the damaged tissue can restore the correct operation of the heart. Such ablation can be performed by percutaneous ablation, a procedure in which a catheter is percutaneously introduced into the patient and directed through an artery to the atrium or ventricle of the heart to perform single or multiple diagnostic, therapeutic, and/or surgical procedures. In such case, an ablation procedure is used to destroy the tissue causing the arrhythmia in an attempt to remove the electrical signal irregularities or create a conductive tissue block to restore normal heart beat or at least an improved heart beat. Successful ablation of the conductive tissue at the arrhythmia initiation site usually terminates the arrhythmia or at least moderates the heart rhythm to acceptable levels. A widely accepted treatment for arrhythmia involves the application of RF energy to the conductive tissue. [0004]
  • In the case of atrial fibrillation (“AF”), a procedure published by Cox et al. and known as the “Maze procedure” involves continuous atrial incisions to prevent atrial reentry and to allow sinus impulses to activate the entire myocardium. While this procedure has been found to be successful, it involves an intensely invasive approach. It is more desirable to accomplish the same result as the Maze procedure by use of a less invasive approach, such as through the use of an appropriate EP catheter system. [0005]
  • There are two general methods of applying RF energy to cardiac tissue, unipolar and bipolar. In the unipolar method a large surface area electrode; e.g., a backplate, is placed on the chest, back or other external location of the patient to serve as a return. The backplate completes an electrical circuit with one or more electrodes that are introduced into the heart, usually via a catheter, and placed in intimate contact with the aberrant conductive tissue. In the bipolar method, electrodes introduced into the heart have different potentials and complete an electrical circuit between themselves. In the bipolar method, the flux traveling between the two electrodes of the catheter enters the tissue to cause ablation. [0006]
  • During ablation, the electrodes are placed in intimate contact with the target endocardial tissue. RF energy is applied to the electrodes to raise the temperature of the target tissue to a non-viable state. In general, the temperature boundary between viable and non-viable tissue is approximately 48° Centigrade. Tissue heated to a temperature above 48° C. becomes non-viable and defines the ablation volume. The objective is to elevate the tissue temperature, which is generally at 37° C., fairly uniformly to an ablation temperature above 48° C., while keeping both the temperature at the tissue surface and the temperature of the electrode below 100° C. [0007]
  • A basic configuration of an ablation catheter for applying RF energy includes a distal tip which is fitted with an electrode device. The electrode device is the source of an electrical signal that causes heating of the contacting and neighboring tissue. In the unipolar method, the electrode device may include a single electrode used for emitting RF energy. This single electrode acts as one electrical pole. The other electrical pole is formed by the backplate in contact with a patient's external body part. A RF source is applied to the electrode. The RF source is typically in the 500 kHz region and produces a sinusoidal voltage. When this is delivered between the distal tip of a standard electrode catheter and a backplate, it produces a localized RF heating effect and produces a well defined, deep acute lesion slightly larger than the tip electrode. [0008]
  • In some procedures a lesion having a larger surface area than that produced by a single electrode in a unipolar arrangement may be required. To this end numerous ablation catheters have been designed. In one catheter designed to provide a larger surface ablation area, an electrode device having four peripheral electrodes which extend from a retracted mode is used. See U.S. Pat. No. 5,500,011 to Desai. When extended, i.e., fanned out, the four peripheral electrodes and the central electrode form an electrode array that covers a larger surface area of the tissue than a single electrode. When used with a conventional RF power source, and in conjunction with a backplate, the five electrodes produce five lesion spots distributed over the area spanned by the electrode array. The lesions produced are discontinuous in relation to each other and there are areas between the electrodes that remain unablated. This device must be manipulated so that when expanded, all electrodes are in contact with the endocardium. An “end on” approach is required such that the end of the catheter, on which all five electrodes are mounted, is in intimate contact with the target tissue. [0009]
  • In another catheter an electrode device having a central electrode and a number of peripheral electrodes which also fan out from a retracted mode is used. During ablation a backplate is not used; instead the central electrode functions as the reference while the peripheral electrodes have multi-phase RF power applied to them. For example, see U.S. Pat. No. 5,383,917 to Desai et al. While this technique provides a more continuous lesion covering a larger surface area of the tissue, the ablation volume is relatively shallow with a nonuniform depth of the lesion. This arrangement also requires the same manipulation of the catheter such that an end-on contact is made by the expanded electrodes, as discussed above. Lesions having a non-uniform ablation volume are undesirable as the depth at one part of the lesion may not be sufficient to stop the irregular signal pathways. Arrhythmia may reoccur because the irregular signals may pass under such an ablation volume and the procedure must then be repeated to once again attempt to obtain an ablation volume having sufficient depth. [0010]
  • The mechanical configuration of both of the above-described techniques comprises an expanding approach. When used for ablation, an electrode device is typically part of a catheter system. Accordingly, it is desirable to minimize the diameter of the electrode device during introduction to and withdrawal from the patient to lessen trauma to the patient. Therefore, electrode devices having peripheral expandable electrodes must be configured so that the peripheral electrodes are expandable to a large size yet are retractable to as small a size as practical. Such requirements pose design and manufacturing difficulties due to the movement of mechanical parts required for proper operation. Further considerations are the undesirable complexity and increased manufacturing cost associated with an expandable a catheter. [0011]
  • Hence, those skilled in the art have recognized a need for a structurally stable invasive ablation apparatus and method that are capable of controlling the flow of current through, and temperature of, a biological site so that lesions with controllable surface and depth characteristics may be produced and the ablation volume thereby controlled. The invention fulfills these needs and others. [0012]
  • SUMMARY OF THE INVENTION
  • Briefly, and in general terms, the invention is directed to an apparatus and a method for controlling the application of energy to, and the temperature of, a biological site during ablation. [0013]
  • In one aspect, the invention relates to an apparatus for delivering energy to biological tissue while maintaining the temperature of the biological tissue near a target temperature. The apparatus includes a plurality of electrodes positionable proximal the biological tissue and at least one temperature sensing device located on at least one of the electrodes. The temperature sensing device provides a temperature signal indicative of the temperature at the interface between the at least one electrode and the tissue. The apparatus also includes a generator that operates under the control of a processor to apply power to each of the electrodes. The power has an associated phase angle and, within a time duration, a plurality of alternating on periods and off periods, one set of adjacent on and off periods defining a duty cycle. The processor is adapted to, during the on period of each duty cycle, set the phase angles of the power provided to each electrode such that at least two of the electrodes are provided power with different phase angles. The processor is further adapted to, in response to the temperature signal, determine the temperature at the at least one electrode/tissue interface; compare the interface temperature to the target temperature and adjust the duty cycle of the power provided to the at least one electrode in response to the comparison. [0014]
  • In a detailed aspect of the invention, the processor is adapted to increase or decrease the duty cycle of the power to the at least one electrode when the at least one electrode/tissue interface temperature is less than or greater than the target temperature. In another detailed facet the processor is adapted to set the power to the at least one electrode to zero when the at least one electrode/tissue interface temperature is a specified first number of degrees greater than the target temperature to thereby allow the electrode to cool off. The processor is further adapted to incrementally increase the power to the electrode until the interface temperature is near the target temperature. In another detailed aspect, the apparatus further includes a power interruption device connected to the processor. The processor is adapted to control the power interruption device to interrupt power to the at least one electrode when the at least one electrode/tissue interface temperature is a specified second number of degrees greater than the target temperature. [0015]
  • In another facet, the invention relates to an apparatus for delivering energy to biological tissue while maintaining the temperature of the biological tissue near a target temperature. The apparatus includes a catheter having a plurality of electrodes at its distal end. The distal end may be positioned so that the electrodes are located proximal the biological tissue. The apparatus also includes a plurality of temperature sensing devices. At least one temperature sensing device is located on a select number of the electrodes. These devices provide a temperature signal indicative of the temperature at the interface between the electrode and the tissue. The apparatus also includes a generator operating under the control of a processor to apply power to each of the electrodes. The power has an associated phase angle and, within a time duration, a plurality of alternating on periods and off periods. One set of adjacent on and off periods define a duty cycle. The processor is adapted to, in response to each of the temperature signals, determine the temperature at the electrode/tissue interface and regulate the temperature of a plurality of temperature zones. Each zone includes at least one combination electrode/temperature sensing device. The temperature is regulated by controlling the power to at least one electrode in the zone. The processor is further adapted to regulate the power to a plurality of phase groups. Each group includes at least one electrode. The power is regulated by controlling the phase of the power to each electrode in the group such that during the on portion of a duty cycle the phase in one group is different then the phase in another group. [0016]
  • In another aspect, the invention relates to a method for delivering energy to biological tissue while maintaining the temperature of the biological tissue near a target temperature. The method comprises positioning a plurality of electrodes proximal the biological tissue. At least one of the electrodes carries a temperature sensing device for providing a temperature signal indicative of the temperature at the interface between the electrode and the tissue. The method also includes providing power to each of the electrodes. The power has, within a time duration, a plurality of alternating on periods and off periods, wherein one set of adjacent on and off periods defines a duty cycle. Also included in the method is, during the on period of each duty cycle, providing power with different phase angles to at least two of the electrodes; determining the temperature at the at least one electrode/tissue interface in response to the temperature signal; comparing the at least one electrode/tissue interface temperature to the target temperature; and adjusting the duty cycle of the power provided to the at least one electrode in response to the comparison. [0017]
  • In another aspect, the invention relates to a method for delivering energy to biological tissue while maintaining the temperature of the biological tissue near a target temperature. The method comprises positioning a catheter having a plurality of electrodes at its distal end so that the electrodes are located proximal the biological tissue. A select number of the electrodes carry at least one temperature sensing device. The device provides a temperature signal indicative of the temperature at the interface between the electrode and the tissue. The method also includes providing power having an associated phase and, within a time duration, a plurality of alternating on periods and off periods, one set of adjacent on and off periods defining a duty cycle. The method further includes, in response to the temperature signals, determining the temperature at the electrode/tissue interface; individually regulating the temperature of a plurality of temperature zones, wherein each zone comprises at least one combination electrode/temperature sensing device. The temperature is regulated by controlling the power to at least one electrode in the zone. The method further includes regulating the power to a plurality of phase groups, wherein each group comprises at least one electrode. The power is regulated by controlling the phase of the power to each electrode in the group such that during the on portion of a duty cycle the phase in one group is different then the phase in another group. [0018]
  • These and other aspects and advantages of the present invention will become apparent from the following more detailed description, when taken in conjunction with the accompanying drawings which illustrate, by way of example, the preferred embodiments of the invention.[0019]
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a schematic diagram of an ablation apparatus including a power control system, electrode device and backplate; [0020]
  • FIGS. [0021] 2-1 and 2-2 form a block diagram presenting more detail of a power control system in accordance with aspects of the invention, showing phase angle control, duty cycle control, and impedance and temperature monitoring;
  • FIG. 3 is a diagram of a multi-channel ablation apparatus in accordance with aspects of the invention wherein a single microprocessor controls the phase angle and duty cycle of each channel individually; [0022]
  • FIG. 4 depicts a first power waveform having a first phase angle and alternating instances of peak power and very low power; [0023]
  • FIG. 5 depicts a second power waveform having a second phase angle different from the first phase angle and alternating instances of peak power and very low power; [0024]
  • FIG. 6 presents a time frame (TF) diagram showing a fifty-percent duty cycle; [0025]
  • FIG. 7A depicts the phase relationship and voltage potential between the first and second power waveforms having first and second phase angles respectively, as a function of time; [0026]
  • FIG. 7B depicts the phase relationship and voltage potential between the first and second power waveforms having second and first phase angles respectively, as a function of time; [0027]
  • FIGS. 8A, 8B, [0028] 8C, 8D, and 8E are schematic diagrams of an embodiment of a power control system in accordance with aspects of the invention with FIG. 8A showing how FIGS. 8B, 8C, 8D and 8E are related;
  • FIG. 9A is a three dimensional representation of an ablation apparatus having a linear array of band electrodes in contact with a biological site with a backplate at the opposite side of the biological site, in which the phase angle difference between adjacent electrodes of the linear array is zero degrees; [0029]
  • FIGS. 9B through 9D depict, along the x, y, and z axes shown, the depth of the lesions formed by the ablation apparatus of FIG. 9A showing that the apparatus acts as a unipolar device with multiple electrodes and the resulting lesions are discontinuous; [0030]
  • FIG. 10A is a three dimensional representation of an ablation apparatus having a linear array of band electrodes in contact with a biological site with a backplate at the opposite side of the biological site, in which the phase angle difference between adjacent electrodes is 180 degrees; [0031]
  • FIGS. 10B through 10D depict, along the x, y, and z axes shown, the continuity and depth of a lesion formed by the ablation apparatus of FIG. 10A showing that the apparatus acts as a bipolar device with no significant amount of current flowing to the backplate; [0032]
  • FIG. 11A is a three dimensional representation of an ablation apparatus having a linear array of band electrodes in contact with a biological site with a backplate at the opposite side of the biological site, in which the phase difference between adjacent electrodes is approximately 90 degrees; and [0033]
  • FIGS. 11B through 11D depict, along the x, y, and z axes shown, the continuity and depth of a lesion formed by the ablation apparatus of FIG. 11A showing the greater depth of lesion resulting from the phase angle difference. [0034]
  • FIG. 12 presents a block diagram of the current flow among electrodes and the backplate through the biological site for adjacent electrodes having different phase angles; [0035]
  • FIG. 13 presents the same block diagram as FIG. 12 with the phase angles between adjacent electrodes reversed; and [0036]
  • FIGS. 14A through 14D present, along the x, y, and z axes shown, the increased continuity, depth, and uniformity of a lesion formed by the alternating phase apparatus and method shown in previous figures.[0037]
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • Turning now to the drawings, in which like reference numerals are used to designate like or corresponding elements among the several figures, in FIG. 1 there is shown an [0038] ablation apparatus 10 in accordance with aspects of the present invention. The apparatus 10 includes a power control system 12 that provides power or drive 14 to an electrode device 16. The power control system 12 comprises a power generator 18 that may have any number of output channels through which it provides the power 14. The operation of the power generator 18 is controlled by a controller 20 which outputs control signals 21 to the power generator 18. The controller 20 monitors the power 14 provided by the power generator 18. In addition, the controller 20 also receives temperature signals 22 from the electrode device 16. Based on the power 14 and temperature signals 22 the controller 20 adjusts the operation of the power generator 18. A backplate 24 is located proximal to the biological site 26 opposite the site from the electrode device 16, and is connected by a backplate wire 28 to the power generator 18. The backplate 24 is set at the reference level to the power provided to the electrodes, as discussed in detail below.
  • The [0039] electrode device 16 is typically part of a steerable EP catheter 30 capable of being percutaneously introduced into a biological site 26, e.g., the atrium or ventricle of the heart. The electrode device 16 is shown in schematic form with the components drawn to more clearly illustrate the relationship between the components and the relationship between the components and the power control system 12. In this embodiment, the catheter 30 comprises a distal segment 34 and a handle 31 located outside the patient. A preferred embodiment of the electrode device 16 includes twelve band electrodes 32 arranged in a substantially linear array along the distal segment 34 of the catheter 30. The electrode device 16 may include a tip electrode 36. (For clarity of illustration, only four band electrodes 32 are shown in the figures although as stated, a preferred embodiment may include many more.) The band electrodes 32 are arranged so that there is space 38 between adjacent electrodes. In one configuration of the electrode device 16, the width of the band electrodes 32 is 3 mm and the space 38 between the electrodes is 4 mm. The total length of the electrode device 16, as such, is approximately 8 cm.
  • The arrangement of the [0040] band electrodes 32 is not limited to a linear array and may take the form of other patterns. A substantially linear array is preferred for certain therapeutic procedures, such as treatment of atrial fibrillation, in which linear lesions of typically 4 to 8 cm in length are desired. A linear array is more easily carried by the catheter 30 and also lessens the size of the catheter.
  • The [0041] band electrodes 32 are formed of a material having a significantly higher thermal conductivity than that of the biological tissue 26. Possible materials include silver, copper, gold, chromium, aluminum, molybdenum, tungsten, nickel, platinum, and platinum/10% iridium. Because of the difference in thermal conductivity between the electrodes 32 and the tissue 26, the electrodes 32 cool off more rapidly in the flowing fluids at the biological site. The power supplied to the electrodes 32 may be adjusted during ablation to allow for the cooling of the electrodes while at the same time allowing for the temperature of the tissue to build up so that ablation results. The electrodes 32 are sized so that the surface area available for contact with fluid in the heart, e.g., blood, is sufficient to allow for efficient heat dissipation from the electrodes to the surrounding blood. In a preferred embodiment, the electrodes 32 are 7 French (2.3 mm in diameter) with a length of 3 mm.
  • The thickness of the [0042] band electrodes 32 also affects the ability of the electrode to draw thermal energy away from the tissue it contacts. In the present embodiment, the electrodes 32 are kept substantially thin so that the electrodes effectively draw energy away from the tissue without having to unduly increase the outer diameter of the electrode. In a preferred embodiment of the invention, the thickness of the band electrodes is 0.05 to 0.13 mm (0.002 to 0.005 inches).
  • Associated with the [0043] electrode device 16 are temperature sensors 40 for monitoring the temperature of the electrode device 16 at various points along its length. In one embodiment, each band electrode 32 has a temperature sensor 40 mounted to it. Each temperature sensor 40 provides a temperature signal 22 to the controller 20 which is indicative of the temperature of the respective band electrode 32 at that sensor. In another embodiment of the electrode device 16 a temperature sensor 40 is mounted on every other band electrode 32. Thus for a catheter having twelve electrodes, there are temperature sensors on six electrodes. In yet another embodiment of the electrode device 16 every other electrode has two temperature sensors 40. In FIG. 1, which shows an embodiment having one temperature sensor for each electrode, there is shown a single power lead 15 for each electrode 32 to provide power to each electrode for ablation purposes and two temperature leads 23 for each temperature sensor 40 to establish the thermocouple effect.
  • In another approach, the drive wire may comprise one of the thermocouple wires or may comprise a common wire for a plurality of thermocouples mounted on the same electrode. The inventors hereby incorporates by reference U.S. Pat. Nos. 6,049,737 and 6,045,550 both of which are assigned to the assignee of the present invention. [0044]
  • Turning now to FIGS. [0045] 2-1 and 2-2, a block diagram of an ablation apparatus 10 and method in accordance with aspects of the invention is presented. In FIGS. 2-1 and 2-2, a single channel of the power control system 12 is depicted. This channel controls the application of power to a single electrode 32. As will be discussed in relation to other figures, a channel may control a plurality or group of electrodes. In FIG. 2-1, a microprocessor 42, which is part of the controller 20 (FIG. 1), provides a duty cycle control signal 44 to a duty cycle generator (“DCG”) 45. In this case, the duty cycle generator 45 receives the control signal 44 by an 8-bit latch 46. The latch 46 provides an 8-bit signal 47 to a duty cycle comparator 48. The comparator 48 compares the 8-bit signal 47 to a count from an 8-bit duty cycle counter 50 and if the count is the same, provides a duty cycle off signal 49 to the duty cycle gate 52. The gate 52 is connected to a frequency source (“FS”) 54, such as an oscillator that produces 500 kHz. When the gate 52 receives the duty cycle off signal 49 from the comparator 48, it stops its output of the frequency source signal through the gate and no output exists.
  • At a frequency of 500 kHz, an 8-bit control has a period or time frame of 0.5 msec. At a fifty-percent duty cycle, the electrode is in the off period only 0.25 msec. To allow for greater cooling of the electrode, the period or time frame [0046] 78 (FIG. 6) is lengthened by use of a prescalar 56 interposed between the frequency source 54 and the counter 50. In one embodiment, the prescalar 56 lengthens the period to 4 msec thus allowing for a 2 msec off period during a fifty-percent duty cycle. This results in a sufficient cooling time for the very thin band electrodes discussed above. Other lengths of the period may be used depending on the circumstances. It has been found that a ten percent duty cycle is particularly effective in ablating heart tissue. The combination of the application of high peak power, a ten percent duty cycle, the use of high thermal conductivity material in the band electrodes, and fluids flowing past the band electrodes which have a cooling effect on the electrodes result in a much more effective application of power to the tissue. Ablation occurs much more rapidly.
  • A [0047] terminal count detector 58 detects the last count of the period and sends a terminal count signal 59 to the gate 52 which resets the gate for continued output of the frequency source signal. This then begins the on period of the duty cycle and the counter 50 begins its count again. In one preferred embodiment, the duty cycle is set at fifty percent and the 8-bit latch is accordingly set to 128. In another embodiment, the duty cycle is set at ten percent.
  • A programmable logic array (“PLA”) 60 receives phase control signals [0048] 61 from the microprocessor 42 and controls the phase of the frequency source 54 accordingly. In one embodiment, the PLA 60 receives the terminal count signal 59 from the terminal count detector 58 and only permits phase changes after receiving that terminal count signal.
  • The output signal from the [0049] gate 52 during the on period of the duty cycle is provided to a binary power amplifier (“BPA”) 62 that increases the signal to a higher level, in this case, 24 volts. The amplified signals are then filtered with a band pass filter (“BPF”) 64 to convert the somewhat square wave to a sine wave. The band pass filter 64 in one embodiment is centered at 500 kHz. The filtered signal is then provided to an isolated output transformer (“IOT”) 66 that amplifies the signal to a much higher level, for example 350 volts peak-to-peak. This signal is then sent to a relay interconnect (“RI”) 67 before it is provided as a power output signal OUTn 14 to an electrode 32 at the biological site to cause ablation.
  • The [0050] power output signal 14 from the isolated output transformer 66 is monitored in one embodiment to determine the impedance at the electrode 32. In the embodiment shown in FIGS. 2-1 and 2-2, a voltage and current monitor (“VCM”)68 is used. The monitor signal 69 is converted to digital form by an A-to-D converter (“ADC”) 70 and provided to the microprocessor 42. As previously mentioned, some or all of the electrodes 32 may include a temperature sensor 40 (FIG. 1) that provides temperature signals 22 (FIG. 2-2) which are used to determine the temperature at the electrode 32. In one embodiment of the invention, the power 14, in conjunction with the temperature signals 22, are used to determine the temperature at the electrode 32. Both the temperature signals 22 and the power 14 pass through a temperature filter (“FL”) 73 before being sent to the microprocessor 42. In the alternative, the temperature filter 73 is contained in a printed circuit board separate from the controller 20 and contains its own processor. In either case, the filter 73 filters out any RF noise present in the power 14 so that the signal may be used for temperature monitoring purposes. In another embodiment, the microprocessor monitors the power 14 and temperature signals 22 only during the off periods of the power 14 duty cycle. Accordingly, negligible RF noise is present in the power line and filtration is not necessary. In either embodiment, the microprocessor 42 may alter the duty cycle of the power 14 in response to either or both of the impedance or temperature signals.
  • In a manual arrangement, the temperature sensed and/or the determined impedance may be displayed to an operator. The operator in response may then manually control the duty cycle or other power parameters such as by rotating a knob mounted on a front panel of an instrument. In the case of a multiple channel instrument and catheter, as discussed below, multiple knobs may be provided in this manual arrangement for control over each channel. [0051]
  • Referring now to FIG. 3, a multiple channel ablation apparatus is shown. Although only three complete channels are shown, the apparatus comprises many more as indicated by the successive dots. Those channels are not shown in FIG. 3 to preserve clarity of illustration. By providing different voltage levels between two [0052] electrodes 32 in an array, current flows between those electrodes in a bipolar electrode approach. By setting the backplate 24 (FIG. 1) at a voltage level different from at least one of those electrodes 32, current flows between that electrode and the backplate. By controlling the voltage levels among the three (two electrodes and backplate), the current flow through the biological site 26 can be more precisely controlled. One technique for setting different voltage levels between the electrodes 32 is to maintain a phase difference between them in an AC approach. By setting the backplate 24 at the reference level, current flows between the electrodes 32 and the backplate.
  • The [0053] single microprocessor 42, which again is part of the controller 20 (FIG. 1), controls the duty cycle and the phase of each channel individually in this embodiment. Each channel shown comprises the same elements and each channel produces its own power output signal 14 (OUT1, OUT2, through OUTn where “n” is the total number of channels) on respective electrode leads (LEAD 1, LEAD 2, through LEAD n where “n” is the total number of leads) to the electrodes 32. This multi-channel approach permits more individual control over each electrode. For example, the duty cycle of the power applied to each electrode can be individually controlled. One electrode may have a ten percent duty cycle while another has a thirty percent duty cycle.
  • Referring now to the first and second output signals OUT[0054] 1 and OUT2 of FIG. 3, the signals, as shown in FIGS. 4, 5, and 6, have alternating instances of peak power i.e., “on” periods 74, and very low power 76, i.e., “off” periods. Typically, the output power 14 is a 500 kHz sine wave. In FIGS. 4 and 5, the number of cycles of the sine wave contained within one on period 74 has been substantially reduced in the drawing to emphasize the phase difference between the first and second output signals OUT1, OUT2. Preferably, the voltage of each power signal 14 during an off period 76 is substantially zero and during an on period 74 is approximately 350 volts peak-to-peak.
  • The power OUT[0055] 1 and OUT2 also have a variable duty cycle for controlling the length of the on period 74 and the off-period 76 within a time frame 78 (see FIG. 6). The duty cycle is the ratio of the length of the on period 74 to the length of the entire time frame 78. The effective power is the peak power times the duty cycle. Thus, a signal having a peak power of 100 watts and a 50% duty cycle has an effective power of 50 watts.
  • As shown in FIGS. 4, 5, and [0056] 6, the two power signals OUT1, OUT2 are phased differently from each other. As discussed above, the phase angle of each power signal is set and controlled by the processor 42 and PLA 60. Each power signal OUT1 and OUT2 has a respective phase angle and those phase angles differ between the two of them. The phase angle difference between the power OUT1 and OUT2 produces a voltage potential between the band electrodes 32 (FIG. 1) that receive the power. This voltage potential, in turn, induces current flow between the band electrodes 32. The phase angle relationship of the power and the voltage potential produced as a function of time is shown in FIGS. 7A and 7B. The potential between electrodes Ve-e is defined by: V e - e = 2 V sin ( Δ Φ 2 ) sin ( 2 π f t ) (Eq.  1)
    Figure US20030195501A1-20031016-M00001
  • where: ΔΦ=phase angle difference between electrodes [0057]
  • V=voltage amplitude of power [0058]
  • f=frequency in hertz [0059]
  • t=time [0060]
  • FIG. 7A shows first and second power OUT[0061] 1 and OUT2 provided to first and second electrodes respectively having a phase angle difference ΔΦ with OUT1 leading OUT2 by 132 degrees. FIG. 7B shows the same power OUT1 and OUT2 but with the phase angles reversed where OUT2 is now leading OUT 1 by 132 degrees.
  • With reference now to FIGS. 8A through 8E, schematic diagrams of an embodiment of the [0062] ablation apparatus 10 of FIGS. 2-1 and 2-2 are presented in FIGS. 8B through 8E while FIG. 8A shows how FIGS. 8B through 8E should be oriented in relation to each other. The frequency source 54 provides a signal 80, typically at 500 kHz with a phase angle controlled by the microprocessor 42 through the PLA 60, to the duty cycle generator 45. The duty cycle generator 45 modulates the frequency source signal 80 to produce the selected duty cycle in accordance with the duty cycle control signal 44 as previously described. The duty cycle generator 45 outputs two signals 82 and 84 to the binary power amplifier 62. A dual MOSFET driver U2 receives the signals, converts their 5V level to a 12V level, and sends each to a transformer T2 which transforms the signals into 24 V peak-to-peak power.
  • The 24V power is then sent to a [0063] multi-state driver 86 which includes a configuration of FETs Q2, Q3, Q4, and Q5. During a conducting state of the driver 86, which is typically the on period 74 of the power, these FETs Q2 through Q5 conduct and forward the power to a bandpass filter 64 comprising a series LC network. During a high-impedance state of the driver 86, which is typically during the off period 76 of the power, the FETs Q2 through Q5 are nonconducting and no power is sent to the bandpass filter 64. Instead the FETs Q2 through Q5 present a high impedance load to any signals received through the electrode 32. Typically the load impedance on the FETs Q2 through Q5 presented by the circuit following the FETs, the electrode, and the tissue is approximately 150 Ω but transformed through the output transformer T3, it presents a load impedance to the FETs Q2-Q5 of approximately 0.5 to 1 Ω. In the off state, the FETs present an impedance of approximately 250 Ω which is large in comparison to the transformed load impedance of approximately 0.5 to 1 Ω. Therefore, very little power flows when the FETs are in the off state.
  • The [0064] bandpass filter 64 operates to shape the output signal provided by the binary amplifier 62 from a square wave to a sinusoidal wave. The filtered signal 85 then passes to the isolated output section 66 where it is step-up transformed to 350 volt peak-to-peak sinusoidal power at T3. The power is then split into two identical power signals OUT1A, OUT1B and provided to two or more respective band electrodes 32 on the output lines LEAD1A, LEAD1B.
  • The [0065] isolated output section 66 also includes relays 88 that may be individually opened to remove the power signals OUT1A, OUT1B from the electrode leads LEAD 1A, LEAD 1B when an alert condition is detected, such as high temperature or high impedance at the respective electrode 32. As previously mentioned these conditions are determined by the microprocessor 42 which receives signals indicative of the temperature and impedance at each of the band electrodes 32.
  • The power from the [0066] isolated output section 66 is monitored and representative signals are supplied to an RF voltage and current monitor 68 where in this case, the voltage and current of each output signal are measured to determine the impedance of the particular channel. The measured signals are sent to an A-to-D converter 70 (FIG. 2-2) before being sent to the microprocessor 42 for impedance monitoring. If the impedance is above a threshold level indicative of blood clotting or boiling, the microprocessor 42 sends a signal to the duty cycle generator 45 to reduce or discontinue the duty cycle of the power OUT1A, OUT1B and thus lower the effective power delivered to the band electrodes 32.
  • Similarly, the temperature at the [0067] electrodes 32 is determined by monitoring the power 14 and temperature signals 22 and measuring the voltage difference between the signals. As previously mentioned, in one embodiment of the invention, these signals pass through a filter 73 (FIG. 2-2) before being sent to the microprocessor 42. The voltage value is converted to a temperature and if the temperature is above a threshold level the duty cycle of the power 14 is reduced. In the case where a single lead is used to provide a signal which is used to determine the temperature as well as provide power to the electrode 32, the signal from the lead is received on temperature leads 87, 89 connected at the output side of the relays 88.
  • As shown in FIG. 3, the duty cycle of each [0068] electrode 32 may be individually controlled by the microprocessor 42. As previously mentioned, based on the temperature at an electrode 32 and the current and voltage of the output signal provided to an electrode, the duty cycle of the output signal may be adjusted. For example, one electrode 32 may have a temperature requiring a duty cycle of ten percent, while another electrode may have a temperature which allows for a fifty percent duty cycle. In an embodiment in which every other electrode 32 has a temperature sensor 40, the electrodes are grouped in pairs with each electrode in the pair having the same duty cycle.
  • In operation, as depicted in FIGS. 9A through 11D, the [0069] electrode device 16 and the backplate 24 are positioned proximal the biological site 26 undergoing ablation such that the biological site is interposed between the electrode device and the backplate. The band electrodes 32 (only one of which is indicated by a numeral 32 for clarity of illustration) of the electrode device 16 each receives power OUT1, OUT2, OUT3, OUT4 having a phase angle on LEAD 1 through LEAD 4. In one embodiment, every other electrode 32 receives the same phase angle. Therefore, the phase angle of electrode A equals the phase angle of electrode C and the phase angle of electrode B equals the phase angle of electrode D. The advantages of this arrangement are described below. In a preferred embodiment, the electrodes 32 are formed into a linear array as shown. In addition, a thermocouple temperature sensor 40 is located at each of the electrodes A, B, C, and D and uses the electrode power lead LEADS 1 through 4 as one of the sensor leads. The sensors 40 provide temperature sensor signals 22 for receipt by the power control system 12.
  • In another embodiment, [0070] alternate electrodes 32 may be grouped together and each may receive the same power having the same phase angle and duty cycle. Another group or groups of electrodes 32 may be interspaced with the first group such that the electrodes of one group alternate with the electrodes of the other group or groups. Each electrode 32 in a particular group of electrodes has the same phase angle and duty cycle. For example, electrodes A and C may be connected to the same power while interspaced electrodes B and D may be connected to a different power output signal.
  • The use of individual power signals also provides the ability to disable any combination of [0071] electrodes 32 and thereby effectively change the length of the electrode device 16. For example, in one configuration of the present invention an electrode device 16 with twelve electrodes 32 receives twelve power signals from a twelve channel power control system 12. The electrodes 32 are 3 mm in length and are 4 mm apart. Accordingly, by disabling various electrodes, a virtual electrode of any length from 3 mm to 8 cm may be produced by the electrode device 16. In either arrangement the backplate 24 is maintained at the reference voltage level in regard to the voltage level of the power OUT1 through OUTn.
  • As previously described, by varying the phase angles between the power OUT[0072] 1, OUT2 supplied to each electrode 32, a phase angle difference is established between adjacent band electrodes. This phase angle difference may be adjusted to control the voltage potential between adjacent band electrodes 32 and thus to control the flow of current through the biological site 26. The flow of current Ie-e between adjacent band electrodes 32 is defined by: I e - e = 2 V sin ( Δ Φ 2 ) sin ( 2 π f t ) Z e - e e (Eq.  2)
    Figure US20030195501A1-20031016-M00002
  • where: ΔΩ=phase angle difference between electrodes [0073]
  • V=voltage amplitude of power [0074]
  • Z[0075] e-e=impedance between electrodes
  • f=frequency in hertz [0076]
  • t=time [0077]
  • In addition to the current flow between the [0078] band electrodes 32 there is current flow between the band electrodes and the backplate 24. When the backplate 24 is set at the reference level, this current flow Ie-b is defined by: I e - b = V sin ( 2 π f t ) Z e - b (Eq.  3)
    Figure US20030195501A1-20031016-M00003
  • where: ΔΩ=phase angle difference between electrodes [0079]
  • V=voltage amplitude of power [0080]
  • Z[0081] e-b=impedance between electrode and backplate
  • f=frequency in hertz [0082]
  • t=time [0083]
  • Assuming Z[0084] e-b and Ze-e are equal, the ratio of the current flowing between the band electrodes 32 Ie-e to the current flowing between the band electrodes 32 and the backplate 24 Ie-b is defined by: I e - e I e - b = 2 sin ( Δ Φ 2 ) (Eq.  4)
    Figure US20030195501A1-20031016-M00004
  • where: ΔΩ=phase angle difference between electrodes [0085]
  • FIGS. 9A through 11D illustrate various current flow patterns within a biological site. The depths and widths of the lesions depicted in FIGS. 9 through 11 are not necessarily to scale or in scalar proportion to each other but are provided for clarity in discerning the differences between the various power application techniques. When the phase difference between [0086] adjacent electrodes 32 is zero degrees, no current flows between the electrodes in accordance with Eq. 2 above, and the apparatus operates in a unipolar fashion with the current flowing to the backplate 24 as shown in FIGS. 9A through 9D. Substantially all current flows from the band electrodes 32 to the backplate 24 forming a series of relatively deep, acute lesions 90 along the length of the electrode device 16. As seen in the top view of FIG. 9B and the side view of FIG. 9D, the lesions are discrete. The lesions 90 are discontinuous in regard to each other.
  • When the phase difference between [0087] adjacent electrodes 32 is 180 degrees the apparatus operates in both a unipolar and bipolar fashion and the current flow pattern is as shown in FIG. 10A. With this phase difference, approximately twice as much current flows between adjacent band electrodes 32 than flows from the band electrodes to the backplate 24. The resulting lesion 92 is shallow but is continuous along the length of the electrode device 16. The continuity and shallow depth of the lesion 92 are illustrated in FIGS. 10B through 10D. Nevertheless, the lesion depth is still greater than that created by prior bipolar ablation methods alone.
  • When the phase difference between [0088] adjacent electrodes 32 is set within the range of a value greater than zero to less than 180 degrees, the current flow varies from a deep, discontinuous unipolar pattern to a more continuous, shallow bipolar pattern. For example, when the phase difference between adjacent electrodes 32 is around 90 degrees, the current flows as shown in FIG. 11A. With this phase difference, current flows between adjacent band electrodes 32 as well as between the band electrodes and the backplate 24. Accordingly, a lesion which is both deep and continuous along the length of the electrode device 16 is produced. The continuity and depth of the lesion 94 is illustrated in FIGS. 11B through 11D. In one embodiment of FIG. 1A, adjacent electrodes alternated in phase but were provided with power in groups. Electrodes A and C were provided with power at a first phase angle and electrodes B and D were provided with power at a second phase angle, different from the first.
  • Thus, in accordance with the present invention the phase angle of the power may be adjusted in order to produce a lesion having different depth and continuity characteristics. In selecting the phase angle difference necessary to produce a continuous lesion having the greatest possible depth, other elements of the [0089] electrode device 16 are considered. For example, the width of the band electrodes 32 and the spacing between the electrodes are factors in selecting an optimum phase angle. In a preferred embodiment of the present invention, as pointed out above, the width of the band electrodes is 3 mm, the spacing between the electrodes is 4 mm and the electrodes receive power which establish a phase difference of 132 degrees between adjacent electrodes. With this configuration a long continuous lesion having a length of between approximately 3 mm and 8 cm and a depth of 5 mm or greater was produced depending on the number of electrodes energized, the duty cycle employed, and the duration of power application.
  • In another embodiment of the invention, energy is applied to the [0090] biological tissue 26 during the on period of the duty cycle in an alternating unipolar-bipolar manner. During the unipolar mode segment a voltage potential is established between the electrodes 32 and the backplate 24. Thus current flows through the tissue 26 between the electrodes 32 and the backplate 24.
  • During the bipolar mode segment a voltage potential is established between at least two of the [0091] electrodes 32 rather than between the electrodes and the backplate 24. Thus current flows through the tissue 26 between the electrodes 32. While operating in this mode the voltage difference between the electrodes 32 may be established by providing power with different phase angles to the electrodes as previously mentioned. Alternatively, some of the electrodes 32 may be connected to a reference potential while others are maintained at a different voltage level.
  • By adjusting the duration of the unipolar and bipolar mode segments within the on period of the duty cycle, the continuity and depth of the lesion produced may be controlled. For example, operating in the unipolar mode for one-fourth of the on period and in the bipolar mode for three-fourths of the on period produces a lesion having a continuity and depth similar to the [0092] lesion 94 illustrated in FIGS. 11B through 11D.
  • Referring to FIGS. [0093] 8B through and 8E, the following devices are shown:
    Device Part No. Manufacturer
    U1 GAL6002B Lattice
    U2 SN75372 numerous
    Q1 1RFZ34N numerous
    Q2, Q3, Q4, Q5 1RFZ44N numerous
    Q7, Q8, Q9 MPF6601 numerous
    R3, R5 1 Ω numerous
    T1, T4 CMI-4810 Corona Magnetics, Inc.
    T2 GFS97-0131-1 GFS Manufacturing
    T5 CMI-4809 Corona Magnetics, Inc.
  • The transformer denoted by “T[0094] 3” is a 1:12 turns ratio, single turn primary, step up transformer wound on a TDK core PC50EER23Z.
  • FIG. 12 presents a block diagram of the current flow among [0095] electrodes 32 and the backplate 24 through the biological site 26 for adjacent electrodes having different phase angles where the phase angles of the A and C electrodes lead the phase angles of the B and D electrodes. It has been noted that with the approach shown in FIG. 12, the vector sum of the currents flowing through the site 26 is such that more current flows at one or more electrodes than at others. This is shown figuratively with shorter arrows leading to the backplate from the B and D electrodes. Although the ablation volume is greater than in the prior techniques, the ablation volume appears irregular or nonuniform as shown in FIG. 11D. It is desirable to have a more uniform ablation volume, especially as to depth, so that irregular electrical signals do not pass under the ablation volume at a point having less depth and require a repeat of the ablation procedure.
  • FIG. 13 presents the same block diagram as FIG. 12 with the phase angles between adjacent electrodes reversed. In FIG. 13, the phase angles of the power at the B and [0096] D electrodes 32 now lead the phase angles of the power at the A and C electrodes 32. The change in current flow due to this opposite phasing is represented figuratively with shorter arrows now at the A and C electrodes thus balancing the current flow pattern of FIG. 12. It has been found that by alternating the phase angles such as shown in FIGS. 12 and 13, a much more uniform current flow and much more uniform ablation volume result. A cumulative effect of the current flow causes the tissue between all the band electrodes 32 and the backplate 24 to become ablated, depth-wise through the biological site 26, at a substantially even rate and thus a lesion having substantially uniform depth is produced. This is shown in FIGS. 14A through 14D where an ablation volume 96 is shown, which has much greater uniformity in shape. In particular, the ablation lesion 96 has a uniform depth and gives rise to a high level of confidence that the ablation volume created with the ablation apparatus in accordance with the invention will successfully destroy the tissue causing the arrhythmia.
  • In one embodiment, the phase between the electrodes was alternated as shown in FIGS. 12 and 13 only during the off period of the duty cycle. That is, and with reference to FIG. 6, during the entire on [0097] period 74 of the duty cycle of one time frame 78, the phase angles of the power at the A and C electrodes 32 led the phase angles of the power at the B and D electrodes 32 by 132 degrees. During the following off period 76 of the same time frame 78, the phase angles of the power to be supplied was changed to be opposite those phase angles used during the on period 74, in preparation for the next on period. Then at the next on period 74, the phase angles of the power provided to electrodes B and D led the phase angles of the power provided to the A and C electrodes by 132 degrees during that entire on period. During the immediately subsequent off period, the phase angles were again changed so that electrodes A and C would lead electrodes B and D.
  • During an ablation procedure, the [0098] processor 42 monitors the temperatures at the electrodes/tissue interface and automatically makes power adjustments in view of these temperatures. As previously mentioned, in order to effectively ablate tissue it is desirable to uniformly elevate the tissue temperature to a target ablation temperature. For biological tissue this target temperature may range from 50° C. to 65° C.
  • In one configuration of the system, the temperature of each electrode/tissue interface is monitored and the power applied to each [0099] electrode 32 is individually adjusted to maintain the electrode/tissue interface temperature at or near the target temperature. An interface temperature within 5° C. degrees of the target temperature is considered to be “near” the target temperature. Adjustments to the power are made by changing the duty cycle of the power being applied to the electrode 32. When the electrode/tissue interface temperature is less than the target temperature, the duty cycle is increased. Conversely, when the interface temperature is greater than the target temperature, the duty cycle is decreased.
  • Under certain electrode/tissue interface temperature conditions, the [0100] processor 42 may institute a “soft cutoff.” During a soft cutoff the processor temporarily sets the power to an electrode 32 to zero by setting the duty cycle of the power such that there is no on portion of the duty cycle. During this continuous off period, the electrode/tissue interface is able to cool off to a temperature less than the temperature that caused the cutoff and usually to a temperature less than the target temperature. Once the interface cools off, the processor 42 incrementally increases the power to the electrode 32 until the interface temperature settles to a temperature near the target temperature. The incremental increase in power may be achieved by programming the processor, using well known proportional integral derivative (PID) algorithms, to increase the duty cycle in either a step like or smooth, continuous manner. Conditions which necessitate a soft cutoff may be programmed into the processor 42. Such condition may include an interface temperature that is greater than the target temperature by a first specified number of degrees. For example, if the target temperature is 65° C. and the measured interface temperature is at least 5 degrees greater than 65° C., then the electrode may be subject to a soft cutoff.
  • Under more severe electrode/tissue interface temperature conditions, the [0101] processor 42 may institute a “hard cutoff.” During a hard cutoff, power to an electrode 32 may be interrupted by opening the relay 88 (FIG. 80) associated with the power output providing the power to the electrode 32. Conditions which necessitate a hard cutoff may be programmed into the processor 42. Such conditions may include an interface temperature that is greater than the target temperature by a second specified number of degrees that is greater than the specified number of degrees associated with a soft cutoff. For example, if the target temperature is 65° C. and the measured interface temperature is at least 10 degrees greater than 65° C., then the power to the electrode may be interrupted.
  • In another configuration of the system, the [0102] electrodes 32 are grouped into electrode zones, with each zone including one or more electrodes. In a preferred embodiment, the electrodes within a zone are adjacent each other. At least one of the electrodes 32 within each zone includes a temperature sensor 40. The processor 42 monitors the interface temperatures of each electrode 32 having a temperature sensor 40 and adjusts the power to each of the electrodes within an electrode zone based on the maximum interface temperature in that zone. Accordingly, if the electrode 32 having the maximum interface temperature provides an interface temperature sufficient to warrant a duty cycle increase, duty cycle decrease, soft cutoff or hard cutoff, each electrode 32 within the zone is subject to the same adjustment.
  • The inventors hereby incorporate by reference application Ser. No. 09/073,112, now U.S. Pat. No. 6,171,305 and U.S. Pat. No. 6,050,994 both of which are assigned to the assignee of the present invention. [0103]
  • While several particular forms of the invention have been illustrated and described, it will be apparent that various modifications can be made without departing from the spirit and scope of the invention. For example, the [0104] controller 20 is shown in FIG. 1 as forming a part of the power control system 12. However, it may take other forms such as an external processor in a separate computer for example. Likewise, duty cycle control and phase control may be performed by circuits other than those shown here. Accordingly, it is not intended that the invention be limited, except as by the appended claims.

Claims (20)

What is claimed is:
1. A system for delivering energy to biological tissue, said system comprising:
a plurality of electrodes adapted to be positioned at the biological tissue;
at least one temperature sensing device located on at least one of the electrodes for providing a temperature signal indicative of the temperature at the interface between the at least one electrode and the tissue; and
a power control system adapted to:
apply power to each of the electrodes such that a voltage potential is established between at least two of the electrodes, the power having a duty cycle;
in response to the temperature signal, determine the temperature at the at least one electrode/tissue interface;
compare the interface temperature to a target temperature; and
adjust the duty cycle of the power provided to the at least one electrode in response to the comparison.
2. The system of claim 1 wherein the power control system is adapted to increase the duty cycle of the power to the at least one electrode when the at least one electrode/tissue interface temperature is less than the target temperature.
3. The system of claim 1 wherein the power control system is adapted to decreases the duty cycle of the power to the at least one electrode when the at least one electrode/tissue interface temperature is greater than the target temperature.
4. The system of claim 1 wherein the power control system is adapted to:
set the power to the at least one electrode to zero when the at least one electrode/tissue interface temperature is a specified first number of degrees greater than the target temperature; and
incrementally increase the power level to the at least one electrode until the interface temperature is near the target temperature.
5. The system of claim 4 further comprising:
a power interruption device connected to the power control system;
wherein the power control system is further adapted to control the power interruption device to interrupt power to the at least one electrode when the at least one electrode/tissue interface temperature is a specified second number of degrees greater than the target temperature, the second number of degrees being greater than the first number of degrees.
6. The system of claim 1 wherein:
the system comprises a plurality of temperature sensing devices, at least one device associated with each of the electrodes, each device for providing a temperature signal to the power control system indicative of the temperature at the associated electrode; and
the power control system provides separate power to each of the plurality of electrodes with the power being individually controllable as to duty cycle and the duty cycle of each separate power is controlled in response to the temperature signal from the associated electrode.
7. The system of claim 7 wherein the power has an associated phase angle and the voltage potential is established between the at least two electrodes by providing power with different phase angles to the electrodes.
8. A method of delivering energy to biological tissue, said method comprising:
positioning a plurality of electrodes adjacent the biological tissue, at least one of the electrodes carrying a temperature sensing device for providing a temperature signal indicative of the temperature at the interface between the electrode and the tissue;
establishing a voltage potential between at least two of the electrodes using duty cycled power;
determining the temperature at the at least one electrode/tissue interface in response to the temperature signal;
comparing the at least one electrode/tissue interface temperature to the target temperature; and
adjusting the duty cycle of the power provided to the at least one electrode in response to the comparison.
9. The method of claim 8 wherein positioning a plurality of electrodes comprises positioning a catheter carrying the electrodes proximal the tissue such that a select number of the plurality of electrodes are in contact with the tissue.
10. The method of claim 8 further comprising increasing the duty cycle of the power to the at least one electrode when the at least one electrode/tissue interface temperature is less than the target temperature.
11. The method of claim 8 further comprising decreasing the duty cycle of the power to the at least one electrode when the at least one electrode/tissue interface temperature is greater than the target temperature.
12. The method of claim 8 further comprising:
setting the power to the at least one electrode to zero when the at least one electrode/tissue interface temperature is a specified first number of degrees greater than the target temperature; and
incrementally increasing the power level to the at least one electrode until the interface temperature is near the target temperature.
13. The method of claim 12 further comprising interrupting the power to the at least one electrode when the at least one electrode/tissue interface temperature is a specified second number of degrees greater than the target temperature, the second number of degrees being greater than the first number of degrees.
14. The method of claim 8 wherein each of the electrodes carries a temperature sensing device and the method further comprises:
providing separate power to each of the plurality of electrodes; and
individually controlling the duty cycle of each separate power in response to the temperature signal from the electrode.
15. The method of claim 8 wherein the power has an associated phase angle and establishing the voltage potential between the at least two electrodes comprises providing power with different phase angles to the electrodes.
16. A system for delivering energy to biological tissue, said system comprising:
a plurality of electrodes adapted to be positioned at the biological tissue;
at least one temperature sensing device located on at least one of the electrodes for providing a temperature signal indicative of the temperature at the interface between the at least one electrode and the tissue; and
a power control system adapted to:
apply power to each of the electrodes such that at least two of the electrodes are provided power with different phase angles;
in response to the temperature signal, determine the temperature at the at least one electrode/tissue interface;
compare the interface temperature to a target temperature; and
adjust the power provided to the at least one electrode in response to the comparison.
17. The system of claim 16 wherein the power control system is adapted to increase the power to the at least one electrode when the at least one electrode/tissue interface temperature is less than the target temperature.
18. The system of claim 16 wherein the power control system is adapted to decreases the power to the at least one electrode when the at least one electrode/tissue interface temperature is greater than the target temperature.
19. The system of claim 16 wherein the power control system is adapted to:
set the power to the at least one electrode to zero when the at least one electrode/tissue interface temperature is a specified first number of degrees greater than the target temperature; and
incrementally increase the power to the at least one electrode until the interface temperature is near the target temperature.
20. The system of claim 19 further comprising:
a power interruption device connected to the power control system;
wherein the power control system is further adapted to control the power interruption device to interrupt power to the at least one electrode when the at least one electrode/tissue interface temperature is a specified second number of degrees greater than the target temperature, the second number of degrees being greater than the first number of degrees.
US10/400,770 1998-05-05 2003-03-27 RF ablation system and method having automatic temperature control Abandoned US20030195501A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US10/400,770 US20030195501A1 (en) 1998-05-05 2003-03-27 RF ablation system and method having automatic temperature control

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US09/073,392 US6059778A (en) 1998-05-05 1998-05-05 RF ablation apparatus and method using unipolar and bipolar techniques
US09/501,472 US6200314B1 (en) 1998-05-05 2000-02-09 RF ablation apparatus and method using unipolar and bipolar techniques
US09/738,032 US6558378B2 (en) 1998-05-05 2000-12-13 RF ablation system and method having automatic temperature control
US10/400,770 US20030195501A1 (en) 1998-05-05 2003-03-27 RF ablation system and method having automatic temperature control

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US09/738,032 Continuation US6558378B2 (en) 1998-05-05 2000-12-13 RF ablation system and method having automatic temperature control

Publications (1)

Publication Number Publication Date
US20030195501A1 true US20030195501A1 (en) 2003-10-16

Family

ID=24966286

Family Applications (2)

Application Number Title Priority Date Filing Date
US09/738,032 Expired - Lifetime US6558378B2 (en) 1998-05-05 2000-12-13 RF ablation system and method having automatic temperature control
US10/400,770 Abandoned US20030195501A1 (en) 1998-05-05 2003-03-27 RF ablation system and method having automatic temperature control

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US09/738,032 Expired - Lifetime US6558378B2 (en) 1998-05-05 2000-12-13 RF ablation system and method having automatic temperature control

Country Status (3)

Country Link
US (2) US6558378B2 (en)
AU (1) AU2002230812A1 (en)
WO (1) WO2002047565A2 (en)

Cited By (102)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060223455A1 (en) * 2005-03-31 2006-10-05 Silicon Laboratories Inc. System and method for wireless communication using low-pulling digital interface signals
US20070167940A1 (en) * 2003-03-28 2007-07-19 Debbie Stevens-Wright Method and apparatus for selecting operating parameter values in electrophysiology procedures
US20080300590A1 (en) * 2006-12-07 2008-12-04 Cierra, Inc. Apparatus and methods for multipolar tissue welding
US20100030210A1 (en) * 2008-08-01 2010-02-04 Paulus Joseph A Polyphase Electrosurgical System and Method
WO2010051305A1 (en) * 2008-10-28 2010-05-06 Smith & Nephew, Inc. Electrosurgical device with controllable electric field profile
US7742795B2 (en) * 2005-03-28 2010-06-22 Minnow Medical, Inc. Tuned RF energy for selective treatment of atheroma and other target tissues and/or structures
US7846158B2 (en) * 2006-05-05 2010-12-07 Covidien Ag Apparatus and method for electrode thermosurgery
US7850685B2 (en) 2005-06-20 2010-12-14 Medtronic Ablation Frontiers Llc Ablation catheter
US20110218526A1 (en) * 2010-03-03 2011-09-08 Medtronic Ablation Frontiers, Llc Variable-output radiofrequency ablation power supply
US8273084B2 (en) 2004-11-24 2012-09-25 Medtronic Ablation Frontiers Llc Atrial ablation catheter and method of use
US8295902B2 (en) 2008-11-11 2012-10-23 Shifamed Holdings, Llc Low profile electrode assembly
US8361068B2 (en) 2000-03-06 2013-01-29 Medtronic Advanced Energy Llc Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof
US8396548B2 (en) 2008-11-14 2013-03-12 Vessix Vascular, Inc. Selective drug delivery in a lumen
US8401667B2 (en) 2008-11-17 2013-03-19 Vessix Vascular, Inc. Selective accumulation of energy with or without knowledge of tissue topography
US8486063B2 (en) 2004-10-14 2013-07-16 Medtronic Ablation Frontiers Llc Ablation catheter
US8496653B2 (en) 2007-04-23 2013-07-30 Boston Scientific Scimed, Inc. Thrombus removal
US8551096B2 (en) 2009-05-13 2013-10-08 Boston Scientific Scimed, Inc. Directional delivery of energy and bioactives
US8617152B2 (en) 2004-11-15 2013-12-31 Medtronic Ablation Frontiers Llc Ablation system with feedback
US8641704B2 (en) 2007-05-11 2014-02-04 Medtronic Ablation Frontiers Llc Ablation therapy system and method for treating continuous atrial fibrillation
US8657814B2 (en) 2005-08-22 2014-02-25 Medtronic Ablation Frontiers Llc User interface for tissue ablation system
US20140067029A1 (en) * 2012-08-28 2014-03-06 Boston Scientific Scimed, Inc. Renal nerve modulation and ablation catheter electrode design
US8834461B2 (en) 2005-07-11 2014-09-16 Medtronic Ablation Frontiers Llc Low power tissue ablation system
US20140296841A1 (en) * 2010-01-25 2014-10-02 Covidien Lp System and method for monitoring ablation size
US8880185B2 (en) 2010-06-11 2014-11-04 Boston Scientific Scimed, Inc. Renal denervation and stimulation employing wireless vascular energy transfer arrangement
US8920414B2 (en) 2004-09-10 2014-12-30 Vessix Vascular, Inc. Tuned RF energy and electrical tissue characterization for selective treatment of target tissues
US8951251B2 (en) 2011-11-08 2015-02-10 Boston Scientific Scimed, Inc. Ostial renal nerve ablation
US8974451B2 (en) 2010-10-25 2015-03-10 Boston Scientific Scimed, Inc. Renal nerve ablation using conductive fluid jet and RF energy
US9005194B2 (en) 2004-11-24 2015-04-14 Medtronic Ablation Frontiers Llc Atrial ablation catheter adapted for treatment of septal wall arrhythmogenic foci and method of use
US9023034B2 (en) 2010-11-22 2015-05-05 Boston Scientific Scimed, Inc. Renal ablation electrode with force-activatable conduction apparatus
US9028472B2 (en) 2011-12-23 2015-05-12 Vessix Vascular, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9028485B2 (en) 2010-11-15 2015-05-12 Boston Scientific Scimed, Inc. Self-expanding cooling electrode for renal nerve ablation
US9050106B2 (en) 2011-12-29 2015-06-09 Boston Scientific Scimed, Inc. Off-wall electrode device and methods for nerve modulation
US9060761B2 (en) 2010-11-18 2015-06-23 Boston Scientific Scime, Inc. Catheter-focused magnetic field induced renal nerve ablation
US9079000B2 (en) 2011-10-18 2015-07-14 Boston Scientific Scimed, Inc. Integrated crossing balloon catheter
US9084609B2 (en) 2010-07-30 2015-07-21 Boston Scientific Scime, Inc. Spiral balloon catheter for renal nerve ablation
US9089350B2 (en) 2010-11-16 2015-07-28 Boston Scientific Scimed, Inc. Renal denervation catheter with RF electrode and integral contrast dye injection arrangement
US9119600B2 (en) 2011-11-15 2015-09-01 Boston Scientific Scimed, Inc. Device and methods for renal nerve modulation monitoring
US9119632B2 (en) 2011-11-21 2015-09-01 Boston Scientific Scimed, Inc. Deflectable renal nerve ablation catheter
US9125666B2 (en) 2003-09-12 2015-09-08 Vessix Vascular, Inc. Selectable eccentric remodeling and/or ablation of atherosclerotic material
US9125667B2 (en) 2004-09-10 2015-09-08 Vessix Vascular, Inc. System for inducing desirable temperature effects on body tissue
US20150265333A1 (en) * 2012-10-25 2015-09-24 Kyong-Min Shin System for ablation utilizing multiple electrodes and method for controlling same
US9155589B2 (en) 2010-07-30 2015-10-13 Boston Scientific Scimed, Inc. Sequential activation RF electrode set for renal nerve ablation
US9162046B2 (en) 2011-10-18 2015-10-20 Boston Scientific Scimed, Inc. Deflectable medical devices
US9173696B2 (en) 2012-09-17 2015-11-03 Boston Scientific Scimed, Inc. Self-positioning electrode system and method for renal nerve modulation
US9186209B2 (en) 2011-07-22 2015-11-17 Boston Scientific Scimed, Inc. Nerve modulation system having helical guide
US9186210B2 (en) 2011-10-10 2015-11-17 Boston Scientific Scimed, Inc. Medical devices including ablation electrodes
US9192435B2 (en) 2010-11-22 2015-11-24 Boston Scientific Scimed, Inc. Renal denervation catheter with cooled RF electrode
US9192790B2 (en) 2010-04-14 2015-11-24 Boston Scientific Scimed, Inc. Focused ultrasonic renal denervation
US9220558B2 (en) 2010-10-27 2015-12-29 Boston Scientific Scimed, Inc. RF renal denervation catheter with multiple independent electrodes
US9220561B2 (en) 2011-01-19 2015-12-29 Boston Scientific Scimed, Inc. Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury
US9265969B2 (en) 2011-12-21 2016-02-23 Cardiac Pacemakers, Inc. Methods for modulating cell function
US9277955B2 (en) 2010-04-09 2016-03-08 Vessix Vascular, Inc. Power generating and control apparatus for the treatment of tissue
US9297845B2 (en) 2013-03-15 2016-03-29 Boston Scientific Scimed, Inc. Medical devices and methods for treatment of hypertension that utilize impedance compensation
US9326751B2 (en) 2010-11-17 2016-05-03 Boston Scientific Scimed, Inc. Catheter guidance of external energy for renal denervation
US9358365B2 (en) 2010-07-30 2016-06-07 Boston Scientific Scimed, Inc. Precision electrode movement control for renal nerve ablation
US9364284B2 (en) 2011-10-12 2016-06-14 Boston Scientific Scimed, Inc. Method of making an off-wall spacer cage
US9408661B2 (en) 2010-07-30 2016-08-09 Patrick A. Haverkost RF electrodes on multiple flexible wires for renal nerve ablation
US9420955B2 (en) 2011-10-11 2016-08-23 Boston Scientific Scimed, Inc. Intravascular temperature monitoring system and method
US9433760B2 (en) 2011-12-28 2016-09-06 Boston Scientific Scimed, Inc. Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements
US9463062B2 (en) 2010-07-30 2016-10-11 Boston Scientific Scimed, Inc. Cooled conductive balloon RF catheter for renal nerve ablation
US9579030B2 (en) 2011-07-20 2017-02-28 Boston Scientific Scimed, Inc. Percutaneous devices and methods to visualize, target and ablate nerves
WO2017049313A1 (en) * 2015-09-17 2017-03-23 Baylor College Of Medicine Esophageal probes and methods
US9649156B2 (en) 2010-12-15 2017-05-16 Boston Scientific Scimed, Inc. Bipolar off-wall electrode device for renal nerve ablation
US9668811B2 (en) 2010-11-16 2017-06-06 Boston Scientific Scimed, Inc. Minimally invasive access for renal nerve ablation
US9687166B2 (en) 2013-10-14 2017-06-27 Boston Scientific Scimed, Inc. High resolution cardiac mapping electrode array catheter
US9693821B2 (en) 2013-03-11 2017-07-04 Boston Scientific Scimed, Inc. Medical devices for modulating nerves
US9707036B2 (en) 2013-06-25 2017-07-18 Boston Scientific Scimed, Inc. Devices and methods for nerve modulation using localized indifferent electrodes
US9713730B2 (en) 2004-09-10 2017-07-25 Boston Scientific Scimed, Inc. Apparatus and method for treatment of in-stent restenosis
US9770606B2 (en) 2013-10-15 2017-09-26 Boston Scientific Scimed, Inc. Ultrasound ablation catheter with cooling infusion and centering basket
US9808300B2 (en) 2006-05-02 2017-11-07 Boston Scientific Scimed, Inc. Control of arterial smooth muscle tone
US9808311B2 (en) 2013-03-13 2017-11-07 Boston Scientific Scimed, Inc. Deflectable medical devices
US9827039B2 (en) 2013-03-15 2017-11-28 Boston Scientific Scimed, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9833283B2 (en) 2013-07-01 2017-12-05 Boston Scientific Scimed, Inc. Medical devices for renal nerve ablation
US9895194B2 (en) 2013-09-04 2018-02-20 Boston Scientific Scimed, Inc. Radio frequency (RF) balloon catheter having flushing and cooling capability
US9907609B2 (en) 2014-02-04 2018-03-06 Boston Scientific Scimed, Inc. Alternative placement of thermal sensors on bipolar electrode
US9925001B2 (en) 2013-07-19 2018-03-27 Boston Scientific Scimed, Inc. Spiral bipolar electrode renal denervation balloon
US9943365B2 (en) 2013-06-21 2018-04-17 Boston Scientific Scimed, Inc. Renal denervation balloon catheter with ride along electrode support
US9956033B2 (en) 2013-03-11 2018-05-01 Boston Scientific Scimed, Inc. Medical devices for modulating nerves
US9962223B2 (en) 2013-10-15 2018-05-08 Boston Scientific Scimed, Inc. Medical device balloon
US9974607B2 (en) 2006-10-18 2018-05-22 Vessix Vascular, Inc. Inducing desirable temperature effects on body tissue
US10022182B2 (en) 2013-06-21 2018-07-17 Boston Scientific Scimed, Inc. Medical devices for renal nerve ablation having rotatable shafts
US10085799B2 (en) 2011-10-11 2018-10-02 Boston Scientific Scimed, Inc. Off-wall electrode device and methods for nerve modulation
US10265122B2 (en) 2013-03-15 2019-04-23 Boston Scientific Scimed, Inc. Nerve ablation devices and related methods of use
US10271898B2 (en) 2013-10-25 2019-04-30 Boston Scientific Scimed, Inc. Embedded thermocouple in denervation flex circuit
US10321946B2 (en) 2012-08-24 2019-06-18 Boston Scientific Scimed, Inc. Renal nerve modulation devices with weeping RF ablation balloons
US10342609B2 (en) 2013-07-22 2019-07-09 Boston Scientific Scimed, Inc. Medical devices for renal nerve ablation
US10398464B2 (en) 2012-09-21 2019-09-03 Boston Scientific Scimed, Inc. System for nerve modulation and innocuous thermal gradient nerve block
US10413357B2 (en) 2013-07-11 2019-09-17 Boston Scientific Scimed, Inc. Medical device with stretchable electrode assemblies
US10524859B2 (en) 2016-06-07 2020-01-07 Metavention, Inc. Therapeutic tissue modulation devices and methods
US10543034B2 (en) 2011-12-09 2020-01-28 Metavention, Inc. Modulation of nerves innervating the liver
US10549127B2 (en) 2012-09-21 2020-02-04 Boston Scientific Scimed, Inc. Self-cooling ultrasound ablation catheter
US10660703B2 (en) 2012-05-08 2020-05-26 Boston Scientific Scimed, Inc. Renal nerve modulation devices
US10660698B2 (en) 2013-07-11 2020-05-26 Boston Scientific Scimed, Inc. Devices and methods for nerve modulation
US10695124B2 (en) 2013-07-22 2020-06-30 Boston Scientific Scimed, Inc. Renal nerve ablation catheter having twist balloon
US10722300B2 (en) 2013-08-22 2020-07-28 Boston Scientific Scimed, Inc. Flexible circuit having improved adhesion to a renal nerve modulation balloon
US10835305B2 (en) 2012-10-10 2020-11-17 Boston Scientific Scimed, Inc. Renal nerve modulation devices and methods
US10945786B2 (en) 2013-10-18 2021-03-16 Boston Scientific Scimed, Inc. Balloon catheters with flexible conducting wires and related methods of use and manufacture
US10952790B2 (en) 2013-09-13 2021-03-23 Boston Scientific Scimed, Inc. Ablation balloon with vapor deposited cover layer
US11000679B2 (en) 2014-02-04 2021-05-11 Boston Scientific Scimed, Inc. Balloon protection and rewrapping devices and related methods of use
US11202671B2 (en) 2014-01-06 2021-12-21 Boston Scientific Scimed, Inc. Tear resistant flex circuit assembly
US11246654B2 (en) 2013-10-14 2022-02-15 Boston Scientific Scimed, Inc. Flexible renal nerve ablation devices and related methods of use and manufacture
US12011212B2 (en) 2013-06-05 2024-06-18 Medtronic Ireland Manufacturing Unlimited Company Modulation of targeted nerve fibers

Families Citing this family (598)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6634363B1 (en) 1997-04-07 2003-10-21 Broncus Technologies, Inc. Methods of treating lungs having reversible obstructive pulmonary disease
US7992572B2 (en) 1998-06-10 2011-08-09 Asthmatx, Inc. Methods of evaluating individuals having reversible obstructive pulmonary disease
US6488673B1 (en) * 1997-04-07 2002-12-03 Broncus Technologies, Inc. Method of increasing gas exchange of a lung
US7027869B2 (en) * 1998-01-07 2006-04-11 Asthmatx, Inc. Method for treating an asthma attack
US7921855B2 (en) 1998-01-07 2011-04-12 Asthmatx, Inc. Method for treating an asthma attack
US7198635B2 (en) 2000-10-17 2007-04-03 Asthmatx, Inc. Modification of airways by application of energy
US8181656B2 (en) * 1998-06-10 2012-05-22 Asthmatx, Inc. Methods for treating airways
US7137980B2 (en) 1998-10-23 2006-11-21 Sherwood Services Ag Method and system for controlling output of RF medical generator
US8251070B2 (en) 2000-03-27 2012-08-28 Asthmatx, Inc. Methods for treating airways
AU2001279026B2 (en) 2000-07-25 2005-12-22 Angiodynamics, Inc. Apparatus for detecting and treating tumors using localized impedance measurement
US7104987B2 (en) 2000-10-17 2006-09-12 Asthmatx, Inc. Control system and process for application of energy to airway walls and other mediums
US6994706B2 (en) 2001-08-13 2006-02-07 Minnesota Medical Physics, Llc Apparatus and method for treatment of benign prostatic hyperplasia
US20050033137A1 (en) * 2002-10-25 2005-02-10 The Regents Of The University Of Michigan Ablation catheters and methods for their use
US20040082947A1 (en) 2002-10-25 2004-04-29 The Regents Of The University Of Michigan Ablation catheters
US7255694B2 (en) * 2002-12-10 2007-08-14 Sherwood Services Ag Variable output crest factor electrosurgical generator
US20040226556A1 (en) 2003-05-13 2004-11-18 Deem Mark E. Apparatus for treating asthma using neurotoxin
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
GB2403148C2 (en) 2003-06-23 2013-02-13 Microsulis Ltd Radiation applicator
US7396336B2 (en) 2003-10-30 2008-07-08 Sherwood Services Ag Switched resonant ultrasonic power amplifier system
US8409219B2 (en) 2004-06-18 2013-04-02 Medtronic, Inc. Method and system for placement of electrical lead inside heart
GB2415630C2 (en) 2004-07-02 2007-03-22 Microsulis Ltd Radiation applicator and method of radiating tissue
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US11998198B2 (en) 2004-07-28 2024-06-04 Cilag Gmbh International Surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US11896225B2 (en) 2004-07-28 2024-02-13 Cilag Gmbh International Staple cartridge comprising a pan
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US8075498B2 (en) 2005-03-04 2011-12-13 Endosense Sa Medical apparatus system having optical fiber load sensing capability
US8182433B2 (en) * 2005-03-04 2012-05-22 Endosense Sa Medical apparatus system having optical fiber load sensing capability
US9474564B2 (en) 2005-03-31 2016-10-25 Covidien Ag Method and system for compensating for external impedance of an energy carrying component when controlling an electrosurgical generator
JP4958896B2 (en) 2005-04-21 2012-06-20 アスマティックス,インコーポレイテッド Control method and apparatus for energy delivery
GB2434314B (en) 2006-01-03 2011-06-15 Microsulis Ltd Microwave applicator with dipole antenna
EP2363073B1 (en) 2005-08-01 2015-10-07 St. Jude Medical Luxembourg Holding S.à.r.l. Medical apparatus system having optical fiber load sensing capability
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US7673781B2 (en) 2005-08-31 2010-03-09 Ethicon Endo-Surgery, Inc. Surgical stapling device with staple driver that supports multiple wire diameter staples
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US8734438B2 (en) 2005-10-21 2014-05-27 Covidien Ag Circuit and method for reducing stored energy in an electrosurgical generator
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
WO2007099460A2 (en) 2006-01-17 2007-09-07 Endymion Medical Ltd. Electrosurgical methods and devices employing phase-controlled radiofrequency energy
US9186200B2 (en) 2006-01-24 2015-11-17 Covidien Ag System and method for tissue sealing
CA2574935A1 (en) 2006-01-24 2007-07-24 Sherwood Services Ag A method and system for controlling an output of a radio-frequency medical generator having an impedance based control algorithm
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US20110295295A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument having recording capabilities
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US8236010B2 (en) 2006-03-23 2012-08-07 Ethicon Endo-Surgery, Inc. Surgical fastener and cutter with mimicking end effector
US7651492B2 (en) 2006-04-24 2010-01-26 Covidien Ag Arc based adaptive control system for an electrosurgical unit
US8567265B2 (en) 2006-06-09 2013-10-29 Endosense, SA Triaxial fiber optic force sensing catheter
US8048063B2 (en) 2006-06-09 2011-11-01 Endosense Sa Catheter having tri-axial force sensor
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
PL2037840T3 (en) * 2006-06-28 2012-09-28 Medtronic Ardian Luxembourg Systems for thermally-induced renal neuromodulation
US7722603B2 (en) * 2006-09-28 2010-05-25 Covidien Ag Smart return electrode pad
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US20080078802A1 (en) 2006-09-29 2008-04-03 Hess Christopher J Surgical staples and stapling instruments
US11980366B2 (en) 2006-10-03 2024-05-14 Cilag Gmbh International Surgical instrument
US8840603B2 (en) 2007-01-10 2014-09-23 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US8827133B2 (en) 2007-01-11 2014-09-09 Ethicon Endo-Surgery, Inc. Surgical stapling device having supports for a flexible drive mechanism
WO2008125962A2 (en) * 2007-03-01 2008-10-23 Endymed Medical Ltd. Electrosurgical methods and devices employing semiconductor chips
WO2008118737A1 (en) 2007-03-22 2008-10-02 University Of Virginia Patent Foundation Electrode catheter for ablation purposes and related method thereof
WO2008112870A2 (en) 2007-03-13 2008-09-18 University Of Virginia Patent Foundation Epicardial ablation catheter and method of use
US8590762B2 (en) 2007-03-15 2013-11-26 Ethicon Endo-Surgery, Inc. Staple cartridge cavity configurations
US9468396B2 (en) 2007-03-19 2016-10-18 University Of Virginia Patent Foundation Systems and methods for determining location of an access needle in a subject
CA2680639C (en) 2007-03-19 2017-03-07 University Of Virginia Patent Foundation Access needle pressure sensor device and method of use
US11058354B2 (en) 2007-03-19 2021-07-13 University Of Virginia Patent Foundation Access needle with direct visualization and related methods
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US8157789B2 (en) * 2007-05-24 2012-04-17 Endosense Sa Touch sensing catheter
US8622935B1 (en) 2007-05-25 2014-01-07 Endosense Sa Elongated surgical manipulator with body position and distal force sensing
US11672531B2 (en) 2007-06-04 2023-06-13 Cilag Gmbh International Rotary drive systems for surgical instruments
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8308040B2 (en) 2007-06-22 2012-11-13 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
WO2009015278A1 (en) * 2007-07-24 2009-01-29 Asthmatx, Inc. System and method for controlling power based on impedance detection, such as controlling power to tissue treatment devices
US8512332B2 (en) 2007-09-21 2013-08-20 Covidien Lp Real-time arc control in electrosurgical generators
US20100241185A1 (en) * 2007-11-09 2010-09-23 University Of Virginia Patent Foundation Steerable epicardial pacing catheter system placed via the subxiphoid process
US8906011B2 (en) 2007-11-16 2014-12-09 Kardium Inc. Medical device for use in bodily lumens, for example an atrium
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US8657174B2 (en) * 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
RU2493788C2 (en) 2008-02-14 2013-09-27 Этикон Эндо-Серджери, Инк. Surgical cutting and fixing instrument, which has radio-frequency electrodes
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US11986183B2 (en) 2008-02-14 2024-05-21 Cilag Gmbh International Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US9585657B2 (en) 2008-02-15 2017-03-07 Ethicon Endo-Surgery, Llc Actuator for releasing a layer of material from a surgical end effector
US8483831B1 (en) 2008-02-15 2013-07-09 Holaira, Inc. System and method for bronchial dilation
US10238447B2 (en) 2008-04-29 2019-03-26 Virginia Tech Intellectual Properties, Inc. System and method for ablating a tissue site by electroporation with real-time monitoring of treatment progress
US8992517B2 (en) 2008-04-29 2015-03-31 Virginia Tech Intellectual Properties Inc. Irreversible electroporation to treat aberrant cell masses
US9198733B2 (en) 2008-04-29 2015-12-01 Virginia Tech Intellectual Properties, Inc. Treatment planning for electroporation-based therapies
US11272979B2 (en) 2008-04-29 2022-03-15 Virginia Tech Intellectual Properties, Inc. System and method for estimating tissue heating of a target ablation zone for electrical-energy based therapies
US10448989B2 (en) 2009-04-09 2019-10-22 Virginia Tech Intellectual Properties, Inc. High-frequency electroporation for cancer therapy
US10702326B2 (en) 2011-07-15 2020-07-07 Virginia Tech Intellectual Properties, Inc. Device and method for electroporation based treatment of stenosis of a tubular body part
US9598691B2 (en) 2008-04-29 2017-03-21 Virginia Tech Intellectual Properties, Inc. Irreversible electroporation to create tissue scaffolds
US10117707B2 (en) 2008-04-29 2018-11-06 Virginia Tech Intellectual Properties, Inc. System and method for estimating tissue heating of a target ablation zone for electrical-energy based therapies
US9867652B2 (en) 2008-04-29 2018-01-16 Virginia Tech Intellectual Properties, Inc. Irreversible electroporation using tissue vasculature to treat aberrant cell masses or create tissue scaffolds
US10245098B2 (en) 2008-04-29 2019-04-02 Virginia Tech Intellectual Properties, Inc. Acute blood-brain barrier disruption using electrical energy based therapy
US10272178B2 (en) 2008-04-29 2019-04-30 Virginia Tech Intellectual Properties Inc. Methods for blood-brain barrier disruption using electrical energy
US9283051B2 (en) 2008-04-29 2016-03-15 Virginia Tech Intellectual Properties, Inc. System and method for estimating a treatment volume for administering electrical-energy based therapies
US11254926B2 (en) 2008-04-29 2022-02-22 Virginia Tech Intellectual Properties, Inc. Devices and methods for high frequency electroporation
EP2662116B1 (en) 2008-05-09 2022-09-21 Nuvaira, Inc. Systems and assemblies for treating a bronchial tree
US8298227B2 (en) * 2008-05-14 2012-10-30 Endosense Sa Temperature compensated strain sensing catheter
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US9795442B2 (en) 2008-11-11 2017-10-24 Shifamed Holdings, Llc Ablation catheters
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8453907B2 (en) 2009-02-06 2013-06-04 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with cutting member reversing mechanism
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
JP2012517287A (en) 2009-02-06 2012-08-02 エシコン・エンド−サージェリィ・インコーポレイテッド Improvement of driven surgical stapler
US10166067B2 (en) * 2009-02-12 2019-01-01 St. Jude Medical, Atrial Fibrillation Division, Inc. Ablation catheter and method for electically isolating cardiac tissue
US11382681B2 (en) 2009-04-09 2022-07-12 Virginia Tech Intellectual Properties, Inc. Device and methods for delivery of high frequency electrical pulses for non-thermal ablation
US11638603B2 (en) 2009-04-09 2023-05-02 Virginia Tech Intellectual Properties, Inc. Selective modulation of intracellular effects of cells using pulsed electric fields
US8903488B2 (en) 2009-05-28 2014-12-02 Angiodynamics, Inc. System and method for synchronizing energy delivery to the cardiac rhythm
US9895189B2 (en) 2009-06-19 2018-02-20 Angiodynamics, Inc. Methods of sterilization and treating infection using irreversible electroporation
US8920369B2 (en) 2009-06-24 2014-12-30 Shifamed Holdings, Llc Steerable delivery sheaths
CN102481433B (en) * 2009-06-24 2014-12-31 施菲姆德控股有限责任公司 Steerable medical delivery devices and methods of use
US8932282B2 (en) 2009-08-03 2015-01-13 Covidien Lp Power level transitioning in a surgical instrument
US9572624B2 (en) 2009-08-05 2017-02-21 Atricure, Inc. Bipolar belt systems and methods
US9642534B2 (en) 2009-09-11 2017-05-09 University Of Virginia Patent Foundation Systems and methods for determining location of an access needle in a subject
GB2474233A (en) 2009-10-06 2011-04-13 Uk Investments Associates Llc Cooling pump comprising a detachable head portion
CN112089394A (en) 2009-10-27 2020-12-18 努瓦拉公司 Delivery device with coolable energy emitting assembly
WO2011060200A1 (en) 2009-11-11 2011-05-19 Innovative Pulmonary Solutions, Inc. Systems, apparatuses, and methods for treating tissue and controlling stenosis
US8911439B2 (en) 2009-11-11 2014-12-16 Holaira, Inc. Non-invasive and minimally invasive denervation methods and systems for performing the same
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
CA2790328C (en) 2010-02-18 2017-04-18 University Of Virginia Patent Foundation System, method, and computer program product for simulating epicardial electrophysiology procedures
WO2011104664A1 (en) * 2010-02-26 2011-09-01 Koninklijke Philips Electronics N.V. Interventional ablation device with tissue discriminating capability
EP2550040A4 (en) 2010-03-24 2014-03-26 Shifamed Holdings Llc Intravascular tissue disruption
US9655677B2 (en) 2010-05-12 2017-05-23 Shifamed Holdings, Llc Ablation catheters including a balloon and electrodes
CN103118620B (en) 2010-05-12 2015-09-23 施菲姆德控股有限责任公司 The electrode assemblie of low profile
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8632525B2 (en) 2010-09-17 2014-01-21 Ethicon Endo-Surgery, Inc. Power control arrangements for surgical instruments and batteries
US9289212B2 (en) 2010-09-17 2016-03-22 Ethicon Endo-Surgery, Inc. Surgical instruments and batteries for surgical instruments
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US9204880B2 (en) 2012-03-28 2015-12-08 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising capsules defining a low pressure environment
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US11849952B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9055941B2 (en) 2011-09-23 2015-06-16 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck
US9480476B2 (en) 2010-09-30 2016-11-01 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising resilient members
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US8740038B2 (en) 2010-09-30 2014-06-03 Ethicon Endo-Surgery, Inc. Staple cartridge comprising a releasable portion
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
BR112013007717B1 (en) 2010-09-30 2020-09-24 Ethicon Endo-Surgery, Inc. SURGICAL CLAMPING SYSTEM
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
WO2012051433A2 (en) 2010-10-13 2012-04-19 Angiodynamics, Inc. System and method for electrically ablating tissue of a patient
CN103313671B (en) 2010-10-25 2017-06-06 美敦力Af卢森堡有限责任公司 Device, the system and method for estimation and feedback for nerve modulation treatment
US9532828B2 (en) 2010-11-29 2017-01-03 Medtronic Ablation Frontiers Llc System and method for adaptive RF ablation
US9737353B2 (en) 2010-12-16 2017-08-22 Biosense Webster (Israel) Ltd. System for controlling tissue ablation using temperature sensors
US9044245B2 (en) * 2011-01-05 2015-06-02 Medtronic Ablation Frontiers Llc Multipolarity epicardial radiofrequency ablation
CA2764494A1 (en) 2011-01-21 2012-07-21 Kardium Inc. Enhanced medical device for use in bodily cavities, for example an atrium
US9480525B2 (en) 2011-01-21 2016-11-01 Kardium, Inc. High-density electrode-based medical device system
US11259867B2 (en) 2011-01-21 2022-03-01 Kardium Inc. High-density electrode-based medical device system
US9452016B2 (en) 2011-01-21 2016-09-27 Kardium Inc. Catheter system
CN103607961B (en) 2011-04-14 2016-12-14 圣犹达医疗用品卢森堡控股有限公司 Compact force sensor for conduit
CA2834649C (en) 2011-04-29 2021-02-16 Ethicon Endo-Surgery, Inc. Staple cartridge comprising staples positioned within a compressible portion thereof
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US9277960B2 (en) 2011-09-08 2016-03-08 Kardium Inc. Intra-cardiac mapping and ablating
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9078665B2 (en) 2011-09-28 2015-07-14 Angiodynamics, Inc. Multiple treatment zone ablation probe
EP2765939B1 (en) * 2011-10-15 2018-09-26 Diros Technology Inc. Apparatus for precisely controlling the size and shape of radiofrequency ablations
US9414881B2 (en) 2012-02-08 2016-08-16 Angiodynamics, Inc. System and method for increasing a target zone for electrical ablation
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
CN104379068B (en) 2012-03-28 2017-09-22 伊西康内外科公司 Holding device assembly including tissue thickness compensation part
CN104334098B (en) 2012-03-28 2017-03-22 伊西康内外科公司 Tissue thickness compensator comprising capsules defining a low pressure environment
RU2014143258A (en) 2012-03-28 2016-05-20 Этикон Эндо-Серджери, Инк. FABRIC THICKNESS COMPENSATOR CONTAINING MANY LAYERS
US8961550B2 (en) 2012-04-17 2015-02-24 Indian Wells Medical, Inc. Steerable endoluminal punch
WO2013184319A1 (en) 2012-06-04 2013-12-12 Boston Scientific Scimed, Inc. Systems and methods for treating tissue of a passageway within a body
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US20140001234A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Coupling arrangements for attaching surgical end effectors to drive systems therefor
US11197671B2 (en) 2012-06-28 2021-12-14 Cilag Gmbh International Stapling assembly comprising a lockout
BR112014032776B1 (en) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM
CN104487005B (en) 2012-06-28 2017-09-08 伊西康内外科公司 Empty squeeze latching member
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9529025B2 (en) 2012-06-29 2016-12-27 Covidien Lp Systems and methods for measuring the frequency of signals generated by high frequency medical devices
WO2014018153A1 (en) 2012-07-24 2014-01-30 Boston Scientific Scimed, Inc. Electrodes for tissue treatment
US9272132B2 (en) 2012-11-02 2016-03-01 Boston Scientific Scimed, Inc. Medical device for treating airways and related methods of use
WO2014071372A1 (en) 2012-11-05 2014-05-08 Boston Scientific Scimed, Inc. Devices for delivering energy to body lumens
US9398933B2 (en) 2012-12-27 2016-07-26 Holaira, Inc. Methods for improving drug efficacy including a combination of drug administration and nerve modulation
US20140200639A1 (en) * 2013-01-16 2014-07-17 Advanced Neuromodulation Systems, Inc. Self-expanding neurostimulation leads having broad multi-electrode arrays
MX368026B (en) 2013-03-01 2019-09-12 Ethicon Endo Surgery Inc Articulatable surgical instruments with conductive pathways for signal communication.
BR112015021082B1 (en) 2013-03-01 2022-05-10 Ethicon Endo-Surgery, Inc surgical instrument
US9700309B2 (en) 2013-03-01 2017-07-11 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
US20140263552A1 (en) 2013-03-13 2014-09-18 Ethicon Endo-Surgery, Inc. Staple cartridge tissue thickness sensor system
US9332987B2 (en) 2013-03-14 2016-05-10 Ethicon Endo-Surgery, Llc Control arrangements for a drive member of a surgical instrument
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US10098694B2 (en) 2013-04-08 2018-10-16 Apama Medical, Inc. Tissue ablation and monitoring thereof
EP2983603B1 (en) 2013-04-08 2020-03-25 Apama Medical, Inc. Cardiac ablation catheters
US10349824B2 (en) 2013-04-08 2019-07-16 Apama Medical, Inc. Tissue mapping and visualization systems
US10405857B2 (en) 2013-04-16 2019-09-10 Ethicon Llc Powered linear surgical stapler
BR112015026109B1 (en) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc surgical instrument
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
US9872719B2 (en) 2013-07-24 2018-01-23 Covidien Lp Systems and methods for generating electrosurgical energy using a multistage power converter
US9655670B2 (en) 2013-07-29 2017-05-23 Covidien Lp Systems and methods for measuring tissue impedance through an electrosurgical cable
EP3708104A1 (en) 2013-08-09 2020-09-16 Boston Scientific Scimed, Inc. Expandable catheter and related methods of manufacture and use
CN106028966B (en) 2013-08-23 2018-06-22 伊西康内外科有限责任公司 For the firing member restoring device of powered surgical instrument
US20150053737A1 (en) 2013-08-23 2015-02-26 Ethicon Endo-Surgery, Inc. End effector detection systems for surgical instruments
US10448986B2 (en) * 2013-09-27 2019-10-22 Covidien Lp Electrosurgical medical device with power modulation
US10433902B2 (en) 2013-10-23 2019-10-08 Medtronic Ardian Luxembourg S.A.R.L. Current control methods and systems
US10098685B2 (en) 2013-10-30 2018-10-16 Medtronic Cryocath Lp Feedback system for cryoablation of cardiac tissue
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US9687232B2 (en) 2013-12-23 2017-06-27 Ethicon Llc Surgical staples
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
US20150173756A1 (en) 2013-12-23 2015-06-25 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling methods
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9693777B2 (en) 2014-02-24 2017-07-04 Ethicon Llc Implantable layers comprising a pressed region
JP6462004B2 (en) 2014-02-24 2019-01-30 エシコン エルエルシー Fastening system with launcher lockout
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
BR112016021943B1 (en) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE
US10028761B2 (en) 2014-03-26 2018-07-24 Ethicon Llc Feedback algorithms for manual bailout systems for surgical instruments
CN106456158B (en) 2014-04-16 2019-02-05 伊西康内外科有限责任公司 Fastener cartridge including non-uniform fastener
US9844369B2 (en) 2014-04-16 2017-12-19 Ethicon Llc Surgical end effectors with firing element monitoring arrangements
US10327764B2 (en) 2014-09-26 2019-06-25 Ethicon Llc Method for creating a flexible staple line
BR112016023698B1 (en) 2014-04-16 2022-07-26 Ethicon Endo-Surgery, Llc FASTENER CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
CN106456159B (en) 2014-04-16 2019-03-08 伊西康内外科有限责任公司 Fastener cartridge assembly and nail retainer lid arragement construction
US10610292B2 (en) 2014-04-25 2020-04-07 Medtronic Ardian Luxembourg S.A.R.L. Devices, systems, and methods for monitoring and/or controlling deployment of a neuromodulation element within a body lumen and related technology
CN112807074A (en) 2014-05-12 2021-05-18 弗吉尼亚暨州立大学知识产权公司 Electroporation system
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
CN105361944A (en) * 2014-08-27 2016-03-02 上海微创电生理医疗科技有限公司 Ablation catheter and method using same to implement ablation
US12114911B2 (en) 2014-08-28 2024-10-15 Angiodynamics, Inc. System and method for ablating a tissue site by electroporation with real-time pulse monitoring
US9757128B2 (en) 2014-09-05 2017-09-12 Ethicon Llc Multiple sensors with one sensor affecting a second sensor's output or interpretation
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
BR112017004361B1 (en) 2014-09-05 2023-04-11 Ethicon Llc ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
CN107427300B (en) 2014-09-26 2020-12-04 伊西康有限责任公司 Surgical suture buttress and buttress material
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
WO2016080965A1 (en) 2014-11-18 2016-05-26 Kardium Inc. Systems and methods for activating transducers
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
WO2016100325A1 (en) 2014-12-15 2016-06-23 Virginia Tech Intellectual Properties, Inc. Devices, systems, and methods for real-time monitoring of electrophysical effects during tissue treatment
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
BR112017012996B1 (en) 2014-12-18 2022-11-08 Ethicon Llc SURGICAL INSTRUMENT WITH AN ANvil WHICH IS SELECTIVELY MOVABLE ABOUT AN IMMOVABLE GEOMETRIC AXIS DIFFERENT FROM A STAPLE CARTRIDGE
US10117649B2 (en) 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US10159483B2 (en) 2015-02-27 2018-12-25 Ethicon Llc Surgical apparatus configured to track an end-of-life parameter
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US9993258B2 (en) 2015-02-27 2018-06-12 Ethicon Llc Adaptable surgical instrument handle
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
JP2020121162A (en) 2015-03-06 2020-08-13 エシコン エルエルシーEthicon LLC Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
JP6797131B2 (en) 2015-03-27 2020-12-09 カリラ メディカル インコーポレイテッド Manipulable medical devices, systems and usage
US10390825B2 (en) 2015-03-31 2019-08-27 Ethicon Llc Surgical instrument with progressive rotary drive systems
EP3285849A4 (en) 2015-04-24 2018-12-26 Shifamed Holdings, LLC Steerable medical devices, systems, and methods of use
US10368861B2 (en) 2015-06-18 2019-08-06 Ethicon Llc Dual articulation drive system arrangements for articulatable surgical instruments
US10835249B2 (en) 2015-08-17 2020-11-17 Ethicon Llc Implantable layers for a surgical instrument
US10166026B2 (en) 2015-08-26 2019-01-01 Ethicon Llc Staple cartridge assembly including features for controlling the rotation of staples when being ejected therefrom
RU2725081C2 (en) 2015-08-26 2020-06-29 ЭТИКОН ЭлЭлСи Strips with surgical staples allowing the presence of staples with variable properties and providing simple loading of the cartridge
MX2022009705A (en) 2015-08-26 2022-11-07 Ethicon Llc Surgical staples comprising hardness variations for improved fastening of tissue.
US10357252B2 (en) 2015-09-02 2019-07-23 Ethicon Llc Surgical staple configurations with camming surfaces located between portions supporting surgical staples
MX2022006189A (en) 2015-09-02 2022-06-16 Ethicon Llc Surgical staple configurations with camming surfaces located between portions supporting surgical staples.
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10433846B2 (en) 2015-09-30 2019-10-08 Ethicon Llc Compressible adjunct with crossing spacer fibers
US10478188B2 (en) 2015-09-30 2019-11-19 Ethicon Llc Implantable layer comprising a constricted configuration
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
AU2016354143A1 (en) 2015-11-09 2018-05-10 Shifamed Holdings, Llc Steering assemblies for medical devices, and methods of use
EP4302713A3 (en) 2015-11-16 2024-03-13 Boston Scientific Scimed, Inc. Energy delivery devices
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
EP3376986B1 (en) 2016-01-07 2020-02-19 St. Jude Medical International Holding S.à r.l. Medical device with multi-core fiber for optical sensing
BR112018016098B1 (en) 2016-02-09 2023-02-23 Ethicon Llc SURGICAL INSTRUMENT
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US10245030B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instruments with tensioning arrangements for cable driven articulation systems
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10314582B2 (en) 2016-04-01 2019-06-11 Ethicon Llc Surgical instrument comprising a shifting mechanism
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US10478181B2 (en) 2016-04-18 2019-11-19 Ethicon Llc Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US10702270B2 (en) 2016-06-24 2020-07-07 Ethicon Llc Stapling system for use with wire staples and stamped staples
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
USD826405S1 (en) 2016-06-24 2018-08-21 Ethicon Llc Surgical fastener
CN109310431B (en) 2016-06-24 2022-03-04 伊西康有限责任公司 Staple cartridge comprising wire staples and punch staples
USD850617S1 (en) 2016-06-24 2019-06-04 Ethicon Llc Surgical fastener cartridge
US10905492B2 (en) 2016-11-17 2021-02-02 Angiodynamics, Inc. Techniques for irreversible electroporation using a single-pole tine-style internal device communicating with an external surface electrode
US10682138B2 (en) 2016-12-21 2020-06-16 Ethicon Llc Bilaterally asymmetric staple forming pocket pairs
JP7010956B2 (en) 2016-12-21 2022-01-26 エシコン エルエルシー How to staple tissue
JP6983893B2 (en) 2016-12-21 2021-12-17 エシコン エルエルシーEthicon LLC Lockout configuration for surgical end effectors and replaceable tool assemblies
US10993715B2 (en) 2016-12-21 2021-05-04 Ethicon Llc Staple cartridge comprising staples with different clamping breadths
US10736629B2 (en) 2016-12-21 2020-08-11 Ethicon Llc Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation and firing systems
BR112019011947A2 (en) 2016-12-21 2019-10-29 Ethicon Llc surgical stapling systems
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US11684367B2 (en) 2016-12-21 2023-06-27 Cilag Gmbh International Stepped assembly having and end-of-life indicator
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US10758229B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument comprising improved jaw control
US20180168609A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Firing assembly comprising a fuse
US11191539B2 (en) 2016-12-21 2021-12-07 Cilag Gmbh International Shaft assembly comprising a manually-operable retraction system for use with a motorized surgical instrument system
US10758230B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument with primary and safety processors
US10667811B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Surgical stapling instruments and staple-forming anvils
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10568624B2 (en) 2016-12-21 2020-02-25 Ethicon Llc Surgical instruments with jaws that are pivotable about a fixed axis and include separate and distinct closure and firing systems
US10945727B2 (en) 2016-12-21 2021-03-16 Ethicon Llc Staple cartridge with deformable driver retention features
MX2019007295A (en) 2016-12-21 2019-10-15 Ethicon Llc Surgical instrument system comprising an end effector lockout and a firing assembly lockout.
US10687810B2 (en) 2016-12-21 2020-06-23 Ethicon Llc Stepped staple cartridge with tissue retention and gap setting features
US11090048B2 (en) 2016-12-21 2021-08-17 Cilag Gmbh International Method for resetting a fuse of a surgical instrument shaft
US10537324B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Stepped staple cartridge with asymmetrical staples
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US20180168618A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling systems
WO2018200254A2 (en) 2017-04-28 2018-11-01 Stryker Corporation Control console and accessories for rf nerve ablation and methods of operating the same
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US20180368844A1 (en) 2017-06-27 2018-12-27 Ethicon Llc Staple forming pocket arrangements
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
EP3420947B1 (en) 2017-06-28 2022-05-25 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
US11678880B2 (en) 2017-06-28 2023-06-20 Cilag Gmbh International Surgical instrument comprising a shaft including a housing arrangement
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
US11020114B2 (en) 2017-06-28 2021-06-01 Cilag Gmbh International Surgical instruments with articulatable end effector with axially shortened articulation joint configurations
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US11666379B2 (en) 2017-07-06 2023-06-06 Biosense Webster (Israel) Ltd. Temperature controlled short duration ablation with multiple electrodes
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US11974742B2 (en) 2017-08-03 2024-05-07 Cilag Gmbh International Surgical system comprising an articulation bailout
US11944300B2 (en) 2017-08-03 2024-04-02 Cilag Gmbh International Method for operating a surgical system bailout
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US11607537B2 (en) 2017-12-05 2023-03-21 Virginia Tech Intellectual Properties, Inc. Method for treating neurological disorders, including tumors, with electroporation
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US20190192147A1 (en) 2017-12-21 2019-06-27 Ethicon Llc Surgical instrument comprising an articulatable distal head
US11154352B2 (en) * 2018-01-23 2021-10-26 Biosense Webster (Israel) Ltd. Power controlled short duration ablation with varying temperature limits
US12082917B2 (en) 2018-01-24 2024-09-10 Medtronic Ireland Manufacturing Unlimited Company Systems, devices, and methods for assessing efficacy of renal neuromodulation therapy
US11925405B2 (en) 2018-03-13 2024-03-12 Virginia Tech Intellectual Properties, Inc. Treatment planning system for immunotherapy enhancement via non-thermal ablation
US11311329B2 (en) 2018-03-13 2022-04-26 Virginia Tech Intellectual Properties, Inc. Treatment planning for immunotherapy based treatments using non-thermal ablation techniques
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US20210378735A1 (en) * 2018-11-13 2021-12-09 St. Jude Medical, Cardiology Division, Inc. Phased array radiofrequency ablation catheter and method of its manufacture
EP4019080A1 (en) 2018-11-19 2022-06-29 Novocure GmbH Arrays for delivering tumor treating fields (ttfields) with selectively addressable sub-elements
EP3954314A1 (en) * 2019-02-27 2022-02-16 Novocure GmbH Delivering tumor treating fields (ttfields) using implantable transducer arrays
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
CN110063787B (en) * 2019-04-30 2023-04-21 北京博海康源医疗器械有限公司 Temperature control method and device of radio frequency ablation device
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11172984B2 (en) 2019-05-03 2021-11-16 Biosense Webster (Israel) Ltd. Device, system and method to ablate cardiac tissue
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US12004740B2 (en) 2019-06-28 2024-06-11 Cilag Gmbh International Surgical stapling system having an information decryption protocol
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11950835B2 (en) 2019-06-28 2024-04-09 Virginia Tech Intellectual Properties, Inc. Cycled pulsing to mitigate thermal damage for multi-electrode irreversible electroporation therapy
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11931033B2 (en) 2019-12-19 2024-03-19 Cilag Gmbh International Staple cartridge comprising a latch lockout
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US12035913B2 (en) 2019-12-19 2024-07-16 Cilag Gmbh International Staple cartridge comprising a deployable knife
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
WO2021245570A1 (en) 2020-06-02 2021-12-09 Novocure Gmbh Implantable arrays for providing tumor treating fields
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
US20220031350A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with double pivot articulation joint arrangements
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US12053175B2 (en) 2020-10-29 2024-08-06 Cilag Gmbh International Surgical instrument comprising a stowed closure actuator stop
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
WO2022130183A2 (en) * 2020-12-17 2022-06-23 Novocure Gmbh Pyroelectric-based temperature sensing of transducer arrays for applying tumor treating fields (ttfields)
US11980362B2 (en) 2021-02-26 2024-05-14 Cilag Gmbh International Surgical instrument system comprising a power transfer coil
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US12108951B2 (en) 2021-02-26 2024-10-08 Cilag Gmbh International Staple cartridge comprising a sensing array and a temperature control system
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11950779B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Method of powering and communicating with a staple cartridge
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US12102323B2 (en) 2021-03-24 2024-10-01 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising a floatable component
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11944336B2 (en) 2021-03-24 2024-04-02 Cilag Gmbh International Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11998201B2 (en) 2021-05-28 2024-06-04 Cilag CmbH International Stapling instrument comprising a firing lockout
US11980363B2 (en) 2021-10-18 2024-05-14 Cilag Gmbh International Row-to-row staple array variations
US11957337B2 (en) 2021-10-18 2024-04-16 Cilag Gmbh International Surgical stapling assembly with offset ramped drive surfaces
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments
US12089841B2 (en) 2021-10-28 2024-09-17 Cilag CmbH International Staple cartridge identification systems

Citations (50)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4281373A (en) * 1977-05-18 1981-07-28 Societe Satelec High frequency voltage generator
US4531524A (en) * 1982-12-27 1985-07-30 Rdm International, Inc. Circuit apparatus and method for electrothermal treatment of cancer eye
US4559943A (en) * 1981-09-03 1985-12-24 C. R. Bard, Inc. Electrosurgical generator
US4644955A (en) * 1982-12-27 1987-02-24 Rdm International, Inc. Circuit apparatus and method for electrothermal treatment of cancer eye
US4739759A (en) * 1985-02-26 1988-04-26 Concept, Inc. Microprocessor controlled electrosurgical generator
US4907589A (en) * 1988-04-29 1990-03-13 Cosman Eric R Automatic over-temperature control apparatus for a therapeutic heating device
US4936281A (en) * 1989-04-13 1990-06-26 Everest Medical Corporation Ultrasonically enhanced RF ablation catheter
US5122137A (en) * 1990-04-27 1992-06-16 Boston Scientific Corporation Temperature controlled rf coagulation
US5233515A (en) * 1990-06-08 1993-08-03 Cosman Eric R Real-time graphic display of heat lesioning parameters in a clinical lesion generator system
US5300068A (en) * 1992-04-21 1994-04-05 St. Jude Medical, Inc. Electrosurgical apparatus
US5372596A (en) * 1993-07-27 1994-12-13 Valleylab Inc. Apparatus for leakage control and method for its use
US5383917A (en) * 1991-07-05 1995-01-24 Jawahar M. Desai Device and method for multi-phase radio-frequency ablation
US5423808A (en) * 1991-11-08 1995-06-13 Ep Technologies, Inc. Systems and methods for radiofrequency ablation with phase sensitive power detection
US5433740A (en) * 1991-04-25 1995-07-18 Olympus Optical Co., Ltd. Method and apparatus for thermotherapy
US5438302A (en) * 1993-07-12 1995-08-01 Gyrus Medical Limited Electrosurgical radiofrequency generator having regulated voltage across switching device
US5437664A (en) * 1994-01-18 1995-08-01 Endovascular, Inc. Apparatus and method for venous ligation
US5476495A (en) * 1993-03-16 1995-12-19 Ep Technologies, Inc. Cardiac mapping and ablation systems
US5487385A (en) * 1993-12-03 1996-01-30 Avitall; Boaz Atrial mapping and ablation catheter system
US5496312A (en) * 1993-10-07 1996-03-05 Valleylab Inc. Impedance and temperature generator control
US5500011A (en) * 1986-11-14 1996-03-19 Desai; Jawahar M. Catheter for mapping and ablation and method therefor
US5514130A (en) * 1994-10-11 1996-05-07 Dorsal Med International RF apparatus for controlled depth ablation of soft tissue
US5540684A (en) * 1994-07-28 1996-07-30 Hassler, Jr.; William L. Method and apparatus for electrosurgically treating tissue
US5540681A (en) * 1992-04-10 1996-07-30 Medtronic Cardiorhythm Method and system for radiofrequency ablation of tissue
US5542916A (en) * 1992-08-12 1996-08-06 Vidamed, Inc. Dual-channel RF power delivery system
US5562720A (en) * 1992-05-01 1996-10-08 Vesta Medical, Inc. Bipolar/monopolar endometrial ablation device and method
US5573533A (en) * 1992-04-10 1996-11-12 Medtronic Cardiorhythm Method and system for radiofrequency ablation of cardiac tissue
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
US5584830A (en) * 1994-03-30 1996-12-17 Medtronic Cardiorhythm Method and system for radiofrequency ablation of cardiac tissue
US5617854A (en) * 1994-06-22 1997-04-08 Munsif; Anand Shaped catheter device and method
US5620481A (en) * 1991-07-05 1997-04-15 Desai; Jawahar M. Device for multi-phase radio-frequency ablation
US5643197A (en) * 1993-12-21 1997-07-01 Angeion Corporation Fluid cooled and perfused tip for a catheter
US5697928A (en) * 1996-09-23 1997-12-16 Uab Research Foundation Cardic electrode catheter
US5702386A (en) * 1991-11-08 1997-12-30 Ep Technologies, Inc. Non-linear control systems and methods for heating and ablating body tissue
US5769847A (en) * 1994-06-27 1998-06-23 Ep Technologies, Inc. Systems and methods for controlling tissue ablation using multiple temperature sensing elements
US5797903A (en) * 1996-04-12 1998-08-25 Ep Technologies, Inc. Tissue heating and ablation systems and methods using porous electrode structures with electrically conductive surfaces
US5810802A (en) * 1994-08-08 1998-09-22 E.P. Technologies, Inc. Systems and methods for controlling tissue ablation using multiple temperature sensing elements
US5827273A (en) * 1994-06-24 1998-10-27 Stuart D. Edwards Thin layer ablation apparatus
US5837001A (en) * 1995-12-08 1998-11-17 C. R. Bard Radio frequency energy delivery system for multipolar electrode catheters
US5954719A (en) * 1996-12-11 1999-09-21 Irvine Biomedical, Inc. System for operating a RF ablation generator
US6042580A (en) * 1998-05-05 2000-03-28 Cardiac Pacemakers, Inc. Electrode having composition-matched, common-lead thermocouple wire for providing multiple temperature-sensitive junctions
US6045550A (en) * 1998-05-05 2000-04-04 Cardiac Peacemakers, Inc. Electrode having non-joined thermocouple for providing multiple temperature-sensitive junctions
US6050994A (en) * 1998-05-05 2000-04-18 Cardiac Pacemakers, Inc. RF ablation apparatus and method using controllable duty cycle with alternate phasing
US6059778A (en) * 1998-05-05 2000-05-09 Cardiac Pacemakers, Inc. RF ablation apparatus and method using unipolar and bipolar techniques
US6123702A (en) * 1998-09-10 2000-09-26 Scimed Life Systems, Inc. Systems and methods for controlling power in an electrosurgical probe
US6132426A (en) * 1998-05-05 2000-10-17 Daig Corporation Temperature and current limited ablation catheter
US6139546A (en) * 1997-10-06 2000-10-31 Somnus Medical Technologies, Inc. Linear power control with digital phase lock
US6162217A (en) * 1999-04-21 2000-12-19 Oratec Interventions, Inc. Method and apparatus for controlling a temperature-controlled probe
US6171305B1 (en) * 1998-05-05 2001-01-09 Cardiac Pacemakers, Inc. RF ablation apparatus and method having high output impedance drivers
US6183468B1 (en) * 1998-09-10 2001-02-06 Scimed Life Systems, Inc. Systems and methods for controlling power in an electrosurgical probe
US6468270B1 (en) * 1995-06-07 2002-10-22 Arthocare Corporation System and method for electrosurgical treatment of intervertebral discs

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6049737A (en) 1998-05-05 2000-04-11 Cardiac Pacemakers, Inc. Catheter having common lead for electrode and sensor

Patent Citations (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4281373A (en) * 1977-05-18 1981-07-28 Societe Satelec High frequency voltage generator
US4559943A (en) * 1981-09-03 1985-12-24 C. R. Bard, Inc. Electrosurgical generator
US4644955A (en) * 1982-12-27 1987-02-24 Rdm International, Inc. Circuit apparatus and method for electrothermal treatment of cancer eye
US4531524A (en) * 1982-12-27 1985-07-30 Rdm International, Inc. Circuit apparatus and method for electrothermal treatment of cancer eye
US4739759A (en) * 1985-02-26 1988-04-26 Concept, Inc. Microprocessor controlled electrosurgical generator
US5500011A (en) * 1986-11-14 1996-03-19 Desai; Jawahar M. Catheter for mapping and ablation and method therefor
US4907589A (en) * 1988-04-29 1990-03-13 Cosman Eric R Automatic over-temperature control apparatus for a therapeutic heating device
US4936281A (en) * 1989-04-13 1990-06-26 Everest Medical Corporation Ultrasonically enhanced RF ablation catheter
US5122137A (en) * 1990-04-27 1992-06-16 Boston Scientific Corporation Temperature controlled rf coagulation
US5233515A (en) * 1990-06-08 1993-08-03 Cosman Eric R Real-time graphic display of heat lesioning parameters in a clinical lesion generator system
US5433740A (en) * 1991-04-25 1995-07-18 Olympus Optical Co., Ltd. Method and apparatus for thermotherapy
US5383917A (en) * 1991-07-05 1995-01-24 Jawahar M. Desai Device and method for multi-phase radio-frequency ablation
US5620481A (en) * 1991-07-05 1997-04-15 Desai; Jawahar M. Device for multi-phase radio-frequency ablation
US5423808A (en) * 1991-11-08 1995-06-13 Ep Technologies, Inc. Systems and methods for radiofrequency ablation with phase sensitive power detection
US5702386A (en) * 1991-11-08 1997-12-30 Ep Technologies, Inc. Non-linear control systems and methods for heating and ablating body tissue
US5573533A (en) * 1992-04-10 1996-11-12 Medtronic Cardiorhythm Method and system for radiofrequency ablation of cardiac tissue
US5540681A (en) * 1992-04-10 1996-07-30 Medtronic Cardiorhythm Method and system for radiofrequency ablation of tissue
US5300068A (en) * 1992-04-21 1994-04-05 St. Jude Medical, Inc. Electrosurgical apparatus
US5562720A (en) * 1992-05-01 1996-10-08 Vesta Medical, Inc. Bipolar/monopolar endometrial ablation device and method
US5542916A (en) * 1992-08-12 1996-08-06 Vidamed, Inc. Dual-channel RF power delivery system
US5476495A (en) * 1993-03-16 1995-12-19 Ep Technologies, Inc. Cardiac mapping and ablation systems
US5438302A (en) * 1993-07-12 1995-08-01 Gyrus Medical Limited Electrosurgical radiofrequency generator having regulated voltage across switching device
US5372596A (en) * 1993-07-27 1994-12-13 Valleylab Inc. Apparatus for leakage control and method for its use
US5496312A (en) * 1993-10-07 1996-03-05 Valleylab Inc. Impedance and temperature generator control
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
US5487385A (en) * 1993-12-03 1996-01-30 Avitall; Boaz Atrial mapping and ablation catheter system
US5643197A (en) * 1993-12-21 1997-07-01 Angeion Corporation Fluid cooled and perfused tip for a catheter
US5437664A (en) * 1994-01-18 1995-08-01 Endovascular, Inc. Apparatus and method for venous ligation
US5584830A (en) * 1994-03-30 1996-12-17 Medtronic Cardiorhythm Method and system for radiofrequency ablation of cardiac tissue
US5617854A (en) * 1994-06-22 1997-04-08 Munsif; Anand Shaped catheter device and method
US5827273A (en) * 1994-06-24 1998-10-27 Stuart D. Edwards Thin layer ablation apparatus
US5769847A (en) * 1994-06-27 1998-06-23 Ep Technologies, Inc. Systems and methods for controlling tissue ablation using multiple temperature sensing elements
US5540684A (en) * 1994-07-28 1996-07-30 Hassler, Jr.; William L. Method and apparatus for electrosurgically treating tissue
US5810802A (en) * 1994-08-08 1998-09-22 E.P. Technologies, Inc. Systems and methods for controlling tissue ablation using multiple temperature sensing elements
US5514130A (en) * 1994-10-11 1996-05-07 Dorsal Med International RF apparatus for controlled depth ablation of soft tissue
US6468270B1 (en) * 1995-06-07 2002-10-22 Arthocare Corporation System and method for electrosurgical treatment of intervertebral discs
US5837001A (en) * 1995-12-08 1998-11-17 C. R. Bard Radio frequency energy delivery system for multipolar electrode catheters
US5797903A (en) * 1996-04-12 1998-08-25 Ep Technologies, Inc. Tissue heating and ablation systems and methods using porous electrode structures with electrically conductive surfaces
US5697928A (en) * 1996-09-23 1997-12-16 Uab Research Foundation Cardic electrode catheter
US5954719A (en) * 1996-12-11 1999-09-21 Irvine Biomedical, Inc. System for operating a RF ablation generator
US6139546A (en) * 1997-10-06 2000-10-31 Somnus Medical Technologies, Inc. Linear power control with digital phase lock
US6059778A (en) * 1998-05-05 2000-05-09 Cardiac Pacemakers, Inc. RF ablation apparatus and method using unipolar and bipolar techniques
US6042580A (en) * 1998-05-05 2000-03-28 Cardiac Pacemakers, Inc. Electrode having composition-matched, common-lead thermocouple wire for providing multiple temperature-sensitive junctions
US6132426A (en) * 1998-05-05 2000-10-17 Daig Corporation Temperature and current limited ablation catheter
US6050994A (en) * 1998-05-05 2000-04-18 Cardiac Pacemakers, Inc. RF ablation apparatus and method using controllable duty cycle with alternate phasing
US6171305B1 (en) * 1998-05-05 2001-01-09 Cardiac Pacemakers, Inc. RF ablation apparatus and method having high output impedance drivers
US6200314B1 (en) * 1998-05-05 2001-03-13 Cardiac Pacemakers, Inc. RF ablation apparatus and method using unipolar and bipolar techniques
US6309385B1 (en) * 1998-05-05 2001-10-30 Cardiac Pacemakers, Inc. Electrode having composition-matched, common-lead thermocouple wire for providing multiple temperature-sensitive junctions
US6045550A (en) * 1998-05-05 2000-04-04 Cardiac Peacemakers, Inc. Electrode having non-joined thermocouple for providing multiple temperature-sensitive junctions
US6123702A (en) * 1998-09-10 2000-09-26 Scimed Life Systems, Inc. Systems and methods for controlling power in an electrosurgical probe
US6183468B1 (en) * 1998-09-10 2001-02-06 Scimed Life Systems, Inc. Systems and methods for controlling power in an electrosurgical probe
US6162217A (en) * 1999-04-21 2000-12-19 Oratec Interventions, Inc. Method and apparatus for controlling a temperature-controlled probe

Cited By (149)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8361068B2 (en) 2000-03-06 2013-01-29 Medtronic Advanced Energy Llc Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof
US20070167940A1 (en) * 2003-03-28 2007-07-19 Debbie Stevens-Wright Method and apparatus for selecting operating parameter values in electrophysiology procedures
US7922714B2 (en) 2003-03-28 2011-04-12 C.R. Bard, Inc. Method and apparatus for selecting operating parameter values in electrophysiology procedures
US10188457B2 (en) 2003-09-12 2019-01-29 Vessix Vascular, Inc. Selectable eccentric remodeling and/or ablation
US9510901B2 (en) 2003-09-12 2016-12-06 Vessix Vascular, Inc. Selectable eccentric remodeling and/or ablation
US9125666B2 (en) 2003-09-12 2015-09-08 Vessix Vascular, Inc. Selectable eccentric remodeling and/or ablation of atherosclerotic material
US8920414B2 (en) 2004-09-10 2014-12-30 Vessix Vascular, Inc. Tuned RF energy and electrical tissue characterization for selective treatment of target tissues
US9713730B2 (en) 2004-09-10 2017-07-25 Boston Scientific Scimed, Inc. Apparatus and method for treatment of in-stent restenosis
US8939970B2 (en) 2004-09-10 2015-01-27 Vessix Vascular, Inc. Tuned RF energy and electrical tissue characterization for selective treatment of target tissues
US9125667B2 (en) 2004-09-10 2015-09-08 Vessix Vascular, Inc. System for inducing desirable temperature effects on body tissue
US8486063B2 (en) 2004-10-14 2013-07-16 Medtronic Ablation Frontiers Llc Ablation catheter
US9642675B2 (en) 2004-10-14 2017-05-09 Medtronic Ablation Frontiers Llc Ablation catheter
US8617152B2 (en) 2004-11-15 2013-12-31 Medtronic Ablation Frontiers Llc Ablation system with feedback
US8273084B2 (en) 2004-11-24 2012-09-25 Medtronic Ablation Frontiers Llc Atrial ablation catheter and method of use
US9005194B2 (en) 2004-11-24 2015-04-14 Medtronic Ablation Frontiers Llc Atrial ablation catheter adapted for treatment of septal wall arrhythmogenic foci and method of use
US8364237B2 (en) 2005-03-28 2013-01-29 Vessix Vascular, Inc. Tuned RF energy for selective treatment of atheroma and other target tissues and/or structures
US7742795B2 (en) * 2005-03-28 2010-06-22 Minnow Medical, Inc. Tuned RF energy for selective treatment of atheroma and other target tissues and/or structures
US20060223455A1 (en) * 2005-03-31 2006-10-05 Silicon Laboratories Inc. System and method for wireless communication using low-pulling digital interface signals
US9486355B2 (en) 2005-05-03 2016-11-08 Vessix Vascular, Inc. Selective accumulation of energy with or without knowledge of tissue topography
US8771267B2 (en) 2005-06-20 2014-07-08 Medtronic Ablation Frontiers Llc Ablation catheter
US8337492B2 (en) 2005-06-20 2012-12-25 Medtronic Ablation Frontiers Llc Ablation catheter
US9468495B2 (en) 2005-06-20 2016-10-18 Medtronic Ablation Frontiers Llc Ablation catheter
US7850685B2 (en) 2005-06-20 2010-12-14 Medtronic Ablation Frontiers Llc Ablation catheter
US8979841B2 (en) 2005-06-20 2015-03-17 Medtronic Ablation Frontiers Llc Ablation catheter
US9566113B2 (en) 2005-07-11 2017-02-14 Medtronic Ablation Frontiers Llc Low power tissue ablation system
US8834461B2 (en) 2005-07-11 2014-09-16 Medtronic Ablation Frontiers Llc Low power tissue ablation system
US8657814B2 (en) 2005-08-22 2014-02-25 Medtronic Ablation Frontiers Llc User interface for tissue ablation system
US9808300B2 (en) 2006-05-02 2017-11-07 Boston Scientific Scimed, Inc. Control of arterial smooth muscle tone
US8034052B2 (en) 2006-05-05 2011-10-11 Covidien Ag Apparatus and method for electrode thermosurgery
US7846158B2 (en) * 2006-05-05 2010-12-07 Covidien Ag Apparatus and method for electrode thermosurgery
US10413356B2 (en) 2006-10-18 2019-09-17 Boston Scientific Scimed, Inc. System for inducing desirable temperature effects on body tissue
US9974607B2 (en) 2006-10-18 2018-05-22 Vessix Vascular, Inc. Inducing desirable temperature effects on body tissue
US10213252B2 (en) 2006-10-18 2019-02-26 Vessix, Inc. Inducing desirable temperature effects on body tissue
EP2088951A1 (en) * 2006-12-07 2009-08-19 Terumo Kabushiki Kaisha Apparatus and methods for multipolar tissue welding
US20080300590A1 (en) * 2006-12-07 2008-12-04 Cierra, Inc. Apparatus and methods for multipolar tissue welding
EP2088951A4 (en) * 2006-12-07 2010-05-19 Terumo Corp Apparatus and methods for multipolar tissue welding
US8496653B2 (en) 2007-04-23 2013-07-30 Boston Scientific Scimed, Inc. Thrombus removal
US8771269B2 (en) 2007-05-11 2014-07-08 Medtronic Ablation Frontiers Llc RF energy delivery system and method
US10219857B2 (en) 2007-05-11 2019-03-05 Medtronic Ablation Frontiers Llc RF energy delivery system
US8641704B2 (en) 2007-05-11 2014-02-04 Medtronic Ablation Frontiers Llc Ablation therapy system and method for treating continuous atrial fibrillation
US9700366B2 (en) * 2008-08-01 2017-07-11 Covidien Lp Polyphase electrosurgical system and method
US20100030210A1 (en) * 2008-08-01 2010-02-04 Paulus Joseph A Polyphase Electrosurgical System and Method
WO2010051305A1 (en) * 2008-10-28 2010-05-06 Smith & Nephew, Inc. Electrosurgical device with controllable electric field profile
US20100145329A1 (en) * 2008-10-28 2010-06-10 Smith & Nephew, Inc. Electrosurgical Device with Controllable Electric Field Profile
US8388615B2 (en) 2008-10-28 2013-03-05 Smith & Nephew, Inc. Electrosurgical device with controllable electric field profile
CN102202591A (en) * 2008-10-28 2011-09-28 史密夫和内修有限公司 Electrosurgical device with controllable electric field profile
US8500729B2 (en) 2008-10-28 2013-08-06 Smith & Nephew, Inc. Electrosurgical device with controllable electric field profile
US8295902B2 (en) 2008-11-11 2012-10-23 Shifamed Holdings, Llc Low profile electrode assembly
US9327100B2 (en) 2008-11-14 2016-05-03 Vessix Vascular, Inc. Selective drug delivery in a lumen
US8396548B2 (en) 2008-11-14 2013-03-12 Vessix Vascular, Inc. Selective drug delivery in a lumen
US8401667B2 (en) 2008-11-17 2013-03-19 Vessix Vascular, Inc. Selective accumulation of energy with or without knowledge of tissue topography
US8551096B2 (en) 2009-05-13 2013-10-08 Boston Scientific Scimed, Inc. Directional delivery of energy and bioactives
US20140296841A1 (en) * 2010-01-25 2014-10-02 Covidien Lp System and method for monitoring ablation size
US9820813B2 (en) * 2010-01-25 2017-11-21 Covidien Lp System and method for monitoring ablation size
US10327845B2 (en) 2010-01-25 2019-06-25 Covidien Lp System and method for monitoring ablation size
US20110218526A1 (en) * 2010-03-03 2011-09-08 Medtronic Ablation Frontiers, Llc Variable-output radiofrequency ablation power supply
CN102811677A (en) * 2010-03-03 2012-12-05 麦德托尼克消融前沿有限公司 Variable-output radiofrequency ablation power supply
US8556891B2 (en) 2010-03-03 2013-10-15 Medtronic Ablation Frontiers Llc Variable-output radiofrequency ablation power supply
WO2011109141A1 (en) * 2010-03-03 2011-09-09 Medtronic Ablation Frontiers Llc Variable-output radiofrequency ablation power supply
US9155590B2 (en) 2010-03-03 2015-10-13 Medtronic Ablation Frontiers, Llc Variable-output radiofrequency ablation power supply
US9277955B2 (en) 2010-04-09 2016-03-08 Vessix Vascular, Inc. Power generating and control apparatus for the treatment of tissue
US9192790B2 (en) 2010-04-14 2015-11-24 Boston Scientific Scimed, Inc. Focused ultrasonic renal denervation
US8880185B2 (en) 2010-06-11 2014-11-04 Boston Scientific Scimed, Inc. Renal denervation and stimulation employing wireless vascular energy transfer arrangement
US9155589B2 (en) 2010-07-30 2015-10-13 Boston Scientific Scimed, Inc. Sequential activation RF electrode set for renal nerve ablation
US9084609B2 (en) 2010-07-30 2015-07-21 Boston Scientific Scime, Inc. Spiral balloon catheter for renal nerve ablation
US9358365B2 (en) 2010-07-30 2016-06-07 Boston Scientific Scimed, Inc. Precision electrode movement control for renal nerve ablation
US9463062B2 (en) 2010-07-30 2016-10-11 Boston Scientific Scimed, Inc. Cooled conductive balloon RF catheter for renal nerve ablation
US9408661B2 (en) 2010-07-30 2016-08-09 Patrick A. Haverkost RF electrodes on multiple flexible wires for renal nerve ablation
US8974451B2 (en) 2010-10-25 2015-03-10 Boston Scientific Scimed, Inc. Renal nerve ablation using conductive fluid jet and RF energy
US9220558B2 (en) 2010-10-27 2015-12-29 Boston Scientific Scimed, Inc. RF renal denervation catheter with multiple independent electrodes
US9848946B2 (en) 2010-11-15 2017-12-26 Boston Scientific Scimed, Inc. Self-expanding cooling electrode for renal nerve ablation
US9028485B2 (en) 2010-11-15 2015-05-12 Boston Scientific Scimed, Inc. Self-expanding cooling electrode for renal nerve ablation
US9089350B2 (en) 2010-11-16 2015-07-28 Boston Scientific Scimed, Inc. Renal denervation catheter with RF electrode and integral contrast dye injection arrangement
US9668811B2 (en) 2010-11-16 2017-06-06 Boston Scientific Scimed, Inc. Minimally invasive access for renal nerve ablation
US9326751B2 (en) 2010-11-17 2016-05-03 Boston Scientific Scimed, Inc. Catheter guidance of external energy for renal denervation
US9060761B2 (en) 2010-11-18 2015-06-23 Boston Scientific Scime, Inc. Catheter-focused magnetic field induced renal nerve ablation
US9023034B2 (en) 2010-11-22 2015-05-05 Boston Scientific Scimed, Inc. Renal ablation electrode with force-activatable conduction apparatus
US9192435B2 (en) 2010-11-22 2015-11-24 Boston Scientific Scimed, Inc. Renal denervation catheter with cooled RF electrode
US9649156B2 (en) 2010-12-15 2017-05-16 Boston Scientific Scimed, Inc. Bipolar off-wall electrode device for renal nerve ablation
US9220561B2 (en) 2011-01-19 2015-12-29 Boston Scientific Scimed, Inc. Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury
US9579030B2 (en) 2011-07-20 2017-02-28 Boston Scientific Scimed, Inc. Percutaneous devices and methods to visualize, target and ablate nerves
US9186209B2 (en) 2011-07-22 2015-11-17 Boston Scientific Scimed, Inc. Nerve modulation system having helical guide
US9186210B2 (en) 2011-10-10 2015-11-17 Boston Scientific Scimed, Inc. Medical devices including ablation electrodes
US10085799B2 (en) 2011-10-11 2018-10-02 Boston Scientific Scimed, Inc. Off-wall electrode device and methods for nerve modulation
US9420955B2 (en) 2011-10-11 2016-08-23 Boston Scientific Scimed, Inc. Intravascular temperature monitoring system and method
US9364284B2 (en) 2011-10-12 2016-06-14 Boston Scientific Scimed, Inc. Method of making an off-wall spacer cage
US9162046B2 (en) 2011-10-18 2015-10-20 Boston Scientific Scimed, Inc. Deflectable medical devices
US9079000B2 (en) 2011-10-18 2015-07-14 Boston Scientific Scimed, Inc. Integrated crossing balloon catheter
US8951251B2 (en) 2011-11-08 2015-02-10 Boston Scientific Scimed, Inc. Ostial renal nerve ablation
US9119600B2 (en) 2011-11-15 2015-09-01 Boston Scientific Scimed, Inc. Device and methods for renal nerve modulation monitoring
US9119632B2 (en) 2011-11-21 2015-09-01 Boston Scientific Scimed, Inc. Deflectable renal nerve ablation catheter
US10543034B2 (en) 2011-12-09 2020-01-28 Metavention, Inc. Modulation of nerves innervating the liver
US12029466B2 (en) 2011-12-09 2024-07-09 Medtronic Ireland Manufacturing Unlimited Company Neuromodulation for metabolic conditions or syndromes
US10856926B2 (en) 2011-12-09 2020-12-08 Metavention, Inc. Neuromodulation for metabolic conditions or syndromes
US10617460B2 (en) 2011-12-09 2020-04-14 Metavention, Inc. Neuromodulation for metabolic conditions or syndromes
US9265969B2 (en) 2011-12-21 2016-02-23 Cardiac Pacemakers, Inc. Methods for modulating cell function
US9186211B2 (en) 2011-12-23 2015-11-17 Boston Scientific Scimed, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9072902B2 (en) 2011-12-23 2015-07-07 Vessix Vascular, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9402684B2 (en) 2011-12-23 2016-08-02 Boston Scientific Scimed, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9037259B2 (en) 2011-12-23 2015-05-19 Vessix Vascular, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9592386B2 (en) 2011-12-23 2017-03-14 Vessix Vascular, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9028472B2 (en) 2011-12-23 2015-05-12 Vessix Vascular, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9174050B2 (en) 2011-12-23 2015-11-03 Vessix Vascular, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9433760B2 (en) 2011-12-28 2016-09-06 Boston Scientific Scimed, Inc. Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements
US9050106B2 (en) 2011-12-29 2015-06-09 Boston Scientific Scimed, Inc. Off-wall electrode device and methods for nerve modulation
US10660703B2 (en) 2012-05-08 2020-05-26 Boston Scientific Scimed, Inc. Renal nerve modulation devices
US10321946B2 (en) 2012-08-24 2019-06-18 Boston Scientific Scimed, Inc. Renal nerve modulation devices with weeping RF ablation balloons
US20140067029A1 (en) * 2012-08-28 2014-03-06 Boston Scientific Scimed, Inc. Renal nerve modulation and ablation catheter electrode design
US9173696B2 (en) 2012-09-17 2015-11-03 Boston Scientific Scimed, Inc. Self-positioning electrode system and method for renal nerve modulation
US10398464B2 (en) 2012-09-21 2019-09-03 Boston Scientific Scimed, Inc. System for nerve modulation and innocuous thermal gradient nerve block
US10549127B2 (en) 2012-09-21 2020-02-04 Boston Scientific Scimed, Inc. Self-cooling ultrasound ablation catheter
US10835305B2 (en) 2012-10-10 2020-11-17 Boston Scientific Scimed, Inc. Renal nerve modulation devices and methods
US20150265333A1 (en) * 2012-10-25 2015-09-24 Kyong-Min Shin System for ablation utilizing multiple electrodes and method for controlling same
US9700369B2 (en) * 2012-10-25 2017-07-11 Starmed Co., Ltd System for ablation utilizing multiple electrodes and method for controlling same
US9693821B2 (en) 2013-03-11 2017-07-04 Boston Scientific Scimed, Inc. Medical devices for modulating nerves
US9956033B2 (en) 2013-03-11 2018-05-01 Boston Scientific Scimed, Inc. Medical devices for modulating nerves
US9808311B2 (en) 2013-03-13 2017-11-07 Boston Scientific Scimed, Inc. Deflectable medical devices
US9827039B2 (en) 2013-03-15 2017-11-28 Boston Scientific Scimed, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9297845B2 (en) 2013-03-15 2016-03-29 Boston Scientific Scimed, Inc. Medical devices and methods for treatment of hypertension that utilize impedance compensation
US10265122B2 (en) 2013-03-15 2019-04-23 Boston Scientific Scimed, Inc. Nerve ablation devices and related methods of use
US12011212B2 (en) 2013-06-05 2024-06-18 Medtronic Ireland Manufacturing Unlimited Company Modulation of targeted nerve fibers
US9943365B2 (en) 2013-06-21 2018-04-17 Boston Scientific Scimed, Inc. Renal denervation balloon catheter with ride along electrode support
US10022182B2 (en) 2013-06-21 2018-07-17 Boston Scientific Scimed, Inc. Medical devices for renal nerve ablation having rotatable shafts
US9707036B2 (en) 2013-06-25 2017-07-18 Boston Scientific Scimed, Inc. Devices and methods for nerve modulation using localized indifferent electrodes
US9833283B2 (en) 2013-07-01 2017-12-05 Boston Scientific Scimed, Inc. Medical devices for renal nerve ablation
US10660698B2 (en) 2013-07-11 2020-05-26 Boston Scientific Scimed, Inc. Devices and methods for nerve modulation
US10413357B2 (en) 2013-07-11 2019-09-17 Boston Scientific Scimed, Inc. Medical device with stretchable electrode assemblies
US9925001B2 (en) 2013-07-19 2018-03-27 Boston Scientific Scimed, Inc. Spiral bipolar electrode renal denervation balloon
US10342609B2 (en) 2013-07-22 2019-07-09 Boston Scientific Scimed, Inc. Medical devices for renal nerve ablation
US10695124B2 (en) 2013-07-22 2020-06-30 Boston Scientific Scimed, Inc. Renal nerve ablation catheter having twist balloon
US10722300B2 (en) 2013-08-22 2020-07-28 Boston Scientific Scimed, Inc. Flexible circuit having improved adhesion to a renal nerve modulation balloon
US9895194B2 (en) 2013-09-04 2018-02-20 Boston Scientific Scimed, Inc. Radio frequency (RF) balloon catheter having flushing and cooling capability
US10952790B2 (en) 2013-09-13 2021-03-23 Boston Scientific Scimed, Inc. Ablation balloon with vapor deposited cover layer
US11246654B2 (en) 2013-10-14 2022-02-15 Boston Scientific Scimed, Inc. Flexible renal nerve ablation devices and related methods of use and manufacture
US9687166B2 (en) 2013-10-14 2017-06-27 Boston Scientific Scimed, Inc. High resolution cardiac mapping electrode array catheter
US9962223B2 (en) 2013-10-15 2018-05-08 Boston Scientific Scimed, Inc. Medical device balloon
US9770606B2 (en) 2013-10-15 2017-09-26 Boston Scientific Scimed, Inc. Ultrasound ablation catheter with cooling infusion and centering basket
US10945786B2 (en) 2013-10-18 2021-03-16 Boston Scientific Scimed, Inc. Balloon catheters with flexible conducting wires and related methods of use and manufacture
US10271898B2 (en) 2013-10-25 2019-04-30 Boston Scientific Scimed, Inc. Embedded thermocouple in denervation flex circuit
US11202671B2 (en) 2014-01-06 2021-12-21 Boston Scientific Scimed, Inc. Tear resistant flex circuit assembly
US11000679B2 (en) 2014-02-04 2021-05-11 Boston Scientific Scimed, Inc. Balloon protection and rewrapping devices and related methods of use
US9907609B2 (en) 2014-02-04 2018-03-06 Boston Scientific Scimed, Inc. Alternative placement of thermal sensors on bipolar electrode
AU2016324501B2 (en) * 2015-09-17 2021-07-08 Baylor College Of Medicine Esophageal probes and methods
US11160569B2 (en) 2015-09-17 2021-11-02 Texas Heart Institute Esophageal probes and methods
EP3349640A4 (en) * 2015-09-17 2019-05-15 Baylor College of Medicine Esophageal probes and methods
CN108430301B (en) * 2015-09-17 2022-01-25 贝勒医学院 Esophageal probes and methods
CN108430301A (en) * 2015-09-17 2018-08-21 贝勒医学院 Oesophagus probe and method
WO2017049313A1 (en) * 2015-09-17 2017-03-23 Baylor College Of Medicine Esophageal probes and methods
US10524859B2 (en) 2016-06-07 2020-01-07 Metavention, Inc. Therapeutic tissue modulation devices and methods

Also Published As

Publication number Publication date
US6558378B2 (en) 2003-05-06
WO2002047565A3 (en) 2002-08-22
US20020161361A1 (en) 2002-10-31
AU2002230812A1 (en) 2002-06-24
WO2002047565A2 (en) 2002-06-20

Similar Documents

Publication Publication Date Title
US6558378B2 (en) RF ablation system and method having automatic temperature control
US6171305B1 (en) RF ablation apparatus and method having high output impedance drivers
US6488678B2 (en) RF ablation apparatus and method using unipolar and bipolar techniques
US6050994A (en) RF ablation apparatus and method using controllable duty cycle with alternate phasing
US6049737A (en) Catheter having common lead for electrode and sensor
US6635056B2 (en) RF ablation apparatus and method using amplitude control
US6666862B2 (en) Radio frequency ablation system and method linking energy delivery with fluid flow
US6730078B2 (en) RF ablation apparatus and method using multi-frequency energy delivery
US6042580A (en) Electrode having composition-matched, common-lead thermocouple wire for providing multiple temperature-sensitive junctions
US20030187430A1 (en) System and method for measuring power at tissue during RF ablation
US6045550A (en) Electrode having non-joined thermocouple for providing multiple temperature-sensitive junctions
US6761716B2 (en) System and method for assessing electrode-tissue contact and lesion quality during RF ablation by measurement of conduction time
US6740080B2 (en) Ablation system with selectable current path means
US6391024B1 (en) RF ablation apparatus and method having electrode/tissue contact assessment scheme and electrocardiogram filtering

Legal Events

Date Code Title Description
STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION